Thirteen million people live in the 80 Mexican municipalities and 48 American counties along the US-Mexico border. It is further estimated that 86% of those people live in 14 pairs of sister metropolitan cities in the 2 countries separated by a border.1 These border communities appear unique for at least 2 reasons-their geographic location (often away from the core) and the international environments created within by being adjacent to another country.2 Whether the US-Mexico border communities like other border regions around the world exist in a state of alienation, coexistence, interdependence, or integration as suggested by Martinez,2 they continue to be affected by many unique characteristics, forces, and processes that set them apart from the interior regions of their respective countries.

In recent years, the health and well-being of individuals, families, and communities that make up the US-Mexico border region have been additionally affected, negatively and severely, by politics and social policies on both sides of the border, particularly on the US side of the border. American national fears and seemingly unfavorable attitudes toward immigrants and immigration, tightening fiscal priorities, and limits on social and welfare programs in a declining American economy have created more barriers and roadblocks in addressing the health concerns of border communities.

A growing body of research and data suggest a higher prevalence of chronic illnesses, infectious diseases, pollution and environmental health hazards, mental health conflicts, and addictions that are coupled with higher rates of poverty, joblessness and lower rates of literacy, and access to affordable healthcare in these communities. The above conditions in the US-Mexico border communities pose both a challenge and an opportunity for systematic documentation of prevailing and emerging health issues as well as for the implementation of culturally competent health education, prevention, and treatment programs that integrate and encourage community input, participation, and ownership. The above conditions and circumstances have also increased the attention being given to the health and well-being of border people and communities and have elevated the topic to national and international significance.

The 6 articles included in this issue of Family & Community Health integrate a broad variety of health issues and approaches that have been used to document them and/or address them. The first 3 articles focus on specific populations in 3 states-beginning with the examination of healthcare access and barriers experienced by unauthorized immigrants in El Paso County by Heyman et al, followed by an analysis of focus group results of the individual, social, and environmental barriers and facilitators of physical activity among Latinos living in San Diego County, California, by Martinez et al, and concluding with an exploration by Keifer et al of Hispanic workers' perspectives of risks and hazards of orchard work in Washington State. These 3 articles focus on the unique and specific issues that people in border communities experience in terms of access and availability of healthcare, continued existence and prevalence of risks and hazards in occupational work of migrant and seasonal orchard workers, and the ongoing challenge of overcoming barriers to healthier lifestyles including engaging in physical activity that has the potential to reduce the incidence of chronic illnesses. The final 3 articles highlight some of the strategies being implemented in these border communities to improve the health and well-being of the people who live in and travel through them. McCloskey describes how promotoras have been utilized as partners and catalysts to promote positive change in a diabetes intervention program in New Mexico, de la Rosa et al detail the benefits of outreach in remote border communities by highlighting home visitation services also in New Mexico, and Vozdecky in her article highlights the relevance and importance of patient education on community-acquired methicillin-resistant Staphylococcus aureus in Florida.

I would like to express my thanks to all who submitted manuscripts for consideration for this special issue. The response was overwhelming and gratifying in terms of the recognition that border communities and their health and well-being need to be of paramount importance to both the United States and Mexico. Another special issue focusing on border and immigrant health issues is in the planning for publication in 2010. Thank you again for the interest and for the diverse work being accomplished in border communities despite the odds.

Satya P. Rao, PhD, CHES

Associate Professor, Department of Health Science, New Mexico State University, Las Cruces, NM 88003

mailto:[email protected]

REFERENCES