Swine flu is killing American Indians in New Mexico at a higher rate than other ethnic groups, the Associated Press reports.

New Mexico so far has recorded 40 deaths from the H1N1 virus. But while American Indians make up 10 percent of the state’s population, they represent 20 percent of Swine flu fatalities, according to the AP.

The AP asked deputy state epidemiologist Mike Landen for possible reasons why this is occurring. The answer, in brief, is that Indians have higher rates of diabetes and poverty, making them more susceptible, and often live farther from medical care than non-Indians.

The explanation doesn’t offer much solace, but it pinpoints structural challenges that NM’s American Indian population confronts.