Taos County Health Info - Taos New Mexico Chamber of Commerce by methyae

VIEWS: 75 PAGES: 53

									INTRODUCTION ........................................................................................ 3 THE TAOS C.A.R.E.S. COALITION ........................................................ 4 EXECUTIVE SUMMARY .......................................................................... 6
What is the Taos County Community Health Profile? ............................................... 6 How were the Health Priorities identified? ................................................................. 6 What does the Community see as local strengths? ..................................................... 6 Community Health Priorities ...................................................................................... 7 Environmental Health Assessment ............................................................................. 8 Some Important Facts about significant challenges to well being in Taos County .... 8

PICURIS-PEÑASCO COMMUNITY ASSETS AND HEALTH CHALLENGES SUMMARY ...................................................................... 8 HISTORIC BACKGROUND OF TAOS COUNTY ................................. 9 LAND AND ITS USE IN TAOS COUNTY ............................................. 10 THE PEOPLE ............................................................................................. 10
Population ................................................................................................................. 10 Age and Gender ........................................................................................................ 11 Emerging Concerns regarding Aging Populations in New Mexico.......................... 12 Gender .............................................................................................................. 13

INCOME AND EMPLOYMENT ............................................................. 14
Trends in Employment .............................................................................................. 14 Unemployment Rates in Taos County ...................................................................... 14

HEALTH CONDITIONS........................................................................... 15
Births in Taos County ............................................................................................... 15

ILLNESS IN TAOS COUNTY .................................................................. 19
Based on hospital discharge records for patients in Taos County ’99-2001............. 19 Asthma ...................................................................................................................... 20 Diabetes in Taos County ........................................................................................... 21

INJURY ................................................................................................... 21 DEATH ........................................................................................................ 21 HEALTH SYSTEM CAPACITY ............................................................. 22
Prenatal Care ............................................................................................................. 23

QUALITY OF LIFE AND COMMUNITY STRENGTHS .................... 25
Community Development Successes ........................................................................ 25 Non-Profits ................................................................................................................ 26 Educational Resources .............................................................................................. 27 Family Development Resources ............................................................................... 28

HEALTH RESOURCES FOR PEOPLE OF ALL AGES ..................... 29 RECREATION ........................................................................................... 29
General Access.......................................................................................................... 29 Recreation for Youth................................................................................................. 29

SENIOR LIFE ............................................................................................. 30 INTERRUPTIONS TO COMMUNITY HEALTH ................................ 30 RANKING OF HEALTH INDICATOR PRIORITIES ......................... 31
1

Priority # 1 Alcohol and Other Substance Abuse ..................................................... 31 Priority #2 Violence .................................................................................................. 32 Priority #3 Poverty .................................................................................................... 35 Priority #4 Access to Health Care ............................................................................. 37 Access to Mental Health Care................................................................................... 38 Priority # 5 Obesity ................................................................................................... 39 Priority # 6 Adolescent Pregnancy ........................................................................... 40

Other Interruptions to Health and Wellness ........................................... 41
Diabetes..................................................................................................................... 41 Cost of Living ........................................................................................................... 42 Homelessness ............................................................................................................ 42 Limited access to childcare opportunities ................................................................. 42 Inadequate Pre-Natal Care ........................................................................................ 43 Students leaving school............................................................................................. 43

Environmental Health Assessment & Indicators .................................... 44 Ranking of Environmental Health Priorities ........................................... 45
Priority One: Water Quality ...................................................................................... 45 Priority Two: Water Supply ...................................................................................... 46 Priority Three: Industrial Contamination of Water, Soil and Air. ............................ 47 Priority Four: Quality of Outdoor Air ....................................................................... 48 Priority Five: Quality of Indoor Air .......................................................................... 48

Potential for Successful Community Action ............................................ 49

2

INTRODUCTION
The Taos County Community Health Profile (CHP), produced by the Taos C.A.R.E.S. Coalition, is designed as a snapshot of health in Taos County. Health is defined by the Taos C.A.R.E.S. Coalition as a state of well being. Well being goes beyond the absence of illness. It includes quality of life issues for both the larger community and the individual. In response to this definition, the Taos County Community Health Profile (CHP) recognizes that physical, emotional, economic, environmental and spiritual ingredients contribute to the health of a community. Woven together these ingredients create the fabric of community life. Taos County has long been known and appreciated for the beauty of the land, spiritual strength, independence, art and crafts. But perhaps more than anything Taos County is to be treasured for the inventive and resilient spirit of the people who have lived and worked here. We would like the people of Taos County to be as healthy as this land is beautiful.

3

THE TAOS C.A.R.E.S. COALITION
In 2001 the County Maternal Child Health Council (CMCH) and the Taos Regional Action Coalition began the process of merging to become a Comprehensive Health Coalition, now known as the Taos C.A.R.E.S. Coalition. C.A.R.E.S. is an acronym for Community Action Resource Enhancement Strategies. The mission of Taos C.A.R.E.S. is to unite community efforts and coordinate resources that will enhance the health and well being of area residents by:  Providing an environment that fosters regional involvement and true collaboration  Assessing the health needs of our communities  Engaging in community-based Comprehensive Health Planning  Disseminating information on state and federal funding opportunities and  Advocating for comprehensive community health issues in a way that benefits the entire Taos region. In pursuit of its goals, the Taos C.A.R.E.S. Coalition is committed to developing a broadly based membership representing the diverse ethnic groups, geographical areas, interest sectors, political entities and leadership of Taos County. Each year the Taos County Commissioners approve the roster of the Taos CARES Coalition. The 2004 membership includes: Emmanuel Pacheco, Official Liaison with Taos County Commissioners, Taos County Administration, Holy Cross Hospital, National College of Midwifery and Women’s Birth Center, Rocky Mountain Youth Corp, Youthbuild, Dept. of Health, Long Term Services Division, Community Against Violence, Taos Pueblo HeadStart, U.N.M. Family Resource Center, Family Justice Center, Families First, Taos Public Health Office, Evolving Creative Opportunities Mentorship Program, Community Wellness Center, Maternal Child Health Council, UNM/Health and Human Services, Claudia Bianca, Master Rapid Eye Therapist, Taos Community Health Plan, Physician Hospital Organization, Taos Colfax Community Services, Inc., Taos Municipal Schools, Jane Corinne, Public Health Consultant, Northern New Mexico Boys and Girls Club, Taos Living Center, Talpa Community Center and Jean Kenin, Education consultant. Taos County has an abundance of assets and resources in terms of local initiatives, agencies and non-profit organizations that have rallied to meet the needs of County residents. In addition to identifying health and wellness challenges, the Health Profile

4

illustrates the resources in Taos County and the diverse approaches that County residents use to support the community’s well being, thus providing insight into the areas that call for ongoing or renewed community attention. The Taos Comprehensive Health Coalition (TCHC) has compiled and published the information contained in this Health Profile with the support and encouragement of the New Mexico Department of Health, Public Health Division, Improving Health Initiative and the time, effort and participation of many community members and organizations. Data for this Health Profile was collected from New Mexico Kids Count Data Book 2003, Taos County 2003 County Health Profile, Office of NM Vital Records and Health Statistics, NM Selected Health Statistics, Annual Report 2000, MCH Plan Update 2002, US Census, Quick Facts, 2003, local agency records, and the Taos Chamber of Commerce. It is suggested that you read the Taos County Maternal Child Health Plan Update, 2002, the Picuris-Penasco Health Profile, the Taos County Health Pages and the Picuris-Penasco Community Health Pages for a more in-depth look at health and wellness resources and challenges in Taos County. A copy of each of these documents is available at the Community Wellness Center library at 203 Kit Carson Road, Taos. The Health Profile is also available at www.laplaza.org and as a link at www.taoscommunityfoundation.org and www.taoschamber.com. If you have difficulty accessing these documents please call 505-758-9343.

5

EXECUTIVE SUMMARY What is the Taos County Community Health Profile?
The Taos County Community Health Profile (CHP) provides current and historic information and statistics about Taos County and insights into the health and well being of Taos County residents. It includes trend charts, interpretation of available data and an analysis of community, family, individual and school risk and protective factors for the identified community health priorities. The Profile goes into the greatest detail discussing the Community Identified Health Priorities. The Community Health Profile (CHP) assesses community strengthens and resources and points to the community’s most pressing needs. It offers insights into the interruptions to community wellness that have been shaped by many conditions, including historic and economic influences. The CHP is intended as a base line for tracking specific health indicators, a foundation for prioritization and planning and a means to evaluate community strategies and activities.

How were the Health Priorities identified?
The Taos C.A.R.E.S. Coalition (the Coalition) used a variety of methods to create this Community Health Profile and arrive at the 2004 Community Health Priorities. An Assessment Process was the first step. Community needs, as defined by residents and physicians, were gathered in 2002 by the Maternal Child Health Council, through focus groups, extensive interviews and surveys. In 2003 a review of existing statistics that are relevant or specific to Taos County were obtained from a number of local, State and Federal data banks. At the same time, a map of local Assets and Resources was created by survey of local agencies, non-profits and the business community. In spring 2003, Taos C.A.R.E.S. facilitated a series of meetings which used the existing information about Taos County to inform a community process to identify local health priorities. Meetings were held in Penasco, Picuris Pueblo and Taos -- at Health Council meetings, Taos C.A.R.E.S. Coalition meetings, School Health Advisory Committee Meetings and a meeting with the Taos Early Education Community Network (TEECN). A series of interviews and surveys, facilitated by the Physicians Hospital Organization at Holy Cross Hospital in Spring 2003, involved 70% of Taos County physicians. They identified health concerns based on their professional experience with community health in Taos County.

What does the Community see as local strengths?
In a 2002 process, initiated by the Taos Maternal and Child Health Council, (MCH) and during other forums and discussions, Taos County residents have consistently identified a wide range of community strengths.

6

These strengths include the continued existence of old cultures and traditions, a history of relationship with the land, the presence of extended families, the presence of 2,500 locally owned businesses, a local non-profit hospital, local physicians, large areas of open and agricultural land, the mountains, rivers and other natural resources, 2 local newspapers, 1 local cable TV station and 2 local radio stations, public and private schools and a local college, a diverse number of spiritual congregations, the presence of over 240 non-profits and a long history of personal and public creative expression.

Community Health Priorities
Participants in the 2003 Health Priority process identified the following health priorities in which Taos County rates higher or lower compared to state or national data. Each of these priorities will be discussed in more detail in the Interruptions to Health and Wellness Section of the Health Profile.  Alcohol and substance abuse  Violence in families and youth  Poverty  Access to health care  Obesity as a factor in chronic disease  Teen pregnancy Measurements within each of these priorities will be tracked over time to determine trends, to evaluate health interventions or policy decisions, to compare community data with peer, state, national or benchmark measures, and to establish new priorities through an ongoing community process. The physician survey identified these as their top concerns:  Teen pregnancy  Diabetes  Obesity  Chronic disease  Violence  Depression  Heart disease and  Lack of early diagnosis and treatment Physicians also regarded low income, poverty, barriers to accessing financial aid for medical care, no health insurance, inadequate prescription coverage and limited transportation as the greatest interruptions to health. Both physicians and area residents identified the need for a more streamlined, well-advertised system of services to support and guide those who need to access low cost or subsidized health care services or access existing programs such as Medicare and Medicaid.

Other important concerns
Other community wide concerns regarding community well-being include: Availability of affordable childcare, affordable dental care, emergency ambulance services, homelessness and 7

school drop out rates. The pressures of rapid population growth and environmental degradation have also been identified as influences that exert a negative impact on well being of residents of all ages.

Environmental Health Assessment
In spring 2004 Taos C.A.R.E.S. Coalition hosted the first community meetings regarding Environmental Health as it affects human health. The Environmental Health Indicator Priorities determined by participants in that process are:  Water Quality  Water Supply  Industrial Pollution of Air, Water & Soil  Outdoor Air Quality  Indoor Air Quality These issues are discussed in more detail under the section titled, Environmental Health Assessment.

Some Important Facts about significant challenges to well being in Taos County
Data collected from 1999-2001 shows Taos County ranking:  7th in New Mexico for indirect alcohol, direct alcohol and drug related deaths  6th in alcohol related crashes and 9th in alcohol involved crash fatalities  5th in homicide rates  3rd in unemployment rates  18th in percentage of Medicaid funded births (56.9%) Additionally:  Unemployment rates in Taos County are historically almost double State rates.  Personal per capital earnings are just above $18, 000 per yr.
(N.M. Office of Epidemiology, Social Indicators report, 2003)

PICURIS-PEÑASCO COMMUNITY ASSETS AND HEALTH CHALLENGES SUMMARY
Please refer to the Picuris Penasco Health Profile for a full discussion of this region of Taos County.

The impact of alcohol and drug abuse on area residents is the top concern of the Picuris-Peñasco community and probably the one issue that the majority of community members are willing to work towards resolving. It is acknowledged that alcohol and drug abuse is not a separate issue but is either caused by and/or contributes to a number of other serious behavioral and health concerns: isolation and disconnection; lack of responsible behavior towards family and community; violence in all forms (domestic, sexual, homicide and suicide) mental illness;

8

poverty; chronic illness; poor nutrition; child abuse and neglect; school drop out rates; and teen pregnancy. Several of these health concerns can be viewed as root causes of serious challenges. For instance, physical or mental illness or substance abuse can result in unemployment, and poverty can result in limited access to healthcare services. Access to affordable health care services, from primary to emergency, including mental health care services, vision and dental care, prescription medicines, and affordable childcare services is also critical concerns for many area residents. A new community burden has recently risen in the form of environmental concerns. Increased awareness of possible negative impact of Los Alamos National Labs on air, soil, and water quality, in addition to other water issues, i.e., wastewater and sufficient water supply, is beginning to spread and is becoming one of the major issues for the Picuris-Peñasco community. Residents of the Peñasco Valley want their community to be a healthy place to live and they want to be able to identify and respond to their long-term needs.

HISTORIC BACKGROUND OF TAOS COUNTY
Taos County has a history of geographic isolation. The conditions created by this isolation have inspired the development of a multi-textured, resilient and creative community, as well as bringing specific challenges to bear upon area residents. The layered influences of decades of colonialization and integration have also presented particular challenges to the residents of Taos County. Taos County is, and has been, the historical home of the Pueblo people. For centuries it has also been home to Spanish settlers and Anglo settlers. And has been influenced by the many other people who labored and lived here; Asian laborers helped build some of the oldest roads near the area’s hot springs and Crypto-Jews, seeking refuge from the Spanish inquisition also made their homes here. In addition to the United States government and state and local governments, Taos County is home to two other sovereign governments, Taos Pueblo and Picuris Pueblo. The Taos Pueblo tribe retains tribal ownership of 4.3% of the land in the county. In the early 1970’s Taos Pueblo was successful in their legal activities to have Blue Lake and some surrounding land returned to the tribe under President Nixon. According to the Picuris- Penasco Health Profile, the Picuris tribe has occupied their present location since AD 750, when their ancestors abandoned their previous larger village, an area outside of Taos, New Mexico currently known as Pot Creek. In 1689 Spain extended a land grant to the Picuris tribe, which was reconfirmed in 1821 under Mexican law. After the MexicanAmerican War, the U.S. Congress, following the 1848 Treaty of Guadalupe Hidalgo, once again reconfirmed the Picuris Land Grant. The Picuris Pueblo is the smallest and most physically isolated of New Mexico’s 19 Pueblo tribes. For a more in-depth look at the Picuris-Penasco community please consult their 2001 Community Health Profile. New Mexico remained a territory of the U.S. until statehood was granted in 1912. The Pueblo tribes were granted the right to vote in 1948.

9

LAND AND ITS USE IN TAOS COUNTY
Taos County includes 1, 444, 480 acres of land. 50% is federally controlled, 6.7% is state owned, 4.3% is Native American land and 38.2% is privately owned. The Taos Land Trust protects 2,400 acres in 20 conservation easements. The Town of Taos (pop. 5,000) is the largest incorporated town in Taos County, which also includes the incorporated towns of Red River, Taos Ski Valley and Questa. Unincorporated areas include Amalia, Costilla, Ojo Caliente, Pilar, Penasco, Ranchos de Taos, Talpa, Tres Piedras, and Valdez. (Taos County Chamber of Commerce, 2002) Livestock sales account for 65% of agricultural market value and crop sales account for 35%. (USDA and NM Dept. of Agriculture) The U.S. Congress, between 1858 and 1931, reconfirmed approximately 25% of the total land grants previously held in New Mexico. Most of the land became National Forest or otherwise federally owned. Traditional use and access to federally owned lands by Acequia organizations, grazing cooperatives and others are still contested.

THE PEOPLE Population
According to the US Census Taos County Population 1970-2000 Bureau, the estimated 2002 population for Taos County is 30,000 30,758 people. The County has 25,000 seen a large increase in population over the last three decades. This 20,000 was particularly notable between 15,000 1990 and 2000. Expected and 10,000 particularly unexpected population increases have significant impact 5,000 on the availability of non-renewal 0 1970 1980 1990 2000 resources such as water, open space, and agricultural land. Air quality can be affected by woodburning stoves and increased traffic. Population increased create increased demands for housing and employment, facilities such as schools and hospital beds, and infrastructures such as improved and extended roads, sewage treatment facilities and landfills. Rental costs, home costs and property taxes also increase due to housing shortages. The 1970 census for Taos County was 17,516. A decade later, the 1980 census saw an increase of almost 2,000 persons, for a total of 19,456 persons. In 1990 the census recorded 23,118 persons and in 2000 the total was 29,979. This represents an increase of 6,800 persons, an almost 25% rise in population in 10 yrs. This number exceeded the population expected for the year 2010. 10
number of residents

Age and Gender
Age The 2002 estimated population for Taos County is 30,785 persons of all ages. 26% of the population is under 20 yrs. old. 61.1 % of Taos County residents are between the ages of 20 and 64.The remainder are over 64+. (N.M. Vital Statistics Report, 2003)

The numbers of people in particular age groups impacts the planning that needs to be done in ensure appropriate health care, community services and opportunities. Age appropriate health care, planning for building and maintaining schools, numbers of teachers needed, day care in a community, recreational opportunities, youth employment, transportation, elder care and affordable after school services are examples of age oriented services.

11

Taos County Population
under 20 years old 2500 2000 1500 1000 500 0

Number of

under 5

5-9 Ages 2000

10-14

15-19

2001

2002

Emerging Concerns regarding Aging Populations in New Mexico A review of state projections for the 60 and older and the 75 and older populations indicate that the projected growth in New Mexico is greater than the national average. Consider that from 1990 to 2025, the population of New Mexicans over 65 years old will increase by more than 170 percent. As the aging population increases, so will the demand for services. The State's 60 and older population, which includes 26.9% Hispanic origin, 4.6% Native American, 1.34% Black and less than one percent Asian, represents a significant proportion of ethnic and culturally minority elders. The combined percentage of approximately 31% represents a high proportion of the 60 and older population. In 1979, 21% of the 65 and older population was at or below the census-defined poverty level, compared to 14% nationally As the population ages, per capita hospital and nursing home care will continue to rise. Per capita health care spending is 3.5 times greater for the elderly than for those under 65. The debilitating effects of unhealthy behavior at earlier ages can often be reduced or reversed by health promotion/disease prevention activities later in life.


A report on the Personnel for Health Needs of the Elderly Through Year 2020 prepared by the US Department of Health and Human Services indicates that the number of older persons entering nursing homes in New Mexico will increase by 52% between 1990 and the year 2000, compared to a projected national growth of 27%. The New Mexico rate represents the fifth fastest rate of growth in the nation. Only Nevada (126%), Arizona (82%), Alaska (78%), and Florida (59%) have faster growth rates. This means that increasing numbers of elderly require health and personal care not readily available at the local level and may need to enter nursing homes to receive it.

12

Gender

T o C u t E tmt dP p l to 2 0 a s o ny si ae o uai n 0 2
b a ea dg n e y g n edr 30 00 20 50 20 00 10 50 10 00 50 0 0 01 m 19 1 - 9 2 - 9 3 - 9 4 - 9 5 - 9 6 - 9 7 - 9 8 - 4 8 + -2 o 01 02 03 04 05 06 07 08 5 a e inin r mn o n ey as gs ce e ts f in e r mle a f mle e a

The majority of births in 2002 were male. The number of males and females between 10-19 yrs. old is almost equal. Between ages 40-49 there were more females among the population. This remains true throughout later years. Disparities in gender influence health and other service needs such as prenatal and birth care, injury rates and various forms of cancer as well as prevalence of illness related to smoking. Activities presenting health issues may also vary by gender. Race and Ethnicity In 2000, 58% of 2002 County residents reported themselves Race and Ethnicity or Latino origin, Taos Estimated Taos County Population by as having Hispanic 63.8 % reported themselves as White, and 6.6% as Native American.
17,679 Hispanic or Latino ethnicity. 28,049 White (includes Hispanic) 171 African American 2001 census listed 17,370 people of Hispanic heritage, 10,122 as Anglo 1,975 as Native 2,089 105 as Black or African American, 149 as Asian, 35 as Islander and 7,447 listed American,American Indian/ Alaska native 217 Asian Pacific Islander themselves as other. 1,185 were multi-racial by self-report. 250 2 or more races (US Census Bureau, Taos County New Mexico, Quick Facts, 2002) Total estimated 2002 Population 30,785

numberof pers

13

INCOME AND EMPLOYMENT

Trends in Employment
Agriculture has been declining in Taos County as a source of employment and income in the past decades. However, new organic farms and community gardens are employing some people in Taos County. There remain some ranches with cattle and sheep and areas of land are devoted to raising hay. Between 1990-1999, employment in non-farming establishments grew 29.4%. This indicates a substantial change in land use as well as in employment. In 2004, Taos County has 2,500 small businesses. If the percentages from 1999 remain constant, we can expect that 31.5% of these are owned by women and that 30.1% of all businesses were minority-owned. (Dept. of Labor, Annual Report, 2002)

Unemployment Rates in Taos County
While unemployment rates in Taos County have declined since their peak in 1996, rates are still much higher than state and national rates and continue to be a significant challenge to economic well being. Unemployment rates do not include people who have received their maximum unemployment benefits (a specific number of weeks) or those persons whose sporadic or short term employment makes them ineligible for benefits. These people, however, may still be unemployed.  In 2002, 1,331 people were unemployed representing a 9.1% rate of unemployment in Taos County compared to 5.4 % in the state and 5.8% nationally.

14

HEALTH CONDITIONS Births in Taos County
Births by year Taos County 1990 1991 Total live births 376 387 1992 1993 371 349 1994 1995 366 322 1996 1997 1998 1999 2000 2001 2002 358 352 352 364 350 392 350

Birthing Options

15

Births by Age of Mother This chart is a population chart, with the actual number of births from 1992-2002, grouped according to the age of the mothers.

The chart below illustrates the percentage of the total births in a year, organized by age of the mother.

Births to single mothers The percentage of births to single mothers for year 2000 represented over 54% of all live births that year. Children living in families headed by females are more likely to grow up in poverty. In year 2000, almost 55% of all births in Taos County were to single mothers. This information can be used to plan services for single mothers such as affordable quality day care, health care and support services.

16

T s C u ty b s ao o n irth
40 0 30 5 30 0 20 5 20 0 10 5 10 0 5 0 0

19 90 b s irth

19 91

19 95

19 96

19 99

20 00

sin le m m g o s

1 -1 yr.o m th rs 5 9 ld o e

Births to teen mothers This chart records the actual number of births to mothers under 20 years old from 1992 to 2002. Because of the small population in Taos our numbers are low.

Teenage pregnancies have a higher risk of resulting in low birth weight babies who will experience increased risk for health and other problems. Additionally, teen mothers and their families are more likely to experience poverty and related challenges. Low Birth Weight

Pr e toL w i t Wg t ec n f o B h e h r i
To Cut ad . . 90 00 as on n N 19- 0 y M 2 1 5 1 0

Percent

5 0 19 19 19 19 19 19 19 19 19 19 20 90 91 92 93 94 95 96 97 98 99 00 To as Nw e i o e Mxc

17

Low birth weight is a factor in infant mortality, disabilities, chronic respiratory problems, and learning disabilities. (N.M. Kids count data, 2002).

In 2002, 11.4% of births were to low weight babies. 1.6% of the babies born were classified as very low birth weight babies. The fluctuations noted on the graph are within the normal range for a small population county like Taos County. The trend, however, is fairly consistent, with about 10% of births being to low weight babies in Taos County. This is higher than the overall percentage of low weight babies statewide.

Low birth weight (LBW) is defined as an infant weight of less than 2,500 grams (5 1/2 lbs) at the time of delivery. Birth weight is one of the most important factors in determining the survival and health of an infant. Low birth weight is a public health problem since infants born LBW have increased infant mortality, morbidity, incidence of learning disabilities, and medical costs. Nationally, the risk factors for LBW include maternal age of less than seventeen and greater than 34 years, Black race/ethnicity, low socioeconomic status, single marital status, lower levels of maternal education, smoking, inadequate weight gain, low pre-pregnancy weight, and a variety of medical risk factors (Source: Data to Action). Smoking, which retards fetal growth, is the single largest modifiable risk factor for LBW and infant mortality. It is estimated to account for 20 to 30% of all LBW births.

18

ILLNESS IN TAOS COUNTY
This information only reflects those patients whose illness led to a hospital stay. Future updates of the health profile will include physician analysis of these data and a discussion of the frequency of these illnesses among patients who are not admitted to the hospital. The information below is the actual number of patients. A comparison of the rates for each illness category in Taos County, compared to the statewide rates would give a more accurate picture of the frequency of illnesses in these categories in Taos County.

Based on hospital discharge records for patients in Taos County ’99-2001

19

The following categories represent the top seven most frequent reasons for hospitalization in the State of New Mexico. It displays a comparison of Taos County rates to state wide numbers. This does not include Taos residents hospitalized in federal hospitals or out-of-state.
(Source: New Mexico Health Policy Commission, 2004

R teo M d dM jo D g o is a f o ifie a r ia n s
H s ita a n 1 9 p r 1 0 p p o p liz tio s 9 4 e 0 0 o .
1 1 .3 1 2 1 .8 1 1 0 8 1 2 1 .2 0 8 .8 1 .4 1 9 .3 7 .7 5 .6 3 .2 4 .1 4 .9 .1 5 5

Rates

6 4 2 0 C u to irc la ry in ry ju re p to s ira ry d e tiv ig s e

mn l d e ms u s e n o la m e ta is a u c lo k l e p s s

T ta h s ita a ning p 1 1 o l o p liz tio ra h ,4 8
TO A S N w Mx o e e ic

Chronic Disease Asthma

20

Diabetes in Taos County
  Population of adults in 2002 is estimated at 23,651. 2,246 or 9.5% of adults have diabetes.

INJURY
There were 585 hospitalizations for injury between 1999-2001. These include cut/piercing, falls, burns, and poisoning. Other includes injury from machinery, injuries to cyclists, pedestrians, natural /environmental injuries, struck by/against, suffocation, other specified and unspecified categories.

DEATH

Deaths involving injury in Taos County, 1999-2001.

Taos County residents experience death from accidents, diabetes mellitus, and cirrhosis of the liver at higher rates than the rest of New Mexico and more than twice the national rates. Taos County also has a slightly higher rate of hardening of the arteries, but enjoys a lower rate of deaths caused by heart disease, influenza and pneumonia than both the State of New Mexico and the U.S. The Taos County rate of death by alcoholism matches that of the State of New Mexico (.07%), both of which are higher than the national rate of .02%
(MCH Plan Update, 2002)

Motor vehicle deaths are discussed more fully in the Interruptions to Health & Wellness section of the Taos County Community Health Profile.

21

Once again, low numbers are a consequence of small population. Comparison by rates will be added to the Health Profile in coming updates.

It is important to note that there are many behavioral risk factors as well as resiliency and positive Health behaviors that influence Taos County rates of illness, injury and death. Risk and protective factors, local assets and resources, as well as challenges affected resident health are discussed under Quality of Life and Community Strengths.

HEALTH SYSTEM CAPACITY

22

In future Health Profiles, and as time and resources allow, this section will be developed to assess the continuum of care available to specific sectors of the community’s population related to 1) access 2) utilization and 3) funding to meet these basic needs. Populations groups will include pre-natal, child, adolescent, adult women and adult men and seniors. In each of these groups the following information will be gathered:  Early Identification of Risks., needs for services and timely referral  Health Promotion includes education, primary care well checks, anticipatory guidance, and social supports.  Access to Care including funds for medical and related services along with identifying barriers for hard to reach populations.  Intervention including primary care, specialty care, diagnostics and treatment modalities along with care coordination and social services. This can be detailed out in the resource directory but summarized here.  Follow-up including long-term care. Information about access, utilization and funding points out important gaps in services, identifies the need for improvement and points to areas where collaboration, coordination and funding are most urgently needed.

Prenatal Care
Early Identification of risks for mothers and babies includes assessing health and related risk screenings such as physical activity levels and nutrition. Prenatal care during the first trimester is an important part of early identification of health problems for mothers and their unborn infants.

23

The number of total births in Taos County with prenatal care during the first trimester is a bit below the rate in the State of New Mexico and lower than in the previous three years.

24

QUALITY OF LIFE AND COMMUNITY STRENGTHS Community Development Successes
This profile would not be complete if it did not highlight some of the successful community developments of previous years. Vision 20/20 hosted a series of community discussions, during which Taos County residents identified a pressing need for a new hospital, a new library and a Youth/Family Center. Hospital Services Holy Cross Hospital has relocated to the south end of the Town of Taos. The hospital, with its new addition, will be 89,500 square feet. It is a full service acute care hospital, with 49 adult

25

acute care beds. Holy Cross Hospital has 12 Emergency room beds, 6 bed ICU, 4 bed Labor and Delivery Suite and in August 2004, will have a new 4 bed Progressive care unit. Holy Cross has full time MRI services, full state of the art outpatient surgical center. (Computerized Axial Tomography) that has analysis, which replaces the need, in many cancer - without incisions or recovery time. time nuclear medicine services, and offers a new There is a new 6-slice digital C.A.T. scanner multiple capabilities such as non-invasive cancer cases, for a surgical biopsy for suspected breast

The active medical staff now at Holy Cross is accessible by website and includes 44 physicians, and in addition to our specialties in the past (from last time) Holy Cross has added non-invasive cardiology, full time urology, gynecology, surgery, anesthesiology, orthopedic surgery (with subspecialties in knee, foot and ankle, and shoulder), and pathology and diagnostic radiology. The Community Wellness trailer is Medicare certified in Diabetes treatment and counseling, and Holy Cross now has over 360 nurses, technicians, and support staff on its health care team to support the independent medical staff. Public Library The Taos Public Library, formerly owned by UNM, was adopted by the Town of Taos, resulting in a new building with over 50,000 volumes and five computers for public use. Youth and Family Center In 1999 the Youth and Family Center opened in the Town of Taos, housing an ice arena, skateboard park, billiard tables, computers for resident use and an arcade and concessions. Funds are being raised to build a swimming pool at the Youth and Family Center, to serve a gap in recreational needs of youth. A Teen Center is also being developed with the Town of Taos, to meet a Community identified gap in opportunities for recreation and healthy and safe gathering places for youth.

Non-Profits
Over 240 non-profit organizations operate in Taos County filling essential roles in supporting the health and well being of Taos County residents. The Taos Community Foundation, in partnership with the Taos C.A.R.E.S. Coalition, has created a report on the status of Taos County non-profits. This report can be viewed at their website address here. Efforts towards collaboration continue to be developed among non-profits addressing related or similar needs. A myriad of services are offered by non-profits in Taos County including agricultural projects and programs, including Tierra Lucero and Cerro Farms, educational projects, professional development services, environmental protection organizations such as Amigos Bravos, mentorship programs such as Society of the Muse of the Southwest (SOMOS) and Evolving Creative Opportunities (ECO), youth development and leadership programs such as Rocky Mountain Youth Corp, Youthbuild, and the newly formed Da Vinci Project, non-profits focusing on alternative health, business development and networking non-profits such as the Chambers of Commerce, Taos Economic Development Corporation and the Taos Business Alliance and

26

philanthropic non-profits aimed at community improvement such as the Taos Community Foundation.
Please see the Mosaic of Taos County Health Related Providers and the Health Pages for a listing of non-profit and other organization and agencies in Taos County.

Educational Resources
“Education is an equalizer in society, promoting health and well being.” According to federal studies, education levels are a predictor of income levels in later years and are one perpetuator of poverty. Pre- school Education Headstart is available in Ranchos de Taos, Questa, and Talpa. There are spaces for a little over 200 children, aged 3 and 4 year olds. There are also programs and agencies serving special needs and developmental delays among preschool children. This includes Los Angelitos and La Puerta Preschool. La Puerta also offers half-day preschool to children without developmental delays Grade school and High School Education 3,490 students enrolled in the Taos County school system in 2000-2002, grades K-8, and 1,720 were enrolled in grades 9-12 the same years. Charter and private schools are also found throughout the County as well as home-schooling options. In 1999-2000 there were 290, or roughly 8%, of students (all grades) reporting to the New Mexico Department of Education as home -schooled. 13%, or 459 students, were reported as enrolled in private schools between 2000 and 2002.  In 2002, 79.1% of residents in Taos County, over 25 years old, have high school diplomas. This figure is above the state average of 78.9% . 90% of Taos seniors, 87% of Questa seniors and 94% of Penasco seniors graduated high school in 2001. Among all Taos County residents, age 18-24, 43.6% had high school diplomas or GED in 2000 and 6.7% of that age group had an A.A. or B.A. (US Census, Taos Quick Facts, 2002)  92% of graduating seniors in Taos County, 91% in Questa and 81% of graduating seniors in Penasco, applied to college in 2001. (KIDS Count Report, 2002) Higher Education The Taos Campus of the University of New Mexico serves Taos County & Northern New Mexico. UNM Town of Taos offers AA degrees and Certificate programs. A Bachelor of University Studies Program is offered by Taos Extended Branch of UNM. Other higher education opportunities in Taos County include the National College of Midwifery, the Taos Institute of the Arts, and the Taos School of Massage. In 2002 25.9% of Taos County residents over 25 have a Bachelor’s degree or higher. This is higher than the state percentage of 23.5%. (US Census, Taos Quick Facts, 2002) From 1997 to 2002 UNM-Taos, 126 students received their Associate Arts Degree and 86 students received 27

Certificates. Others complete the general education requirements and transfer to Main Campus or other four- year institutions.  Enrollments from 1998 to 2002 have increased from approximately 1000 to 1600 students per semester UNM Extended recently gained branch status and is a strong leader in prioritizing and supporting educational development, career training, and empowerment of female students. 50% of the UNM student population is Hispanic. 70% of the UNM student population is low-income women with an average age of thirty. (U.N.M. Report, 2003)

Family Development Resources
Birth Babies in Taos County can be born at home, at birthing centers or in the hospital, with midwives, certified nurses, and/or physicians available for professional assistance. In Taos County more babies are born with midwife assistance than in the rest of the state. Child care There are currently nine licensed Care Centers and Preschools, 5 licensed Family Child Care Group Homes, and 9 registered (non-relative) Family Child-Care Homes in Taos County and at least 160 relatives giving childcare. In June 2002 there were 438 licensed childcare slots. 43.4% (212) are Head Start. Nutritional and financial support programs In Fiscal year 2001, WIC provided aid to 865 mothers and Food Supplement (CSFP) was provided to 20 persons. 1,411 persons were believed to be eligible for WIC at that time. TANF, Medicare, Medicaid offer supplemental services to large proportion of Taos County residents.

Parenting Classes and support Noah's Ark and Los Angelitos offer Love and Logic classes for the families they serve. Community Against Violence offers a mother’s group. Community Wellness Center offers groups and programs for teen mothers. The Men’s Resource Center offers groups for young fathers. Housing In 2000  17, 404 housing units were available in Taos County  9.7% of available housing was in multi-unit structures  The homeownership rate for the County, in 2002, was 75.5%. The median value of owner-occupied housing units was $150,400. This is well above the state average of $108,100.  At the same time, the median household money income in Taos County in 1999 was $26, 762, compared to $34,133 for the state and  in the same year, 20.9 % of residents lived below poverty level, compared to the state level of 18%.(US Census, Taos County Quick Facts, 2000)

28

HEALTH RESOURCES FOR PEOPLE OF ALL AGES
Holy Cross Hospital serves the County. There are clinics in Ranchos de Taos, Questa & Penasco. There are approximately 60 doctors working in affiliation with Holy Cross Hospital. Taos County also has many local curanderas (healers) and both holistic and alternative health practitioners. However, Taos County continues to be a designated Health Professional Shortage Area (HPSA) in terms of primary care and dental care, particularly in the areas of Arroyo Hondo, Questa, and Tres Piedras. (MCH Plan Update, 2002)

RECREATION General Access
Most of the larger community sponsored recreation centers are found in the Town of Taos. This includes auditoriums, museums, movie theatres, the Taos Public Library, Taos Youth and Family Centers, Taos Civic Center, Don Fernando Pool and the Guadalupe Sports and Recreation Center. Smaller community recreation centers exist in Questa and Red River as well as some opportunities in the outlaying areas. Seasonal activities are plentiful when conditions permit the use of forests and rivers. Taos, Sipapu, Red River, Amalia host private ski resorts offering opportunities for winter sports. There are also many groomed and un-groomed cross-country skiing opportunities. The Wild and Scenic area, as well as National Forest and BLM land holdings offer hiking and camping. Rafting, kayaking, canoeing and fishing are also available contributing to the attraction of Taos County as a leading tourism destination.

Recreation for Youth
Many of the avenues for youth recreation and involvement are concentrated in the Town of Taos. There are school, volunteer, non-profit and Town sponsored recreational opportunities, as well as a Youth and Family Center, ice skating rink, tennis and basketball courts, soccer fields and baseball diamonds. The villages of Red River and Questa also offer some centralized locations for youth recreation and various other recreational opportunities. Outlying areas, challenged by limited revenue to support such activities, tend to rely on models that do not rely on large facilities, such as clubs, school organized events, volunteer organizations, 4 H Club, schools and church activities.

Community Involvement & Creative Opportunities for Youth
Art and drama opportunities and support programs offering education and recreation for young people are available countywide. These include girltime, Big Brother, Big Sister, Girl Scouts, Boy Scouts, Boys and Girls Clubs and 4-H clubs. Some business alliances offer mentorship programs and apprenticeships with local artists, writers and craftspeople. Among these is S. O. M. O. S., offering mentorship in writing and poetry, the Taos Poetry Circus and the Glass Blowing Project. 29

ECO Art Center offers a variety of creative opportunities to young people between 12-25 yrs. old. Youthbuild works with young people from 18-24 yrs. old, offering leadership training and skills in construction and Rocky Mountain Youth Corps (RMYC) offers vocational training, education and stipends to youth people between 18 & 25 years old. Children’s theatre and other recreational and creative summer programs are available through independent programs and non-profit organizations.

SENIOR LIFE
Los Ancianos Senior Citizens Center in the Town of Taos offers meals five days a week, a Meals on Wheels program, a walking program, health lectures, a Foster Grandparents program and a Senior Companions program. Taos Living Center, located in the Town of Taos, is a 100-bed facility that also offers outpatient rehabilitation services. Plaza de Retiro is a lifetime care facility and retirement home. Similar services are offered in Red River and Questa. Taos Pueblo also has a Senior Citizen and Foster Grandparents Program. Chesed, a Stone Soup Collaborative hosted by the Taos Jewish Center in partnership with several County organizations, offers seniors a selection of free or low cost enrichment opportunities such as writing groups, yoga, walking and exercise groups.

INTERRUPTIONS TO COMMUNITY HEALTH
All communities face interruptions to the health and wellness of its residents. Taos County, despite its many resources and comparatively healthy environmental factors, shares health challenges similar to other communities as well as some interruptions to health that are in higher proportion to communities in other parts of New Mexico or in the nation. For the purpose of this Community Health Profile illness and lack of well being are viewed as the results of interruptions to this community’s natural tendency to good health. Because they are interruptions there is always the possibility of addressing them and restoring the community to health. The challenges/interruptions to health and well being that were identified as priorities in the 2003 Health Prioritization process are listed first in this section of the Taos County Community Health Profile. Please see the Health Resource Pages and the Taos County Community Mosaic that accompany this Profile for agencies & programs that are working to address interruptions to community health and wellness. Trend charts are included for prioritized concerns when available. Other challenges identified by the community are also included in this section and will be tracked and monitored as resources allow, during future updates of the Taos County Community Health Profile.

30

RANKING OF HEALTH INDICATOR PRIORITIES Priority # 1 Alcohol and Other Substance Abuse
Public health experts agree that alcohol — in the form of underage and excessive drinking is the Nation's number one drug problem. General Youth Indicators Youth indicators are gathered from Youth Risk and Resiliency surveys conducted with students in Taos County Schools. New Mexico was very similar to the rest of the nation in the drinking alcohol patterns reported by students answering questioning about their past 30-day alcohol use, past 30-day binge drinking, and past 30-day drinking and driving. 28.6% of students in New Mexico reported binge drinking within the previous 30 days. In New Mexico and nationally, 13.3% reported drinking and driving within the previous 30 days. Mora, Taos, Rio Arriba, and Guadalupe counties had the highest rates of past 30-day alcohol use and binge drinking. Luna, Chaves, Mora, and Taos were the counties with the highest rates of youth drinking and driving. Past 30-day marijuana use was more common among New Mexico youth than national youth. Taos, Santa Fe, and Rio Arriba counties had the highest rates in the state for marijuana use. The US and New Mexico rates for past 30-day cocaine use were similar (4.2% and 4.4% respectively). The highest New Mexico rates were found in Taos, Luna, and Doña Ana counties. Inhalant use was less commonly reported in New Mexico (2.9%) than in the rest of the nation. (4.7%). Alcoholism, DWI and Impacts on Community life Alcohol abuse takes many tolls on the community. In addition to death and injury, alcohol abuse plays a role in missed days at work, family violence, crime and illness. In 1999:  There were 640 vehicle crashes. 246 persons were injured and 4 died.  All the deaths, and 15% of the injuries, resulted from alcohol related crashes.  Of 33 Counties in New Mexico, Taos County ranked 24th in rates of DWI arrests (10th th from the bottom) was the 7 highest county in alcohol related car crashes.  Taos ranked 11th in fatalities where alcohol and/or drugs were involved. (MCH Plan Update,
2002)

Based on data collected 1999-2001, of 33 Counties in New Mexico, Taos County ranked 6th in the state for alcohol related crashes and 9th in the state for alcohol involved crash fatalities. According to the NM Department of Heath Social Indicators Report, 2003, more than 63.3% of deaths in Taos County are due to alcohol, based on a population of 100,000. Almost 20% are directly related, the rest are indirectly related. 44.4% of auto fatalities and a5.4% of auto injuries in Taos County during 2002 involved alcohol use. (NM Dept. of Transportation, Traffic Safety Bureau) 2002 conviction rates for D.W.I. in Taos County are 7.9% compared to 10.1% statewide.

31

Under-age Alcohol Use Nationwide, research reveals that 78 %of high school students have tried alcohol. More than 30% reported binge drinking at least once a month and the average age of initiation into alcohol use is 14 years old. In The Taos County Youth Risk and Resiliency Study, 2002, administered to high school students, 490 students (30%) reported their first drink of alcohol, beyond a few sips, at 11 years old or younger and 56% of these high school students said it would be “very easy” to get beer, wine and hard liquor if they wanted it. Research indicates that adolescents who begin drinking before age 15 are four times more likely to become alcohol dependent than those who do not drink before age 21. In addition to being linked to teen suicide, teen vehicles fatalities and teen pregnancy, underage drinking inflicts economic, social, and health burdens on our community. Alcohol related accidents among adolescents in Taos County  13.2% of the killed or injured persons in alcohol related vehicle crashes in Taos County were less than 19 years old.


35 of the total DWI arrests were people under 19 yrs. old. This represents 11.9% of the total of DWI arrests made in Taos County in the same year, compared to 8.8% statewide. (Vital Statistics, N.M. 2001). This is twice the number of DWI of persons under 19 in 1998.
(N.M. Highway Department, Traffic Safety Bureau)

1999 Accidents & DWI arrests

Total Crashes

Total Fatalities Total injuries

DWI Total arrests

DWI arrests % deaths due % Injury due to DWI of those under to alcohol alcohol-related Rate 19 crash

Age 19 & under as percent of all DWI arrests 1999

Taos

640

4

246

293

35 1,679

100% 42.6%

15 % 11.1%

8.6 10.3

11.9% 8.8%

New Mexico 41,955 387

15,348 19,087

Liquor License Density The density of liquor licenses in Taos County is at least twice the statewide rate. (Social Indicators Report, NM DOH, 2004)

Priority #2 Violence
In Spring 2003, violence was identified as the second highest priority in Taos County. In the late summer and fall of 2003 a dramatic increase in the number of violent deaths involving youth and firearms resulted in a series of community forums sponsored by the District Attorney’s office and the Taos Community Foundation. The formation of a Family Justice Center was the District Attorney’s answer to violence. Many non-profits expanded their prevention and violence programs.

32

Youthbuild, a service program for youth, collaborated with several community partners to host a series of Youth Forums that offered Taos County youth an opportunity to identify causes and solutions to youth violence. These meetings were facilitated by both adults and youth. In early 2004, a Gang Task force was created by the Town of Taos and the Chief of Police, to address the possible relationship between gangs and violence. A Juvenile Justice Board involving juvenile justice agencies, service providers, business people and community members, was formed in 2004, with a grant from Children Youth and Families Department. Their task is to integrate existing prevention and treatment services into a continuum of care for adjudicated youth as an alternative to detention, expand Day Reporting and Electronic Monitoring and integrate restorative justice practices into the juvenile justice system in order to reduce recidivism. Northern New Mexico Boys and Girls Club expanded their visibility in the community and the Youth and Family Center hosted an expanded number of events aimed at adolescents.

Child and Youth Death, Accident, Homicide and Suicide New Mexico has the 7th highest rate of youth suicides in the country. Two-thirds of these deaths are through use of a firearm and two thirds of those are with a family gun that was stored loaded and unlocked. When a firearm is involved the suicide is completed nearly 100% of the time. In Taos County 43% of suicide deaths among young people were caused by firearms between 19982000. In the 2002 recent Youth Risk and Resiliency Survey, 27.4% of students reported seriously considering suicide. 47 % of those had made one suicide attempt. From 1998-2000, 78% of deaths for young people in Taos County, ages 15-19 were accident, homicide or suicide.
(Kids Count, 2002)

33

Death Rates for Ages 15-19 yr. 1998-2002

Source: Taos Vital Statistics Report 2003

Family Violence, Abuse or Neglect “ Witnessing violence at home can lead to behavioral problems including learning disorders, aggressiveness and isolation …male children who witness violence are more likely to engage in spousal abuse as adults and female children witnessing this kind of abuse are more likely to accept domestic situations involving violence.”
(Community Against Violence, Annual Report, 2002)

Domestic violence is a family matter that doesn’t stay at home. The entire community is affected by increased costs of healthcare, strained resources, public and private safety and security issues and an overall lessened quality of life. Domestic violence affects the workplace through higher rates of absenteeism, more employee turnover, lower productivity and the necessity for increased safety measures for employees. Domestic violence also affects children, both victims and witnesses, by decreasing their capacity to learn and thrive. (Community Against Violence, Annual Report,
2002)

From 2001-2002 580 new adult clients were reported receiving services from the Community Against Violence in 2001-’02. 247 children were served and 112 children were seen in the Taos Children’s Safe Room. Child Abuse and Neglect From 1998-2002, 770 cases of Child Abuse or Neglect were substantiated in Taos County, placing Taos County 17th out of 33 counties for substantiated cases during this time period. (Vision
of Health in New Mexico, Protective Services Division; Children, Youth and Families)

In 2002, a total of 239 child abuse cases were filed. 97 of those cases, or 40.6% of all the cases that year, were substantiated. Taos has over 10% more substantiated and 11% less unsubstantiated cases than New Mexico as a whole. 34

Substantiated means that through the course of the investigation, the social worker determined that the child(ren) who is the subject of the report has been determined to have been the victim of abuse or neglect, meaning the allegations are true. Unsubstantiated indicates that the investigator was not able to determine whether the allegation was true or untrue. (NM Vital Records, Taos County Profile, 2003)

Priority #3 Poverty
Poverty is a leading indicator of poor health. According to the 2002 census New Mexico is the nation’s fourth poorest state. Federal Poverty Guidelines place a family of 4 earning less than $18,100 as living in poverty. For many general and professional community participants, poverty was identified as a root cause of many of our health challenges and barriers to wellness. Health Disparties in New Mexico (N.M. DOH Public Health Division Report 2003) reports that the largest disparities in self-reported health surveys, which asked people to rate their health as good, very good or excellent, become evident when comparing the lowest income group with the highest income group.  In 2001 an estimated 6,588, almost 20% of all Taos County residents, of all ages, were living in poverty. 265 residents of Taos County received Temporary Assistance to needy families and 1, 361 persons received food stamps. (U.S. Census Report, 2002)  In 2002, 1,254 Taos households were living in poverty, even though over ¾ of them did have some income from employment. Approximately 1780 children under 18 were living in poverty. 539 families were single parent, female head of household families. 2, 578 of these persons are children under the age of 18, making up 1/3 of the total population living in poverty that year. (US Census, 2002

35

Children in Poverty The percentage of youth under 18 living in poverty in Taos County is 25.1%, (1,824) which is slightly higher than the statewide percentage. 11.1% of youth (809) live below at a level that was 50% lower than the federally established poverty level, compared to 10.7% statewide and 54..1 % (3,945 youth) live below 200% of poverty, compared to the statewide figure of 52,9% . In Taos County, 2,819 youth (38.4%) live in high poverty neighborhoods where 20% or more of the population is below poverty level.
Source: Population Reference Bureau, analysis of data from the U.S. Census Bureau, for The Annie E. Casey Foundation.

Seniors in Poverty
   

In 1979, 21% of the 65 and older population was at or below the census-defined poverty level, compared to 14% nationally . New Mexico also has a high percentage of elderly minorities, elders living in poverty and individuals in the 18 to 64 year age group with severe disabilities. Because of funding changes in Medicare caused by the Balanced Budget Act, funding for home health care has dropped 41 percent. As a result, 70 home health care providers in New Mexico have gone out of business since 1997, leaving only about 100. Other providers are feeling similar financial pressure.

Transportation, isolation and low income remain a problem for Taos County seniors who earned their livings here. According to Kids Count Census Data, 2000, 20.8% of persons over 65 live in poverty in Taos County. Taos County ranks 5th in the state for poverty among persons over age 65. Income among seniors moving to Taos from elsewhere is much higher than that of “local”residents.

36

(Historical Profile Of Taos County Migration at the End of the 20 th Century, Bureau of business and Economic Research, UNM)

Priority #4 Access to Health Care
“The health system…has the responsibility to try to reduce inequalities by preferentially improving the health of the worse-off…The objective of good health is really twofold: the best attainable average level—goodness--and the smallest feasible differences among individuals and groups—fairness.” Wermuth, 2002, The World Health Organization in The World Health Report

National Perspectives: According to a national study released by the Center for Studying Health System Change (HSC) almost 20 million American families had problems paying medical bills in 2003, forcing many to make tough trade-offs between medical, food and housing expenses. While uninsured families are more likely to have medical bill problems two-thirds of families with problems paying medical bills do have health insurance coverage. [HSC News Release, 630-04]. Other research, from the Employee Benefit Research Institute, found that 64% of Americans below age 65 had job-based health benefits in 2002. In 1987 the percentage was 70%. The decrease in job-based health insurance is due to the rising cost of health insurance premiums and a change in employment patterns from manufacturing to services. Benefits are more commonly offered to workers in goods-producing industries than to those working in service industries like hotels, restaurants, bars, art galleries, retail stores, ski or resort establishments. This means less and less people have access to job related health insurance. [Benefit News, 6-22-04] In Taos service industry jobs provide the bulk of employment opportunities for Taosenos. Barriers to Health Care “ We always do without the health care we need in order to take care of our four
children.”

Over half of the 144 low income families in Taos County families participating in an interview process conducted by Maternal Child Health Council in 2001 reported that they did without needed medical care in order to make ends meet, or gave priority to their children’s care. These participants noted access to care, lack of health insurance, gaps in coverage, and limited dental care for Medicaid and indigents as their primary concerns. Awareness of resources and their centralized location in the Town of Taos was also viewed as a barrier to healthcare. (Community
Health Improvement Project, 2001)

In 2003, interviews and surveys conducted with Taos County physicians identified low income and poverty as the greatest barrier or interruption to health. This was followed by lack of medical insurance. Other concerns identified by these physicians included no prescription insurance combined with the high cost of prescriptions and difficulty navigating the system to get access to financial support for medical care.

37

What are some of the factors affecting access to health care?  New Mexico has among the highest percentage of non-elderly uninsured in the nation, with 27% uninsured compared to the national average of 16%. 24% of New Mexico’s children are uninsured compared to 15% in other Mountain states and 12% in the nation. Compared to other Mountain states, New Mexico has the highest percentage of uninsured persons below 100% of the Federal Poverty Level and the lowest percentage of citizens covered by private employer health insurance.  New Mexico has a lower percentage of individuals participating in employer-sponsored and individual/family private insurance (51%) than nationally(65%) and a lower average employer contribution to family insurance costs and individual insurance costs .  State wide, one in four New Mexicans does not have health insurance, even though approximately 75% of them have jobs. In 1999, 23.6% of New Mexicans stated they had NEVER had health insurance, as opposed to 10% nationwide (MCH Plan Update, 2002)  52.4% of the people (interviewed) who needed primary care services in Taos County in the year 1999, 19% had only limited (sometimes) access, or none at all. Of the 18% reporting a need for emergency room services that year, 11.7% were unable to access an emergency room all or part of the time. In both the 2001 and 2003 interview processes, many physicians were concerned about economic and other barriers to health care. Physicians noted that even for those with insurance, rising costs have caused higher patient co-pays, increased deductibles, declining coverage, and often no coverage at all for prescription drugs. In 2001 some physicians noted that many families maintain health care because they are aware of how to apply for Medicaid and they keep current with the required paperwork. Others, they noted, are unable to maintain their eligibility requirements. (Community Health Initiative Report) In a rural area, the health of residents is closely tied to the strength of the health infrastructure. This infrastructure relies on retaining physicians. Malpractice rates for physicians practicing in Taos County, as else where in N.M. and nationally, continues to rise. This nation wide trend needs to be followed as it impacts the number of physicians who can afford to practice medicine in our County. Limited transportation and emergency services: “ Half the county’s population is 25-30 minutes away from advance life support.”

Access to Mental Health Care
According to the Final Report, 2002, Behavioral Health Needs and Gaps in New Mexico, over 400,000 individuals in New Mexico have substance abuse/mental disorders. This represents about 22% of the state’s total population. Among those with substance abuse disorders, an estimated 19,025 are youth and 131,112 are adults. This includes those in state jails and prisons. Approximately 25-35% of those New Mexicans will need services from the publicly funded system of care. Only 19 % of the adults needing public sector mental health services in New Mexico are currently being served. Untreated mental health and substance abuse disorders in New Mexico are estimated to cost more than $3 billion annually. For every dollar spent on 38

alcohol and other drug treatment, $7.14 is saved in reductions in other governmental and economic costs. For every dollar invested in mental health services, there is as much as $10. saved in other social, governmental and economic costs. For every dollar spent on substance abuse prevention, treatment and research, $41.43 is spent by the state of New Mexico on consequences of substance abuse.
(Behavioral Health Needs and Gaps in New Mexico, 2002, Wanda Gielow de Figueroa, DIR/DOH, Technical Collaborative, Inc. Santa Fe, NM) Assistance

Taos County does not have beds for mental health patients other than those at the emergency room of Holy Cross Hospital. The Mental Hospital in Las Vegas New Mexico. If mental health patients are spotted on local roads under the influence of alcohol or drugs, they can be held in open door local jail facilities by Town police, Sheriffs office or the NM State Police for their own protection.

Priority # 5 Obesity
Obesity is now recognized as a more powerful indicator of health issues than poverty, negatively impacting the chances for diabetes and other chronic disease. One in five Americans is obese; three in five are either overweight or obese. The obesity rate has accelerated dramatically in the past 20 years, in conjunction with a national trend toward sedentary lifestyles. Increasingly, unhealthy lifestyles, primarily overeating and lack of exercise, are responsible for alarming increases in cardiovascular problems among overweight children. [Medscape, 6-21-04]
http://www.medscape.com/viewarticle/478258

Obesity rates are increasing dramatically and are correlated with chronic health conditions and increased spending on medications and health care.

39

Information and charts from data collected by Healthcare for Communities in a phone survey among 10,000 respondents, conducted in1998 in an obesity study by RAND research. (http://www.rand.org/publications/RB/RB4549)

Priority # 6 Adolescent Pregnancy
While some teen parents may not view adolescent pregnancy as an interruption to health, data is abundant to support the concerns of national and global communities regarding teen pregnancy. Teen mothers and their children face particular challenges that impact the community: Limited access to education, jobs, safe housing and childcare.   Teen mothers have more limited opportunities for education and substantial employment, which increases the probability that they and their children will live in poverty. Children born to teen mothers are more than twice as likely to be abused or neglected and to be placed in foster care. Many more are left to the care of other family members and they are at least twice as likely to run away from home prior to age 16. Teen mothers have 50% more low birth weight babies than do women who delay their first birth until 20 or 21. Low birth weight is a factor in infant mortality, disabilities, chronic respiratory problems, and learning disabilities
(N.M. Kids count data, 2002)





Children of teen parents tend to have more health problems and to have learning difficulties and behavioral disabilities.

(New Mexico Teen Pregnancy Coalition, “Future Voices II: Teen Parents and Their Children in New
Mexico,” 2002).

Taos County

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 61 56 58 49 64 54 64 65 59 51

Birth for mothers 15-19 58

40

The rates in the chart above demonstrate number of births in Taos County that were to mothers 15-19 yrs. old. 2002 data are provisional. (NM D.O.H. Vital Records) While there are County programs to support the health, well being and development of teen mothers and their children, the need for further support remains high. The need for information regarding puberty, disease prevention, and sexual health in general, and for older adolescents, knowledge of and access to contraceptive methods for those choosing to become sexually-active remains high. “Abstinence only” education approaches remain largely un-proven in terms of their effectiveness. (Douglas Kirby, “Emerging Answers,” May 2001). There is no Planned Parenthood organization in Taos County.
T o Cu t b t s a s o ny i h r
40 0 30 5 30 0 20 5 20 0 10 5 10 0 5 0 0

19 90

19 91 bt s i h r

19 95

19 96

19 99 1 - 9 r o mh r 51 y. l o es d t

20 00

sn l m s ig o e m

Thi s graph compares reflects the total number of births, the number to single mothers and the number to mothers 15-19 yrs. old during specific years.

Other Interruptions to Health and Wellness Diabetes
Nationally, more than 16 million people have diabetes, but half of them are unaware of it. In New Mexico, more than 100,000 people, 6.5 % of the state's population, have diabetes. In Taos County alone, an estimated 1900 have diabetes. People can have diabetes for 10 or 20 years, undetected. If the disease is not treated, life-threatening complications can develop. In the 2003 survey process Taos County physicians reported that diabetes among youth in Taos County is also a concern. Diabetes also affects kidney function. About half of the people who are on dialysis here in New Mexico are individuals with diabetes. It increases risk for heart disease - about 15 times greater. Diabetes also causes nerve damage, which can lead to amputation. People most at risk for having diabetes include:  Those over 30 years old who are overweight and have a family history of diabetes  Mexican-Americans and Native Americans, who are more than twice as likely to have diabetes.  Over weight children are at risk.

