New Mexico Public Health Association

100 Years of Public Health in New Mexico

By Sharz Weeks


1917 - 1939

1940 - 1959

1960 - 1979

1980 - 1999

2000 - Present



The history of public health in New Mexico is complex, detailed, and integral to the development of the state. In celebration of the New Mexico Public Health Association’s Centennial, this series will focus on public health development, challenges, and successes the people of the state have experienced in the past 100 years.


1917 – 1939

Migration to New Mexico before and just after it became a state was driven by the railroads, mining, and ranching; however, disease was what really drove economic development in the early 20th century. People would travel to the higher, drier elevations of New Mexico in hopes of finding some relief from, and perhaps curing, the sickness.[1] It was commonplace, because there was no cure until the 1940’s, for doctors to prescribe climate and sunshine as treatments for tuberculosis. In fact, Bronson Cutting, US senator from 1927-1935 and a former publisher for the Santa Fe New Mexican, came to New Mexico in 1910 from the wet East Coast in search of a climate that would reverse his tuberculosis diagnosis. The arid and high climate seemed to work for him, and many others seeking the same treatment. [3]

Another such individual coming to New Mexico in the early twentieth century to cure his case of the respiratory illness that was sweeping across the East Coast was John Tombs. He was a Canadian by birth, a businessman, and a sufferer of tuberculosis. Because of his medical diagnosis and his quest for a cure, he became very interested in matters of health when he arrived in the newly established state. [2]

At the time, there was no established Department of Health or any other such local health agency to address health issues, yet Spanish flu and tuberculosis were running rampant. World War I was also in full swing, and the need for an organized, well-run Department of Health was identified as soldiers from New Mexico were being denied entry to the armed forces for tuberculosis infection. The establishment of the agency gained support from Governor W. E. Lindsey during his governorship in 1917 and 1918. He contacted Surgeon General Rupert Blue with the US Public Health Service and requested a complete survey of health conditions and needs in New Mexico. Obliging, the Surgeon General sent Surgeon John W. Kerr out west to conduct the survey and needs assessment. [2]

During this time, New Mexico was asked to join several nationwide initiatives, but couldn’t because there was no infrastructure or money supporting public health in the state at that time. In addition to the Children’s Bureau of the Department of Labor’s project aimed at saving infant lives, a national rural health act allowed states to apply for up to $10,000 to assist in health-related issues. New Mexico aimed at participating in both, as the need was certainly there, but lack of an infrastructure prevented that from happening. [2]

As a result, John Tombs set off to establish an infrastructure to address the health of all New Mexicans, what he called “an adequately financed and efficiently managed State Department of Health.”[1]  He used his connections in business and journalism, and his interpersonal communication skills to educate people on the health needs of the state, lobbying for a dedicated Department.  [2]

As he was fighting for a better infrastructure, John Tombs established the New Mexico Public Health Association on May 2nd, 1917, which was two years before the State’s Department of Health was established. He established the organization initially as an institute that would study and work to prevent tuberculosis. NMPHA would later become an affiliate of the National Tuberculosis Association. John Tombs was on the original board, and became the executive secretary later in 1917. [2]

The original mission was to educate and disseminate knowledge of infectious diseases, information and vital statistics of these diseases, collaborate with local public authorities and organizations, and to establish and further an infrastructure in New Mexico that would contribute to improved health for all New Mexicans. This mission is largely the same today. In fact, here’s an excerpt of the original constitution and by-laws of the original NMPHA. [2]





And here’s the original board. [2]




NMPHA played an integral role in assisting in the establishment of the State Department of Health. Advocacy and the sale of small merchandise to help raise funds to care for returning soldiers and heavy media campaigning were among the tactics used by NMPHA and John Tombs to leverage support for the State Department of Health. Dr. Kerr’s report led to interactions with Governor Larrazolo (who had succeeded Lindsey), John Tombs and other NMPHA members, lead to a discussion of legislation that would establish the Department. After several revisions, J. Frank Curns of Mora introduced Bill 118 in the House of Representatives. After much work, the Department of Health was born. [2]

Now that the infrastructure had been put in place, it was time to address the health needs of the state. The Spanish influenza epidemic of 1919 was among the top priorities along with ensuring tuberculosis sanatoria development. The state saw a high infant mortality rate, and sanitation was poor, which led to an increase in diseases such as diphtheria, malaria, typhoid, and chronic diarrhea.

