Skip to main content



The world premiere of a new video series by Dr. Katherine Ortega Courtney and Dominic Cappello, co-directors of the Anna, Age Eight Institute.




Our mission is to create a New Mexico where 100% of children, students, and families can thrive. The Anna, Age Eight Institute is addressing two of our state’s most costly interrelated challenges: adverse childhood experiences (ACEs) and the adverse social determinant of health. This site provides an overview of our challenges and our 100% New Mexico initiative designed to provide local stakeholders with the frameworks, research, and technical assistance to end the epidemic rates of ACEs and ACEs-related trauma and transform the adverse social determinants of health into positive ones by ensuring all families have access to ten vital services for surviving and thriving.

The Anna, Age Eight Institute was established in 2019 with funding from the New Mexico state legislature. Our mission is to ensure that children, students, and families in the state are able to thrive and succeed, free from the impact of trauma. To achieve this goal, we rely on a collaborative and data-driven approach. We work closely with counties to build capacity and strengthen local services and systems related to health, safety, education, job readiness, and resilience. Our work is informed by decades of research on social determinants of health and guided by the social-ecological model, which is widely used in public health initiatives.

We offer county leaders and stakeholders a comprehensive problem-solving process that includes brainstorming, learning, mobilizing, capacity-building, and innovating, all supported by cutting-edge technology. Our 100% New Mexico initiative guides collaborative efforts to increase access to ten vital services, starting with assessing barriers, planning proven strategies, building infrastructure, and evaluating progress.



In Anna Age Eight: The data-driven prevention of childhood trauma and maltreatment, we describe the emotional and financial costs associated with adverse childhood experiences (ACEs). To address New Mexico's high rates of ACEs and related trauma, our 100% New Mexico initiative focuses on preventing ACEs and their negative impacts on public health and education, including substance use disorders, untreated mental health challenges, and family violence. The ten ACEs were first identified in the landmark ACEs Study of 1998 by Dr. Vincent Felitti and his team.



Image 1. ACEs: The ten forms of adverse childhood experiences (ACEs) endured in the home that can lead to trauma in children and untreated trauma in parents and other adults in the household. One in four New Mexicans reports four or more ACEs, with physical abuse, emotional abuse, and living in homes with substance use disorders being the most common.

ACEs Problems

Image 2. ACEs-related challenges: ACEs can impact our health, safety, and capacity to learn, be job-ready, and perform at work.

We know why we do or don’t thrive

The social determinants of health refer to the conditions in which people are born, grow, live, work, and age that influence their health and well-being. These determinants are shaped by a range of factors, including social, economic, and environmental factors. Key social determinants include vital services that promote health, education, and self-sufficiency.

Our vision is for 100% of New Mexico families to thrive, and our mission is to build the capacity of each community to provide access to ten vital services for surviving and thriving. By ensuring that communities have accessible, family-friendly environments filled with vital services, we can reduce adverse childhood experiences that can lead to trauma, substance use disorders, violence, injury, and fatalities.

Our goal is to provide local stakeholders with a collective impact framework that transforms adverse social determinants of health into positive ones by strengthening the capacity of local service organizations. This represents the largest focus on public health, education, and job readiness since the New Deal of the 1930s. Our approach focuses on providing the following vital services:

Medical/Dental Care, Behavioral Healthcare, Food Security Programs, Housing Security Programs, Transportation, Parent Supports, Early Childhood Learning, Community Schools, Youth Mentor Programs, and Job Training.

  • Medical/Dental Care
  • Behavioral Healthcare
  • Food Security Programs
  • Housing Security Programs
  • Transportation
  • Parent Supports
  • Early Childhood Learning
  • Community Schools
  • Youth Mentor Programs
  • Job training

Social Adversity

Image 3. Social Adversity: This graphic illustrates the social adversity our families may endure as they step outside their front door into the community. These can be environments described by public health as the adverse social determinants of health.



