Population Health and Rural New Mexico

On average, life expectancy in the United States has slowly declined in the last several years. This decline has been prompted by climbing rates of drug overdose, suicide, and Alzheimer’s disease.¹ In the state of New Mexico, life expectancy has declined at a disproportionately alarming rate when compared to national figures. This is predominantly due to drug overdose, motor vehicle injuries, heart disease, and infant mortality.¹ These principally alarming health disparities in New Mexico are significant among minority groups but also among rural communities. According to the New Mexico Department of Health, “rural areas in New Mexico are on the wrong end of many health disparities…overall, persons living there have a shorter life expectancy due in part to higher smoking rates and less access to care.”¹ In a 2018 health report for the state, rural New Mexicans, who make up 25 percent of the state’s total population, experienced health disparities in infant mortality, food insecurity, access to prenatal and birthing services, childhood obesity, sexual health especially among rural LGBTQ+ men, substance use, mental health services, unintentional injury and death, emergency medical services, access to clean water, access to healthcare providers, and age-dependency.¹  

The rural-urban divide has only grown in the first two decades of the twenty-first century, not only in New Mexico, but across the nation. The recent presidential election of Joe Biden and the Coronavirus pandemic have only accentuated this trend. According to Georgetown University’s Health Policy Institute, “the rural population is consistently less well-off than the urban population with respect to health…[and] is more likely to engage in risky health-related behaviors and to experience higher rates of chronic conditions and activity limitations.”² In a thought-provoking article from the Washington Post, shockingly titled, The Real (surprisingly comforting) Reason rural America is Doomed to Decline, the author calls the contest between urban and rural communities “rigged” because “official definitions are regularly updated in such a way that rural counties are continually losing their most successful placed to urbanization. When a rural county grows, it transmutes into an urban one.”³ This interesting perspective on the condition that rural communities often find themselves in underlines the reality that rural communities are those with the most need, since the ‘rural’ classification is befitting of communities with stalled, stagnant, or scarce economic growth. The moment a community begins to economically prosper and grow, they are reclassified as urban centers. The economic, geographic, and social conditions of rural areas lead to the prevalence of largely negative health trends found in these communities, justifying the need of expanding health care access and population health programs. 

In addition to the already prevalent poor health outcomes of many rural communities, rural areas are experiencing a severe regression in population and, therefore, federal representation and resources. Since 2010, for the first time in American history, rural counties’ populations have decreased, and their share of the nation’s population hit an all-time low of fourteen percent.³ Shifts in population are often followed by shifts in resources as well as federal representation in national government changes relative to decadal Census data. As rural America declines in population, so do the resources that are sent to these communities which are already suffering from existing poor health outcomes. While healthcare, especially in the United States, is often brutally expensive, population health interventions can uniquely address health disparities by preventing illness and injury and the bills associated with treatment and care. Creative, sustainable, and community-building interventions can bring communities together to provide and better utilize existing resources that advance quality health. Expanding access to care can be difficult with little financial support, but not impossible. Preventing illness and injury through prevention programs can reduce the need for individuals to seek expensive care and, overall, better the health of rural communities.  

Addressing the health disparities in rural New Mexico will require a handful of community-inspired interventions that focus on broadening access to care, improving social and economic conditions, and expanding health resources and education to incentivize, spur, and sustain health.  Potential prevention programs that have the capacity to better health in rural communities include expanding access to walking trails and open-areas or parks for exercise, improving internet connectivity by expanding and subsidizing broadband access so that communities can access telehealth care solutions for geographically strained and isolated rural regions, investing in mental health initiatives and programs, and investing in mobile clinics that can provide primary care to communities with small or nonexistent clinics. Prevention programs can contribute to the construction of a food pantry or investment in a mobile food pantry that brings affordable and nutritious food to those who are without access to quality nutrition, installing sex education programs to reduce the high rates of teenage pregnancies and sexually transmitted diseases, provide workplace safety programs to lessen susceptibility to dangerous workplace hazards, and expand resources and care for mothers. While it is important to first assess the health needs of every community to better understand their specific needs and health priorities, there are many realistic prevention programs that can be implemented to better a rural community’s health.