Health Status of Communities within the US-Mexico Border - Essay Example

? Research Project: Environmental Issues Affecting the Health Status Of Communities Within the U.S. – Mexico Border Elements of Research Instructor’s Name Date Table of Contents I. Topic 2 II. Literature Review 2 A.U.S. – Mexican Border Profile 2 B.Factors Influencing Health Conditions 3 C.Health Problems within the U.S. – Mexican Border 4 D.Health Programs and Policy Recommendations 5 III. Research Design 7 A. Research Design 1 7 B. Setting, Participants, and Sampling 8 C. Problem Statement, Research Questions and Null Hypotheses 8 D. Variables/Issues 9 E. Data Collection 9 F. Data Analysis 10 IV. Research Design 2 10 A. Research Design 2 11 B. Setting, Participants, and Sampling 11 C. Problem Statement, Research Questions and Null Hypotheses 12 D. Variables/Issues 12 E. Data Collection 12 F. Data Analysis 13 References 13 I. Topic The research aims to determine the factors that contribute to the emergence of environmental problems within the U.S. – Mexico border that pose health hazards to the residents within these areas. From a review of related literature, it was revealed that problems that ensue from the area are enumerated as follows: “1) rapid urbanization and lack of adequate infrastructure, 2) air pollution from open burning, vehicle emissions, and industrial operations, 3) contamination of surface water and groundwater from open sewers and industrial waste, 4) overuse of aquifers and surface streams, 5) transportation and illegal dumping of hazardous waste, and 6) destruction of natural resources” (Western Sustainability and Pollution Prevention , 2011). As such, the current study aims to examine the repercussions of these environmental issues on the health condition of residents living within these areas and to identify recommendations that would address the dilemma. II. Literature Review A. U.S. – Mexican Border Profile The report written by the Good Neighbor Environmental Board (GNEB) presented the appropriate context that made the identified area distinct and susceptible to environmental and health problems. As noted, “the U.S. border region is defined by rapid economic and population growth, rapid urbanization, spillover effects from Mexico, asymmetries with Mexican communities across the border, international commerce and trade flows, high rates of poverty, and a distinct ethnic identity” (Good Neighbor Environmental Board, 2010). Likewise, the study written by Warner and Jahnke (2003) revealed that in addition to the abovementioned factors, the passage of the North American Free Trade Agreement (NAFTA) in 1993 provided the impetus for facilitating significant socioeconomic, fiscal and political changes that reported to have spurred disparities and challenges in access to health and in regulating subsequent environmental consequences. Specific details and profile on the states and communities within this border were enumerated in Western Sustainability and Pollution Prevention (WSPP) (2011), to wit: “The border’s length is approximately 2,000 miles, and there are 14 metropolitan areas on both sides, with 4 states on the U.S. side and 6 states on the Mexican side. The states on the U.S. include Texas, New Mexico, Arizona and California. The states on the Mexican side include Tamaulipas, Nuevo Leon, Coahuila, Chihuahua, Sonora and Baja California. There are nearly 14 million people that call this region home. Typically, the width of the U.S. Mexico border as defined by the La Paz Agreement is 100 kilometers (62.5 miles) into U.S. territory and 100 kilometers (62.5 miles) into Mexican territory” (Western Sustainability and Pollution Prevention , 2011, par. 2). B. Factors Influencing Health Conditions According to the Environmental Protection Agency (EPA) (2011), the health status and environmental living condition of people residing within the border is influenced by “trends in population, the economy, and industrial activity” (p. 5). With population projected to increase due to migration to urban and industrialized areas, the report disclosed that additional pressure would be imposed on natural resources such as land, air, and water. Likewise, parallel with the increasing trend in population is the obvious rise in economic activity. The result of this, as indicated, is the release of toxic pollutants and the significant increase in demand for safe drinking water and for wastwater treatment facilities (Environmental Protection Agency, 2011). As emphasized, “developing infrastructure to deliver safe drinking water to people and to reduce untreated discharges to border region rivers, aquifers, and oceans has been a high priority of Border 2012 and previous binational environmental programs” (Environmental Protection Agency, 2011, p. 23). Also, as noted by Warner & Jahnke (2003), there are more people who were reportedly crossing the U.S. – Mexican border than any identified borders globally. As emphasized, “there are over 250 million legal border crossings from Mexico into the United States each year” (Warner & Jahnke, 2003, p. 8). The health implications of this is that “infectious diseases may be easily carried from one country into the other. The impact of this health risk is heaviest on the border region, but diseases are also carried to the interior of both countries” (Warner & Jahnke, 2003, p. 8). From the comprehensive report published by the EPA (2011), it was disclosed that human activities adds pressure and stress in the environment. The factors and goals indicated in their report include: (1) reducing water contamination; (2) reducing air pollution; (3) reducing land contamination; (4) improving environmental health; (5) enhancing joint readiness for environmental response; and (6) improving environmental performance (Environmental Protection Agency, 2011). C. Health Problems within the U.S. – Mexican Border From the Status Report on the Water and WasteWater Infrastructure Program for the U.S. / Mexico Borderlands published by the EPA (2012) , it was revealed that the “disease rates are higher in the U.S. border area than in most other areas of the United States. The level of drinking water and wastewater treatment tends to be less adequate as a general matter on both sides of the border than in the rest of the U.S.” (Environmental Protection Agency: Problems Remain, 2012, par. 1). As such, the identified incidence rates of diseases for the U.S. border., Mexican