The environments in which we live, work, learn and play have a life-long impact on our health. Governments and organizations make decisions to create and enact policies that, to a large extent, determine the qualities of our environments and how they impact us. Thus, it is imperative that health considerations are embedded into decision-making processes across a broad array of sectors.
The New Mexico Health Equity Partnership (NMHEP) is an initiative of the Santa Fe Community Foundation. Its mission is to help strengthen the capacity of New Mexico communities to advocate for systemic and policy changes that support healthy children and families. To accomplish this, the partnership works to address structural, cultural and institutional inequities based on race, class, gender and geography.
To strengthen community leadership skills and effectively advocate for health-equity policies, NMHEP collaborates with a diverse network of New Mexico communities, organizations and decision makers. This includes thirty state and local organizations, four core community-based partners, and a team of four staff. Human Impact Partners and the National Collaborative for Health Equity provide technical support. The Santa Fe Community Foundation and the W.K. Kellogg Foundation provide funding.
The NMHEP is committed to 1) solidifying a health-equity network and developing a statewide policy agenda; 2) recruiting partners and decision makers to ensure health is considered in policy making; and 3) strengthening community capacity and leadership to conduct health impact assessments (HIAs) in rural and tribal areas, training local HIA technical-assistance providers, facilitating community peer learning and advancing community-based health-equity efforts.
In January 2016, more than 30 participants came to the National Educational Association building, in Santa Fe, for a two-day HIA training and reception. The training served as a work session and kickoff for three HIA teams that were recently awarded funding from the NMHEP to support their work in rural and tribal communities in New Mexico. These were the McKinley Worker Justice Coalition, the Tularosa Basin Downwinders Consortium (TBDC) and the University of New Mexico, in partnership with the Santa Fe Indian Center.
The McKinley community’s PLACE MATTERS is partnering with Somos Un Pueblo Unido and Somos Gallup to conduct the McKinley Worker Justice Coalition Wage Theft HIA. The assessment includes an effort to strengthen capacity across cultural differences of low-wage workers. It is not unusual for these workers to encounter wage theft, which, when unreported, impacts families because workers are misclassified, not paid overtime or the minimum wage, or not paid at all.
The second HIA was awarded to the TBDC to evaluate the potential impact of the Radiation Exposure Compensation Act amendments on the health of the people of New Mexico. On July 16, 1945, the U.S. government tested “the Gadget,” the first nuclear device, at the Trinity Site in south-central New Mexico. TBDC has been working for 10 years to bring attention to the health effects of radioactive fallout from the Trinity test. For many years, TBDC has partnered in this endeavor with Joni Arends of Concerned Citizens for Nuclear Safety, Holly Beaumont of Interfaith Worker Justice-NM and Dr. Maureen Merritt of Physicians for Social Responsibility.
In 1990, the U.S. Government set up a fund called the Radiation Exposure Compensation Act (RECA) to compensate people who lived downwind of the Nevada Nuclear Test Site and had become sick. For five years, Sen. Tom Udall and others have introduced amendments to RECA that would include New Mexican “downwinders” in the program. TBDC and its associates are providing data collected through the HIA to inform decision makers as to why New Mexico should be included in the program.
The HIA at Santa Fe Indian Health Services is focused on the federal Indian Health Services budget and, specifically, the impact of the Santa Fe Indian Health Service Hospital. Until now, there has been little documentation of the effectiveness of the underfunded/defunded IHS facility. The HIA will quantify the extent to which Santa Fe’s urban Indian community is impacted by chronic illness and other conditions that require specialty care not eligible for contract health payment. The research and documentation will inform future budgetary proposals.
The HIA training in January 2016 was led and facilitated by the first cohort of New Mexico trainees currently participating in NMHEP’s HIA Technical Assistance Training Program. They are from Doña Ana, McKinley, San Miguel and San Juan counties. They are trained to provide culturally appropriate assistance to New Mexico’s rural and tribal communities.
The New Mexico Health Equity Partnership’s work is a call to action in response to increasing inequalities, inequities and injustices reported in many communities. By engaging communities, organizations and individuals, the partnership hopes to achieve a “Health in All Policies” framework that can be adopted within policy agendas statewide.
The New Mexico Health Equity Policy team, Tularosa Basin Downwinders HIA team, Jordon Johnson, executive director McKinley Community Place Matters, and Emily Haozous, Ph.D., contributed to this article.