Allegheny County, Pennsylvania

Located near the southwestern edge of the border with Ohio, Allegheny County is Pennsylvania’s second largest county and home to the city of Pittsburgh as well as 129 other municipalities. Our research tracks the community's journey to promote health, well-being, and equity.

Allegheny County’s awareness of health inequities and early steps to address them in 2017 has continued over the past five years. With increased understanding of health and health equity, the county has taken policy action, including declaring racism a public health crisis and incorporating equity positions in government departments. The county has an array of anchor institutions that serve as both economic drivers and employers. These institutions include universities, healthcare systems, and philanthropic foundations. Concerns remain about how community organizations are represented in local decision-making and leadership, especially as they influence health, well-being, and equity.

As the community continues its work to dismantle the lasting effects of systemic racism, there are still very visible disparities between White communities and Black communities, particularly those with lower socioeconomic status. Various initiatives are in place to combat these disparities, including the Eco-Innovation District and Opportunity Zones. With an increase in economic development in historically Black neighborhoods, however, comes the continued risk of gentrification.

Guided by the Allegheny County Health Department (ACHD), the community is working to address persistent health issues including maternal and child health, environmental risks that lead to diseases such as asthma and cancer, and the opioid epidemic, as well as embracing newer conceptualizations of health that recognize the health impacts of community violence and the role of mental health.

Overview

Population

1,221,744

Race/Ethnicity

Median Household Income

Population Living in Poverty by Race

Sources:

U.S. Census Bureau; photography courtesy Flickr user Rockin’Rita, CC BY-NC-ND 2.0.

Notes:

* AINA denotes American Indian Native Alaskan

Community Context

Allegheny County is nestled between the Monongahela and Youghiogheny rivers with the Allegheny River to the northeast. Historically, the county has been a hub for coal and steel industries, yet more recently the community has been in the process of reimagining its identity. Though some communities are pushing for clean energy and the reduction of factors contributing to climate change, others believe that many coal and steel workers should be able to maintain their livelihood through these industries. Despite efforts by the coal and steel industries to modernize, they have significantly contributed to air pollution and urban poverty.

Over the years, there have been increased efforts by both the local governments and non-profit organizations to not only revitalize disenfranchised neighborhoods but also work to reverse some of the effects of discriminatory practices such as red-lining that took place up until the 1980s. These structural inequities have resulted in high unemployment rates, lack of generational wealth, lack of transportation, and profound health disparities in many low-income neighborhoods. Though progress is slow, the county is working to address ongoing health issues, including poor environmental conditions, high rates of sexually transmitted diseases among adolescents, poor maternal and child health, and the opioid epidemic.

Allegheny County’s Journey to Promote Health, Well-Being, and Equity

Five years into the Sentinel Communities Surveillance Project, collaboration across various sectors has remained strong.

Though the role of community-based organizations has evolved in terms of health engagement, anchor institutions as well as health organizations, such as Allegheny County Health Department (ACHD), struggle to fully incorporate community input. Allegheny County has benefited from long-term plans focused specifically on promoting health and well-being and more recently, these plans have begun to incorporate equity. Stakeholders in Allegheny County have long recognized that issues such as the environment, lack of safe and affordable housing, and access to transportation play a role in determining health outcomes. Yet, over the past five years, community members broadened their understanding of health by developing a social determinants of health lens and shifting away from an individualistic view of health. Allegheny County has taken a variety of approaches to address health equity, yet it has faced challenges related to representation and power as well as authentic community engagement.

Baseline research started in 2016 to track community programs and initiatives. The most recent report, from 2022, provides more in-depth insights and analysis into the community's efforts to build a Culture of Health.

Lessons Learned: Where is Allegheny County Five Years Later?

While there are milestones that signify progress toward health, well- being, and equity, Allegheny County is now facing the next big challenge: Ensuring that progress is not fleeting and is foundational to systemic change.

The county recognizes that it is important to both track progress on health equity outcomes and to increase community engagement in health decision-making. Allegheny County has made significant progress in recognizing and taking action to achieve health equity, yet the county has room for improvement in terms of reaching a shared definition of health equity and ensuring that all community members are on board.

Allegheny County also has a strong capacity for data with DASH, WPRDC, and university resources. However, the county is still tackling its ability to consistently integrate data systems and share data across sectors.

Allegheny County is home to powerful institutions including universities, healthcare systems, and foundations that provide critical resources to advance the community’s efforts to promote health and well-being. However, significant challenges remain, such as difficulties with community engagement and increased competition among small community-based organizations.

Facilitators:

Community-based organizations playing key roles
Presence of medical and educational institutions
Strong spirit of cross-sector collaboration around health
Data capacity remains robust

Barriers:

Challenges with authentically including community members in decision-making
Difficulty securing funding for community-based organizations, which leads to unhealthy competition
Ongoing barriers related to systemic racism

Downloads

See more Sentinel Communities

Each of these Sentinel Community Reports provides insight into the various ways communities across America are working to develop a Culture of Health.