Health issues at the US-Mexican border

Article Abstract:

As a result of pressure due to population growth on both sides of the border between the US and Mexico, the border communities face special health problems. These are reviewed and evaluated. Ten million people currently live near the border, in communities that stretch across it: Tucson, Arizona and Nogales, Mexico; San Diego, California and Tijuana, Mexico; Mexicali, Mexico and Imperial County, California, are examples. Unincorporated colonias house more than 100,000 people, and often lack septic tanks, running water, and indoor toilets. Statistics are presented concerning mortality (which is low, because of the relatively young population), fertility (high, but declining), infant mortality (low on the US side, considerably higher on the Mexican side), infectious diseases (a significant health problem at the border), and environmental health (very problematic; several binational agencies and commissions have been established to regulate this). The US and Mexican health care systems are described and compared. Cross-utilization of the systems by border residents is common. The only large US border city with a public hospital is El Paso, and many people, unable to pay for health care, are forced to forego it. Medication is purchased in Mexico by more than one quarter of the poor border residents of the lower Rio Grande Valley, according to one survey. Programs have been established to refer patients from the US to Mexico for certain tests or for sterilization at lower cost. Mexico has a national health system, but many poor people face problems similar to those in the US. The US services are used by the wealthy, by those who are employed in the US who have health insurance, and by those who want their children to be born in the US or who need emergency care. Improvements in border health care will be made only when both sides are motivated to make them. Three sets of proposals have been formulated: one by public health officials from both countries, one by the American Academy of Pediatrics (whose members come from both countries), and one by the Pan American Health Organization and the US-Mexico Border Health Association. Universities, too, show signs of involvement with border health issues. The continued integration of the economies of the US and Mexico may depend on improving the health of border residents. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, International aspects, Medical care, Mexican-American border region

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A national agenda for research on aging

Article Abstract:

A report is presented concerning a national agenda for research on aging prepared by the Institute of Medicine of the National Academy of Sciences. Released in June 1991, the report represented the work of an 18-member committee of health care experts who, with the help of 63 scientists, outlined research goals in four areas: basic biomedical research; clinical research; behavioral and social research; and research on the delivery of health services. Thirty-three million Americans are now 65 years of age or older, and most are healthy; at the same time, the number of older adults who are disabled is growing. A shortage of physicians with special training in the needs of the geriatric population exists, and funds for research on aging are limited. Fifteen research areas were named by the committee as having the most potential for increasing knowledge about the aging process and for improving the quality of life for the elderly. These are briefly discussed. Increased funding for these projects is to be sought from Congress and the federal agencies and institutes that usually underwrite such research. An allocation of $312 million for research grants on aging was recommended over a five-year period, with an additional one-time expenditure of $110 million for construction. Projects in related fields (behavioral and social sciences, health services delivery) relevant to aging should also be supported more generously. Other recommended sums are listed for clinical trials, training of faculty members, specialized Centers of Excellence in Research and Teaching in Geriatrics and Gerontology, research infrastructure (to provide resources such as laboratories and cell culture facilities), and construction. Major increases in research funds for studying aging can only come from the federal government, but other sources include private foundations, corporations, industry, and cooperative endeavors among all such participants. The committee held that the responsibility for improving the well-being of the elderly lies with the leaders of the country, who must act to broaden the base of scientific research on aging. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aging, Research, Laws, regulations and rules, Reports, Medical research, Institute of Medicine

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