U.S. Mexico Border Health Issues

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Dr. Cecilia Rosales, director of the new Phoenix program of the University of Arizona’s Mel and Enid Zuckerman College of Public Health, the state’s only nationally accredited college of public health, discusses quality of life and health issues among border populations in both the southwestern United States and in Mexico.


Richard Ruelas: Dr. Cecilia Rosales was named director of the new Phoenix program for the University of Arizona's Mel and Enid Zuckerman College of public health, the state's only accredited college of public health. She is on the U.S.-Mexico border health commission and recently hosted a meeting of health officials from both sides of the border. With me is Dr. Cecilia Rosales. Thanks for joining us. Let's start with the meeting, who was there and what was the hot topic?

Dr. Cecilia Rosales: This is a meeting we convened, high level officials from Mexico city, the department of health and human services from the U.S., the states and border states and representation from both sides of the border states to discuss a strategic framework for developing our healthy border 2020 initiative. This is an initiative that is based on the healthy people initiative in the U.S. and Mexico's national health plan.

Richard Ruelas: Explain why Arizonans should care why Sonora or Mexico city folks are healthy.

Dr. Cecilia Rosales: It's more about the wellness of the border population. Our focus is on the U.S. Mexico border which is a region of 10 states, four on the U.S. side and six on the Mexican side. It's a very unique region that has very -- even though there are different health systems and politics and economy, we actually share very common health status in the region and so it's a very interdependent region. Most of us have family, most of us -- it's fluid, we move back and forth to work. Because we do have U.S. citizens would work in Mexico and vice versa. It's a very interdependent, very fluid community.

Richard Ruelas: When you say common health status, meaning things like diabetes, heart rates. What kind of things are we seeing that are here and in Mexico?

Dr. Cecilia Rosales: They're very similar health issues in the border region. As a matter of fact, the top eight conditions, health conditions are very similar to both. Diabetes, for example, is one big issue, tuberculosis is another. Infectious and non-infectious diseases are very similar on both sides in terms of rates and health status of border residents.

Richard Ruelas: I guess infectious diseases sounds pretty simplistic, that they can carry over as families move back and forth.

Dr. Cecilia Rosales: Absolutely, there's a -- there's an imaginary boundary, though now we have a physical structure that separates the two countries but it's still very fluid.

Richard Ruelas: Even for those who have long-standing ties you might go home for family visits and around the holidays and it's in the states' interests?

Dr. Cecilia Rosales: Absolutely. There a myth that most diseases come from South to North. We learned a big lesson during the H1N1 outbreak that most people thought it was a situation that only Mexico had to worry about. Arizona was very vigilant and we had -- we have a very good infrastructure on the border that has -- it's called an early warning infectious disease surveillance system and we knew what the status was during that entire time for that outbreak because of that system in place where we share information between Mexico and Arizona. As well as or states on the border region.

Richard Ruelas: Yeah.

Dr. Cecilia Rosales: But what we found was that there was actually a case in Arizona that was actually imported into Mexico. In other words, we exported it.

Richard Ruelas: We were case zero for that?

Dr. Cecilia Rosales: Yes, it's North to South as well. For the non-infectious disease, what problems do we share and I assume you're going to eventually blame some of this on diet.

Dr. Cecilia Rosales: Diet is part of it. But there are many other factors. Social factors that we don't think about. Social, economic, political factors that contribute to whether we have a healthy community. It's not just diseases. You know, it's about where people live, where people work. Where people play. And if we don't have good housing, if we don't have good transportation systems or a good built environment where people can exercise and live a healthy lifestyle, if we don't have that, or good working conditions, people are not working in safe and secure places and maintaining, you know -- having -- keeping people healthy in the workplace, people aren't going to be healthy. It's more about where people live and work and it's those social factors that contribute to health.

Richard Ruelas: What did Mexico officials express as biggest concerns about the border state here, as far as access to medical care and the things you speak about?

Dr. Cecilia Rosales: There's a large population that migrates to the border region and through the border region. They come through the border and into other areas we refer to as border impact areas. Other states, there are these streams that have existed for years. Migrant streams. It's of importance to them that their residents whether here as legal residents or not, they have -- you know, they're concerned about the health and welfare of their residents and nationals.

Richard Ruelas: Yeah, and then do -- do the states that are there, more rural than I imagine the states here? As far as access to medical care? Longer way to go to see a doctor, that kind of stuff?

Dr. Cecilia Rosales: That's a big issue for residents in general and especially in the state of Arizona. Access to healthcare has always been a big issue for a lot of our residents here in Arizona and in particular, the border region.

Richard Ruelas: I appreciate the time and we're going to look at, I imagine, more, as the -- as the two countries work together. We have 2020 as the goal, I guess.

Dr. Cecilia Rosales: That's correct.

Richard Ruelas: That's it for us tonight. For all of us here at "Horizonte," I'm Richard Ruelas, have a good evening.

Dr. Cecilia Rosales:Director, University of Arizona's Mel and Enid Zuckerman College of Public Health;

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