Hispanic and Native American Center of Excellence

What are the health issues for Hispanics and Native Americans in New Mexico?

Data compiled by the Center of Excellence, November 2003

Several demographic factors make New Mexico unique. New Mexico has the highest proportion of Hispanics at 42.1%. Of the contiguous 48 states, New Mexico has the highest proportion of Native Americans at 9.5%.[i] Our state's population of 1.8 million is widely distributed across a geographic area of 121,593 sq. miles.

Table A-1. New Mexico Population by Ethnicity

	Native American	Asian & Pacific Islander	African American	Hispanic	Other	Total
Count	173,483	20,758	34,343	765,386	825,076	1,819,046
% Total	9.5%	1.2 %	1.9%	42.0%	45.3%	99.9%

Source: Census 2000 Summary File 1 (SF1). US Bureau of the Census. November 4, 2003.

Impact of poverty on minority health

In 2001 New Mexico ranked 47th among the states in per capita income at $23,155, which was 24% lower than the national average of $30,472.[ii] In 2000 18.0% of New Mexicans were at or below the poverty level, compared with the 2001 US rate of 11.7%. In 1999 the rate for children below the poverty level was 24.6% for New Mexico, compared with 17.0% for the US. In 2000, among our ethnic population, the poverty rate for Hispanics was at 23.2%, for Native Americans it was 28.2%, while the Anglo population was at 10.6%.[iii] According to Bureau of Labor Statistics (11/18/03), our state experiences a 6.1% rate of unemployment, which is similar to the 6.0% current national rate. The social and health-related problems that arise from economic disadvantage manifest in high levels of depression, divorce, domestic violence, chronic disease, and substance abuse.

Hispanic and Native American health issue

As the two largest minority groups in New Mexico, Hispanics and Native Americans suffer disproportionately in opportunities for education and employment. Hispanic and Native American students have the lowest high school graduation rates and the highest high school drop out rates, for reasons that include economic displacement, poverty, first generation school completion, as well as language barriers. Minorities in New Mexico suffer disproportionately high rates of death from accidents, diabetes, chronic liver and cirrhosis, homicide, suicide and alcoholism, all of which can be linked to poverty.

In 2001 the life expectancy for NM males was 72.8 years compared with the national expectancy of 74.1; for NM females life expectancy was 77.3 compared with the national expectancy of 79.5.[iv] The following data (Table A-2) document the high prevalence of disease and early death from accidents within our Hispanic and Native American population.

Table A-2. Mortality and Major Health Risks in New Mexico. [v]
(Rates are described for each ethnic group)

Ethnicity	Native American	Hispanic	African American	White	All Races NM	All Races National
% NM Population	9.5	42.1	1.9	44.7
Poverty	46.0	27.8	27.8	16.1	20.6
Teen Mothers	69.8	47.8	53.9	25.6	44.0
Low Birth Wt.	6.5	7.5	9.0	7.7	7.5
Infant Mortality	6.8	6.0	8.6	7.4	6.4
Heart Disease Mortality	15.4	22.0	21.0	26.0	24.0
Cancer Mortality	16.8	18.7	22.0	22.0	20.8
Accidents-All	12.6	9.8	7.1	4.7	6.8	4.0
MV Accidents	8.2	4.3	2.7	1.6	2.9
Diabetes Mortality	7.4	5.5	5.9	2.7	3.9	2.9
Suicide	3.5	2.7	2.3	2.4	2.6	1.2
Chronic Liver, Cirrhosis Mortality	6.5	3.2	2.7	1.4	2.3
Chronic Lower Respiratory	2.1	3.7	5.1	7.2	5.8

Source: New Mexico Selected Health Statistics Annual Report, 2001.

Access to health care

In 2003, 17 of the 33 New Mexico counties were designated as full or partial Health Professions Shortage Areas (HPSA), evidence of a severe problem in providing health care to NM residents. Thirty-four communities in New Mexico received a "frontier" designation, defined as having a population density of less than seven people per square mile (www.hrsa.gov, 11-12-03). Low population density counties may not qualify as shortage areas, however, access to health care is challenging because of the large territories served by the few available health providers.

