Public Health Challenges in the U.S.-Mexico Border

Region

The U.S.-Mexico Border Region• Approximately 12 million people reside in the US-Mexico Border

Region (2000 Census); a figure that is expected to grow to 24 million by 2020.

• The Paso del Norte Region (Juarez, Mexico; El Paso, Texas; and the Southwest part of New Mexico) has a population of approximately 3.5 million.

Mobility in the Region

Everyday, 89,237 people and trucks cross legally into the United States from Chihuahua, Mexico via car, truck, bus and on foot.

The Paso del Norte bridge is the second busiest entry point into the U.S from Mexico.

• U.S. border patrol works tirelessly to detect and prevent the illegal entry of

undocumented.

• In the past 10 years, approximately 2,000 immigrants have died while

trying to enter the United States.

• High militarization and heavy border patrol have led undocumented

immigrants away from the relatively safe crossing zones into remote and

waterless desert areas.

© David Cook Photography

”If you build a 15-foot wall, they will just build a 16-foot ladder “

-Janet Napolitano, previous Governor of Arizona

Migration Trends

Migration Trends

Border Population in New Mexico

The U.S/Mexico border population includes:

immigrant and migrant populations, documented and undocumented

U.S. and Mexican residents who cross the border on a regular basis for work, school and recreation

In 2013, the border population in New Mexico was approximately 243,000.

• 65.5% Hispanic

• 27.22% living at or below the poverty line

• poverty rates are more than 75% in immigrant enclave communities (colonias)

• Approximately 20% of the state’s population self-identified as Mexican.

New Mexico trends

New Mexico trends

• One-third of the border population is uninsured;

• Up to 75% of adults in the Colonia communities are uninsured

• About 70% of border residents under 21 are enrolled in Medicaid—a proxy expression of poverty

Health Care Coverage in border region

Occupational Hazards

Fatal injuries, foreign-born workers

24080

19570

17050

14160

1236011420

9440 9130

0

5000

10000

15000

20000

25000

30000

Transportation

and Materials

Transportation

Manufacturing Recreation and

Hotel Trade

Education and

Health Services

Construction Professionists and

Executives

Natural

Resources and

Mining

Other

Occupational injuries and illness of Latino population, causing missed work days, 2011

Source: U.S. Bureau of Labor Statistics, Survey of

Occupational Injuries and Illnesses in cooperation with

participating State agencies

The majority of Latino injuries/illnesses occur with occupations that are in the

lowest paid sector (transport, manufacturing, production, construction);

Hispanic/Latino make up a big part of these industries (see next slide).

Industry Distribution by Ethnicity (by percentage), 2013

Health in the NM Border Region

Majority of new TB cases in the state are linked with Mexico

25% of cases in 2014, were from Doña Ana and Luna County

High rates of STDs in border counties and migrant and immigrant enclave neighborhoods

especially among ages 15-24

HIV rates are increasing, especially among low-income Hispanics

High-risk births (diabetics), congenital syphilis, fetal alcohol syndrome, teen birthrates among highest in the nation

Increasing rates of obesity and diabetes among adults and children

Challenges to the Health Services Delivery Model in the Binational Border Region

Trans-mobile population

Mexican residents using American healthcare services and vice versa

Uninsured indigents and undocumented patients with no way to pay for services

Underground/mixed status families

Absence of a comprehensive federal immigration policy

Poverty

Difficulty balancing the costs of preventive versus critical care

Costs ultimately borne by state, federal and county programs and/or written off by providers at a loss

Current System for Providing Healthcare to the Border Population

Community health centers; local public health offices; private providers in rural areas; and hospitals.

In the interest of public health, nobody is turned away, and residence status is not a question posed to clients as to eligibility of services.

Fee-for-services, fragmented system (versus single-payer system or universal health care system)

Funding Sources to Provide Healthcare Services In New Mexico

New Mexico State Health Insurance Exchange

Medicaid (expanded Medicaid) and Medicare

New Mexico Rural Primary Care Act

Seasonal Farmworker Healthcare Grants

County Indigent Healthcare Funds

Children’s Health Insurance Program (CHIP)

Sole Provider agreements w/ hospitals (Fed/County match)

Section 1011 (undocumented receive emergency healthcare services underwritten by U.S. Government)

The Office of Border Health’s Mission Statement

To improve heath status and health services in the New Mexico border region and other border-impact areas of the State.

The Office of Border Health Role

To serve as both catalyst and facilitator in ensuring that public health objectives are met in our shared culturally and socio-economically unique US-Mexico Border Region and immigrant and migrant populations throughout the State.

Other border states on U.S. and Mexican sides

US-Mexico Border Health Commission

Mexican Health Secretariat

Centers for Disease Control and Prevention

Academic Institutions (NMSU, UNM, UTEP, Texas Tech) and

Border Governors Conference

Among other stakeholder organizations/agencies

…to align priorities and resources to address issues border-wide

The Office of Border Health works with….

If you would like more information about the New Mexico Department of Health,

Office of Border Health,

please visit us at our webpage:http://nmhealth.org/about/asd/ohe/obh/

or write us at: Office of Border Health

1170 N. Solano Dr., Suite LLas Cruces, NM 88001