border as compared to the whole U.S. population are shown in Table 1 below: Table 1: Current Incidence Rates of Diseases, Comparative Analysis Disease US Border Rates per 100,000 people Mexican Border Rates per 100,000 people US Nationwide Rates per 100,000 people Amoebiasis 1.38 798.8 1.34 Hepatitis A 37.1 50.1 12.6 Shigellosis 35.3 ---- 10.9 Typhoid fever 0.4 36.1 0.2 Source: Environmental Protection Agency, 2012 Likewise, air-borne illnesses such as respiratory and lung diseases were reported (Environmental Protection Agency, 2012); and for invasive meningococcal disease (IMD) in children as surveyed and evaluated in the study conducted by Chacon-Cruz, et al. (2011). In Warner & Jahnke’s (2003) research, the author identified a number of communicable diseases in the area, ranging from “tuberculosis, cholera, and malaria often imported from Mexico, and Mexico is concerned about diseases such as HIV/AIDS often imported from the United States” (p. 11). The proliferation and increased incidences of these diseases within the border were also corroborated by the study conducted by Chacon-Cruz, et al. (2011). Gastrointestinal diseases which were identified to be water-borne included “shigellosis (a bacterial infection) and hepatitis A (a viral infection affecting the liver that is often spread by fecally contaminated food or water) are higher in the study area than in Texas as a whole and in the U.S.” (Warner & Jahnke, 2003, p. 13). D. Health Programs and Policy Recommendations Due to the complexity and the higher incidences of health hazards within the U.S. – Mexican border, it was apparently revealed that an interplay of federal, state, local, private and binational health agencies and components govern the health requirements of the general public (Warner & Jahnke, 2003). The disparities in control and access to public health systems within the area were reported to make implementation of a consistent health program more challenging. This therefore makes addressing health conditions and illnesses more difficult. As noted, “while services are not completely uniform in Mexico’s northern border, they share some level of consistency due to the vertical lines of communication characterizing the system. U.S. health officials, on the other hand, lack a unified voice, making large-scale binational cooperation more difficult” (Warner & Jahnke, 2003, p. 29). The Environmental Protection Agency (EPA) (2011) report has clearly indicated that policies, immediate response and appropriate action on environmental issues and concerns are governed by diverse agencies on both the U.S and Mexican side. Accordingly, “environmental regulatory programs on both sides of the border establish and enforce rules to limit pollutant discharges to air, water, and land, as well as to manage the generation, transportation, storage, and treatment of hazardous wastes. In addition to these regulatory programs, both the U.S. and Mexico have developed programs that encourage voluntary activities to protect human health and the environment that go beyond what is legally required. Border states, tribes, local governments and the federal government all play key roles in establishing and enforcing rules and promoting voluntary action” (Environmental Protection Agency, 2011, p. 89). A U.S.-Mexico Border Health Commission was likewise reportedly created in 2000 and was cited to disclose its mission, to wit: “provide international leadership to optimize health and quality of life along the U.S./Mexico border,” and it is authorized to do the following activities to carry out its mission: • Conduct or support health promotion and disease prevention in the border area; • Conduct or support the establishment of a coordinated system which uses advanced technologies to gather health-related data and monitor health problems in the border area; • Conduct public health needs assessments in the border area and conduct or support investigations, research, or studies designed to identify and monitor health problems on the border; and • Provide financial, technical, or administrative support to assist the efforts of public and private nonprofit entities to prevent and resolve health problems” (Borderlines, 2001; cited in Warner & Jahnke, 2003, p. 30). In this regard, the current research determines the factors that contribute to the emergence of environmental problems and thereby, aim to determine the perception of community residents within the border on the environmental issues and health hazards to confirm and validate the effects on people’s health. III. Research Design The types of research designs to be used to investigate the current problem are as follows: 1) Quantitative descriptive, through self-constructed questionnaire to gather the needed data from the community members; and 2) Qualitative research, through interviews and case studies. A. Research Design 1 The study aims to determine the effects of environmental problems, specifically water pollution to the communities within the U.S. – Mexican border in terms of causing water-borne illnesses. Through getting a representative sample of the community residents from the identified states within the border, the research would collect the needed data using self-constructed questionnaire and subsequent interviews. The researcher has identified two representative states that could be the basis for getting samples from the population within the U.S. – Mexican border according to the number of residents. As evident from a previous study by Cardenas, et al. (2010) who evaluated the “higher incidence of infectious disease (that) has been documented in U.S. regions bordering Mexico compared with non-border areas” (p. 441), the current study would likewise use samples from the residents of “Ciudad Juarez, Mexico, and El Paso, Texas, the largest binational community along the U.S.