Healthy Border 2010/2020
List of Publications
Healthy Border 2010/2020 Strategic Framework (November 2010)
Plan Estratégico Frontera Saludable 2010/2020 (November 2010)
Frontera Saludable 2010-Reporte de Medio Plazo-Frontera Norte de México (July 2010)
Healthy Border 2010 Midterm Review-U.S. Border Area (July 2009)
Healthy Border 2010: An Agenda for Improving Health on the U.S.-México Border (2003)
Frontera Saludable 2010: Una Agenda para Mejorar la Salud en la Frontera México-Estados Unidos (2003)
Healthy Border 2010 aims to improve health in the United States-México border region, an area defined as 100 kilometers (62 miles) north and south of the United States-México border and close to 2000 miles in length. This area includes 80 municipios in 6 Mexican states and 48 counties in 4 U.S. states that form the border between México and the United States. For the purposes of the Healthy Border 2010 initiative, the border definition is limited only to the 44 U.S. border counties, excluding Maricopa, Pinal, and La Paz in Arizona and Riverside County in California. The Healthy Border 2010 initiative was established as the U.S.-México Border Health Commission’s (BHC) binational agenda of health promotion and disease prevention during the Commission’s second meeting in March of 2001. The Healthy Border 2010 agenda established 10-year objectives for binational health promotion and disease prevention in the border region. The initiative also serves as a basis for the development of bilateral, borderwide, and community health improvement plans.
The BHC is currently developing a strategic plan for the implementation of Healthy Border 2020 that is intended to coincide with the closure of Healthy Border 2010. Implementing Healthy Border 2020 will involve a strong scientific team of binational experts working jointly with other border health partners to insure the best possible plan that captures the essential border health outcome and social determinant objectives for the border region.
The BHC has recently published the Healthy Border 2010/2020 Strategic Framework Report that describes the framework and timeline in completing steps toward the closeout of Healthy Border 2010 and the rollout of the proposed Healthy Border 2020.
Since the publication of the first HB 2010 Report, Healthy Border 2010: An Agenda for Improving Health on the U.S.-México Border, in 2003, the BHC has published two midterm reports: a U.S. component midterm report, Healthy Border 2010 Midterm Review-U.S. Border Area, in July 2009 and a México component midterm report, Frontera Saludable 2010-Reporte de Medio Plazo-Frontera Norte de México, in July 2010. The aim was to ensure that the Healthy Border 2010 initiative remains current, accurate, and relevant. Nearly one-quarter of the Healthy Border objectives were established as developmental because they had no measurable data available at the beginning of the decade. However, they were proposed with the assumption that appropriate data would be available by mid-decade. These reports are also available from our homepage under "Border Health Reports." A binational executive summary combining both reports will be published at a later date, followed by plans for the closeout of HB 2010 and the rollout of HB 2020 that will include opportunities for community and public input during the development of HB 2020.
The Healthy Border 2010 initiative is composed of the common elements from México’s National Health Indicators and the United States Healthy Gente objectives. From the United States, it draws on the 1998 Healthy Gente Program (Gente is the Spanish word for people), which provides health objectives for the United States region that borders México and is designed to be compatible with the United States Healthy People 2010 Program. From México it draws on the National Health Indicators (Indicadores de Resultados) Program, which tracks health measures at the national, state and local levels in México.
Out of the 46 Mexican health indicators and the 25 United States Healthy Gente objectives, there are 20 common measures. These represent most of the priority areas for action on health issues in the border region. Reflecting the selection criteria used for the Healthy Gente Program and México’s National Health Indicators Program, the objectives are deliberately limited to a relatively small number of variables that can be measured with reliable data. These objectives will help focus health improvement activities on both sides of the border, guide the allocation of health resources and promote binational health projects.
Because of national differences in areas such as the organization of health care systems and data availability, Healthy Border does not attempt to impose identical objectives on both sides of the border. Instead, these objectives are topic areas for health improvement in the border regions of both countries. The specific objectives, as well as the targets for the year 2010, are defined by each country or state and local entities and differ, to at least some extent, for most objectives.
Implementation of the Healthy Border 2010 initiative will almost certainly differ between the United States and México, because state and local health authorities in each nation will be responsible for designing and implementing their own programs. However, the Commission also will encourage binational activities, especially those established in sister communities along the border. Ideally, these cross-border activities will attract partners such as non-governmental organizations, the private sector, and international organizations. The existing binational cooperation infrastructure which includes the Binational Health Councils is ideal for use in community-level planning and implementation.
