United States-México Border Health Commission

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Goals, Actions, and Accomplishments Updated March 2016 Mission To provide international leadership to optimize health and quality of life along the U.S.-México border Strategic Principles Leadership-Focus-Venue Strategic Priorities The priority areas for program year 2015 2016 include the following: Transversal Axis Priorities Strategic planning Access to care Research Strategic Priorities Infectious diseases Degenerative chronic diseases Maternal and child health Accidents (injuries/road traffic accidents) Mental health (addiction, depression, violence) Strategic Actions The following action items include activities and product-oriented, measurable outputs planned for 2015 2016: Sponsor the annual Border Binational Health Week to promote borderwide sustainable partnerships that can address border health problems. Convene the Border Binational Reproductive Health Technical Work Group to implement activities defined in their strategic plan to facilitate binational coordination and collaboration on reproductive health issues, including maternal mortality and teen pregnancy prevention. Sponsor the sixth iteration of Leaders across Borders to advance binational leadership development for public health and health care professionals working to improve community health along the U.S.-México border region. Coordinate follow-up train-the-trainer events for community health workers, known as promotores along the U.S.-México border, in U.S. border cities that focus on community mental health and substance use disorders in non-specialized health settings. Convene the Border Health Research Work Group to improve processes for collaborative cross-border research that can be replicated and to promote resource sharing and collaborative partnerships. 1

Continue to guide the implementation of the U.S.-México Border Tuberculosis (TB) Initiative to support and advance the work of the TB Continuity of Care and TB Legal Issues Work Groups as well as the Multi-drug Resistant TB Expert Consultation Network by promoting continuity of care of all TB patients along the U.S.- México border; facilitating coordination of TB patient management across multi-level legal frameworks; and establishing uniform meet and greet standards and guidelines applicable to all TB patients facing repatriation. Conduct the Border Health Research Forum to identify processes for collaborative cross-border research that can be replicated and promote resource sharing and collaborative partnerships. Finalize implementation of the U.S.-México Border Obesity Prevention Work Group Plan by publishing a white paper on border obesity prevention strategy to address critical obesity prevention and treatment issues affecting the U.S.-México border region. Continue implementation of the Healthy Border 2020 Initiative to improve quality of life and to eliminate health disparities along the U.S.-México border. This includes disseminating small grants, the Healthy Border 2020 Community Grants, to encourage key partners and community organizations to conduct activities and interventions that address priority areas. Continue promotion of the Community-Based Healthy Border Initiative in support of year-round regional activities and events that focus on BHC priorities. Implement the Binational Border Health Consortium of the Californias Strategic Plan in coordination with participating organizations to facilitate communication, coordination, and collaboration among public and private health institutions working to benefit the communities of the California-Baja California region. Initiatives and Activities The following list identifies the primary achievements of the (BHC) from 2000 to present (most recent on top): Sponsored the annual Border Binational Health Week to promote borderwide sustainable partnerships that can address border health problems (2004 to present). Conducted promotores trainings to address mental health and substance use, and environmental health issues. These trainings were completed as part of the Border Promotores de Salud Initiative and were implemented with several partners including the Substance Abuse and Mental Health Services Administration (SAMHSA), the Pan American Health Organization (PAHO) and the U.S. Environmental Protection Agency (EPA). (2015) Established a partnership with the U.S. Environmental Protection Agency to identify mutual areas of interest and collaborative efforts in support of the EPA s Border 2020 Program goals and the BHC s Healthy Border 2020 Initiative and other priorities. The BHC s Community-based Healthy Border Initiative, which includes BBHW, and EPA s focus area of air quality and asthma education awareness for Regions VI and IX are included in this collaboration. In 2015, worked together to establish the Southwest Center for Pediatric Environmental Health (SWCPEH) in El Paso, Texas; in 2016, collaborated with EPA Region IX to organize a Children s Environmental Health Symposium in San Diego, California. Established the U.S.-México Border Reproductive Health Initiative in 2013 to address reproductive health inequities and related issues impacting U.S.-México border populations and increase the region s visibility within global reproductive health. In 2014 the BHC held the first U.S.-México Border Reproductive Health Summit in San Diego, California, bringing together more than 190 researchers, practitioners, and policy leaders to advance evidencebased reproductive health practices, policies, and programs that support the safety and choices of women 2

