The U.S.-Mexico border region is an area of tremendous human
interaction where two countries and two cultures meet and flow
across a porous international boundary. The border stretches
approximately 2,000 miles from the southern tip of Texas to
California, and comprises six Mexican states as well as California,
New Mexico, Arizona, and Texas. The U.S.-Mexico Border Health
Commission reports that approximately 13 million people live along
the border; by 2025, the population is expected to double. The
region has experienced recent annual growth rates of 2 to 5
percent.
The border is a dynamic region whose population exhibits alarming
adverse health and social conditions. (See
Figure 4
.) The border is medically underserved, its residents oftentimes
uninsured. If it were to be made the 51st state, the U.S.-Mexico
border region would rank:
- Last in per-capita income,
- Last in access to health care,
- Second in death rates due to hepatitis,
- Third in deaths related to diabetes,
- First in the number of schoolchildren living in poverty,
and
- First in the number of children who are uninsured.
[44]
The federal government classifies every county along the border
(wholly or in part) as medically underserved. The number of primary
care physicians there falls far short of meeting the needs of
border patients. In the cities, the number of primary care
physicians per 100,000 patients is about 12 percent lower along the
border than in the rest of the state. In nonmetropolitan areas, the
border is nearly 18 percent lower. And Texas as a whole trails the
national average by more than 18 percent.
[45]
Physicians practicing along the U.S.-Mexico border are besieged
by a "medical practice perfect storm." Their practices depend
disproportionately on government payers, with few privately insured
patients to offset narrow margins. Their patients typically exhibit
more severe and complex medical needs.
The general health of the border closely resembles that of an
underdeveloped country in that the region is plagued with diseases
affecting third-world nations. These are diseases that virtually
have been eradicated in Europe and the vast majority of the United
States.
The Texas-Mexico border is the gateway to our state. Not only
does the border serve as a portal for the state's continued
economic development and international commerce, it also provides
an opening for the spread of deadly, contagious diseases such as
tuberculosis, diphtheria, and hantavirus. Investment in the border
health care delivery system is an investment that benefits all
Texans.
[44]
Texas Comptroller of Public Accounts. Bordering the Future; 1998
(Updated 2001).
[45]
Texas Department of State Health Services. Supply Trends Among
Licensed Health Professions, Texas, 1980-2004. Second Edition;
March 2005.