U.S.-Mexico Border Health Commission VIII Border Legislative Conference VIII Border Legislative Conference Santa Fe, NM July 9, 2004

U.S.-Mexico Border Health

Commission

VIII Border Legislative VIII Border Legislative ConferenceConference

Santa Fe, NM

July 9, 2004

U.S.-Mexico Border Health Commission

Welcome to the third coastWelcome to the third coast



Different cultures and languages (historically agricultural)

Different economic development & severe macro-economic issues

High population growth Different health systems Higher unemployment rates in the U.S. border Migrant and immigrant challenges and opportunities Beautiful region with a mystique, soul and spirit of its

own, share a common destiny All of the above blend on the border USMBHA, 1998

The U.S. - Mexico Border is The U.S. - Mexico Border is Characterized by:Characterized by:


More than 13 million inhabitants400 million border north-bound crossings annually

(INS 1999)

If the U.S.-Mexico Border were a If the U.S.-Mexico Border were a separate state, it would rank...separate state, it would rank...

Last in access to health care;

Second in death rates due to hepatitis;

Third in deaths related to diabetes;

First in the number of cases of TB;

First in school children living in poverty; and

Last in per capita income.

Texas Controller Report 2000


United States- Mexico Border United States- Mexico Border Population, 2000Population, 2000

59% of the population 59% of the population lives in the U.S. Border lives in the U.S. Border states states

79% of the U.S. Border 79% of the U.S. Border population is of population is of Hispanic originHispanic origin

40% of the population 40% of the population lives in the Mexico lives in the Mexico border statesborder states

48% of the border 48% of the border population is under 20 population is under 20 years of ageyears of age

0

1

2

3

4

5

6

Mexico

U.S.Border

PAHO, Mortality Profiles, 1999


Populations affected includePopulations affected include Border crossers Border crossers

(documented & (documented & undocumented)undocumented)

Immigrant, migrant and Immigrant, migrant and seasonal workersseasonal workers

Refugees and displaced Refugees and displaced workersworkers

Border impact Border impact communitiescommunities

Tribal nations and Tribal nations and reservationsreservations

NCFH, 1999

Poverty ConditionsPoverty Conditions 38% fall below 200% of 38% fall below 200% of

U.S. Federal poverty levelsU.S. Federal poverty levels

Unemployment rate is 2.5 - Unemployment rate is 2.5 - 3 times higher than U.S. 3 times higher than U.S. averageaverage

3 of the 5 poorest cities 3 of the 5 poorest cities and 4 of the 10 poorest and 4 of the 10 poorest U.S. counties are in this U.S. counties are in this areaarea

37 of 44 counties in 37 of 44 counties in immediate border area are immediate border area are Health Professional Health Professional Shortage AreasShortage Areas


“To provide international leadership to optimize health and quality of life along the United States-Mexico

border.”

Commission Commission MissionMission


Commission HistoryCommission History

1988-1994: Intense border, States, and 1988-1994: Intense border, States, and American Medical Association advocacy and American Medical Association advocacy and legislative efforts;legislative efforts;

1994-Commission has its origins in Public Law 1994-Commission has its origins in Public Law 103-400. Authorized the President to enter 103-400. Authorized the President to enter into an agreement with Mexico;into an agreement with Mexico;

July 2000-Signing of the International July 2000-Signing of the International Agreement creates the Commission; andAgreement creates the Commission; and

November 2000-Commission held its 1November 2000-Commission held its 1stst Binational Meeting.Binational Meeting.


PurposePurpose

To identify and evaluate current and To identify and evaluate current and future health problems affecting the future health problems affecting the population in the United States-Mexico population in the United States-Mexico border area.border area.

To encourage and facilitate actions to To encourage and facilitate actions to address these problems.address these problems.


GoalsGoals

To institutionalize a domestic focus on border health which would transcend political changes

To create an effective venue for binational discussion to address public health issues and problems


RolesRoles

Promote social and community participation;

Act as a catalyst for needed change;

Act as a policy advocate;

Increase resources for the border;

Encourage self-responsibility for health; and

Facilitate Border Early Warning Infectious Disease Surveillance Project.


