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

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

2 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 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.

3 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.

4 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

5 If you build a 15-foot wall, they will just build a 16-foot ladder -Janet Napolitano, previous Governor of Arizona

6 Migration Trends

7 Migration Trends

8 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, % 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.

9 New Mexico trends

10 New Mexico trends

11 Health Care Coverage in border region 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

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13 Occupational Hazards

14 Fatal injuries, foreign-born workers

15 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 Transportation and Materials Transportation Manufacturing Recreation and Hotel Trade Education and Health Services Construction Professionists and Executives Natural Resources and Mining Other 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).

16 Industry Distribution by Ethnicity (by percentage), 2013

17 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 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

18 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

19 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)

20 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)

21 The Office of Border Health s Mission Statement To improve heath status and health services in the New Mexico border region and other borderimpact areas of the State.

22 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.

23 The Office of Border Health works with. 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

24 If you would like more information about the New Mexico Department of Health, Office of Border Health, please visit us at our webpage: or write us at: Office of Border Health 1170 N. Solano Dr., Suite L Las Cruces, NM 88001