New Mexico had the second to the highest rate of death due to TB in the nation, superseded by Arizona. TB was the leading cause of death in New Mexico all the way into the 1940’s and trended much higher than the US average. However, it is speculated that over half of the TB deaths in the state were of people who had moved to New Mexico for treatment. The increased prevalence and death rates of TB were the main reasons for the establishment of so many sanatoria throughout the state. Some notable sanatoria include Boyd’s Sanatorium outside of Las Cruces, Fort Bayard near Silver City, St. Anthony’s Sanatorium in Las Vegas, and the Southwestern Presbyterian Sanatorium in Albuquerque, to name just a few. During the period of 1880-1940, there were over sixty sanatoria throughout the state. [3]  

In the mid 1920’s, public health nurses engaged in home visitation to address childhood illnesses, which was seen as the most effective way to educate and treat patients and improve sanitation.[4] Nurses engaged with almost 25,000 children during 1925 and found that around half of them had some type of health problem.[4] 

The Commonwealth Fund helped pay for State public health nurses to make these home visits[2] and by the end of 1930, there were just over 30 nurses.[4]

Sanitation continued to be an area of needed improvement in New Mexico during the 1920’s and 1930’s. Diphtheria deaths trended higher than the national average with a spike in cases around 1932. Typhoid fever death rates were also significantly higher than the national average. Poor sanitation and non-pasteurized milk were considered to be the main contributing factors to the elevated rates of typhoid and diphtheria. By the end of the 1930’s, death rates for both diseases had fallen to close to the national average.[4]

Malaria was also a problem during the 1930’s, especially along the Rio Grande valley. New Mexicans began to solve this by draining swampy areas that proved to be optimal breeding grounds for mosquitos. The counties with the most malaria-carrying mosquitos were Rio Arriba, Doña Ana, Santa Fe, and Mora. Draining and filling typical breeding grounds led to a reduction in malaria cases, but it wasn’t the only thing. There were many education programs that came about, including a motion picture called “Malaria in New Mexico” and poster campaigns, including the one below from WPA that educates on malaria control. Because of these efforts, the malaria death rates below the national average by 1938.[4]


           

[1] Albuquerque Business First. (2012). Disease played a major role in development of New Mexico’s economy. Retrieved on 3/6/17 from http://www.bizjournals.com/albuquerque/print-edition/2012/02/03/disease-played-major-role-in.html?ana=fbk

[2] Greenfield, M. (1962). A History of Public Health in New Mexico. University of New Mexico Press. Albuquerque, NM.

[3] Lewis, N. O. (2016). Chasing the Cure in New Mexico: Tuberculosis and the quest for health. Museum of New Mexico Press. Santa Fe, NM. 

[4] Whorton, B. (2002). New Mexico Public Health Achievements During the 20th Century. Office of New Mexico Vital Records & Health Statistics, New Mexico Department of Health. 