We have the blueprint guiding solutions

100% Community: Ensuring 10 vital services for surviving and thriving describes the process for identifying gaps in ten vital service areas and strategies for increasing service access. The 100% Community model is radical in its simplicity: 10 vital services built for 100% of families within a county. The long-term outcomes are trauma-free childhoods, empowered students, and self-sufficient families.

The adverse social determinants of health lead to costly challenges

Without access to vital services, family members will endure a host of problems that have a detrimental impact on the quality of health and education.

  1. Untreated medical challenges leading to ER visits
  2. Untreated substance use disorders leading to injury, violence, and illness
  3. Hunger leading to lack of capacity to focus on school work and poor nutrition
  4. Lack of housing options to support leaving a domestic violence situation
  5. Lack of transportation to vital services for infants and children
  6. Lack of support when a parent is at risk for harming a child
  7. Lack of readiness for kindergarten, without reading or social skills
  8. Low student achievement and engagement in school
  9. Lack of role models to prevent youth substance use and suicidal ideation
  10. Lack of job readiness and the capacity to be self-sufficient

100% New Mexico

Image 4. The 100% New Mexico Model: This graphic illustrates the ten vital services for surviving and thriving shown to increase the health, safety, and self-sufficiency of families. These services, when easily accessible, are the components of the positive social determinants of health.

Social Ecological Model

Image 5. The Social-Ecological Model: This model illustrates how change can be supported on many levels within the county-based initiative. Addressing ACEs and the adverse social determinants of health requires supporting change on many levels.



This website is a repository for research, programs, and learning opportunities. Across the menu you’ll find links to our 100% New Mexico Action Teams, 100% Power Hours, Project Overviews, and Research.

100% Action Teams: These are the ten action teams each county forms as part of the 100% New Mexico initiative, focused on ensuring vital services within a county’s borders. These teams turn service barriers into timely access to family-friendly services.

100% Power Hours: This is the 100% Power Hour webinar series provided quarterly to introduce county stakeholders, elected officials, and our higher education partners to the components of the 100% New Mexico initiative.

100% Project Overviews: These are the various projects the county-based 100% New Mexico initiative can implement to achieve the goal of health equity. They include:

  • 100% Community Schools Project – creating fully-resourced community schools with health centers
  • 100% Family Center Project – creating a one-stop service hub
  • 100% Mural Project – provides public education and engagement
  • 100% Family Services Directory Project – providing a web-based resource directory to ten vital services
  • 100% Ready – our readiness workshop for local initiative participants
  • 100% County Projects – provides an overview of all our county initiatives across New Mexico.

Research: Here we provide links to three areas of interrelated research guiding the 100% New Mexico initiative: Adverse Childhood Experiences (ACEs) and Research, Adversity and Research, and 10 Sectors and Research. More than 300 journal articles document the costly challenges our residents endure, as well as the evidence-informed solutions that focus on ensuring the vital services shown to increase health, safety, learning, job readiness, and self-sufficiency.



Challenges can arise on individual, relationship, community, and societal levels. Some of us are faced with sudden public health crises or economic downturns, while others are born into a world of adversity, trauma, and chaos. The 100% New Mexico initiative is designed to address these challenges by strengthening systems of health and safety that serve everyone, everywhere. As part of this initiative, we work to ensure that all counties have access to the necessary resources and insights to provide ten vital services that increase the health and safety of all residents within each community's borders. By working together, we can create a more resilient and equitable society that supports the well-being of all individuals and communities.

To visit our local initiative programs and learn more about the 100% New Mexico initiative, please visit our 100% New Mexico site.



Access to vital services is crucial in determining our overall health, education, and quality of life. The social determinants of health refer to the services and resources that can increase people's overall well-being, empowering them to succeed. To assess the degree to which these vital services exist in each county, we measure what we call "surviving services." These services include medical care, behavioral health care, housing security programs, food security programs, and transportation to vital services that are essential to everyone's well-being.

