Abstract
The U.S.-Mexico Border Region is one of the most dynamic in the world. Population projections are that by 2020 some 24 million people will live in the area. The majority live in or near the 14 sister cities which face each other along a 2,000 mile border and share social, economic, environmental and health interests. The rapid growth of the border region over the past several decades has significantly outpaced the development of infrastructure to meet residents’ needs. What were social and cultural differences have become persistent social inequalities. The public health of one sister city affects the others. Poverty is prevalent, accompanied by infectious and environmentally-created diseases due to absent sewage treatment, toxic waste and poor air and water quality. Congenital anomalies persist in some counties. Recently the border area has experienced gang-related drug and gun violence, and diverted resources to public safety. The environmental and public health challenges in this region are great. The Border XXI Program of 1996 and the Healthy Border 2012/2020 Program commits the governments of Mexico and the U.S., and non-government stakeholders at all levels, to assist in border transformations. U.S. and Mexican border communities have collaborated on joint health improvements to reduce inequalities for many decades. Some of these programs have been limited to a single pair of sister cities, while others have been statewide or border-wide programs. Evaluations of the short and long-term effects or outcomes of these programs have not always been a high priority; the criteria for successful programs and their sustainability have not been widely studied or replicated, and uncertainties in economic and leadership resources have prevented the gathering of uniform, continuous data that are useful on both sides of the border.
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Notes
- 1.
See Dear (2013), who states that without the presence of an international boundary, each pair of borderland twin cities would be instantly recognizable as a single, integrated metropolis. He shows how to think about the possibility of a border region without walls.
- 2.
On October 26, 2006 President George W. Bush signed H.R. 6061 into law, known as the Secure Fence Act. There is a down payment of $1.2 billion to the Department of Homeland Security marked for border security but not specifically for a border fence. As of 2010 the fence project had been completed from San Diego to Yuma. Controversy led Congress to revisit the fence plan. On March 16, 2010, President Obama stated the money would be used to upgrade current border technology. The border fence is not one continuous structure rather it is a grouping of short physical walls that stop and start, secured in between with a “virtual fence” which includes a system of sensors and cameras monitored by Border Patrol Agents. See The Border Fence (http://www.pbs.org/now/shows/432).
- 3.
See Good Neighbor Environmental Board (GNEB) and Environmental Advisors Across Borders (2010). National Service Center for Environmental Publications, Pub. No. EPA 130-R-10-001, nscep@bps-lmt.com . The GNEB is an independent U.S. Presidential advisory committee that meets twice yearly in various U.S. border communities and also in Washington D.C. to inform the President and Congress about environmental issues along the U.S.-Mexico border.
- 4.
- 5.
The terms “health disparities” and “health inequalities” will be used interchangeably here.
- 6.
See Bergner and Rothman (1987). Health status is not commonly understood because the term “health status” has not been clearly defined and a consensus agreed to. Few have operationalized the term so that it can be used to access the level of health among a group of people. Length of life is the ultimate measure of health status where acute illnesses that are potentially fatal is concerned. In chronic illnesses where palliative therapies may prevent further deterioration the relevant measure of health status will include aspects of health other than the length of life.
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Bruhn, J.G. (2014). The Border Region: Its Culture and Health Disparities. In: Culture and Health Disparities. SpringerBriefs in Public Health. Springer, Cham. https://doi.org/10.1007/978-3-319-06462-8_1
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