1940-1959

We saw during our review of the 1930s that child and maternal health was quickly becoming an area of focus in the public health sphere in New Mexico. That trend continued and became a major focus of public health efforts. During the 1930’s, various clinics arose to specifically address maternal and child health and wellness, including Well-Child Clinics and birthing clinics. Maternal services were often held at public schools for women who had either recently had a child or for those who were expecting a child and who did not have a regular physician. It is surmised that many of these women would likely be giving birth at home with the help of midwives, so these clinics were very important. In fact, women would walk for miles in order to attend the pregnancy clinics. [1] Infant mortality continued to be an issue in New Mexico all the way through the 50’s. In 1950 and 1951, child deaths within the first year of life accounted for 22% of all deaths. The number of births rose drastically throughout the 40’s and 50’s, but so did the number of infant deaths. This was another reason an adequate maternal and child health division was needed. [2]

Throughout the early 40’s, public health nurses conducted nursing classes in people’s homes. WWII brought about a shortage of medically-trained personnel in the state, so the Department of Health thought it wise to take education classes to the people and teach them how to prevent disease and care for the sick. [2] Midwives began taking a more active role in home healthcare as more and more physicians left for the armed forces, so two major training conferences were held in Las Vegas in 1941 to help train midwives. [2]  

During the 1940’s, the number of cases of infectious diseases that were active during the early part of the century began to decline [2] while other diseases, such as heart disease, cerebrovascular disease, and cancer rose. [1]  In the mid 1940’s, a tuberculosis control program was implemented in the state, and immunizations began to rise after the end of WWII, especially for diphtheria, [2] though tuberculosis remained a leading cause of death in New Mexico through the 1950’s. Additionally, a cancer control program began in 1946, which focused on case reporting, cancer detection, and treatment centers. [2] This program proved to be quite successful in the late 1940’s as three diagnostic centers were established, which allowed for an increase in testing and record-keeping.

Because funding was scarce at the Department of Health, additional salary appropriation led to the ability to increase health-related jobs, which included sanitarians. This allowed for better sanitation of milk and other food. Establishing higher purification and sanitation methods in the state benefited the state’s milk production. In the Portales region, where most of the milk was produced, these advances allowed for the production of Grade A and Pasteurized milk which would eventually be distributed throughout the state. [2]  

Health education got its start in the state during this time as well. Traditionally, health education was the job of the director of the Department of Health and the director of the Division of Maternal and Child Health with occasional help from other staff members when they had time. Because all of these people were very busy, Mary Pollard, a woman who had received special training in health education, took on that role, and she eventually joined the New Mexico Health Council board. [2]

Vaccinations rose steadily throughout the 40’s and 50’s. Mainly, vaccinations against the major communicable diseases seen earlier in the century were targeted and prevented. These included diphtheria, smallpox, pertussis, and typhoid. [2]

The mid 1950’s saw a lot of expansion of the State Department of Health. Some of the highlights seen during this period of expansion, thanks to the director of the health department Dr. Gerald Clark. Included the development of school health programs, preventive dental health programs, chronic disease management programs, and communicable disease prevention programs, to name a few.

In the mid 9140’s, the College of Pharmacy was established at the University of New Mexico as the University’s first health professions college. [3] In 1955, the State Legislature approved and appropriated funds to the University of New Mexico to establish their college of Nursing. Eleanor King became the dean of the college at this time. [2]

                 photo of UNM College of Pharmacy students from the past

UNM College of Pharmacy students[3]



Eleanor King, First Dean of the UNM College of Nursing

 [1] Whorton, B. (2002). New Mexico Public Health Achievements During the 20th Century. Office of New Mexico Vital Records & Health Statistics, New Mexico Department of Health.

[2] Greenfield, M. (1962). A History of Public Health in New Mexico. University of New Mexico Press. Albuquerque, NM.

[3] University of New Mexico College of Pharmacy (2016). Retrieved from http://pharmacy.unm.edu/about/our-history.html




1960-1979

          

As we move into the 1960s and 1970s, communicable diseases began to take less priority as many of them were now under relative control. Instead, the public health focus shifted to environmental health and safety. After WWII, New Mexico’s population grew rapidly and there were new exposures to airborne pollutants. [1]