Goals and Objectives
The overarching goals of the Healthy Border 2010 initiative are:
1. Improve the quality and increase the years of healthy life, and
2. Eliminate health disparities
The 20 common elements included in the Healthy Border 2010 initiative are grouped into 11 areas, each with a specific set of objectives. The areas and their respective objectives comprise the following:
- Access to Health Care – ensuring access to primary care or basic health care services;
- Cancer – reducing breast cancer and cervical cancer mortality;
- Diabetes – reducing both the mortality rate of diabetes and the need for hospitalization;
- Environmental Health – improving household access to sewage disposal and reducing hospital admissions for acute pesticide poisoning;
- HIV/AIDS - reducing the incidence of HIV/AIDS;
- Immunization and Infectious Diseases – expanding immunization coverage for young children, as well as reducing the incidence of hepatitis and tuberculosis;
- Injury Prevention – reducing mortality from motor vehicle crashes as well as childhood mortality from injuries;
- Maternal, Infant and Child Health – reducing infant mortality due to congenital defects, improving prenatal care and reducing teenage pregnancy rates;
- Mental Health – reducing suicide mortality;
- Oral Health – improving access to oral health care; and
- Respiratory Diseases – reducing the rate of hospitalization for asthma.
These focus areas identify specific issues that greatly affect the health and quality of life of individuals and communities in the border region. Monitoring progress to fulfill the Healthy Border targets will help in the identification of achievements as well as areas where efforts may need to be re-directed.
“Healthy Border 2010: An Agenda for Improving Health on the U.S.-México Border,” the first report of the initiative, was published in 2003. The report provides baseline data for the year 2000 for the U.S.-México border as well as targets for 2010. As a “living document,” it will be enhanced by companion reports that will focus on health statistics for the border, continued development of the initiative, and specific efforts to address the issues and the evaluation of those efforts.
Previous Related Activities in the United States
Healthy Border is a direct descendant of the national health promotion and disease prevention program known as Healthy People. Beginning in 1979, the Department of Health and Human Services set health improvement objectives for 1990 in 15 priority areas under the general heading of "1990 Health Objectives for the Nation". This activity was succeeded by the Healthy People 2000 Program, which was designed to conform with the World Health Organization’s global program, "Health for All by the Year 2000". The Healthy People 2000 Program established more than 300 specific health objectives to be attained during the decade of the 1990s. A new national program, Healthy People 2010, was established in 2000 to continue health promotion and disease prevention activities through the next decade. All three of these programs combined health promotion and disease prevention activities at the national, state and local levels, as well as a rigorous monitoring program.
U.S. "Healthy Gente" draws on the national health objectives defined in the U.S. Healthy People Program, identifying 25 of the most important objectives to address the distinct needs and concerns of the United States communities that border México. The "Healthy Gente" Program was developed by the U.S. section of the Border Health Commission, using four principles to guide the selection of objectives:
- The objectives should address key health issues on the border;
- They should be limited in number;
- To the extent possible, they should be measurable;
- They should be compatible with federal and state objectives.
Objectives also were designed to resonate with the border population, be easily understood by the public, and help coordinate public and private health programs. Most, but not all, of the objectives are databased: 18 were tracked with routinely collected data. Data for the remaining 7 objectives, known as developmental objectives, were sought with the assumption that appropriate data would be available by mid-decade.
Previous Related Activities In Mexico
The National Health Indicators Program grew out of the Health Sector Reform Program, which redefined the planning and evaluation process as a part of the decentralization of the Mexican national health care system. During the previous national administration, the Secretariat of Health of México proposed 46 indicators to evaluate and monitor the effectiveness of health policies within México. The indicators were selected to meet the following criteria:
- They should represent priority health issues in México;
- They should be measurable;
- The information should come from reliable sources.
The National Health Indicators Program set targets for the year 2000 for each objective. Because the program was part of the health care decentralization program, both national and state-level targets were established. Although targets were not set at the local level (municipios), information for many indicators was available at the municipio level, making it possible to monitor many local conditions.
On both sides of the border: U.S. and Mexican border communities have collaborated on joint health improvement activities for many decades. Some of these health projects have been limited to a single pair of sister cities, while others have been statewide or border-wide programs. In some cases the projects have focused on a single disease, such as the "Ten Against TB" project involving the ten border states. Others have been broader in scope, such as the "Project Consenso" coordinated by the U.S.-México Border Health Association, which sought to identify the major health issues in the border region. The Healthy Border Program has drawn on all of these activities, to varying degrees, in order to establish a regional health improvement program for the U.S.-México border region.