and girls on regional, national, and global levels. To date, the BHC has convened the Border Reproductive Technical Work Group meetings in San Diego, California (2016); Piedras Negras, Coahuila (2015) and San Diego, California (2013). Established the Border Obesity Prevention (BOP) Initiative in 2013 to address rising trends in the prevalence of obesity along and across the binational border. The BHC convened the first BOP Summit in McAllen, Texas, bringing together subject matter experts in obesity, physical activity, and nutrition representing local, state, and federal government and nongovernmental organizations and binational academic institutions to develop a strategic action plan that prioritizes obesity as a regional health concern. In 2014 the BOP Technical Work Group met to initiate the development of a five-year binational strategic plan. The BHC then convened the BOP workshop on August 4 6, 2015 in Laredo, Texas to develop recommendations aimed to impact major policies and programs in addition to smaller projects along the border. Participants drafted a white paper to serve as a reference document for decision-makers and other stakeholders to assist them in identifying issues and potential best practices specific to the border region. Sponsored the Prevention and Health Promotion among Vulnerable Populations Initiative Regional Stakeholder Meetings in 2013 convening stakeholders from various local and state agencies, organizations, universities, and education centers in each respective sub-regional outreach area on the U.S. side of the border that serve vulnerable populations who can define population cohorts with limited or no access to health and human services and the barriers to access; identify/evaluate current health and human services referral systems/networks and document system gaps; and propose strategic/operational interventions. The meetings took place in Calexico and San Diego, California; Nogales and Yuma, Arizona; and Eagle Pass and El Paso, Texas. Established the Leaders across Borders binational leadership-training program in 2009, with five graduations accomplished to date (2010 El Paso, Texas; 2011 Tucson, Arizona; 2013 San Diego, California; 2014 San Diego, California; 2015 Phoenix, Arizona). To date, 100 binational public health leaders have graduated from the LaB program. Established the U.S.-México Border TB Consortium in 2010 to enhance the integration of binational and borderwide efforts on mutual TB issues. Sponsored meetings include those held in 2010 and 2011 in San Diego, California, and 2012, 2013, 2014 in Las Cruces, New Mexico, and 2015 in El Paso, Texas. Technical work groups established as part of the TB Consortium have completed or are working on the following: U.S.-México Legal Manual for TB Patient Continuity of Care In 2015, the U.S. Section of the TB Legal Issues Work Group drafted its portion of the manual, currently under review, that identifies and describes U.S. laws and procedures for TB case management and transfer. Project Extension for Community Healthcare Outcomes (ECHO) Site Visit The MDR-TB Consultative Network of Experts participated in a live Project ECHO demonstration in 2015 to identify the feasibility of establishing a TB Project ECHO to coordinate complex binational MDR-TB cases between U.S. and Mexican clinicians and public health experts. Project ECHO staff provided a follow-up consult in 2015 for the BHC U.S. Section central office staff. As a result, the BHC and Project ECHO staff are exploring opportunities to utilize this model for binational TB case management as well as potentially replicate it for other BHC initiatives. U.S.-México Border Environmental Scan In 2014, the Continuity of Care Work Group conducted a regional environmental scan to identify binational TB projects that serve border communities toward establishing an effective communication protocol. 3

Established the U.S.-México Border Binational Infectious Disease Initiative in 2010 to document critical infectious disease issues impacting the border region (sponsored conferences to date: 2010-San Antonio, Texas; 2011-El Paso, Texas; 2012-Austin, Texas; 2014-El Paso, Texas). Sponsored Obesity Mini Fora in 2012 (in Laredo, Presidio, Eagle Pass, and Brownsville, Texas) to identify interventions relevant to obesity-related issues affecting various border communities that were used to inform the development of the 2013 U.S.-México Border Obesity Prevention Summit. Sponsored the annual border component of National Infant Immunization Week/Vaccination Week in the Americas to promote vaccination in the U.S.-México border region (2004 2012). Supported the New Mexico-Chihuahua TB Pilot Project (2009 2012), an innovative binational project designed to improve surveillance, contact investigations, and directly-observed therapy of TB patients in the New Mexico-Chihuahua border region, focusing especially on small urban and rural areas within the Nuevo Casas Grandes Health Jurisdiction. Initiated action to address critical binational legal issues affecting the bi-state and binational management of TB cases by conducting a U.S. Border States TB Legal Issues Forum (2007-Phoenix, Arizona), a related Mexican TB Legal Issues Forum (2010-México City, México), and a Binational TB Legal Issues Forum (2010-El Paso, Texas). Sponsored the Binational Border Health Research Work Group & Expert Panel Meetings (2015, 2006-Monterrey, Nuevo León; 2014, 2012-San Diego, California; 2011-Las Cruces, New Mexico; 2010-El Paso, Texas; 2009- La Jolla, California, 2008-McAllen, Texas, 2007-El Paso, Texas) to guide the BHC s plans and actions in its efforts to develop a comprehensive borderwide agenda. Established the U.S.-México Binational Border Health Research Forum in 2006 to provide U.S. and Mexican academic and research institutions collaborative opportunities to initiate cross-border research that governments can use to establish policy. Sponsored fora to date: 2015, 2006-Monterrey, Nuevo León; 2012- San Diego, California; 2011-Las Cruces, New Mexico; 2009-La Jolla, California. Sponsored the Binational Health Councils Strategic Planning Workshops to enhance the organizational capacity of binational health councils, analyze and discuss border health strategic priorities proposed in respective sister-city sub-regions, and provide a forum to present local public health recommendations to borderwide organizations that have a mandate to improve border health (2011, 2010-El Paso, Texas; 2008-San Antonio, Texas). Established the Healthy Border 2010 strategic initiative in 2001. Since this initiative, the Border Binational Technical Work Group was later formed in 2010 to focus on the closeout of Healthy Border 2010 and the rollout of Healthy Border 2020 (Healthy Border 2010/2020 Border Binational Technical Work Group Meetings to date: 2013, 2012, 2011-Phoenix, Arizona; 2011-El Paso, Texas). Sponsored the Border Models of Excellence Initiative (2010-focus on childhood obesity and TB programs; 2003-focus on promotora programs) to recognize community-based health programs and initiatives along the U.S.-México border that have made great strides in improving community health. Sponsored youth focus groups in 2010 in support of developing an obesity and diabetes prevention multimedia campaign. Outcomes included fotonovelas and movies. Sponsored the U.S.-México Border Child and Adolescent Forum in 2009 in El Paso, Texas to address critical issues affecting children and adolescents in the border region. Established the Binational Border Health Research Expert Panel in 2007 to bring together selected border research partners who serve in key leadership positions within their respective institutions to advise the BHC on border health research. 4