A number of laws emerged nationally during the 1960s and 1970s surrounding environmental health and regulation. In 1969, the National Environmental Policy Act was enacted that required all branches of government to consider environmental impact before taking any federal action that would significantly affect the environment. Additionally, the Clean Air Act of 1979 mandated heightened standards of air quality, the Clean Water Act in 1972 mandated further regulation of pollutants into waters (among other things) and the Safe Drinking Water Act of 1974 mandated higher standards to protect drinking water. [2]

Similar acts were seen in New Mexico as sanitation issues turned into environmental health issues. In fact, in the early 1950s, the Sanitary Engineering and Sanitation Division was renamed Environmental Sanitation Services. The Albuquerque Health Department, under the leadership of Larry Gordon, was renamed the Albuquerque-Bernalillo County Environmental Health Department and was the first local environmental health department in the nation. They focused on sanitary issues including dairy processing, food processing, sewage, etc. and were responsible for the passage of what is referred to as the New Mexico Air Pollution Control Act [1] or the NM Air Quality Control Act, which required the state to adopt or improve air quality plans in the state in accordance with the federal Clean Air Act.

Further development of the state’s air and water standards were developed around 1967 by the Environmental Services Division under the guidance of the state’s recently-enacted air and water quality acts. The work of the Division at this time also led to the establishment of the state’s OSHA bill and related workforce safety regulations. The Division also pushed for the enactment of a bill that would establish the New Mexico Environmental Improvement Agency in 1971, which was renamed in 1976 to the Environmental Improvement Division and then the Environment Department. [1]  

In 1979, there was a devastating spill near Church Rock at the United Nuclear Corporation’s uranium processing plant in the Navajo Nation. The spill, caused by the rupture of an earthen dam, released an excess of 1,100 tons of uranium mining wastes and an additional 100 million gallons of radioactive water into the Pipeline Arroyo which then moved into the Rio Puerco and onto Gallup. This spill contaminated the land and is blamed for an increase in illnesses in the area, as there were various methods of contamination from the different chemicals and associated isotopes including inhalation, ingestion (especially of contaminated animals or plants) and absorption. [5]

Motor vehicle safety was also a focus of the work in the 1950s and beyond. In 1970, motor vehicle death rates reached its all-time high. [3] Motor vehicle deaths were relatively high during the 1930s, 1940s, and 1950s despite the fact that there were not very many vehicles used in New Mexico during those times. In 1970, the death rate reached around 47 deaths per 100,000 population. After 1970, these began to decline rapidly, which can be attributed to improved car manufacturing safety standards (i.e. seatbelts, airbags, framing, etc.) improvements to highway infrastructure, and auto safety education. [3]

There were many other public health achievements during the 1960s and 1970s. In 1961, the State Legislature approved a two-year medical school at the University of New Mexico, which was appropriated $5.3 million. The medical school opened in 1964 and was changed to a 4-year program in 1966. In 1974, New Mexico State University started their Associates of Nursing program and in 1975, their School of Social Work began its Bachelor’s degree program. In 1977, the UNM Medical School Library and Informatics Center opened. In 1979, NMSU’s College of Health and Social Services was founded, originally called the College of Health and Community Services. [4]  

There were several important people during this time period as well. Annie Dodge Wauneka was a key leader in public health in New Mexico. She was a Navajo Native American woman who advocated for public health education and social justice. She was a member of the Governor’s Committee on Aging and worked to coordinate the polio vaccination program for Navajo children. In 1976, she was recognized as Woman of the Year by the Ladies Home Journal. [4]

Also of note is Larry Gordon who, in 1975, gave a presentation at the annual NMPHA conference on the future of NMPHA. The organization had an uncertain future and Mr. Gordon presented several options for the organization including the extreme option of disbanding altogether. [4] NMPHA prevailed and persisted.


References

[1] Gordon, L., J. (1993). History of environmental health and protection in Albuquerque and New Mexico: An overview. Retrieved on March 21, 2017 from http://www.sanitarians.org/Resources/Documents/History_of_EH_P_in_Albuq.pdf

[2]Friis, R., H. (2012). Essentials of environmental health. (2nd ed.). Jones & Bartlett Learning.

