1. Border Health Commission
United States – Mexico
Border Health Commission
United States - Mexico Border Health Commission

2. If the U.S. - Mexico Border were a separate state, it would rank...
First in number of children living in poverty;
Second in Tuberculosis incidences;
Third in deaths from Hepatitis;
Last in number of health professionals/100,000 population;
Last in per capita income.
U.S. Mexico Border Counties Coalition March 2006

3. Definition of Border – 100 km – 60 miles
La Paz Agreement
Definition of Border – 100 km – 60 miles

5. Issues Associated with Access to Health Care Along the U. S
Issues Associated with Access to Health Care Along the U.S. - Mexico Border Region
Lack of knowledge on how to access services;
Language and cultural barriers;
Cost of care;
Need for training and distribution of health care providers;
Denial of access to services for undocumented (illegal status) individuals;
Availability of services;
Transportation (distance/means of); and
Limited public health infrastructure.
(UA, RHO Border Vision Fronteriza Initiative, Delphi Study, 1997)
For further information:
(information on EPA/SEMARNAP Border XXI program)
(Mexico's federal environmental protection agency)
United States - Mexico Border Health Commission

6. Close to 13 million inhabitants
Photo: National Geography 1997
Close to 13 million inhabitants
Dangerous territory, heavily fortified and certainly the busiest border
400 million legal border north-bound crossings annually (1998)
Terrorism and significant public health threats
United States - Mexico Border Health Commission

7. Population Growth Trends
In the next 8 years the Mexican Border population will double
In the next 22 years the U.S. Hispanic Population of the Border will double
In the next 43 years the U.S. population all races in the Border Counties will double
United States - Mexico Border Health Commission

8. Commission's History
: Intense border, States, and American Medical Association advocacy and legislative efforts;
1994-Commission has its origins in Public Law Authorized the President to enter into an agreement with Mexico;
July 2000-Signing of the International Agreement creates the Commission; and
November 2000-Commission held its 1st Binational Meeting.

9. Mission
“To provide international leadership to optimize health and quality of life along the United States - Mexico border.”

10. Purpose
To identify and evaluate current and future health problems affecting the population in the United States-Mexico border area.
To encourage and facilitate actions to address these problems.
Goals
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

11. Roles 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
Institutionalize domestic focus.
Facilitate Border Early Warning Infectious Disease Surveillance Project

12. Composition and Structure
Two nations
Ten border states
44 counties and 80 municipalities
14 pairs of sister cities
Public International Organization
United States and Mexico Sections
26 Commission Members and two sections
U.S. Inter Agency Border Action Team

13. Basic Elements of Border Cooperation
Identification of a common problem and opportunities
Recognition that each country is independent
Trust and respect
Consensus in decision making
Equitable allocation of resources

14. Outreach 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.

15. Commission Outreach Offices (OROs)

16. Healthy Border Program
Based on U.S. Healthy People 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
living document

17. Healthy Border Focus Themes
Access to Care
Cancer
Diabetes
Environmental Health
HIV/AIDS
Immunization
Infectious Diseases
Tuberculosis
Injury Prevention
Maternal, Infant and Child Health
Mental Health
Oral Health
Respiratory Diseases

18. Themes in Development Terrorism Preparedness Nutrition Obesity
Alcohol, Tobacco, and other drugs

19. For information , please visit
United States-Mexico Binational TB Referral and Case Management Project
Binational TB Card - a portable health document
Insures continuity of care and completion of treatment
Coordinates the referral of patients between health systems of both countries
More than 1000 cards have been distributed
Medical savings between $50,000-$250,000 for every multi-drug resistant case prevented
For information , please visit

20. Core Recommendations to Governments
Increase and Improve Meaningful Access to Quality Preventive Care
Improve Health Education, Disease Prevention and Control
Improve Health Workforce Development, Training, Placement and Retention
Improve Public Health Infrastructure

21. Increase and Improve Meaningful Access to Quality Preventive Care
Continue to support the advancement of skills in the public health sector and promote incentives to encourage private sector providers to meet the emerging health needs of people along the border by providing insurance that pays for care in both countries;
Promote dissemination / replication of existing high quality public / private health programs throughout the border region through the expansion of the Commission’s Border Models of Excellence;
Support the use of binational health cards such as the binational TB and Immunization cards to facilitate binational transfer of information critical to prevention and spread of disease and the treatment of health conditions.

22. Increase and Improve Meaningful Access to Quality Preventive Care
United States Specific
Strengthen the health programs that assist migrants and immigrants that live either on a temporary basis or permanently in the U.S.; and
Improve methods that increase access and enrollment of eligible U.S. border residents in existing health care service plans / systems in both Spanish and English, and to continue assisting these enrollees to receive necessary medical attention.
Mexico Specific
Develop strategies to increase the availability of the Seguro Popular (Popular Insurance) health insurance program in the border region; and
Develop programs to address the needs of repatriated Mexican citizens who are in need of health education / medical care.

23. Improve Health Education, Disease Prevention and Control
Support the Commission in implementing border wide and binational efforts through its Healthy Border 2010 Program;
Increase federal programs and resources for schools to teach health, nutrition and fitness, and encourage healthy lifestyles;
Support the Commission and the Ten Against TB Strategic Plan to:
Develop a TB outreach initiative to work through existing community-based outreach programs and promotores in establishing methods to identify cases in their communities
Identify and screen at least 90 % of TB contacts to active pulmonary TB cases
Expand the Binational Directly Observed Therapy Outreach Initiative

24. Improve Health Education, Disease Prevention and Control
Encourage private industry through trade and border conferences and associations to provide financial support for projects to promote health and prevention of diseases;
Provide adequate funding for ongoing border specific surveillance studies to assess / enhance achievement of Healthy Border 2010 objectives; and
Advance HIV / AIDS care along the border by supporting projects such as the Care Act Special Projects of National Significance, that lead to a more productive care environment for people living with HIV / AIDS.

25. Improve Health Workforce Development, Training, Placement and Retention
Develop an exchange program to train border and binational health professionals; and
Promote health professions among the youth who reside in the border region and expand the U.S. Department of Health and Human Services’ Health Careers Opportunity Program.
United States - Mexico Border Health Commission

26. Improve Public Health Infrastructure
Support and promote border state / local coordination for the implementation of a binational vertical public health preparedness strategy and cross-border sharing of public resources;
Improve the integration of the Border Infectious Disease Surveillance (BIDS) and the Early Warning Infectious Disease Surveillance (EWIDS) Projects to maximize resources in the border;
Encourage continuing education binationally for the specific public health preparedness;
Expedite binational communication and information exchange for public health and emergency response purposes;
Pursue International Organization status; and
Review USMBHC treaties and agreements.

27. Early Warning Infectious Disease Surveillance (EWIDS) Project
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 Secretariat of Health, U.S. Department of Health and Human Services, and CDC.

28. Critical Capacities for Public Health Emergency Preparedness
Surveillance and Epidemiologic Capacity
Laboratory Capacity – Biologic Agents
Surveillance and Epidemiology – Related communication and information technology
Surveillance and Epidemiology – Related education and training

29. To download a copy of the report please visit:
1st Border Binational
Health Week
October , 2004
To download a copy of the report please visit:
United States - Mexico Border Health Commission

30. Outcomes
Shared 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;
Exercised binational and Departmental collaboration and cooperation in support of border health improvement; (evidence of collaborative efforts)
Leveraged financial, technical, organizational support and partnerships; and
Established benchmark indicators to document outcomes and progress.