The border region: Its culture and health disparities

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.