Supported the Border Influenza Surveillance Network in 2007 that operated sentinel sites and weekly influenza activity reporting (including the H1N1 Pandemic) in the binational tri-state region of Southwestern New Mexico-Northern Chihuahua and West Texas. The network serves as a model for expansion throughout the border region. Sponsored the Binational Pandemic Avian Flu Forum (2006-Hermosillo, Sonora) to promote coordinated actions related to binational pandemic influenza planning which set the state for the Binational Pandemic Avian Flu Table Top Exercise (2007-San Diego, California), the final installment of a two-phase binational influenza initiative. Sponsored the Binational TB Card Pilot Project in 2003, a critical step in responding to the TB health crisis in the U.S.-México border region. Proposed establishment of the U.S.-border states and México Early Warning Infectious Disease Surveillance in 2003, a project designed to improve the ability to rapidly detect, identify, and report infectious disease outbreaks. Sponsored the Ventanillas de Salud (VDS) Pilot Project in 2003 by establishing VDS centers in three Mexican consulates along the border that focused on providing information and referral services. To date, the Mexican Secretariats of Health and Foreign Relations have expanded the VDS program to 50 Mexican consulates in the United States. Established state outreach offices in each of the 10 U.S.-México border states (2000). Publications Proceedings Reports Binational Border Health Research Forum (2006, 2011, 2012, 2015) Binational Border Health Research Work Group & Expert Panel Meeting (2009, 2010, 2011, 2012) Border Reproductive Health Summit (2014) U.S.-México Border Tuberculosis Consortium (2010, 2012, 2013, 2014) U.S.-México Border Binational Infectious Disease Conference (2010, 2011, 2012) Binational Health Councils Strategic Planning Workshop (2008, 2010, 2011) U.S.-México Border Child and Adolescent Health Forum (2009) Legal Forum: Cross-Jurisdictional Issues in Tuberculosis Control (2007) Access to Health Care in the U.S.-México Border Region: Models, Research, Policy and Action (2005) Topic Briefs The and Promotores (2012) Healthy Border 2010/2020 Initiative (2011) United States-México Binational Coordination in Epidemiological Surveillance, Reporting, and Response (2009) United States-México Cross-Border Pilot Project (2009) Health Care Reform: Border Challenges and Opportunities (2009) White Papers Access to Health Care in the U.S.-México Border Region: Challenges and Opportunities (2014) Binational Collaboration and Infectious Disease Surveillance along the U.S.-México Border (2011) Health Research on the U.S.-México Border: Promoting a Binational Agenda (2010) 5

White Papers (continued) Health Disparities and the U.S.-México Border: Challenges and Opportunities (2010) Childhood Obesity and the U.S.-México Border (2009) Tuberculosis along the United States-México Border (2009) U.S. Border States Early Warning Infectious Disease Surveillance Project (2009) Other Publications Healthy Border 2020: A Prevention & Health Promotion Initiative (2015) Newsletters (2003 2014) Annual Reports (2001 2012) Synthesis Report: Prevention and Health Promotion among Vulnerable Populations on the U.S.-México Border (2013) Annual Accomplishments (2006 2009; 2011 2012) Annual Meeting Summary Reports (2008, 2010, 2011) Institutional Review Boards in the U.S.-México Border: Current Protocols and Practices (2010) Border Lives: Health Status in the United States-México Border Region (2010) BHC 10-Year Anniversary Report (2010) Frontera Saludable 2010 Reporte de Medio Plazo: Frontera Norte de México (2010) Healthy Border 2010/2020 Strategic Framework Report (2010) Situación de la Tuberculosis en la Frontera México-Estados Unidos (2010) Healthy Border 2010 Midterm Review: U.S. Border Area (2009) Researching Border Health: A Review of Initiatives to Develop a Border Health Research Agenda, 1995 2009 (2009) U.S. Border Lead Outreach Project: Lead in Traditional Pottery (2008) Border Models of Excellence Compendium: Community Health Worker (Promotora) Programs (2003) Healthy Border 2010: An Agenda for Improving Health on the United States-México Border (2003) 6