Faced with one of the nation’s highest poverty rates and the second highest percentage of the population living without health insurance, New Mexico is navigating significant challenges when it comes to the medical care of its residents - often making health care reform a top issue of discussion during this election year.

“When you look at the social determinants of health, poverty being one of them, we have many issues that challenge us on a statewide basis as far as both delivering health care services and providing coverage,” said Patricia Montoya, the director of New Business Development with New Mexico Medical Review Association and former Secretary of Health for the state.

Turning the state’s system around may take some creative thinking and a new approach to the reasons behind health care disparities.

“The way we have to do that is to look at addressing health disparities and underlying that are the social determinants of disease,” said Art Kaufman, the vice president for community health at the University of New Mexico’s Health Sciences Center. Kaufman’s center works to connect citizens to “medical homes” that would offer primary care and focus on prevention of risks.

The concept of medical homes is not unique to New Mexico. It focuses in partnering with the community the reduce health risks, Kaufman explains.

Along with other states around the country, New Mexico is feeling the impact of a nationwide shortage of physicians to care for an aging population and other aspects of traditional family care. This is in addition to what Kaufman describes as a social change in the nature of the medical profession.

“No longer are health professionals as willing as in past decades to spend their whole lives as a slave to the profession,” he explains.

And the state of New Mexico, where the majority of the population lives in rural areas, has a harder time attracting doctors who may have less resources and small paychecks than those in urban areas.

The state’s Native American population, meanwhile, faces a separate set of challenges in running its own unique health care system. Many Native Americans receive care through the Indian Health Services, a federal government program administered though the Department of Health and Human Services.

The complex IHS system is built around regions of the country, explains Ken Lucero, the director for Native American Health Policy at the Indian Pueblo Cultural Center. Clinics offer limited services and are only open during certain hours.

In an extended interview, Lucero describes the system; the biggest health care issues facing Native Americans and why continued funding challenges are such a big factor in providing health care.

The NewsHour examined New Mexico’s health care system and the positions of both presidential candidates as part of its Big Picture: New Mexico election coverage.