Low family income often reflects employment in sectors of the economy that rarely provide health insurance benefits. The percentage of New Mexicans without health insurance between 2000-2002 was 22.0%; only Texas at 24.1% was higher. Averages for 2000, 2001, and 2002 for New Mexico children under the age of 19 indicated that 266,000 were at or below 200% of poverty (50.9%), and of those, 58,000 were at or below 200% of poverty and without health insurance coverage (11.0%).[vi] Many of these families are eligible for coverage under programs such as Medicaid, but do not acquire coverage due to language, transportation, and logistical barriers. Our problems of access to health care relate to the low number of health professionals available in rural areas, and inadequate cultural knowledge and skills exhibited by health providers in these areas. This latter problem contributes to poor assimilation of providers into these rural areas and thus an absence of health care delivery to patients. Problems include poor communication with patients and families, unrealistic expectations for treatment compliance as well as patient difficulties with transportation to health care facilities, and ability to pay for health care.

For more information contact the resources below, or the UNM and HSC Library

References

[i] US Bureau of Census, 2000,, November 4, 2003.

[ii] New Mexico Selected Health Statistics Annual Report for 2001, The State Center for Health Statistics at New Mexico Vital Records and Health Statistics, published June 2003, pg. 16

[iii] Ibid, p. 16, 17

[iv] New Mexico Selected Health Statistics Annual Report for 2001, The State Center for Health Statistics at New Mexico Vital Records and Health Statistics, published June 2003, pg. 45

[v] Ibid, p. 46-47

[vi] US Census Bureau, Health Insurance Statistics by State. Insurance Statistics. November 2003

Hispanic and American Indian programs at UNM.

Native Health Research Database - joint venture between IHS and the UNM HSC to develop the internet-accessible Native Health Research Database (NHRD) and related archival collection. The collection includes entries from 1965; the database

provides bibliographic information and abstracts of resource documents developed primarily by IHS staff, tribal health professionals and health care practitioners working in American Indian reservations and urban areas with significant American Indian and Alaska Native (AI/AN) productions.
Offers access to more than 200 years of health information focused on the AI/AN populations.
Provides document delivery service, with access to complete publications. Some full-text documents are available online.
Includes resources for program development, grant proposals, program evaluation, health research and education.

Contact:
Pat Bradley
Native Services Librarian
Telephone: 505-272-0664
Email : pbradley@salud.unm.edu

Minority Research Infrastructure Support Program (M-RISP), supported by the National Institute of mental health (NIMH) since 1998. The project activities include:

Develop the research capacity of junior minority faculty to conduct rigorous mental health research.
Emphasize mental health services research in primary care and mixed primary care-psychiatry ambulatory settings, focusing on Native American and Hispanic populations.
Build the capacity for conducting mental health research among minority populations to reduce disparities in services to these populations.

Contact : Joel Yager
Telephone: (505) 272-5416
Email : jyager@salud.unm.edu

New Mexico Tumor Registry Program - The National Center Act of 1971 mandated the collectio, analysis and dissemination of all data useful in the prevention, diagnosis and treatment of cancer. The act resulted in the establishment of the National Cancer Program, under which the Surveillance, Epidemiology and End results (SEER) Program was developed. This program :

Collects cancer data on a routine basis from designated population-based cancer.
Compiles cancer -related data on American Indian populations in New Mexico and Arizona (since 1969).
Assists with data collection activities with the IHS Area offices in Albuquerque. Phoenix and Navajo areas; the Alaska Native Medical Center; and the Cherokee Nation of Oklahoma.