Composition and StructureComposition and Structure

Two sovereign nations and two cultures Ten border states 44 counties and 80 municipalities 14 pairs of sister cities International organization 26 Commission Members, two sections

and three standing committees U.S. Inter Agency Border Action Team


Basic Elements of Basic Elements of Border CooperationBorder Cooperation

Identification of common problems and opportunities

Recognition that each country is independent

Trust and respect

Consensus in decision making

Equitable allocation of resources


Commission State and Commission State and Regional Outreach OfficesRegional Outreach Offices


Outreach Office RolesOutreach Office Roles

Assure that the Commission mission and outreach plans are carried out at the local and bilateral level;

Promote Healthy Border 2010 Program;

Complement the local State Border Health Office’s mission by coordinating work plan activities and bilateral efforts with Commission and local organizations.


Healthy Border ProgramHealthy Border Program

Based on Healthy People and Healthy Gente 2010

Grounded in science; build through consensus; and

designed to measure progress

Focus attention on key health issues

Improve allocation of health resources

Coordinate public and private action

Inspire ownership of objectives through:

- coordinated program activities

- community projects


Healthy Border 2010 AgendaHealthy Border 2010 Agenda

Access to Care

Cancer

Diabetes

Environmental Health

HIV/AIDS

Immunization

Infectious Diseases

Injury Prevention

Maternal, Infant and Child Health

Mental Health (Suicide)

Oral Health

Respiratory Disease (Asthma)

Terrorism Preparedness ** Developmental theme


PublicationPublication

To download a copy, visit www.borderhealth.org


Ten Great Public Health AchievementsTen Great Public Health AchievementsUnited States, 1900 - 2000United States, 1900 - 2000

Vaccination Motor – vehicle safety Safer workplaces Control of infectious diseases Decline in deaths from coronary heart diseases and

stroke Safer and healthier foods Healthier mothers and babies Family planning Fluoridation of drinking water Tobacco is a health hazard


Existing ChallengesExisting Challenges

High health and medical cost

Higher uninsured rates

Disproportionate reimbursements

Significant uncompensated care

Significant health disparities

High poverty rates and lower educational attainment


Our VisionOur VisionA border where diseases are prevented when A border where diseases are prevented when possible, controlled when necessary and treated possible, controlled when necessary and treated

when appropriate.when appropriate.

Reducing burden of disease:Reducing burden of disease:ObesityObesityDiabetesDiabetesAsthmaAsthma

Addressing risk factors:Addressing risk factors:Poor Diet/NutritionPoor Diet/Nutrition

Lack of Physical activity Lack of Physical activity Tobacco useTobacco use

Youth risk taskingYouth risk tasking


Border HealthBorder HealthInformation NetworkInformation Network

Web based communication system

Developed jointly with Mexico

Designed to improve communications and collaboration among health professionals

Geographic Information System Tools



Mapping ServiceMapping Service

Online mapping designed to serve our partners needs;

Tool to map and query HB health indicators;

Assist decision makers in monitoring and assessing health needs;

Completed the 1st phase; and

Gathering health data


For more information, please visit

www.borderhealth.org


United States-Mexico Binational TB United States-Mexico Binational TB

Referral and Case Management ProjectReferral and Case Management Project

Binational TB Card- a portable health document

Insures continuity of care and completion of TB treatment

Coordinates the referral of patients between health systems of both countries

For information , please visit www.borderhealth.org


2004 Work Plan2004 Work Plan1. Commission infrastructure:

Operation of U.S. and Mexico Sections

Information technology

Assessment, surveillance & evaluation• Behavioral Risk Factor Surveillance Survey (BRFSS)

2. Healthy Border outreach plans: performance focus

3. Health innovation and best practices• Border Binational Health Week

• Immunization Week in the Americas

4. Binational public emergency preparedness


Planning and Response to Public Planning and Response to Public Health EmergenciesHealth Emergencies

ForumsForums

Sonora-Arizona

Chihuahua-New Mexico-Texas

Mexico-Texas Border States

Baja California-California


Early Warning Infectious Early Warning Infectious Disease Surveillance (EWIDS)Disease Surveillance (EWIDS)

Enhance the infectious disease surveillance capabilities along the United States-Mexico Border by creating public health preparedness systems in the six Mexican Border States that are interoperable with one another and with those of the four United States Border States.

A collaboration between the Commission, Mexico A collaboration between the Commission, Mexico Secretariat of Health, U.S. Department of Health Secretariat of Health, U.S. Department of Health and Human Services, and CDC.and Human Services, and CDC.


Core Recommendations Core Recommendations to Governmentsto Governments

1. Access to Health Care

2. Disease Prevention and Health Education

3. Health Workforce Needs

4. Public Health Infrastructure Improvements


Dissemination ofDissemination of2004 - 20052004 - 2005

Healthy Healthy BorderBorder

CalendarCalendar

December 12, 2003December 12, 2003Healthy Healthy BorderBorder

Health CardsHealth Cards““Tarjetas de Salud”Tarjetas de Salud”

Summer of 2004Summer of 2004

World World Tuberculosis Tuberculosis

(TB) Day(TB) DayMarch 24, 2004March 24, 2004

Border Celebration in Border Celebration in Tijuana, Baja CaliforniaTijuana, Baja California

April 1April 1stst

World World Health DayHealth Day

““Road Safety”Road Safety”April 7, 2004April 7, 2004

Binational Conference on Binational Conference on Transportation and Road SafetyTransportation and Road Safety

April 14 –16, 2004April 14 –16, 2004South Padre Island, TXSouth Padre Island, TX

U.S.-Mexico BorderU.S.-Mexico BorderImmunization Week Immunization Week

in the Americasin the Americas

11stst Wk is April 24-30 Wk is April 24-30 (1(1stst Dose) Dose)

22ndnd Wk is July 31-August 6 Wk is July 31-August 6(2(2ndnd Dose) Dose)

33rdrd Wk is October 11-17 Wk is October 11-17(3(3rdrd Dose) Dose)

U.S.-Mexico U.S.-Mexico Border BinationalBorder Binational

Health WeekHealth Week““Families in Action Families in Action

for Health”for Health”USMBHCUSMBHC

Healthy BorderHealthy Border2010 Program2010 Program

Love them. Protect them.Love them. Protect them.Immunize them.Immunize them.

October 11 - 17, 2004 October 11 - 17, 2004


Inauguration hosted by Inauguration hosted by

Arizona – Sonora, October 12Arizona – Sonora, October 12

Closing events hosted by Closing events hosted by

Texas – New Mexico, October 15Texas – New Mexico, October 15

Border Binational Health WeekBorder Binational Health WeekOctober 11- 17October 11- 17


Commission

Advance the implementation of the Advance the implementation of the Healthy Border 2010 Program, by:Healthy Border 2010 Program, by:

Encouraging and creating sustainable efforts, organizational relationships, and community networks to improve health status; and

Address health disparities in a border wide manner.

GoalGoal


Commission

U.S. Department of Health and Human Services;

Mexico Secretariat of Health;

Health Resources and Services Administration;

Office of Minority Health;

The ten U.S.-Mexico Border States;

USMBHC Outreach Offices/States Offices of Border Health;

Centers for Disease Control and Prevention;

California-Mexico Health Initiative; and

Pan American Health Organization.

Partnerships in place


Primary Topics:Access

ImmunizationHealthy Life Styles

Theme: Families in Action to Improve HealthTheme: Families in Action to Improve Health

Services:Immunizations (Across Life Span)

Screenings/ReferralsTrainings

Health Fairs/FiestasOther

Actions:Simple

PracticalTangible

Border FocusedBinational Activities


Commission

Share easy to understand health information, prevention and best practices;

Strengthen community based organizational networks and structures and foster partnership opportunities in support of HB 2010 program;

Exercise binational collaboration;

Leverage financial, technical, organizational support and partnerships; and

Establish benchmark indicators to document outcomes and progress.

