New Mexico is rich in its cultural heritage and is resilient. Our citizens are community-minded. As a state, we are committed to reducing health and social disparities. Our social benefits are generous compared to other Southwestern and rural states. In recent years, the state has done much to increase access of medical care in an attempt to mitigate the effects of poverty and lack of education on health. Our government has aggressively promoted enrollment in the Affordable Care Act and was among the first to expand Medicaid.  Our universities and colleges have increased the number of health care workers and physicians they train. 

Still,  our state has consistently ranked very low in health status. Total annual healthcare spending in New Mexico is approximately $26 billion^[1],nearly three times the State’s total budget. Despite this,  New Mexicans’ health status significantly trails national trends. New Mexico ranked 37^th in life expectancy in 2019, with overall life expectancy dropping by 0.2 years from 2018 levels. US New and World Reports lists our public health system as 36^th overall and health care access at 38^th (although we do better at health care quality, coming in at 24^th.)  We have high levels of chronic diseases, drug and alcohol addiction, and mental health problems. Two-thirds of New Mexicans need improvements in their long-term health care. These include 950,000 (Medicaid), 50,000 (Children’s Health Insurance) and 400,000 (uninsured and undocumented), or about 1.4 million people. The remaining 600,000 in our state are receiving adequate healthcare through traditional systems.

DOH Secretary Kunkel’s 2019 Health Equity in New Mexico report, identifies several health-related challenges including, but not limited to, the following:

• Prenatal care among women in the first trimester significantly lags nationwide rates.
• Diabetes, especially among certain minority populations, is a major concern.
• Obesity is increasingly contributing to health challenges among New Mexicans.
• Sexually transmitted disease is growing rapidly across the State.
• Motor vehicle accidents, suicide, and alcohol death rates are alarmingly high.
• Mental illness is growing, especially among young people.

These health-related challenges have worsened under Covid-19. In particular, chronic disease treatment and mental health have grown worse since March 2020.

Public health leaders and other experts agree that our long-standing poverty is a substantial contributing factor to our health outcomes. New Mexico has the highest percentage of Medicaid recipients of all states and ranks 44^th for its population of uninsured people. Taken together, more than 50% of our population is either on Medicaid or uninsured.

Although State government has made great strides, focusing solely on the healthcare system will not help improve the health of our population . Social determinants of health:  poverty, lack of housing and low education levels will continue to negatively impact our collective health status if they are not addressed. Although recent advances, like the implementation of free college tuition will certainly help, what is required is a comprehensive system to pool the many resources our local communities have at their disposal to ensure that no one is falling through the cracks and to bring preventive care directly to the population before chronic diseases develop.

We  have a unique opportunity to reverse our state’s fortunes. Today, New Mexico is no longer a poor state. One-time Federal contributions such as ARPA and Covid relief have created a three-year boost in revenues. Even better, our oil and gas revenues have propelled our state budget to new highs. Unlike past boom and bust periods, the State can expect to see substantially higher revenues for years to come.

So, while we’re at the bottom in health and wellbeing, we have a gushing surplus from now into the foreseeable future. How are we to use this money to improve the health of all our citizens? And how are we to learn from, amplify and share innovations that are emerging across the state that inform how money can be spent wisely?

[1] Assumes annual healthcare costs throughout New Mexico follow national trends of $12,530 per person (https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet).