As much of the country was contemplating whether or not to have a Thanksgiving gathering, residents of New Mexico were once again bracing for a stay-at-home order, starting in the second half of November, as COVID cases soared and hospitals reached near capacity.
While the whole state is dealing with a second wave, the pandemic has affected native americans in New Mexico at an alarming rate. This population represents a total of about 11% of the state total, yet they account for 17.26% of all COVID-19 cases.
The numbers become even more chilling when looking at the total number of deaths, as the percentage of Native American and Alaska Natives (AIAN) is almost half. Even by national standard that is notably high: the US average number of COVID-19 AIAN deaths per 100 people is 85, but that number jumps to 290 when looking at New Mexico alone.
“I feel like it’s almost criminal to let them die at such a high rate,” Jagdish Khubchandani, Professor of Public Health at New Mexico State University said.
Systemic issues that lead to poor healthcare and lack of access to basic services have put these communities at a disadvantage from the outset of the COVID-19 pandemic.
“Pandemics are not made in a day. Pandemics are made in decades. And preparedness is also not done in a day,” Khubchandani said. “[New Mexico] was a poor state before the pandemic, one of the poorest with such a diverse population that had chronically underfunded health systems. I think what we have is the sin of the past punishing us now. We have never prepared to deal with the pandemic nationwide. And with these populations, we didn’t have the outreach, the extension, the messaging methodology.”
To understand the devastating effects of the pandemic on the AIAN population, Khubchandani says we have to look at both pre causation factors and pandemic response issues.
“Much of what’s happening now with these populations and New Mexico is because of the historic underfunding and being historically marginalized,” Khubchandani said. “These are people who have very poor air quality. They don’t have water to wash their hands. They don’t have the resources and the money to buy materials, and they are getting sicker at a younger age, dying at a younger age than the national average. In part, because they have so many medical complications: high amount of diabetes, hypertension… which is related to poverty, the type of occupations.”
Access to healthcare is harder, not only because of geographic factors, for many who live in more remote areas, but also cultural reasons. This means many of the COVID patients from AIAN communities who reach the hospital will already be in a more severe condition.
“Imagine if you have fever right now and you have to go 15 miles to see a doctor, most likely we’ll just let it go,” Khubchandani said. “Most of them seem to be living in areas where there’s no healthcare. So it could be an urban neglected area or a tribal area where there’s no health care. And then it’s hard to reach out to the community. They have their own clanship and clan systems where they heal each other. Traditional medicine outreach has been weak.”
Communication is also a major issue, Khubchandani warned. “Not everyone understands English. Not everyone understands the seriousness of the pandemic,” he said, pointing out Texas — “a state with a large proportion of Hispanic people” — as an example. “They don’t even care to translate messages into Spanish or other languages or plan special communication strategies.”
While Khubchandani believes New Mexico has fared somewhat good in terms of communication, there is still a lot to be desired, especially when it comes to reaching out to people living in remote areas, who for example might not have a cellphone or speak English.
Entities such as the Indian health service, which falls within the Department of Health and Human Services, play a crucial role in this outreach, but their jobs are hindered by the resources they lack.
“They have tried to do some word of the mouth, local flyers and local info, but it’s not been aggressive enough,” Khubchandani said. “They have to be very aggressive. But that’s a difficult population to reach out to.”
Still, the professor believes that, while it’s one of the poorest states in the country, New Mexico’s overall response to the pandemic, on a larger scale has been exemplary when compared to other states — especially given that it’s working with very limited responses. The governor’s action has been stern, taking extreme measure when needed.
“I think New Mexico again is a role model, (…) given so many pre existing disadvantages, whereas I think there are places that had so much advantage and they messed up,” he said. “We have hard populations to reach out to. Navajo nations are not easy to deal with. But still they did what they could.”