41

Cost of Living
Population growth is one factor impacting the cost of living. Taos County has grown more than 50% since 1970. This growth, which has had a greater impact than out-migration or birth and death rates, has impacted the cost of owning or renting a home in Taos County, increased the cost of land and had an impact on increasing property taxes over the last 30 yrs. Higher land values may account for the sale of large sections of agricultural and open land for housing and other development purposes. Higher property taxes may have also motivated the sale of some family-owned properties. (Historic Profile of Taos County Migration at the end of the 20th century,
Bureau of Business & Economic Research)

Homelessness
Homeless people in New Mexico include families with children, people who are working at low wage jobs, people suffering from mental illness, those with substance abuse problems, migrant workers, runaway or throwaway teens, victims of domestic violence, disabled people, and veterans. Some of the factors contributing to homelessness are major illnesses and disabilities, domestic violence, mental illness and addiction disorders. In order to bring someone suffering from one or more of these conditions out of homelessness it is necessary to address both the conditions and the housing needs of the homeless person. While the number of homeless persons in Taos County is not currently available, homelessness is recognized as an increasing problem in our County. A statewide coalition on homelessness has been created and it is hoped that local statistics will be available in the future as well as state and county plans for acting in response to the suffering of those without adequate and safe shelter. At the time of this Health Profile various churches offer some relief to the homeless, the Men’s Resource Center can offer limited sleeping gear and some food and Dreamtree offers relief to homeless youth.  As housing costs continued to rise faster than incomes and the national economy remained weak, requests for emergency food assistance increased an average of 19 percent over the past year, according to a 25-city survey released today by the U.S. Conference of Mayors. The survey also found that requests for emergency shelter assistance grew an average of 19 percent in the 18 cities that reported an increase, the steepest rise in a decade. (U.S. Conference of
Mayors, 2002)

 About 35% of Albuquerque's homeless are chronically mentally ill or mentally incapacitated. According to some estimates, between 25% to 75% of the homeless have substance abuse issues. They comprise the most obvious segment of the homeless to the general public. A substantial portion of the homeless (30%) in Albuquerque are women and children. Families are the fastest growing sub-group of homeless people in Albuquerque, following the larger national trend. At least 35% work part- or full-time.
Source: Homelessness Awareness and Advocacy Group - UNM, www.unm.edu/~willow/homeless/index.html )

Limited access to childcare opportunities
“ Even with free help from relatives or participation in subsidized programs, child care is a significant burden for low-income working families. ” (Urban Institute, 2003).

42

The current funding crisis has drastically reduced the amount of state funding available for childcare resulting in a critical shortage of childcare assistance for families. At the same time, new legislation drastically increases the need for childcare by increasing both the number of welfare recipients who will be required to work (from 50% to 70%) and the number of hours each parent must work, from 30 to 40 hours per week. (Urban Institute Assessing the New Federalism, 2003) While there are licensed day-care and pre-school facilities available in Taos County, serving up to 438 children, the Taos Family Resource Center alone reported 148 persons asking for referrals for infant and childcare services in 2001. When safe and affordable child care is not available parents become limited in their capacity to be employed or use grandparents, other families members or unlicensed sources of child care. Twenty of the referrals in 2001 were for infants/toddlers with special needs.  In 2000, 1,886 children under 6 yrs. old lived in Taos County 1,264 of those children lived in families where both parents work  There was a potential pool for Head Start of approximately 400 children.  Nationally, 48% of employed families with children under 13 years of age pay for child care Low income working families have a lower monthly child care bill than higher income families, however this amount represents a higher percentage of their earnings Families living below the federal poverty line pay an even higher percentage of their earnings, up to 18%. (Urban Institute Assessing the New Federalism, 2003)  In New Mexico, 46,014 grandparents live in the same household as their grand children. Over half of the grandparents have primary responsibility for these children. There are currently no numbers available regarding the number of grandparents offering childcare in Taos County (Taos County Census, 2002)

Inadequate Pre-Natal Care
Inadequate prenatal care is defined as no prenatal care by the 3rd trimester. Low birth weight, which is often associated with lack of pre-natal care, is connected to infant mortality, chronic respiratory disease, learning and other disabilities. In Taos County low birth weight may be related to high elevation and birth of twins. In 2001, 231 of the 350 babies born to Taos County residents had received prenatal care during their 1st trimester. 147 mothers and unborn babies are listed as receiving adequate care, 44 intermediate care, and 74 received intensive care. 45 mothers and their unborn babies received inadequate care.
(Taos County 2002 County Health Profile, NM Vital Records and Health Statistics)

Students leaving school
Lack of formal education remains an indicator of poverty in later years. A “drop out” is a student who was enrolled in the previous year, but did not enroll the following year and did not graduate, or meet transfer or illness exclusions.

43

 In 1997-1998 drop out rates for Taos were 6.6%, 16.4% in Questa and 1.7% in Penasco.  In 1990- 2000 the drop out rate was 13.7% in Taos, 2.8% in Questa and 5.3% in Penasco.
(KIDS Count, 2002)

Environmental Health Assessment & Indicators
Environmental Health Indicators are measurements that suggest areas of health in the environment that impact human health and wellness. An Environmental Assessment meeting, including Picuris and Taos Pueblos, Peñasco and Questa as well as community members from areas closer to the Town of Taos, listed their environmental health concerns and then prioritized them, according to these criteria:  Severity  Numbers of persons potentially affected, and  Presence of resources to address the problem

The following is a prioritized list of the top five health concerns related to this Environmental Health Assessment and the suggested indicators, or measurements, for determining the presence or impact of environmental conditions that may or do adversely affect human health: 1. Water Quality:
   

drugs and pesticides in water, contamination of upper water shed from cyanide/ and nanotechnology to suppress recent fire. pollution from septic tanks and other sources,

2.Water Supply…adequate water resources, affects of drought
3. Concerns about Industrial Contamination: Effects of contamination from Molycorp and LANL
4. Concerns about Outdoor Air Quality:

Effects of dust, wood smoke, trash burning and auto emissions. 5. Concerns about Indoor Air pollution:  Radon,  Indoor smoking in public places,  Fumes from hair dressers etc. chemical toxins and wood burning stoves. There was a general and overarching concern that existing regulations be strengthened and enforced and that residents of Taos County recognize and implement whatever conservation methods are currently at their disposal such as composting, recycling and water conservation.

44

The Coalition researched data related to these health indicators and passed a report onto the Improving Health Initiative for forwarding to the Environment Department and the Center for Disease Control.

Ranking of Environmental Health Priorities Priority One: Water Quality
Specific concerns of community residents include: 1. Possibility of contamination of drinking water sources due to household sewage system seepage, seepage and contamination from waste facilities, development and land use issues, contamination from dumps, mine tailings etc. 2. Possible pollution from septic tanks and other sources, including drugs and pesticides in the water, as they affect the health of the Rio Grande, Red River, Rio Pueblo etc. and therefore impact local public health and quality of life in Taos County. Concerns were centered around outdoor water and well as water used for drinking. Outdoor Water Quality Indicators: 1. Monitored contaminants in outdoor water Measure: levels of contaminants monitored under Clean Water Act and state regulations and guidelines for surface, recreational water. Measure land use patterns. 2. Point-source discharges into outdoor water Measure: Volume of point-source discharges by type of contaminant, from waste disposal, sewage overflows, unintentional spills and discharges. Levels of contaminants such as mercury, dioxin, PCB, in recreational and fishing waters. 3. Contaminants in fish Measure: Levels of fecal coliform, Levels of contaminants such as mercury, dioxin, PCB, in sport fish. Drinking Water Quality Indicators: 1. Monitored contaminants in drinking water Measure: Number and proportion of drinking water systems that fail to meet water quality regulations, Safe Drinking Water Act, Maximum Contaminant levels monitored under state regulations. 2. Source Water contamination Measure: levels and types of contamination of private water supplies, point source discharges into drinking water aquifers.

What is being done now about Water Quality?
Town of Taos A Main sewer inceptor was installed in 2003 to improve sewer capacity and act as a connector to the sewage treatment plant. Sewer Facilities and System Use regulations were adopted to regulate and control fats, oils, and grease discharged in the Town’s public sewer system.

45

Funding for upgrades and improvements to the Wastewater Treatment Plant Fertilizer Facility for odor elimination and Process Control Improvements. Funds were allocated in the Town for Improvements to the Municipal Wastewater Treatment Plant with a Design of New Head Works Facility Funding for Sludge Disposal Project. $ 1,000,000 for use in arsenic treatment project or a wastewater treatment plant upgrade. Taos Pueblo Tribal clean water standards have a human health component, to protect traditional use of the river. Their standard is that surface water should be safe to drink and bathe in. Runoff from ash due to last years fire is a concern, they monitor both physical and chemical indicators. Picuris Pueblo Tests its water for purity. They have established sampling sites and periodically test surface water and wells. The EPA collects data on the Ogilivie Norton Speciality Minerals mine. Other actions:     Amigos Bravos will have fish toxicology data for the Rio Grande by Nov. 04. Amigos Bravos has a library of Water quality data Clean Water Act training by Amigos Bravos Dept. of Game and Fish or Surface Water Quality Bureau where information is gathered regarding toxins in the water.

Priority Two: Water Supply
In light of years of drought and development, Taos County faces issues regarding available water supplies for residents, who use water for households, livestock, gardening and agriculture as well as car washes, golf courses etc. Other important considerations related to drought include its effect on soil and the increased possibilities of fires and the related erosion of soil and silting of water supplies. While there are currently no household water use regulations in Taos County, personal conservation of water: fixing dripping faucets, xeriscaping, low water use toilets, low water use showers recycling household water, and reducing planting that requires high water maintenance are all means of conservation that can make best use of available. Commercial conservation can also be instituted. Water Supply Indicator: 1. Availability of water in specific areas, mapping of young /recharging areas. Measure: Number and depth of wells, incidence and locations of dry wells, use of water for non-essential activities. What is Currently Being Done To Address Water Supply?  Taos County is under a mandate from the Interstate Stream Commission to put together a 40 yr. regional water plan.  Taos Judicial District is under orders to develop a Water Court Division, to hear and decide on water related issues.