In addition to these surviving services, we also focus on strengthening the "thriving services," which include parent support, early childhood learning programs, community schools, youth mentor programs, and job training. Each of these services plays a vital role in safeguarding us from costly challenges such as childhood maltreatment, family trauma, substance use disorders, untreated mental health problems, interpersonal violence, hunger, housing insecurity, and lack of job skills. These essential services also determine our ability to perform well in school, achieve job readiness, and become self-sufficient.

The 100% New Mexico initiative aims to bring together county leaders and stakeholders from ten key family-serving sectors. This collaborative effort is designed to strengthen families by ensuring access to essential services that can increase their overall well-being. By working together, we can create a more resilient and equitable society that supports the health and safety of all residents.


Image 6. 100% New Mexico local initiative organization: This graphic illustrates how a county-based initiative can be structured with ten action teams, each one focused on ensuring access to a vital service. Each county initiative customizes its leadership structure to meet local needs.



The 100% New Mexico initiative empowers local leaders and stakeholders to strengthen their communities' readiness, care, and safety systems, making them as crisis-proof as possible. In a world where new challenges can arise any day, we can work together to make our communities strong and prepared, guided by courage, compassion, cooperation, and timely facts.

Investing in strong local systems of care, safety, and education can decrease the challenges of accessing vital community services. By partnering with local leadership, we can also strengthen the local capacity to address problems related to crime, violence, adverse childhood experiences, trauma, substance misuse, and injury.

At the heart of the local initiative are action teams representing ten service sectors that provide the "surviving" and "thriving" services. These teams work towards the goal of ensuring 100% of county residents have access to the ten vital services for surviving and thriving. Our vision is expansive because the need is urgent, and the opportunities are abundant.

Short-term goals: building the organizational structure to implement the 100% New Mexico framework, educating county residents about the costs of adverse childhood experiences, family trauma, and social adversity. We will also establish ten action teams with a shared vision, goals, interconnected activities, and a protocol for using data, technology, and communication.

Intermediate goals: supporting ten action teams in identifying barriers to vital services, guiding initiative project leaders through the process of assessment, planning, acting, and evaluation. We will identify funding and resources to support our three main strategies: building the 100% Family Center, a one-stop service hub offering access to all ten vital services; transforming public schools into fully-resourced 100% Community Schools offering access to all ten services to students and parents; and ending the digital divide so that 100% of residents can access ten vital services online.

Long-term goals: removing service barriers within each community within a county's borders, measuring increases in family self-sufficiency, school achievement, job readiness, work performance, and community engagement, with a focus on growing a culture of caring where every child is the top priority.


The 100% New Mexico County reports identify where and why service barriers exist, hindering residents’ capacity to find support services. Click to download a PDF copy of the county survey reports to identify barriers. These reports serve as the starting point for our county initiatives, with our action teams focused on addressing the service barriers identified in all ten sectors.

Click to download a PDF copy of the county survey reports.


Bernalillo AAEI_SurveyReport_Catron_2021_final.jpg Curry-Roosevelt Doña Ana Otero Rio Arriba Santa Fe San Miguel Socorro


7 STEPS TO 100%

The 100% New Mexico initiative is a comprehensive seven-step process that begins with surveying community members to assess the percentage of individuals facing difficulties in accessing each vital service and determining the underlying reasons. The identified barriers can range from the absence of services in the community to challenges related to transportation. Each county establishes ten action teams, representing the ten sectors, which then analyze the gathered data, identify evidence-informed solutions to address the identified barriers, and implement these solutions in collaboration with local stakeholders and government entities. This process of capacity-building operates on the principle of continuous quality improvement, ensuring that progress is ongoing and responsive to evolving needs. The framework of the initiative may be simple, yet its goal is ambitious and audacious: to ensure access to ten vital services for 100% of families. Learn more about our 7 Steps to 100%.
100% New Mexico

Image 7. 100% New Mexico partners: These are the seven steps of the 100% New Mexico initiative. The process is customized by each local initiative to meet local needs and based on local capacity.


