Little-known public health councils are key to public health but chronically underfunded

The COVID-19 pandemic has laid bare the limits of New Mexico’s understaffed and highly centralized public health system. 

Unlike most other states, New Mexico does not have county-based health boards. Instead, public health services like vaccination have traditionally fallen to the chronically understaffed state health department, which has struggled to contain the pandemic’s spread. “The big lesson is that we’ve underfunded public health,” said Sen. Jerry Ortiz y Pino, D-Albuquerque. “Our infrastructure was woefully inadequate and now we’re paying the price.”

That includes funding for the state’s 42 county and tribal comprehensive community health planning councils that, in the absence of local health boards, fill an important role identifying local public health gaps and needs. Many of the health councils have gone beyond their statutory mandates, in recent months, to pitch in with local COVID response efforts – helping to coordinate local testing and vaccination efforts, get word out to local residents about where they can get booster shots, and at times serving as an important channel of communication between state health officials and local governments. 

But the health councils are woefully underfunded, despite legislation passed in 2019 that expanded their mandates and directed the health department to provide them more funding.

A fair and equitable recovery starts with supporting women of color

New Mexicans share a belief that all of us – no matter where we live, how we look, or what we believe – deserve access to the same opportunities that help us achieve our unique potential. These opportunities – receiving a quality education, and having access to affordable health care, jobs that pay family-sustaining wages, and safe and affordable housing – are often referred to as social determinants of health and they impact everything from the conditions surrounding our births to the length of our lives. The COVID-19 pandemic made it apparent that these opportunities are not universally available and their lack has led to lower-quality social determinants of health for some communities. Clearly, communities of color and those earning low incomes were hardest hit by the pandemic as well as the economic aftermath. But another aspect that hasn’t gotten as much notice is how the pandemic and recession have hurt women more than men, with women of color being hurt the most.

New Mexico has opportunity to learn what works best from two years of extraordinary innovation

The 2022 regular legislative session will be the second under the persistent shadow of COVID-19. For those of us who focus on child and family well-being, the situation is simultaneously dire and hopeful. The dire: Families with children, especially those with lower incomes, have been slammed by the simultaneous impacts of school and child care closures, job losses, and the anxiety and grief that have characterized this time for many. 

The hopeful: The sudden loss of in-person schooling and child care has renewed public focus on the importance of these sectors. States have received federal funding to stabilize them from the impacts of COVID, allowing new resources to flow into schools, child care, internet connectivity and other longstanding needs. 

During the session and in the coming year, our team at the University of New Mexico Cradle to Career Policy Institute will watch to see what New Mexico decides to keep from the pandemic, and what the state casts aside. In our policy and personal lives, the pandemic has offered a complex mix of things we are eager to lose forever, alongside those we hope to maintain. 

In the child care sector, COVID-19 has brought great instability for providers faced with decreased enrollment, family and provider fears about COVID exposure, and unpredictable closures and quarantines.

A century of federal indifference left generations of Navajo homes without running water

When Julie Badonie was growing up in the small Navajo community of Tohatchi in the 1940s, her father drove a horse-drawn wagon early each morning to a nearby spring. There, he filled wooden barrels with water the family would use that day to drink, cook, and wash. 

Badonie, the youngest of seven children, including brothers who fought in World War II and the Korean War, or one of her siblings would go along. She remembers it as fun. At home, a hose siphoned the water into buckets to bring into the house. Badonie left for boarding school in kindergarten, first just a few miles across town, then several days’ travel away in Crownpoint, where an older sister worked as a cook, and eventually, all the way to Albuquerque for high school.

As water reaches eastern Navajo communities, it brings possibilities and homecomings

For a while, Chee Smith Jr. thought he was going to have to send his father to die among strangers. His family lives at Whitehorse Lake, a Navajo chapter where, until a few years ago, roughly 550 of 700 residents had no running water in their homes, including Smith’s. As Smith’s father aged and his health worsened, it became harder and harder for him to live at home. “We had to haul water from the chapterhouse or the watering points every day for just basic things — for cooking, for laundry, for stuff like that, and also for our livestock,” Smith said. “It takes a big toll.

It’s unclear whether vaccines are reaching hardest hit New Mexico communities

As New Mexico continues to amp up vaccine distribution, health officials don’t appear to be allocating a greater number of doses to those living in low-income areas that have been hit hardest by the COVID-19 pandemic. Those areas include McKinley County, the southern border region, and communities in central New Mexico where some of the highest rates of positive cases, hospitalizations and deaths have occurred. 

Other than some targeted distribution to congregant facilities like nursing homes and prisons, as well as health care and medical workers, the state is taking an approach of calling up individuals who’ve registered on the state vaccine portal. People are prioritized based on various risk categories, such as age, underlying conditions, or being an essential worker. “…basically we’re randomizing them to see who will receive that vaccine dose,” New Mexico Health Secretary Dr. Tracie Collins said at a Wednesday afternoon press conference. It’s an approach designed to ensure there is no favoritism in vaccine access, Collins said. 

But the hardest hit populations are low income communities that are disproportionately Native American and Latino, Black and other communities of color, and there is currently no publicly available information about whether or not vaccine distribution is sufficiently reaching these groups.

COVID disparities force a public health reckoning

The coronavirus feels the way it looks in widely circulated images, said Cleo Otero: like a thorn. “That’s how it felt inside my body, especially my lungs. It was painful. Like it was scratching the inside of your body. I could really literally feel the virus inside my body.” 

Otero’s first clue she was sick came at the laundromat in Albuquerque where she usually buys a bag of spicy chips as she waits on her clothes.

Images show reality in El Paso that must be seen

Workers and guards outside an El Paso mobile morgue during the COVID-19 pandemic. Claudia Silva/New Mexico In Depth

It felt surreal pulling into the cemetery next to the University Medical Center of El Paso. Large trailers with doors flung wide open are lined up outside the medical examiner’s office tucked away just down the street. The trailers house rows of shelves holding the overflow of those who have died of COVID-19. As Texas has reached over 1 million cases, the border city of El Paso has become a hot-spot, some calling it the new New York, with one of every 20 to 30 people estimated to be positive. 

As the situation has worsened the city’s prisoners have been asked to help handle the dead.