The Arkansas River looks stunning, even from the highway, and it’s a big relief from the arid stretches of land we’ve been riding through. Pueblo is often called “Colorado’s Second City,” but it’s not because of population. At a little over 100,000 people, it’s currently the ninth most populous city in Colorado. But for a long time, it’s been the economic center of southern Colorado and northeast New Mexico, and is still a hub for the steel and aviation industries.

With only two hours to go to Denver, now’s a good time to take a quick look at the Colorado healthcare system. Unlike New Mexico, where 40% of the physician workforce practiced in rural areas, Colorado is much more stratified -- with a whopping 89% in urban and suburban areas and only 11% in rural areas. This makes some sense in terms of population distribution, since 85% of Coloradans live in cities and 15% live in rural areas. But it means rural physicians have a lot of ground to cover! They also have a lot more to do -- the largest portion of Coloradans who are over 65 live in rural areas.

Despite the concentration in cities, the inner-city communities are still considered underserved -- a problem for cities like Pueblo, where 13.9% of families and 17.8% of the population lives below the poverty line.

If you haven’t heard about Las Vegas, NM, you DEFINITELY haven’t heard of Springer. It’s has just under 1,300 people, with 15% of families and 17% of the population below the poverty line. Colfax County is one of the northernmost counties in New Mexico -- we’re clearly out of the urban areas of New Mexico. As such, there are disparities in access to healthcare between urban and rural communities which are pronounced.

Bernalillo County alone contains over half of the physicians in New Mexico, and 64% of active physicians live in urban areas like Albuquerque, Los Alamos and Santa Fe. However, 60% of the population lives in rural areas, like Colfax County. As a result, many counties lack an adequate number of physicians. The healthcare disparities by region amplify the effect of healthcare disparities by socio-economic standing -- after all, in New Mexico as in most of the nation, the rural areas tend to be poorer, with more uninsured patients and a more at-risk population.

As much as the physician shortage currently impacts the rural communities of New Mexico now, the population trends are even more concerning for those who care about access to quality healthcare.

We’re on the highway, driving through Santa Fe, the capital of New Mexico and the fourth-largest city in the state.

Approximately 72,000 people call the city home. Santa Fe County also has 8.8% of the active physicians in the state, making it second only to Bernalillo County (which contains Albuquerque). Now seems like a good time to discuss many of the challenges facing the healthcare system in New Mexico, given that this state is one of the poorest in the country.

Dr. Winters has perspective from working here for the past two years. “New Mexico is really one the most impoverished states relative to the rest of the U.S., and most of our patients are uninsured or underinsured. It makes it a really rewarding place to train,” he says. “But it’s also really difficult. Dealing with the uninsured and the frustrations with the system in a place like New Mexico makes it really clear how poorly our healthcare system is set up and how poorly the wealth in our system has been distributed.”