Everyone thrives! With an investment in the 100% New Mexico initiative, we can reduce service barriers to increase family functioning, school achievement, job readiness, and workforce performance. We can also work on the local economic engine to revitalize downtowns and increase employment and small businesses. We can decrease costly involvement with child welfare, law enforcement, the courts, first responders, and ER visits.

With service barriers removed, all residents can access vital services to improve health and address historical trauma and all the costly public health challenges that are associated with ACEs and the adverse social determinants of health. Social adversity in the form of racism, classism, sexism, and ageism is also addressed using social justice frameworks. Each county can reach results through collaboration, courage, and creativity, with the full support of the Anna, Age Eight Institute technical assistance team.

With the alignment of all local leadership, both elected and informal, each county can become an engine for local problem-solving to ensure all residents are healthy, safe, and resilient. The work of the initiative builds on current local efforts to improve systems of care, always committed to working in alignment with city government, county government, and local nonprofit organizations.


Our theory of change guiding the 100% New Mexico Initiative is informed by a wealth of research focused on a wide variety of topics including the public health social-ecological model and decades of research focused on the social determinants of health, health equity, health and education disparities and historical trauma.

THEORY OF CHANGE: If we ensure that all our families and community residents have access to the five surviving services and the five thriving services, we will increase self-sufficient, healthy, and resilient family households.

Framework for change

Image 8. The Framework for Change: This graphic illustrates the change process within all communities within a county’s borders leading to outcomes.


100% New Mexico

Image 9. County Initiative Partners: This graphic illustrates the various partnerships that strengthen the work of the initiative, including elected leaders on the city, county, and state levels.


In our rush to connect everyone on the planet over the last two decades, we failed to make sure that 100% of residents had access to the internet and to encourage service providers to use technology to make their services as cost-effective and user-friendly as possible.

Revolutionary advances in the promotion of idea-sharing, the prevention and treatment of health challenges, and the strengthening of countywide systems of safety, health, education, and economic stability depend on technology. We have to step back to take a realistic look at how technology could or should help us create healthier communities where we’re all in, leaving no one out. There are powerful tools out there waiting to be used effectively.


Visit our county websites:

Bernalillo Catron Curry & Roosevelt Dona Ana Guadalupe Mckinley Otero Rio Arriba San Juan San Miguel Socorro Taos Valencia



Creating a statewide university-sponsored process for transforming the adverse social determinants of health into positive ones is nothing less than groundbreaking. New Mexico is the only state engaged in such a bold initiative. We are doing what many have said is too ambitious. We disagree with such limited thinking and lack of imagination. We are not tinkering around the edges of our historical challenges, instead, we are working in partnership with each county to address the root causes of our most costly public health and education problems.

The 100% New Mexico initiative brings together leaders in the public and private sectors to design innovative systems of health, safety, and education that serve all residents of New Mexico. The initiative is inclusive, welcoming the participation of change agents from governmental and non-governmental organizations, college students, youth, parents, grandparents, community and social justice activists, and socially-engaged business people.

Amid a collision of crises, with a new one appearing almost weekly, each county has a choice to make. Either we surrender to manmade chaos or we, as local leaders and stakeholders, forge a new path. We can collaborate on the state, county, city, and organizational levels to ensure 100% of us are safe and successful. We have the strategies, vision, goals, and inspiring local leaders, as well as a tested collaborative process for measurable and meaningful progress. Join us in making every county in New Mexico a place where 100% of children, and everyone, everywhere thrives.


