May 1 2014
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Place Matters: Eliminating Health Disparities in McKinley County, New Mexico

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file A sign warns of lingering radiation danger

In 1979 a dam broke at a uranium processing mill in McKinley County, New Mexico, releasing more than 1,100 tons of uranium mining waste and 100 million gallons of radioactive water—the second largest radioactive materials accident in the United States. Since then, say public health experts, minimal attention has been given to the health risks associated with the environmental contamination from the accident, or of the risks posed by plans for new mining opportunities in the region.

The McKinley County Place Matters team and its partners want to ensure that people are aware of the health risks associated with working in the mines, as well as secondary exposure through such things as a relative’s clothes or pollutants from the mines. The team also wants to address the health and social needs that resulted from the accident decades ago. In addition, people living in the community have noticed increased rates of cancers and other health problems, and state health assessment reports show that between 2008 and 2010, cancer was the leading cause of death in McKinley County.

file The McKinley County Place Matters Team

“To proceed with more mines without knowing the scope of impact to people’s health is dangerous,” said Jordon Johnson, the county’s Place Matters team leader.

The team’s vision statement is that “all people in McKinley County live in a safe, healthy, and prosperous environment that honors health-in-all policies and leaves a legacy of responsible leadership grounded in equity.” Its mission is to use a health equity lens to change systems that perpetuate environmental health disparities related to the impacts of multi-generational trauma and institutional racism by empowering participating communities within the county to impact equitable policy change.

Key Team Objectives:

  • Heal individual and community health and restore the environment with Traditional and Western values and medicine.
  • Use the Navajo Nation Fundamental Laws as the foundation to shift conversations around uranium mining and justice.
  • Conduct a health impact assessment on mining in the county to look at determinants of health including environmental pollution and contamination; displacement and relocation; community efficacy; and cultural relevance of the land to holistic health.
  • Support the community in building a multipurpose facility to serve as a space to heal, gather for meetings, and provide education.
  • To educate decision makers and general public about the poor health outcomes related to uranium mining.
  • To model a non-hierarchal structure, establishing shared leadership and creating a safe space for open and honest discussions to emerge about difficult subjects, particularly related to environmental justice and race relations. These conversations, along with a foundational understanding and commitment to moving the local community forward in a culturally relevant way, contribute to elevating the voices of community members participating in local decisions, said team leader Jordon Johnson.

The role of the Place Matters team is especially important in New Mexico because the state has a centralized, statewide health department—rather than county- or municipal-based health departments—which makes community-based health planning, assessment and action at the local level critical, say Place Matters team members.

A key partner of the Place Matters team is the McKinley Community Health Alliance, formed in 1998. The alliance includes more than 100 citizen activists, educators, human service providers and health-care workers throughout McKinley County and the neighboring region. Members represent the wide diversity of the area, including the Navajo Nation and the Zuni Pueblo. The Council defines “health” very broadly and believes that health concerns of the area—as related to education, economics, environment and access to appropriate human services—are best addressed collaboratively.

Ophelia Reeder, the health alliance coordinator, said issues the alliance has been addressing include payday lending and capping interest rates to help put an end to the debt cycle in McKinley County among too many residents, as well as ending substance abuse and tobacco use.

The health impact assessment (HIA) is pending based on a review of the Navajo Nation Human Research Review Board, but the team expects to be able to begin by next year, according to  Johnson. The four issues the HIA will look at include environmental pollution, environmental contamination, displacement and relocation. Johnsons said that they’ll be trying to capture the potential changes in mental health, as well as people’s physical health. They will also look at community efficacy, meaning peoples’ hopefulness, people’s trusting relationships and sense of discouragement.

Philmer Bluehouse, the Place Matters team’s community liaison who has both a criminal justice background and is a traditional medicine practitioner, is involved in several ways, including working with groups that rely on herbs for their traditional medicine work that were likely contaminated by the 1979 mining accident. Bluehouse said Navajo healing involves analyzing data and information, and then putting it into motion and making something substantive.

file Red Water Pond, N.M.

My experience in this whole process has been really enlightening,” he said. “I grew up being taught traditional knowledge and I used it every day. And when we told the people of Red Water Pond how this process were going to work, I felt that we were re-empowering the community to move forward, using their indigenous knowledge.”

Johnson said that, as a white person working in a predominantly Native American community, it’s important to be an ally, build trust within the community and generally keep himself teachable.

“There is a way to come together with traditional and Western values and practices, and I think that’s what we’re working to figure out...to really heal the community,” he said. And once we begin to deal with the impact of the uranium skill in all the various ways we need to, we’ll be able to pursue other critical health issues as well.”

Another critical outcome, said Reeder, is that “we’re having a reawakening of the younger generations really wanting to learn about their cultures, so this process also gives those of us who are in the younger generation the ability to really understand what some of the cultural aspects are. Before they were really ambiguous, but now, we’ve been able to paint the picture a lot clearer.”

Tags: Community-based care, Health Impact Assessment, Health disparities, Place Matters, Public health