A CONCLUSION, A REFLECTION

I thoroughly enjoyed being a part of Border Beat. Through the articles and blogs of my classmates I learned about individuals and organizations that are a part of the United States - Mexico border as well as the unique culture of the border.

Throughout this semester, I updated and maintained this blog which focused on health organizations and healthcare issues related to the border. I hope that I was able to convey my genuine interest in this issue to anyone who read this blog. I also hope that the information, resources and links were useful to readers.

I met exceptional individuals involved with unique healthcare organizations. I learned that there are a lot of people and organizations that provide invaluable aid and support to the border communities.

Not only did I write on this blog but I also published articles about the border. These articles included; "A line in the sand: The history of the Arizona-Mexico border fence," "Something Worth Waiting For," and "Fighting Venom with a VIPER."

One of the most unique and beneficial aspects of this course was learning new multimedia skills. These included; how to upload, publish and edit articles, photos and audio online, how to set up a blog, how to create links with HTML, as well as the basics of programs like SoundSlides and Final Cut Pro.

Another great part of this course was the variety of topics that reported on and written about. This publication covered aspects of culture, lifestyle, people and news. Our reporters delved deeper into political and social issues as well as wrote fun articles about the diverse and interesting culture of the border.

I am very glad and grateful to have been a part of Border Beat. I have learned so much about the U.S. – Mexico border largely because of the individual perspective each person brought to this publication.

I hope that you have enjoyed reading my blog and learning about healthcare and the border. I hope that I’ve shown you that the healthcare issues we battle here in the United States are also battled along the border but often without the same vital resources. We may have shared symptoms, but there still isn’t a shared solution.

CHANGING THE STAGGERING STATISTICS OF LATINA TEEN PREGNANCY

Between 2005 and 2006 there was a 3 percent increase in teen birth rates, unfortunately Latinas have the highest teen birth and pregnancy rate of all racial and ethnic groups in the United States. Nearly 53 percent of Latinas get pregnant at least once before their 20th birthday.

These startling statistics are courtesy of The National Campaign to Prevent Teen and Unplanned Pregnancy. This organization has recently developed, The Latino Initiative.

The Latino Initiative’s mission is to reduce the persistently high teen pregnancy and birth rates and in doing so improve the lives and future prospects of children and families, according to the Latino Initiative’s Web site.

By why are these numbers so high for such a specific demographic?

Teen Pregnancy Rates by Race/Ethnicity, 1990-2004

Graph provided courtesy of The National Campaign to Prevent Teen and Unplanned Pregnancy, Latino Initiative.
The organization suggests four possibilities.

According to the organization, Latina teens commonly have sexual partners that are four or more years older. However, teens with older partners are less likely to use contraception and thus more likely to get pregnant, also according to the organization.

Another possibility for the high pregnancy rate is that Latino teens are also less likely to use contraception such as condoms, according to a 2008 presentation from the organization.

Sexually active teens who reported that they used a condom the last time they had sex

Graph provided courtesy of The National Campaign to Prevent Teen and Unplanned Pregnancy, Latino Initiative.
Other factors include acculturation, or adapting to another culture amidst generation and language barriers, as well as ineffective parent-teen communication. Roughly 75 percent of Latino teen boys and girls said that parents send varying messages to their sons and daughters about this issue, according to the organization.

The ultimate goal of this initiative is to decrease the rate of Latina teen pregnancy to only 2 out of 10 teens by 2015.

To reach this goal, the organization has outlined five steps; 1. Conduct an environmental scan, 2. Build capacity and partnerships with guidance of Latino Initiative Advisory Group, 3. Strengthen the research base for action, 4. Offer technical assistance and provide resources for parents, teens, and communities, 5. Reach out to key organizations and sectors, including policymakers, faith leaders, and media, also according to the presentation.

No teen wants to end up with this fate and every teen deserves to have a hopeful and meaningful future. Teens want to learn more information about methods of protection in order to ensure a successful future.

According to the organization, 84 percent of Latino teens report either graduating from college or a career is the most important goal for the future and 70 percent of teens want more information about abstinence and contraception.