Contact : Charles R. Key
Telephone: (505) 272-5541
Email: ckey@salud.unm.edu

New Mexico Geriatric Education Center (NMGEC) - Based at the UNM center of Aging, the NMGEC is dedicated to improving the health care of New Mexico's elders through education and training. Programs:

Improve the ability of health care providers to deliver culturally sensitive geriatric care.
Offer educational programs within New Mexico's IHS clinics and hospitals.
Produce a bio-monthly newsletter which releases health care providers, Community health representatives, Title VI programs and elders throughout New Mexico.
Produce videotapes featuring interviews with American Indian elders regarding their health and health care concerns.

Contact : Darlene Franklin, M.A.
Telephone: (505) 272-0903
Email: dfranklin@salud.unm.edu

Office of Native American Diabetes Program (NADP) - Through funding from the National Institutes of Health/National Institutes of Diabetes, Digestive and Kidney Disease, NADP has designed implemented and evaluated a lifestyle curriculum, "Strong in body and spirit!" The project :

Encourages participants with diabetes to make behavioral changes to improve their health and prevent complications associated with diabetes.
Features culturally relevant stories.
Emphasize a curriculum built on strengths of Native American communities, i.e. health of the community, importance of children and raising them to be strong in body and spirit.

Contact: Telephone: (505) 272-8465

Women Change/ENDOW Project - Funded by the office of women's health, NIH and the CDC Prevention Center, this project is focused on understanding ethnic variation in women's beliefs and decision making regarding hysterectomy, menopause and hormone replacement in Navajo, Hispanic and non-Hispanic white women in New Mexico. The program :

Conducts focus groups and uses surveys to elicit data to develop health education materials for women.
Provides culturally appropriate educational materials for women and their health care providers.
Staff women/change exchange, a mid-life women's center in Gallup, to assure that the health education intervention materials are available and disseminated to Navajo women.

Contact : Carla Herman
Telephone: (505) 272-5630
Email : cherman@salud.unm.edu

NIEHS/BRIDGE Center - brings together regional partners to advance discussions on collaborations and partnerships on border environmental health issues in the Paso del Norte region. Serious environmental issues include airborne particles and ozone, which result in increased risk for environmental lung diseases and cancer; and heavy metals in drinking water; soil contamination issues pertaining to agrochemicals, solvents and industrial pollution. Goals of the center include:

Develop a model of scientific and administrative interactions within the region and with other partnering BRIDGE Centers to leverage the scientific and professional resources of these institutions.
Create a cohesive and coordinated multidisciplinary approach to environmental health issues.

Contact : Scott W. Burchiel
Telephone: (505) 272-0920
Email : sburchiel@salud.unm.edu

New Mexico Children's Program (NMICP) - funded by IHS and is part of a consortia including Utah State University and North Arizona University. It is a community-based program which provides supplemental services to Native American children from its birth through 21 years old, who have developmental disabilities and special needs. Licensed personnel provide services with motor, speech and language, and cognitive/medical expertise. The program:

Provides training, technical assistance and limited therapeutic services.
Responds to referrals from community based agencies, including the Bureau of Indian Affairs IHS, Head start Programs and other service providers.
Includes the "Navajo Way Kit Project" (funded by Navajo Way, Inc.), which provides home therapy kits to children residing in the Gallup, Tohatchi, Thoreau and Torreon areas. The kits encourage family members to assist in delivering therapeutic services with the guidance of ICP therapists.

Contact : Telephone: (505) 272-0388

Project Na'nitin - a project designed to maximize the knowledge and skills of Navajo paraprofessionals to work more effectively with children with special needs and their family members. The project:

Conducts research in both state-of-the-art intervention and techniques and traditional Navajo beliefs and treatments.
Develops culturally relevant and linguistically appropriate modules for Navajo paraprofessionals to use with Navajo children and families.
Provides in-service to use with Navajo-speaking paraprofessionals and patients.
Disseminates training modules and products at local, state and national levels.