[3] Whorton, B. (2002). New Mexico Public Health Achievements During the 20th Century. Office of New Mexico Vital Records & Health Statistics, New Mexico Department of Health.

[4] Gonzales, T. (2016). NMPHA 100 years of New Mexico public health history: Decade by decade list of events, achievements, challenges/hardships, legislation and key leaders.

[5] Rangel, V. (2016). Church Rock tailings spill: July 16, 1979. Retrieved on March 21, 2017 from http://dev.newmexicohistory.org/filedetails.php?fileID=24161




1980 – 1999


One of the largest domestic epidemics in recent history is the HIV/AIDS epidemic of the 1980’s and 90’s.  New Mexico was subject to the pandemic as well. The outbreak began in the early 1980’s as cases of a rare lung infection called Pneumocystis carinii pneumonia (PCP) was discovered in a few gay individuals in LA, then a handful of individuals who inject substances later on that same year. This would later be discovered to be a hallmark of severe immunodeficiency. As the pandemic grew to other parts of the country and world, more and more services to address the problem began arising. [1]

In New Mexico, for instance, the AIDS InfoNet was established in 1998 by Dr. Bob Munk. It was an educational project of the International Association of Providers of AIDS Car and was designed to provide HIV/AIDS treatment information in a way that could easily be understood by anyone accessing the site. The AIDS InfoNet continues to provide up to date information on HIV and AIDS and, through international partnerships, provides this information in a variety of languages. [2]

Before the AIDS InfoNet was established, New Mexico’s HIV Community Action and Planning Group was established in 1995 to ensure that the community impacted by HIV/AIDS and professionals working in HIV prevention were able to come together to engage in planning activities. The community participation aspect of this group is key to success, as it takes into account the needs of the community to create successful HIV prevention programs. [3] This organization is still active and successful in their mission today.

Advances in science and healthcare have changed the way we deal with disease. As infectious diseases such as polio and measles become vaccine preventable, human life expectancy increases. With that increase, different health issues tend to emerge. There is a shift away from infectious diseases as we learn how to prevent them and away from accidental deaths as we become more educated and make advancements in personal safety resulting in a move toward chronic disease issues. As people are living longer lives, issues that arise later on in life are now becoming more prevalent than they were in the past. Things such as cancer, arthritis, and heart disease are taking the forefront of public health attention in the recent decades. [4]  

To help address the issues of chronic disease, several organizations popped up around New Mexico. One such organization is the Chronic Disease Prevention Council, established in 1997. The CDPC started out as an advisory group for the NM DOH Chronic Disease Bureau. The main focus of the CDPC is to reduce the burden of multiple chronic diseases through risk management strategies. [5] The NM DOH Chronic Disease and Prevention Bureau works to promote healthy lifestyles and promotes the early detection of chronic diseases, among other activities that actively work to limit the burden of chronic diseases in the state. They have programs aimed at tobacco cessation, diabetes prevention and control, breast and cervical cancer early detection and arthritis programs, just to name a few.[6]


The New Mexico Department of Health’s Chronic Disease Prevention and Control Bureau was originally part of the Health Promotion Bureau in the late 1980s and became its own bureau in the mid 1990’s as the Health Promotion Bureau was disbanded with the expectation that all sections of the DOH should be engaging in health promotion activities. Judith Candelaria was the first Bureau chief.  In the 1990’s, the Chronic Disease Prevention and Control Bureau received two major grants – one to focus on early detection of breast and cervical cancer and one to focus on tobacco use prevention.