But in order for this initiative to be successful, it requires effort from everyone in the community. The community needs to believe in the Latino youth and encourage them to be dedicated to their future as well as involve parents in the lives of their teens, according to the organization. It is also critical to appreciate the diversity of the Latino community and recognize that these statistics do not and cannot be applied to every individual.

This data is frightening. These young girls are only 15 years old to 19 years old.

This is a vital issue; not only are the futures of these teen girls at stake but so are the futures of these children.

By providing more information, resources and aid for this specific demographic, this organization has taken large strides to impede the rise in these statistics.

UNITED STATES - MEXICO BORDER HEALTH COMMISSION

Back in 1994, United States section of the Border Health Commission was established, but it wasn’t an entirely comprehensive border commission without the other half of the border.

July 24, 2000, an agreement was made between the U.S. and Mexico that established the United States-Mexico Border Health Commission (BHC) and in 2004, President George W. Bush signed an Executive Order that designated the BHC as a public international organization.

The U.S. – Mexico border houses a population of roughly 12 million people and more than 800,000 people legally, and thousands illegally, cross the border daily, according to the BHC Web site.

Many border communities are impoverished, have limited healthcare resources as well as poor access to healthcare, according to the Web site.

Whether it is for travel or medical care, U.S. and Mexican citizens can’t check their health problems at the border and thus enter the neighboring country as a potential health risk.

High population growth and constant migration, put further strain on the healthcare system of both countries. This strain can be dangerous to the dissemination of care and resources in an area desperate in need of proper healthcare.

Some of the biggest health threats at the border are chronic diseases like, diabetes, and hypertension, according to the Web site. Border communities also struggle with respiratory and gastrointestinal disease and as well as communicable diseases like, HIV/AIDS and tuberculosis, also according to the Web site.

A map of the Border Health Comission state outreach offices along the U.S. - Mexico Border.
The BHC’s mission is to provide international leadership to optimize the health and quality of life for those living along the border.

“The Commission was established after many years of many leaders on the border advocating for the establishment of a border health authority […] that would provide the necessary leadership to serve in a coordinating capacity to develop and advocate for specific binational actions and secure binational resources that would improve the health and quality of life on the border,” said Cecilia Rosales who was appointed to the to the U.S. section of the commission in 2006 and is also an associate professor at the UA’s Mel and Enid Zuckerman College of Public Health.

Until its creation, there was no method of addressing and improving the health of this region.

Through focusing on access to and promotion of healthcare as well as research and data collection at the border, the BHC facilitates identification of public health issues and encourages the collaboration of federal, state and local resources, according to the Web site.

In order to accomplish these goals the commission conducts public health need assessments along the border, provides support to public and nonprofit entities, aids in health promotion and disease prevention actives and has established a system of coordinated care.

The commission’s commitment to border communities is clearly illustrated through their extensive list of public health actions.

This includes; Healthy Border 2010, Border Binational Health Week, National Infant Immunization Week, Border Health Research, Pandemic/Avian Influenza Planning, Border Lead Issues, Border Tele-health, and the Border Health Information Platform.

Healthy Border 2010 is composed of aspects from Mexico’s National Health Indicators and the United States’ Healthy People 2010 programs. It establishes 10-year objectives for health promotion and disease prevention in the border region. This includes improving the quality of life, increasing the years of healthy life and eliminating health disparities.

Some of the focus areas of Healthy Border 2010 are; access to healthcare, cancer, diabetes, injury prevention and oral health.

National Infant Immunization Week is a collaboration between the Center for Disease Control and Prevention, the Pan American Health Organization, border agencies and community organizations. These groups work to coordinate activities along the border that promote immunizations and highlight the importance of protecting infants from vaccine-preventable diseases, according to the CDC Web site.

The United States section is led by the Secretary of Health and Human Services and the Mexico section is led by the Secretary of Health of Mexico. The commission is made-up of 26 members from the six Mexican and four U.S. border states.

The commission receives funding and support from the U.S. Department of Health and Human Services and the Mexican Secretaria de Salud.

The need for healthcare and health services at the border is blatantly obvious and unreasonably high. Fortunately, the Border Health Commission assemble a group of individuals who are genuinely concerned about the welfare of individuals living at the border and who are dedicated to improving the lives of those individuals.