Expected OutcomesExpected Outcomes


Time LineTime LineOctober 11October 11

León, Guanajuato Inauguration by President Fox and both Secretaries of Health and

Policy Forum on Migrant Health

San Diego/Tijuana Launch event with Promotoras Conference

October 12October 12 Arizona-Sonora

– Inauguration of Binational Health Week by Sec. Tommy Thompson and Sec. Julio Frenk Mora

October 13October 13 Douglas/Agua Prieta

Children and Families, Immunizations, Heart Healthy


Time LineTime LineOctober 14October 14

Tohono O’odham Nation/Puerto PeñascoTohono O’odham Nation/Puerto Peñasco Health fair, Physical Activity, Immunizations

October 15October 15 Yuma and San Luis CountiesYuma and San Luis Counties

Health fair, Immunizations, Teens, Substance AbuseHealth fair, Immunizations, Teens, Substance Abuse

San Diego/TijuanaSan Diego/Tijuana HIV/AIDS conferenceHIV/AIDS conference

Closing ceremony by Surgeon General Richard Closing ceremony by Surgeon General Richard Carmona, Dr. Elizabeth Duke and Mexico Carmona, Dr. Elizabeth Duke and Mexico Health officials in Paso del Norte regionHealth officials in Paso del Norte region


Time LineTime Line

October 16October 16 San Diego/TijuanaSan Diego/Tijuana

Mobile units in northern San Diego CountyMobile units in northern San Diego County

October 17October 17 San Diego/TijuanaSan Diego/Tijuana

Mobile units in northern San Diego CountyMobile units in northern San Diego County


Commission

BORDER IMMUNIZATION WEEKS IN THE AMERICASBORDER IMMUNIZATION WEEKS IN THE AMERICAS

JULY 31 – AUGUST 6JULY 31 – AUGUST 6&&

OCTOBER 11 - 17OCTOBER 11 - 17



Substance AbuseSubstance Abuse

Illicit drug situation in the border is characterized by:Illicit drug situation in the border is characterized by:

Heroin has surpassed crack with the most serious Heroin has surpassed crack with the most serious consequences;consequences;

Number of female heroin users has increased, Number of female heroin users has increased, seeing gender equity among a number of chronic seeing gender equity among a number of chronic drug users;drug users;

Marijuana remains the most widely abused illicit Marijuana remains the most widely abused illicit drug;drug;

Pulse Check 2002


Substance AbuseSubstance Abuse

Metamphetamine continues to be an Metamphetamine continues to be an emerging problem contributing to domestic emerging problem contributing to domestic violence;violence;

Tobacco continues to be the number one Tobacco continues to be the number one preventable killer in America; and preventable killer in America; and

Heightened security at U.S.-Mexico points Heightened security at U.S.-Mexico points of entry may have changed trafficking of entry may have changed trafficking modes or routes.modes or routes. Pulse Check 2002


Challenges and OpportunitiesChallenges and Opportunities Promote, fund and disseminate substance Promote, fund and disseminate substance

abuse educationabuse education

Have accessible and affordable treatment Have accessible and affordable treatment servicesservices

Reduce demand and availabilityReduce demand and availability

Fund behavioral and mental health servicesFund behavioral and mental health services

Fund comprehensive and effective Fund comprehensive and effective prevention, education, and treatment prevention, education, and treatment programsprograms


“Our challenge is to have a border, a world of order, characterized by peace and prosperity

in the midst of diversity.”


Thank you for all that you do – Thank you for all that you do – GraciasGracias por todo lo que hacenpor todo lo que hacen

For more information:For more information:

www.borderhealth.orgwww.borderhealth.org

www.saludfronteriza.orgwww.saludfronteriza.org

Documents

U.S.-Mexico Border Health Commission VIII Border Legislative Conference VIII Border Legislative Conference Santa Fe, NM July 9, 2004