Other major events in public health in New Mexico helped shape the state of health in NM that we see today. In 1980, NMSU’s School of Social Work became its own department. The Carrie Tingley Hospital was relocated to Albuquerque at the approval of the NM Legislature in 1981 because, due to the polio vaccine, the disease was nearly eradicated. The New Mexico Commission for the Blind was established in 1986 and in 1988, NMSU received national accreditation from the National League of Nursing and began its first bachelors and masters in Nursing in 1994. [7]

The 1990s saw similar advances in the health ecosystem. In 1991, the NM Commission for the Deaf and Hard of Hearing was established as a result of legislation as well as the New Mexico Alliance of Health Councils. [7] Health Councils were established in the various counties to initially address child and maternal health at the local level and were guided by the newly established Alliance of Health Councils. Additionally, in 1994, the NM Border Health Office established its Maternal and Child Health Program to assist in reaching at-risk populations to improve child and maternal health. Children Youth and Families Department (CYFD) began operations in 1992 as a result of legislature. Additionally, in 1996, New Mexico Kids portal was established to act as a tool for families and professionals in the early childhood education sector to find information on child development [7] – a resource that proved to be very valuable.

UNM began it’s first MPH program in 1994 and added the MPH in Epidemiology section in 1997. Lastly, in 1993, a hantavirus outbreak in the Four Corners area killed multiple Navajo people and led to an increase in research of the pulmonary disease, including the discovery that it was found to be carried by deer mice. [7]



[1] Avert. (2017). History of HIV and AIDS Overview. Retrieved on March 25, 2017 from https://www.avert.org/professionals/history-hiv-aids/overview

[2] AIDS InfoNet. (2017). About the AIDS InfoNet. Retrieved on March 25, 2017 from http://www.aidsinfonet.org/

[3] New Mexico’s HIV Community Planning and Action Group. (2017). Retrieved on March 25, 2017 from http://www.nmcpag.org/

[4] Whorton, B. (2002). New Mexico Public Health Achievements During the 20th Century. Office of New Mexico Vital Records & Health Statistics, New Mexico Department of Health.

[5] Chronic Disease Prevention Council. (2016). About us. Retrieved on March 25, 2017 from http://chronicdiseasenm.org/about/who-we-are/

[6] NM DOH Chronic Disease and Prevention Bureau. (2016). Retrieved on March 28, 17 from http://archive.nmhealth.org/phd/about_cdp.shtml

[7] Gonzales, T. (2016). NMPHA 100 years of New Mexico public health history: Decade by decade list of events, achievements, challenges/hardships, legislation and key leaders. 




2000 - Present


As we move toward the present, public health work continues to advance with new research and health issues as they arise. In the recent twenty years, public health has taken a more active role in addressing the environment in which people live, learn, work, and play. A recognition that social and environmental aspects have an effect on health helped drive some of these advances. The recognition of social determinants of health has helped public health professionals address health issues from a variety of angles. Social determinants include nonmedical factors that affect health and can include such things as cultural factors, legal and institutional influences, living and working conditions, socioeconomic status, and lifestyle. [1]

It was discovered during the HIV/AIDS pandemic that individuals who inject substances were particularly at risk of contracting bloodborne infections such as HIV and Hepatitis C. This brought about the need for syringe exchange programs throughout the states, where individuals who inject substances could exchange their used syringes for sterile ones. This was slow in development, but would eventually prove to be a successful way to reduce the instance of Hepatitis C and HIV in these communities. Between 1994 and 1997, New Mexico conducted a Sero-prevalence Study with 1003 participants who were individuals injecting substances. The study found that 0.5% were HIV positive, 61% were Hepatitis B positive, and 82% were Hepatitis C positive. [2] This study revealed the prevalence of Hepatitis C among individuals who inject substances and provided vital evidence needed to pass the New Mexico Harm Reduction Act of 1997. This act established the harm reduction program to provide sterile hypodermic syringes and needle exchange and allowed for further data collection. The statute establishes access to sterile injection equipment a right rather than a privilege in New Mexico.

