Border Health Issues in the Age of NAFTA


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Emergent Public Health Issues in the US-Mexico Border Region


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US-Mexico border region area has unique social, demographic and policy forces at work that shape the health of its residents as well as serves as a microcosm of migration health challenges facing an increasingly mobile and globalized world. This region reflects the largest migratory flow between any two nations in the world. Data from the Pew Research Center shows over the last 25 years there has never been lower than 140,000 annual immigrants from Mexico to the United States (with peaks over 700,000). This migratory route is extremely hazardous due to natural (e.g., arid and hot desert regions) and human made barriers as well as border enforcement practices tied to socio-political and geopolitical pressures. Also, reflecting the national interdependency of public health and human services needs, during the most recent five year period surveyed the migratory flow between the US and Mexico has equaled that of the flow of Mexico to the US--both around 1.4 million persons. Of particular public health concern, within the US-Mexico region of both nations there is among the highest disparities in income, education, infrastructure and access to health care--factors within the World Health Organization’s conceptualization of the Social Determinants of Health, and among the highest rates of chronic disease. For instance obesity and diabetes rates in this region are among the highest of those monitored in the world, with adult population estimates of the former over 40% and estimates in some population sub-groups for the latter over 20%. The publications reflected in this Research Topic, all reviewed from experts in the field, addressed many of the public health issues in the US Mexico Border Health Commission’s Healthy Border 2020 objectives. Those objectives-- broad public health goals used to guide a diverse range of government, research and community-based stakeholders--include Non Communicable Diseases (including adult and childhood obesity-related ones; cancer), Infectious Diseases (e.g., tuberculosis; HIV; emerging diseases--particularly mosquito borne illnesses), Maternal and Child Health, Mental Health Disorders, and Motor Vehicle Accidents. Other relevant public health issues affecting this region, for example environmental health, binational health services coordination (e.g., immunization), the impact of migration throughout the Americas and globally in this region, health issues related to the physical climate, access to quality health care, discrimination/mistreatment and well-being, acculturative/immigration stress, violence, substance use/abuse, oral health, respiratory disease, and well-being from a social determinants of health framework, are critical areas addressed in these publications or for future research. Each of these Research Topic publications presented applied solutions (e.g., new programs, technology or infrastructure) and/or public health policy recommendations relevant to each public health challenge addressed.




Sustaining the Borderlands in the Age of NAFTA


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Sustaining the Borderlands in the Age of NAFTA provides the only book-length study of the impact on residents of the US-Mexico border of NAFTA's Environmental and Labor Side Accords, which required each state to enforce labor and environmental regulations. Through field research in Matamoros, Tamaulipas, anthropologist Suzanne Simon tests the premise that the side accords would encourage Mexican grassroots democratization. The effectiveness of the side accords was tied to transparency and accountability, and practically bound to opportunities for Mexican border populations to participate in the side accord petitioning and civil society input mechanisms. Simon conducted sixteen months of fieldwork with both a group of environmental activists and a group of those fighting for labor justice in Mexico. Both of these groups became enmeshed in the types of cross-border advocacy networks and coalition building efforts that are typical of the NAFTA era. Although the key to the side accords' anticipated success lay in their ostensibly generous participatory, civil society inclusion and sustainable development opportunities, Sustaining the Borderlands reveals that the Mexican border populations for which they were largely created are effectively excluded from participating. This is due to the ongoing online, territorial, class, and cultural barriers that shape the borderlands. Rather than experiencing the side accords and their companion institutions as transparent and accessible, residents experienced them as opaque and indecipherable. Simon concludes that the side accords have failed to deliver on their promise of bringing democracy to Mexico because practical mechanisms that would ensure their effective implementation were never put in place. NAFTA took effect at a time when Mexico was undergoing a democratic transition. The treaty was supposed to encourage this transition and improve environmental and labor conditions on the US-Mexico border. This book demonstrates that, twenty years later, the promises of NAFTA have not come to pass.




NAFTA and the US/Mexico Border Health


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Eating NAFTA


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Mexican cuisine has emerged as a paradox of globalization. Food enthusiasts throughout the world celebrate the humble taco at the same time that Mexicans are eating fewer tortillas and more processed food. Today Mexico is experiencing an epidemic of diet-related chronic illness. The precipitous rise of obesity and diabetes—attributed to changes in the Mexican diet—has resulted in a public health emergency. In her gripping new book, Alyshia Gálvez exposes how changes in policy following NAFTA have fundamentally altered one of the most basic elements of life in Mexico—sustenance. Mexicans are faced with a food system that favors food security over subsistence agriculture, development over sustainability, market participation over social welfare, and ideologies of self-care over public health. Trade agreements negotiated to improve lives have resulted in unintended consequences for people’s everyday lives.




The NAFTA, Report on Environmental Issues


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The Wall


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In her Brookings Essay, The Wall, Brookings Senior Fellow Vanda Felbab-Brown explains the true costs of building a barrier along the U.S.-Mexico border, including (but not limited to) the estimated $12 to $21.6 billion price tag of construction. Felbab-Brown explains the importance of the United States' relationship with Mexico, on which the U.S. relies for cooperation on security, environmental, agricultural, water-sharing, trade, and drug smuggling issues. The author uses her extensive on-the-ground experience in Mexico to illustrate the environmental and community disruption that the construction of a wall would cause, while arguing that the barrier would do nothing to stop illicit flows into the United States. She recalls personal interviews she has had with people living in border areas, including a woman whose family relies on remittances from the U.S., a teenager trying to get out of a local gang, and others.




Borders: A Very Short Introduction


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Compelling and accessible, this Very Short Introduction challenges the perception of borders as passive lines on a map, revealing them instead to be integral forces in the economic, social, political, and environmental processes that shape our lives. Highlighting the historical development and continued relevance of borders, Alexander Diener and Joshua Hagen offer a powerful counterpoint to the idea of an imminent borderless world, underscoring the impact borders have on a range of issues, such as economic development, inter- and intra-state conflict, global terrorism, migration, nationalism, international law, environmental sustainability, and natural resource management. Diener and Hagen demonstrate how and why borders have been, are currently, and will undoubtedly remain hot topics across the social sciences and in the global headlines for years to come. This compact volume will appeal to a broad, interdisciplinary audience of scholars and students, including geographers, political scientists, anthropologists, sociologists, historians, international relations and law experts, as well as lay readers interested in understanding current events.




NAFTA Revisited


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NAFTA entered into force in 1994 after a bitter Congressional debate. But NAFTA in operation has proved no less controversial than NAFTA before ratification, for both supporters and opponents of trade liberalization have cited experience with the agreement to justify their positions. To provide a factual basis for this ongoing debate, the authors evaluate NAFTA's performance over the first seven years, comparing actual experience with both the objectives of the agreement's supporters and the charges of its critics. They then examine future challenges and opportunities in the trade and investment relationships among the three partner countries and the broader implications for new trade initiatives throughout the hemisphere.