Dr. Courtney Image

Katherine Ortega Courtney, PhD

Dr. Ortega Courtney serves as the co-director of the Anna Age Eight Institute and is the co-developer of the 100% New Mexico initiative. She is a changemaker, psychologist, author, and life coach. Her work in child welfare advocacy has instilled change in data-driven trauma prevention in states across the country. She has worked in policy and research and has led community initiatives through her work at the Santa Fe Community Foundation and the New Mexico Early Childhood Development Partnership. As a psychologist and life coach, she coaches individuals and organizations on interrupting the cycles of trauma, addressing the burnout rate in government jobs and child welfare, and providing the tools and skills to achieve the work-life balance that will trickle down to better outcomes in prevention. Her doctorate work at Texas Christian University was in experimental psychology focused on substance abuse treatment and prevention. She is also the co-author, with Dominic Cappello, of Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment, which served as a catalyst for the development of the Anna, Age Eight Institute in Santa Fe, New Mexico, where she serves as co-director. Dr. Ortega Courtney and Dominic Cappello wrote the follow-up books 100% Community and David, Age 14: Who and what determines our children’s health, education and future to guide local leadership in every county in their work designing trauma-free and truly family-friendly cities and towns. Email:

Dominic Cappello Image

Dominic Cappello

Cappello serves as the co-director of the Anna Age Eight Institute and is the co-developer of the 100% New Mexico initiative. He is a New York Times bestselling author and TEDx Conference curator with decades of experience advocating for health, safety, and education. He has a Master of Arts in Liberal Studies with an emphasis on Language and Communication from Regis University He worked for the New Mexico Department of Health Epidemiology and Response Division and the New Mexico Child Protective Services Research, Assessment, and Data Bureau, where he co-developed the Data Leader for Child Welfare program, which he implemented in New York City, Connecticut, and New Mexico. Cappello created the Ten Talks book series on family safety that gained a national audience when he discussed his work on the Oprah Winfrey Show. He is also the co-author of Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment, which served as a catalyst for the development of the Anna, Age Eight Institute in Santa Fe, New Mexico, where he serves as co-director. Cappello and Dr. Ortega Courtney wrote the follow-up books 100% Community: Ensuring 10 vital services for surviving and thriving and David, Age 14: Who and what determines our children’s health, education and future to guide local change agents in their work transforming the adverse social determinants of health into the positive ones. Email:

Gregory Sherrow Image Gregory Sherrow

Gregory began as an educator, but his early career sharply veered off into the world of information technology and web-based enterprises, giving Gregory decades of experience in creating educational, nonprofit, and commercial technology solutions. He has architected learning management systems for the Data Leaders for Child Welfare program in New Mexico, Connecticut, and New York City; he developed the technology prototypes for the Safety+Success learning management systems focused on family safety and health piloted in South Carolina and New Mexico; and his learning management system clients have included state departments of health, state departments of education and offices of attorneys general. Over the last decade and a half, he has become an author and resource for remote work management strategies and a proponent of using technology to positively empower agencies and communities while strengthening national, state, and local systems of public health, safety, and education. Email:

Marangellie Trujillo Image Marangellie Trujillo

Marangellie serves as the Associate Director, the official liaison to all county initiatives. Marangellie has over 15 years of experience in initiating and developing collaborative partnerships with communities, organizations, and institutions; and in leading, planning, and implementing statewide health-related and educational programs. Recently, she led and advanced the community schools strategy in New Mexico, directed the ECHO for Community Schools Program, facilitated statewide performance management systems, and conducted research and evaluation. Marangellie’s academic background is in science (Bachelor of Science in Cellular and Molecular Biology from the Universidad Metropolitana in Puerto Rico; Master’s in Biotechnology with a concentration in Biodefense from The Johns Hopkins University in Maryland), communicable and infectious diseases, public health, and education, among others. Marangellie values the strength of New Mexico’s diverse communities, multilingualism, resilience, creativity, culture, and compassion for one another. She strives to create a culture of shared governance, where we can rethink school-community relationships and redefine the core values of parents as first teachers. Marangellie firmly believes in community schools as an equitable strategy that will transform education and positively change the social determinants of health for the children of New Mexico. She is committed to making this vision a reality. For questions related to strengthening or starting a local 100% New Mexico initiative, developing the 100% Family Center: One-Stop Hub, 100% Community Schools, or sponsoring a 100% Summit. Email:


To learn more about our work and our evaluation process please visit