46

     

New Mexico Water Trust approved funding to develop the San Juan Chama protect and connect it to the Town of Taos Water System. A mapping of underground water aquifers is underway, that could guide the placement of housing densities. A hydrology map could show water rich areas and places where well-drilling would result in low flow well or impact existing wells. Hydrological zone mapping tells also tells when a well is likely to recharge and whether it will go dry. As of Jan. 2004, 400 square miles of the 2,000 square miles in Taos County has been mapped aeromagnetically. Water well inventory is underway by the Taos Soil and Water Conservancy District. This can lead to a water table map, which measures water levels recorded by well diggers. Taos Pueblo is looking to preserve their wetlands, particularly the buffalo pastures between the road into the Pueblo and the pow-wow grounds. These lands are affected by over-pumping and development.

Priority Three: Industrial Contamination of Water, Soil and Air.
Molycorp Contaminated water that does not evaporate from tailings ponds penetrates into ground water. Drinking water wells near the tailings ponds have been condemned. Tailings ponds and waste rock dumps have raised issues about threats to the health of local residents. Toxic waste from tailings pipelines has contaminated land and may be contaminating local drinking water. “Molybdenum is present in the bedding material of a Questa water main. Two state agencies and the EPA advised the village that the levels of metals found in the drinking water samples were all below federal drinking water standards. The EPA, however, has issued health advisories for molybdenum in drinking water in amounts greater than 40 parts per billion. The village samples all contain molybdenum at an average of 6 parts per billion, leading the state agencies and the EPA to inform the village that the water is safe to drink. The agencies and the EPA are developing a long-term testing program to monitor the molybdenum levels in Questa's water system. Molycorp and Air Quality: The residents of Questa and Red River are most affected by tailings and other air born particles resulting from mining.  Questa schools have been closed on occasion due to dust and tailings in the air. Community members reveal that clouds of tailings often blanket the town. Asthma and other upper respiratory ailments in that area have not been specifically tracked. Industrial Air Quality Indicators: 1. Hazardous or toxic substances Measurement: Quantity of criteria pollutants and hazardous or toxic substances released into the air, reports of non-compliance for emissions releases. 2. Programs addressing hazardous or toxic substances Measurements: Number of air toxics monitoring programs, operating permits for releases of hazardous pollutants, fines for hazardous releases violations

47

3. Unusual pattern of asthma events Measurements: asthma-related deaths, incidence of asthma, rates of hospitalization for acute asthma, proportion of population filling prescriptions for asthma medication. 4. Unusual pattern of cardiovascular or respiratory events. Measurements: Incidence of events, rates of hospitalization and emergency department visits.

Priority Four: Quality of Outdoor Air
Air is polluted by driving cars and trucks; burning coal, oil, and other fossil fuels; and manufacturing chemicals. Air pollution can come from everyday activities such as dry cleaning, filling your car with gas, and degreasing and painting operations. These activities add gases and particles to the air. The average adult breathes over 3,000 gallons of air every day. Children breathe even more air per pound of body weight and are more susceptible to air pollution. Many air pollutants and toxic compounds remain in the environment for long periods of time and are carried by the winds hundreds of miles from their origin. People exposed to high enough levels of certain air pollutants may experience burning in their eyes, an irritated throat, or breathing difficulties. Long-term exposure to air pollution can cause cancer and long-term damage to the immune, neurological, reproductive, and respiratory systems. Outdoor Air Quality Indicators: 1. Pollutants in air Measurements: Annual levels of criteria pollutants: carbon monoxide, lead, nitrogen dioxide, ozone, sulfur dioxide. Level of one or more hazardous or toxic substances. Vehicle miles driven per capita 2.Unusual pattern of asthma events Measurements: asthma-related deaths, incidence of asthma, rates of hospitalization for acute asthma, proportion of population filling prescriptions for asthma medication. 3. Unusual pattern of cardiovascular or respiratory events. Measurements: incidence of events, rates of hospitalization and emergency department visits. What’s being done now to Improve Quality of Outdoor Air? Taos Pueblo Environmental Department is developing an EPA approved monitoring system.

Priority Five: Quality of Indoor Air
Indoor Air Quality Indicators: 1. Tobacco Smoke in homes with children Measurements: Proportion of children living in households with adult smokers, proportion of persons under age 21, who smoke. 2. Hazardous or toxic substances in indoor air Measurements: Number of schools with indoor air hazards 3. Unusual pattern of respiratory events Measurements: Emergency room visits with suspected air-borne agent involvement. 4. Use of best practices for protecting indoor air.

48

Measurement: Proportion of resident population that have access to radon testing programs, number of smoke free workplace policies and privately owned smoke free businesses, proportion of non-manufacturing work force working where indoor air quality management practices address human health. What is being done to improve Quality of Indoor Air? Taos Pueblo is developing their efforts to assess and mitigate problems with radon. They will test public buildings and homes on the reservation. Clean Air Works in Taos is collaborating to educate the public and private sector on the dangers of second hand smoke.

Potential for Successful Community Action
Scientific and ecological studies now recognize that systems with diversity and flexibility have the greatest chances of survival. The word health comes from the word hale, Latin for wholeness. Wholeness. Nothing left out. Data and the conscientious tracking of trends paint part of the picture, but not the whole picture. The health and wellbeing of Taos County residents also depends upon creating what is often not measured, an atmosphere of goodwill, collaboration and partnership. Our community health and well being has roots in many causes and conditions. The interrelatedness of the conditions that become interruptions to community health can seem overwhelming. Continuing to develop a strong, interactive community of resources is our best hope for meeting the needs reflected in this Health Profile. There are so many ways to address these needs. Please see the Health Pages and Taos County Asset Map for listing and discussion of those working on addressing improved health and wellness for Taos County residents. Collaborative community action that incorporates diverse perspectives and diverse styles of service can and will make a difference in the quality of life for all the people of our County. May everyone benefit from our best effort.

49

Behavioral Health Services Database (BHSD) Owner: Department of Health: Behavioral Health Services Division Contact: Carol A. Thomas, IS Manager 505.827.0489 cat@health.state.nm.us www.health.state.nm.us Purpose: For state-funded (non-Medicaid) mental health and substance abuse client demographic, service and assessment information. Biological Sciences Bureau (BSB) Owner: Department of Health: Scientific Laboratory Division Contact: Dr. Debra Horensky, Bureau Chief 505.841.2556 dhorensky@sld.state.nm.us www.health.state.nm.us Purpose: To assist SLD lab personnel in conducting lab tests on clinical specimens and reporting results of the tests. To provide a source of data for summary reports

50

for SLD managers and State/Federal health agencies related to testing of both human and animal specimens for the presence of pathogenic organisms including bacteria, viruses, fungi, and other microorganisms related to diseases (TB; STD's, plague, hantavirus, rabies); testing for human metabolic or genetic disorders (newborn screening); and for financial analysis and billing.

Death Owner: Department of Health: Public Health Division Contact: Kimberly Peters 827.0124 kpeters@health.state.nm.us www.health.state.nm.us Purpose: To register New Mexico deaths for the issuance of certified death certificates and associated administrative matters; data collection for public health assessment. Emergency Department-Firearm Injury Surveillance System (ED-NMFISS) Owner: Department of Health: Public Health Division Contact: Barbara Chatterjee 476.3563 barbaric@doh.state.nm.us www.health.state.nm.us Purpose: Monitor non-fatal firearm injury Family Automated Client Tracking System (FACTS) Owner: Children, Youth and Families: Employee Services Division Contact: Vicki Gallegos 841.2931 vsgallegos@cyfd.state.nm.us Purpose: Management, tracking, and control of NM child welfare, adult protective services, juvenile justice and child care Hepatitis B & C Registries Owner: Department of Health: Public Health Division Contact: Joan Baumbach, MD, MPH Program Manager Infectious Disease Epidemiology 827.0011 joanb@doh.state.nm.us www.health.state.nm.us

51

Purpose: Surveillance of hepatitis B&C in NM residents HIV/AIDS Reporting System (HARS) Owner: Department of Health: Public Health Division Contact: Jill Gatewood 841.5893 jillg@doh.state.nm.us www.health.state.nm.us Purpose: HIV/AIDS surveillance Hospital Inpatient Discharge Data (HIDD) Owner: Health Policy Commission: Health Information Systems Contact: Kathy Goodyear 424.3200 kfgoodyear@hpc.state.nm.us http://hpc.state.nm.us Purpose: To assist the commission, legislature and other agencies and organizations in the state's efforts in collecting, analyzing and disseminating health information to assist in the performance of health planning and policymaking functions, and in administering, monitoring and evaluating a statewide health plan. Incident Management System (IMS) Owner: Department of Health: Division of Health Improvement Contact: Sidney Buff 827.1605 sidneyb@doh.state.nm.us www.health.state.nm.us Purpose: Track and monitor incidents and investigations of incidents Informix Owner: Workers' Compensation Administration Contact: Merilee Dannemann 841.6074 merilee.dannemann@state.nm.us Purpose: To collect and maintain information on work-related injuries and illness. Integrated Network for Public Health Official Records Management (INPHORM) Owner: Department of Health: Public Health Division Contact: Pat Mays 827.2332

52

patm@doh.state.nm.us www.health.state.nm.us Purpose: To track and report Public Health Division client demographic data and services. NM Live Births (Births) Owner: Department of Health: Public Health Division Contact: Vicky Howell 827.2510 vhowell@health.state.nm.us www.health.state.nm.us Purpose: To register New Mexico live births for the issuance of certified birth certificates and associated administrative matters; data collection for public health assessment. Minimum Data Set Database (MDS) Owner: Department of Health: Division of Health Improvement Contact: Sidney Buff 827.1605 sidneyb@doh.state.nm.us www.health.state.nm.us Purpose: To track and compile patient assessment information from Long Term Care facilities for use by HCFA in determining Medicare reimbursement.

53


								
To top