The State of Health in New Mexico 2018
17. Social Determinants of Health
Healthy Social Conditions Support Healthy Populations
Social Determinants of HealthSocial determinants of health are demographic conditions in the communities in which people live, work, play, and age that affect a wide range of health outcomes. New Mexico faces significant challenges in this area on such highly important factors as economic security, education, crime, and access to health care.
Economic StabilityEconomic stability is associated with many health conditions and risk factors and is thought to influence health through a variety of pathways, including access to care, chronic stress, environmental exposures and health behavior. Median household income in New Mexico ($46,884) was only about 81% of that found in the U.S.,overall ($57,617). In 2016, 19.1% of New Mexicans were living in households with incomes beneath the poverty threshold, compared with 14.0% in the U.S. New Mexico has had among the highest child poverty rates over the years, and in 2016 was ranked 48th among all states with 27.8% of our children under age 18 living in poverty, compared with 19.5% in the U.S. overall. Food insecurity is one outcome of economic insecurity. The highest rates of child food insecurity in 2015 were found in McKinley (34.8% food insecure), Luna (33.6%), and Cibola (32.7%) counties (Figure 1).
EducationHigher educational attainment is associated with better health outcomes. Low educational attainment has been identified as a problem in the U.S. The Robert Wood Johnson Foundation reports that "The United States is the only industrialized nation where young people currently are less likely than members of their parents' generation to be high-school graduates." New Mexico's 2016 high school completion rate (85.4%) gives us a rank of 45 among U.S. states, and we rank at the bottom (50th) for percentage of third graders able to read at a basic level (54%, compared with 69% nationally). The highest percentage of persons with a 4-year college degree were found in Los Alamos, Santa Fe and Bernalillo counties (Figure 2).
Parents and families are characteristically the earliest educators of young children, and the level of parental interaction during formative years is linked to a variety of academic outcomes. However, the degree of parental involvement may be influenced by the labor-force participation of the parents, particularly in single-parent households. An increased need for quality child care is found in family settings where all parents are employed full-time. In New Mexico, the percentage of young children with both parents or their only parent in the labor force (61.6%) is similar to that in the U.S. (65.5%) (Figure 3). Counties with the highest percentage (2012-2016) of working parents of children under age 6 were Cibola, Socorro and Quay counties.
EmploymentThe U.S. unemployment rate was higher than the New Mexico rate during the height of the recent recession (2007-2010). But beginning in 2010, the U.S. rate saw dramatic improvement and was at 4.9% in 2016; lower than the 2016 New Mexico rate of 6.7%. In 2016, the highest unemployment rates were found in Luna, McKinley, Lea and Torrance counties.
CrimeThe impact of crime on an individual victim, their loved ones, and their community depends on a variety of factors, but often crime victimization has significant emotional, psychological, physical, financial, and social consequences. In 2016, every day on average, 224 New Mexicans were victims of property crimes, 32 of which were motor vehicle thefts, and 40 were victims of violent crimes, 4 of which were rapes and 7 were robberies. New Mexico had the highest property crime rate among all 50 states, and the second-highest violent crime rate.
Health DisparitiesHealth status is strongly related to educational attainment, income and poverty status. Families with high incomes can afford to live in nicer neighborhoods, further away from high-crime areas and industrial pollution, where the housing is newer, and the schools are better-funded. In 2016 in the U.S., the following characteristics were associated with a higher percentage of persons in poverty: households with children, especially children under age 6, females, persons under age 18, foreign-born non-citizens, and persons who were unemployed, had a disability, or lacked a high school diploma. In New Mexico, the percentage of persons in poverty is higher among American Indian/Alaska Native, Black, and Hispanic populations.
Assets and ResourcesThe Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is for low-income pregnant and post-partum women, infants, and children up to age 5 who are at nutritional risk. WIC provides nutritious foods to supplement their diets, provides healthy eating information, health counseling, breastfeeding support, cooking classes, and referrals to health care providers and social services.
The Supplemental Nutrition Assistance Program (SNAP), formerly known as the Food Stamp Program, provides financial assistance to eligible New Mexicans with low income and limited resources to purchase food products. SNAP benefits are simple to use to purchase qualifying food products at participating grocery stores.
The New Mexico Public Education Department uses an early warning system (EWS) designed to reduce dropping out by using routinely available data to identify students at risk of dropping out. Once identified, students at risk of habitual truancy and dropping out can be served with a spectrum of interventions, including truancy and dropout prevention coaches, to get them back on track to graduation.
The Child Care Assistance Program subsidizes the cost of child care for low-income families that are working and/or in school and have a need for child care. The subsidy amount varies depending upon the age of the child, the type of child care, the location of the program, and the quality rating of the child care program. Regional offices are located throughout the state and are staffed by eligibility interviewers who work with families to determine the amount of subsidy for which they qualify.
The New Mexico Coalition for Literacy (NMCL) works to coordinate, expand, and enhance New Mexico programs so adults can read and write to achieve their goals. NMCL maintains a statewide directory of adult education and literacy programs.
SummaryNew Mexico has relatively poor health outcomes for suicide, unintentional injury deaths and alcohol deaths, which are likely related to our social determinants of health. Yet despite our relatively poor showing on key social determinants of health, New Mexico fares remarkably well compared to other states in a number of areas, including deaths from cancer and heart disease. Improving social conditions will improve New Mexico's health outcomes, but these social conditions do not change quickly or easily. New Mexico must focus on reducing poverty and improving education, to reap both immediate and long-term benefits to the state.
What is Being Done?
- New Mexico does not tax groceries.
- New Mexico has the Earned Income Tax Credit.
- Lottery scholarship for college students.
- New Mexico Workforce Solutions counseling, referral and job listings.
- Increased collection and broad dissemination of socioeconomic status related information in health surveys and datasets.
What Needs to be Done?
- Intervene in early childhood to support the health and educational development of low SES children.
- Increase resources for public education and access to higher education.
- Focus interventions toward low-health-status populations with the fewest resources.
- Continue to use and promote proven, evidence-based interventions.
Related NM-IBIS Indicator Reports
- Median Household Income
- Percentage of Persons Living in Poverty
- Perentage of Children (Aged 0-17 Years) Living in Poverty
- Food Insecurity
- Child Food Insecurity
Social and Community Context