Contact: Telephone (505) 272-0388

Pathways - A National Heart, Lung, and Blood Institute funded study Pathways works prevent childhood obesity and offer Indian youth a healthier future by drawing on the American Indian tradition of venerating nature. The project:

Fosters healthy eating practices and increased physical activity.
Encourages understanding in different tribal cultures.
Works with American children in Grades 3-5, their families, food service staff, physical education and classroom teachers. and other essential school staff.
Includes the Navajo reservation in New Mexico, Arizona and Utah.

Contact : Sally Davis
Telephone: (505) 272-4462
Email : sdavis@salud.unm.edu

National Diabetes Prevention Center (NDPC) -IHS and CDC-funded initiative to develop a national center to prevent diabetes and its complications through culturally appropriate scientifically sound, and community-based interventions in Native American populations. Goals and Activities :

Establish a partnership among IHS, CDC the Pueblo of Zuni, the Navajo Nation, Gallup Indian Medical Center, the Pueblo of Zuni, Zuni-Ramah PHS, Dine College, and the University of New Mexico Prevention Research Center to create the NDPC in Gallup, New Mexico.
Expand activities nationally to implement and disseminate effective diabetes prevention activities to Indian tribes nationwide.
Focus efforts of prevention research, multidisciplinary collaborative partnerships, surveillance, program evaluation, professional and community education and training.
Serve as clearing house and public information resource.

Contact : Sally Davis
Telephone: (505) 272-4462
Email : sdavis@salud.unm.edu

Steering Committee on Native American Psychiatry (SCONAP) - is a department of Psychiatry group which promotes interest in research and teaching of American Indian culture and mental health concepts. Examples of SCONAP activities include :

Develop three American Indian mental health courses at UNM, offering information on Navajo, Peublo and Apache culture and language, concepts of mental health and illness, and cross-cultural approaches to counseling and healing.
Sponsor research on American Indian anxiety, substance abuse, including clients in Acoma, Laguna, San Felipe and Sandia.
Contribute to the annual Navajo Cultural Values Conference and Department of Psychiatry's Multicultural conference.

Contact : Tina Lujan
Telephone: (505) 272-0541
Email : tlujan@salud.unm.edu

MAIN CAMPUS

Native American Studies Program - is a newly established academic department organized into four components: community, academic, research, and technological. Internet address is http://www.unm.edu/~nasinfo/. The department:

Offers a variety of courses and research opportunities which focus on cultures, contributions, and ideas of Native American people.
Serves students, the university community, and the larger Native American community.

Contact : Gregory Cajete
Telephone: (505) 277-3917
Email : geajetel@unm.edu

American Indian Student Services (AISS) - works with academic advisors in each of UNM's colleges, helping students develop sound plans for their college education. Internet address is http://aiss.unm.edu. Services include

Provide academic advisors to ensure students select appropriate courses and are award of prerequisites.
Offer continuous and individualized network of academic support for American Indian students.

Contact : Pam Agoyo
Telephone: (505) 277-6343
Email : pagoyo@unm.edu

Native American Calling - the first national call-in radio program to focus on Native issues began daily one-hour broadcasts on June 5.1995. Native America Calling is a live, daily program linking public radio stations, and Indian Country together in a thought-provoking national conversation. It is produced from the station KUNM-FM (89.9) in Albuquerque. The program:

Broadcasts Monday through Thursday; each Friday, the Wellness Edition of Native America Calling is produced at the studios of Koahnic Broadcast Corporation in Alaska.
Engages noted guests and experts with callers throughout the US to explore contemporary issues concerning Native America and its neighbors.

Contact : Harlan McKosato
Telephone: (505) 277-5201
Email : harlanl@unm.edu

Center for the study of Latino Health and Culture (CESLAC) - Located at the UCLA School of Medicine, CESLAC is dedicated to exploding myths and stereotypes about Latinos in U.S. society, provide reliable data on Latino health, emphasize the positive contributions of Latinos to California's and the national economy and society and inform public about the important emerging Latino medical market.

Contact : David E. Hayes-Bautista.
Telephone: (310) 794-0663
Email : cesla@ucla.edu