"Up until the Commission was established and operationalized, the region did not have a sustainable process for addressing and improving the health of border residents," Rosales said. "The establishment of a Commission […] was needed to effectively address cross-cultural health disparate issues impacting border communities."

MONITORING THE SPREAD OF INFECTIOUS DISEASE AT THE BORDER

Infectious diseases, also known as contagious or communicable diseases, are a significant health threat chiefly because of their high probability of transmission and increased virulence, or ability to cause disease.

Infectious diseases are caused by organisms such as bacteria, viruses, parasites or fungi, according to the World Health Organization.

This health threat is intensified in border communities.

Fortunately, the Border Infectious Disease Surveillance (BIDS) Program was created in 1997 to combat this threat.

The program is a part of the Arizona Department of Health Services and was formed by the Center for Disease Control and Prevention, the Mexican Secretariat of Health and various border health officials.

"BIDS is a collaboration of federal, state and local public health authorities from both sides of the border to study infectious diseases. These collaborations are intended to improve knowledge gaps of known and emerging diseases along the border. They also improve the exchange of disease surveillance and epidemiological data [...]" said Orion McCotter, infectious disease surveillance epidemiologist for the Office of Border Health, in an e-mail.

The program works to establish an active, binational sentinel surveillance system, exchange disease incidence rates and risk factor information, enhance the public health infrastructure along the U.S. - Mexico border as well as improve binational communication and data exchange, said Robert Guerrero, office chief for the Office of Border Health, in an e-mail.

"There is no system to assess infectious diseases throughout the border as a unit. The large population movement across the border will allow for the disease to reach populations on both sides. The surveillance of infectious diseases by BIDS will allow detection of outbreaks and epidemics," McCotter said.

These agencies include nine clinical facilities in four geographically grouped cities along the border, Tiajuana–San
Diego, Nogales-Nogales, Las Cruces–Ciudad Juarez–El Paso, and Reynosa-McAllen.

The geographically widespread participation in the BIDS program allows participants to focus on a variety of diseases, McCotter said.

Within the BIDS program there is an executive committee and three subcommittees, epidemiology, laboratory and communications. There are nine “sentinel” site surveillance coordinators who are responsible for interviewing patients, completing data entry and also specimen shipping and tracking, according to a CDC report.

The increased participation and surveillance is critical because the proximity of border cities such as Nogales, Ariz. and Nogales, Sonora.

“From an epidemiological perspective, the border population must be considered as one, rather than different populations on two sides of a border, pathogens do not recognize the geopolitical boundaries established by human beings,” also according to the report.

Despite efforts to build walls and fences, as one of the busiest international portals, the constant migration of people across the border amplifies the spread of infectious pathogens. Thus, the BIDS program works to manage the transmission of these infectious diseases.

These diseases can be passed directly, from one person to another, or indirectly through some sort of vector, a mechanism for transporting disease, such as a mosquito.

There are several different types of infectious diseases including, the Avian Flu, leprosy, yellow fever, small pox and cholera.

BIDS past surveillance projects include, the West Nile virus, pediatric influenza, viral hepatitis (A, B, C, D and E), fever and rash syndromes such as, measles , rubella, dengue fever, typhus and ehrlichiosis, Guerrero said. The program’s current focus is Valley Fever, he added.

Past BIDS surveillance projects in Tucson have included, hospitalized pediatric influenza, hospitalized West Nile virus and Dengue Fever, Guerrero said.

This program demonstrates a collaboration of binational organizations as well as infectious disease surveillance strategies.

However, the program has encountered some obstacles along the way such as, language barriers, coordination of information as well as moving equipment, supplies and specimens, according to the report.

Man-made boundaries cannot contain disease-causing pathogens that spread rapidly, infect and can cause death.

"Infectious diseases are among the most critical health issues in the border region. Enhancing the network of surveillance for infectious diseases helps estimate distribution and spread of diseases," McCotter said. "The surveillance activities can also provide early detection of outbreaks. These efforts can lessen the morbidity and mortality of infectious diseases in border communities."