In 2014, NM Ranked 2nd in the US for unintentional overdose deaths and is now ranked 8th, according to the CDC (2017). The opioid epidemic that has recently been seen throughout the nation has been an issue in New Mexico for some time and is being addressed by a number of agencies. In 2013, Bernalillo County Commissioner Maggie Hart-Stebbins approached the Bernalillo County Community Health Council to address this issue that many of her constituents had brought to her attention. The Health Council set up a number of summits that gathered health professionals from around the county to come up with a series of strategies to address the epidemic. The work continues today realized in a series of programs and has recently gotten federal funding, as New Mexico has been identified as a high-need state.

                New Mexico had some great accomplishments during the past twenty years. NMSU’s Department of Public Health Sciences was awarded accreditation in 2001 and again in 2011. In 2001, UNM established their MPH in Community Health Intervention. In 2002, the University of Texas at El Paso conducted a study that investigated lead contamination around the ASARCO smelter plant in El Paso which was suspected of being the cause of the pollution that affected El Paso, Juarez, and Sunland Park, New Mexico. [3]

New Mexico, as we’ve seen, has a long history with midwifery. In 2004, New Mexico had the highest percentage of Certified Midwife-attended births for the previous 4 years running, and a key leader in midwife care was Dona Jesusita Aragon (pictured below). In 2000, she was 93 years old and was the last living curandera-patera registered by the state’s midwife demonstration project. [3]


The Affordable Care Act resulted in an increase in access to care and in increase in National Health Service Corps Clinicians in the state who served underserved areas that would have otherwise not had access to reliable and affordable healthcare. The various health plans in New Mexico were popping up – from Lovelace to New Mexico Health Connections, a nonprofit established in 2012 that acted as a health plan for people in New Mexico established by New Mexicans. In 2016, Presbyterian Hospital was named “Best Regional Hospital” and in 2008/2009, Presbyterian Health Plan was named “America’s Best Health Plans 2008-2009” by the US News and World Report. [3]

Other achievements include the establishment of the New Mexico Community Health Workers Advisory Council in 2006 and the Community Health Workers Act, passed in 2014, that would establish a Certification Board for CHWs in New Mexico. New Mexico received a $400,000 grant from the CDC to address Zika in New Mexico and to invest in detection, treatment and monitoring of the virus to help protect the health of New Mexicans. Still, concerns arose around certain health issues, showing room for improvement. In 2015, the 1945 Trinity Site was re-opened for visitors, and publicity around the area increased. The people who live in the valley near the Trinity Site became angry, as they say that radiation from the detonation persists in the areas and is the cause for many otherwise unexplained instances of illness in communities downwind of the blast site. [3] In fact, during the re-opening of the site in October 2015, protesters gathered outside the entrance to the test site to bring attention to the fact that their concerns over their health have largely one ignored by those who may be responsible.

Additionally, New Mexico’s rankings in national health declined during the early to mid-2000s. New Mexico was ranked 46th in the nation for overall child well-being in 2005, the same year it was ranked the 48th healthiest state in the nation. In 1993, New Mexico had been ranked 22nd, so the drastic change in 18 years indicated a need for improvement. [3]

We look to the future to help solve any public health challenges we see in our state. New Mexico has always had and will likely continue to have a very unique public health climate. Future challenges including emergence/reemergence of communicable and vaccine-preventable diseases, climate change, and public policy will challenge the leaders of the future. With a solid historical foundation of knowledge, hopefully the future leaders in public health will help drive our state forward to become the healthiest state in the nation.



[1] Shi, L., & Johnson, J. A. (2014). Public health administration: Principles for population-based management. Jones & Bartlett Learning.

[2] Samuel, M. C., Doherty, P. M., et. al. (2001). Association between heroin use, needle sharing and tattoos received in prison with hepatitis B and C positivity among street-recruited injecting drug users in New Mexico, USA. Epidemiological Infections, 127, 475-484.

[3] Gonzales, T. (2016). NMPHA 100 years of New Mexico public health history: Decade by decade list of events, achievements, challenges/hardships, legislation and key leaders. 


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