It is no secret that national politics and economics play a significant role in the disparities experienced by border communities in areas such as employment, education, and healthcare. As Dr Rao mentions in this edition of Family & Community Health, border communities are distinct in both their geographic location and their internationalized feel. Together these distinctions place border communities at the center of complex and often-competing national interests. In regards to US-Mexico border communities, increased concern over immigration and security in recent years has placed additional strains on these communities as they attempt to navigate an often-ambiguous identity in the face of growing nationalism. What is more, given their distance from national governments, border communities occupy an interesting geographical and cultural space where language, custom, and commerce meld in ways that are not entirely national, and yet not international. It may be an overstatement to claim that border communities are often a forgotten people, but given the disparities experienced by these communities, especially along lines of health and the delivery of healthcare services, such a claim does not appear entirely misguided.
In his often-misinterpreted poem, "Mending Wall," Robert Frost's narrator ponders, "Something there is that doesn't love a wall[horizontal ellipsis]." Be it natural or supernatural, but each spring the gaps in the narrator's stone wall always reappear. When the narrator and his neighbor engage in their annual mending of the wall, the narrator comments, "He is all pine and I am apple orchard. My apple trees will never get across and eat the cones under his pines." To which his neighbor responds with one of Frost's most famous lines, "Good fences make good neighbors." Most casual readers of Frost's "Mending Wall" often stop here, and it is in the line, "Good fences make good neighbors" that many justifications for barriers between people and communities have been made. However, reading further, we find the narrator asking, "Why do they make good neighbors?" and stating, "Before I built a wall I'd ask to know what I was walling in or walling out, and to whom I was like to give offence. Something there is that doesn't love a wall, that wants it down." To be fair, walls and borders are not without their justification and reason. However, given the current state of healthcare in border communities, with persistent labor hazards, chronic illness, mental illness, and health-related inequalities, the time has come to look at the influence of borders on the provision of care to citizens and neighbors who live in these communities. Be it a sociological or political phenomenon, there is no denying that this notion of separation greatly influences not only the behavior and attitudes of those living in border communities but also those responsible for their care.
In this edition of Family & Community Health (32:1), authors address pertinent border community issues such as risk hazards in orchard labor, access and barriers to healthcare for unauthorized immigrants, community-based diabetes intervention, and barriers to and facilitators of physical activity among Latinas in a California border county. What these and the other authors illustrate is that the provision of care and the delivery of health services to border communities are both unique and pressing. I think you will find this issue informative and insightful.
Jeanette Lancaster