New Mexico lost ground in a national assessment of the health status of the states. The reason: worsening violence.
The 2015 edition of America’s Health Rankings, published by the United Health Foundation, dropped New Mexico from 33rd place in 2014 to 37th place, the second-largest year-over-year decline of any state after Oregon. United Health Foundation praised New Mexico for improving childhood immunizations and HPV immunization among adolescent girls. However, the report said, “Violent crime increased 10 percent from last year.”
There were 613 murders, rapes, robberies and aggravated assaults per 100,000 population in New Mexico, the worst rate in the nation except for Alaska, according to the foundation, which based its assessment on FBI statistics.
The FBI warns against using its data to compare states. The Journal reported in January that although New Mexico was ranked as the second-worst state for violent crime last year, an FBI spokesman cautioned that because the bureau relies on states to report data and states count on reports from victims of crime, the information available can be incomplete.
Comparison among the states is really not the point of United Health’s report. The foundation is more concerned about comparing each state against its own status from years past. The point is to bolster a state’s successful efforts and to identify areas that could be improved. Violent crime certainly qualifies as an area where New Mexico could improve.
Many of us think that crime is a legal problem and that the solution to crime is better enforcement and more efficient courts. Surgeon General C. Everett Koop said in 1985 that solving interpersonal violence is a public health responsibility. A 1993 article in the journal Health Affairs by experts from the Centers for Disease Control and Prevention was one of the first efforts to apply epidemiological tools to the study of violence, by describing in detail how violence afflicts specific populations.
The CDC’s public health approach systematically collects data to determine who suffers from violence, then tries to understand the risk factors for violence, the same way an epidemiologist might try to understand why some people are prone to diabetes and others are not. The information is used to develop prevention strategies, just as someone at risk for diabetes will be advised to lose weight and exercise. Once successful strategies are identified, public health professionals try to disseminate them nationwide.
New Mexico’s Department of Health calls homicide “a significant public health problem in New Mexico,” but a department spokesman said in response to a request for an interview about violence and public health replied that there is “no one in the office with expertise regarding violence”who could respond to questions. The department has collected a great deal of epidemiological information about homicide:
- Homicide death rates declined from 9.3 per 100,000 population in 1999 to 7.0 last year. Even with the improvement, our homicide death rate is 29 percent higher than that of the United States as a whole.
- 56 percent of homicide victims are males ages 15 to 44.
- The death rate among males who are Native Americans is 26.5 per 100,000; it is 25.5 per 100,000 among black males, 12.4 among Hispanic males, and 5.6 among white males.
- From 2010 to 2013, homicide rates were highest in McKinley, Rio Arriba, Taos and Quay counties. They were lowest in Hidalgo, Socorro, Sandoval and Otero counties.
- Most homicides are committed with a firearm.
Such data suggest any number of public health interventions could be possible. For starters, it might help to understand what the counties with the best and worst homicide rates have in common with one another and how the two groups of counties are different from each other.
Epidemiological studies at Johns Hopkins Urban Health Institute identified several characteristics violent adolescents seem to share. They were low-birth weight babies, had minor physical abnormalities, and were difficult to console when upset.
As young children, they often exhibited hyperactivity and delayed motor development, and they had poor memory and reading skills. They experienced parenting that was “often characterized as harsh,” with “inconsistent discipline, rejection, neglect and physical abuse.”
Again, some solutions suggest themselves, including the kind of early childhood home visits that several agencies in New Mexico offer and that were once routinely done by county public health nurses in the state.
One obvious area of research nationally should be public health interventions that could lower the risk of gun violence, but according to The Washington Post, the CDC has avoided that research since 1996, when it was pressured by the National Rifle Association and faced a congressional threat to strip the agency of its funding if it worked on anything that might turn into gun control.