Health doesn’t just happen as a result of visits to the doctor’s office, diet and exercise. Policy and planning decisions that shape where people live, work, learn and play impact quality of life, as well as physical, mental and spiritual well-being. In New Mexico, the quality of health of many individuals, as well as communities, can be traced to economic, environmental and social conditions that are deeply rooted in historical trauma and the pronounced imbalance of geographic resources.
The New Mexico Health Equity Partnership (NMHEP), funded by the W.K. Kellogg Foundation and the Santa Fe Community Foundation, is working to strengthen the capacity of low-income New Mexico communities and communities of color to advocate for systemic and policy changes that address institutionalized inequities based upon race, class, gender and geography. The Partnership’s goal: healthy children, families and communities.
The NMHEP comprises local, state and national partners, including the National Collaborative for Health Equity, New Mexico Alliance of Health Councils, New Mexico Community Data Collaborative, New Mexico Department of Health–Health Promotion, Human Impact Partners and Con Alma Health Foundation–Healthy People, Healthy Places. The Partnership’s extended network includes a broad base of community members, advocacy groups, civic organizations, youth groups, faith-based organizations, nonprofits, legal service providers, universities and other educational entities, government agencies and other allies working closely with NMHEP-affiliated organizations. NMHEP also recognizes that effective policy change must have the support of key decision makers, power brokers and other leaders.
Based on the belief that the solutions to New Mexico’s challenges lie within the resilient fabric of the state’s diverse communities, the NMHEP strives to create healthy conditions for families by actively engaging in advocacy that informs decision-making processes. NMHEP’s work is structured around three key efforts:
• PLACE MATTERS (PM): A national initiative of the National Collaborative for Health Equity. There are four PM teams in the New Mexico counties of Bernalillo, Doña Ana, McKinley and San Juan.
• New Mexico Tribal and Community Health Councils: Health councils work with communities to address important local health issues based on local health needs and resources.
• Health Impact Assessments (HIAs): There are 10 HIA teams in New Mexico. HIAs are a structured process where NMHEP’s diverse partners come together to evaluate how a proposed plan, project or policy—in a variety of domains ranging from transportation to housing—will affect community health if implemented. Recommendations based on community knowledge, narratives and quantitative data are provided to inform and improve decision-making processes.
Community Informed Decision Making
NMHEP uses a unique, multi-stakeholder statewide approach tailored to grassroots community assets and need. This approach draws on the collective strengths of diverse partners and allies. Cross-sector relationships foster the leveraging of expertise and resources. Decisions are made collectively and transparently. The Partnership highly values cultural knowledge and engages communities by building on their assets to advocate for policy change. Groups directly affected by proposed policies and projects are afforded a seat at the table, so they can participate from planning to implementation. Community members directly impacted by health inequities hold active leadership roles.
The following recent cases demonstrate how NMHEP’s partners are actively engaged in educational policy and advocacy in their communities to ensure that health is considered in decision-making processes.
McKinley County: Looking Within – An HIA on Uranium Mining
McKinley Community PLACE MATTERS uses a health-equity lens to address environmental health disparities and explore how institutional racism and multi-generational trauma impact community health. Over the course of two years, great strides have been made in elevating community voices and concerns about the health impacts of the uranium legacy in the county.
The soon to be completed HIA took into consideration health impacts related to environmental contamination and pollution, relocation and displacement, community efficacy and cultural relevance of the land. During the recent state legislative session, McKinley Community PLACE MATTERS was one of the sponsors of Uranium Workers’ Day at the Roundhouse, organized to focus public attention on New Mexico’s uranium legacy. Over 200 people shared their stories, advocated for policy change and spoke about the health impacts of uranium mining and milling.
San Miguel County: An HIA of the Proposed Northeast New Mexico Adult Reintegration Center
Communities in San Miguel, Mora and Guadalupe counties struggle with higher-than-average rates of unemployment, substance abuse, DWIs, poverty, lack of access to health care and other basic services. These conditions lead to higher incarceration and recidivism rates. The health inequities among those who end up incarcerated are especially apparent. In spite of these challenges, these communities demonstrate deep partnerships and embody diverse skill sets and strengths, resiliency and determination to come up with solutions.
In 2014, the San Miguel County Detention Center and its Citizen Advisory Committee, Las Vegas Peace and Justice Center, San Miguel County Family and Community Health Council, New Mexico Highlands University Foundation, NMHU School of Social Work students, community members who were formerly incarcerated, and other stakeholders, with assistance from Human Impact Partners and the NMHEP team, worked together to conduct an HIA on a proposed adult-reintegration center in northeastern New Mexico. The assessment considered potential impacts of the proposed center on addiction, violence and recidivism.
The assessment process served as a mechanism to develop evidence-based recommendations for how the reintegration center should be implemented in order to improve health in northern New Mexico. The group’s report made it possible to effectively communicate with the San Miguel County Commission.
Proposed Lobos CO2 Pipeline HIA
Sometimes, the most unanticipated events can spur a group of previously nonaligned—and even adversarial—individuals and organizations to respond to a call to action and galvanize around an issue perceived as potentially harmful to all. Such is the case with the proposed Kinder Morgan Lobos CO2 pipeline. The landowners and Manzano Land Grant heirs of a sparsely populated frontier county would be most impacted by the project.
It is a David-and-Goliath tale that pits the third-largest global corporation and a federal agency against community members from a traditional Hispanic land grant. These families are steeped in a culture and way of life that is inextricably linked to the land, water, mountains and forests rich with sacred sites. Joining these land grant families are not only ranching families but also retirees who migrated to the area attracted by the availability of large tracts of unspoiled affordable land and an active arts community. Together, they formed a citizens group, “Resistiendo,” and reached out to other communities for support. The Partnership for a Healthy Torrance Community and the New Mexico Department of Health–Health Promotion specialist responded to the call. That initiated the HIA process. Human Impact Partners provided technical assistance and expertise. The NMHEP team contributed mentorship and the opportunity to network with other HIA teams around the state. The local steering committee and all involved have given voice to a marginalized population, as well as purpose and direction to the Community Health Improvement Council. The participants report that a sense of empowerment has come from engagement in collective action around a common goal.
Other proposed plans and projects where HIAs are being used:
• Bernalillo County Comprehensive Plan
• Food and funding distribution formula within the Statewide Emergency Food Assistance Program Plan
• Nuestra Santa Fe
• Sunport Boulevard Extension (Albuquerque)
• Taos place-based, strategic funding
• Trail access from Cuba to the Continental Divide National Scenic Trail
• Viva Doña Ana Comprehensive Plan (Doña Ana County)
In 25 years, what will New Mexico look like as a result of NMHEP’s efforts? Quotations from a few of NMHEP’s partners describe the Partnership’s vision:
“… a New Mexico where there is widespread community leadership and engagement informing policy—all of it made under an umbrella of cultural competence and inclusivity; policy-making by the people for the people!”
Where… “everyone’s voices are heard…” and “residents see their solutions, vision and diversity reflected in neighborhoods, resulting in a sense of place and community that is resilient, empowering and nurturing of all its residents’ potential, from the very young to the oldest.”
The New Mexico Health Equity Partnership is based at the Santa Fe Community Foundation, 501 Halona St., Santa Fe, NM 87505. For more information about the Partnership and upcoming gatherings, visit www.nmhealthequitypartnership.org
Contributors to this article include NMHEP; Santa Fe Community Foundation Team; Jordon Johnson, coordinator, McKinley Community PLACE MATTERS; San Miguel County Health Impact Assessment Team; and Steering Committee of the Lobos Co2 Pipeline Health Impact Assessment Project.