-Mexico border” (Cardenas, et al., 2010, p. 441). A cross-sectional study based on a representative number of samples from both identified areas would be used. After all participants would be identified, the questionnaires that were prepared would be distributed, collected, gathered and eventually evaluated. The researcher would thereby interpret the results with the use of statistical treatment and analysis, as needed. B. Setting, Participants, and Sampling The setting of the study would take place with participants who reside in Ciudad Juarez and in El Paso. The potential sample and participants would be composed of individuals of all ages, both male and female, to be an appropriate representative of the target of the population of Ciudad Juarez and El Paso. The participants would be selected using random sampling method using the census list provided by the local governments. A total of 150 households would be approximately selected from both areas composed of 75 households each. Participants would be contacted through the community health centers and local community groups. C. Problem Statement, Research Questions and Null Hypotheses The purpose of this study is to examine the repercussions of the environmental issues, focusing on water-related health conditions of residents living within the Ciudad Juarez, Mexico and El Paso, Texas areas, as representative of the population along the U.S. - Mexican border. The research questions are as follows: 1. What are the marked water-related illnesses of the community residents within the Ciudad Juarez, Mexico and El Paso, Texas areas, as representative of the population along the U.S. - Mexican border, within the last two years that are related to environmental issues? D. Variables/Issues The variables to be researched are the environmental problems that focus on water pollution, including the level of safe drinking water and observance to hand washing that could be contributory to the incidence of water-related illnesses. Variables such as microbiological contamination of drinking water and observing strict adherence to hand washing would be used. These variables would be examined through getting samples of each household’s source of drinking water and the level of microbiological contamination. The participants would be asked the simple question: “how often do you wash your hands before eating and specifically after going to the toilet?” E. Data Collection As previously indicated, through random sampling using the local communities’ most recent census, an equal number of participants from each municipality would be selected (75 households from Ciudad Juarez, Mexico and 75 households from El Paso, Texas). The participants would be asked the question: “how often do you wash your hands before eating and specifically after going to the toilet?” and their responses would be noted and tabulated, as needed. Likewise, samples from their drinking water would be collected and sent to laboratories to note the level of microbiological contamination. These would also be noted and tabulated for further examination and assessment. Other questions in the survey would include the noted illnesses that members of the family have contracted within the last two years and the members’ perception on what caused these illnesses. F. Data Analysis Each variable (level of microbiological contamination, frequencies of hand washing and incidence of water-related illnesses) would be interpreted using percentages, frequency distributions and the total number of respondents who reported incidents and rates of illnesses within the stipulated time frame (last two years). The significant difference of water-related health problems the community would be subjected to analysis of variance in which the F-test and T-test would be used. To establish the relationship between the independent and dependent variables (environmental problems (water pollution) and health status of the community members), the research would utilize the Pearson’s f formula. IV. Research Design 2 The second research design is the qualitative research, through interviews and case studies. The participants who have exhibited significant findings on water-borne illnesses due to water pollution and health condition would be interviewed. Likewise, from the interviews conducted from community health centers, residents who were reported to have contracted water-borne illnesses would also be interviewed and their cases noted and examined. For instance, from the households surveyed, the number of households identified to have significantly high levels of microbiological contaminations in their drinking water would be noted and tabulated. The member of these households would likewise be further interviewed in terms of their awareness on the contamination of drinking water and what are their sources of drinking water. Also, the number of incidences of water-borne illnesses would be recorded, where and how they addressed these concerns; and further confirmed through the community health centers. A. Research Design 2 The qualitative method utilizing interviews and case studies involve delving more closely on any identified relationship that has been reported between the environmental issues (water pollution) and the health status of community members within Ciudad Juarez, Mexico and El Paso, Texas areas, as representative of the population along the U.S. - Mexican border. The interview would be sought through prior approval relayed from community health centers and respective household participants through the local agencies and from the residents themselves. Emphasis on confidentiality and privacy would be relayed to conform to ethics in conducting the research. B. Setting, Participants, and Sampling Just like the first research design, the potential sample and participants would be composed of individuals of all ages, both male and female, to be an appropriate representative of the target of the population of Ciudad Juarez and El Paso. The participants who would be selected using random sampling method using the census list provided by the local governments, would be composed of approximately 150 households where 75 households each from representative location would be interviewed. Participants would be contacted through the community health centers and local community groups. As abovementioned, from the households surveyed, the number of households identified to have significantly high levels of microbiological contaminations in their drinking water would be noted and tabulated. The member of these households would likewise be further interviewed in terms of their awareness on the contamination of drinking water and what are their sources of drinking water. Also, the number of incidences of water-borne illnesses would be recorded (after verifying their responses to the hand washing questions); where and how they addressed these concerns; and further confirmed through the community health centers. C. Problem Statement, Research Questions and Null Hypotheses The purpose of this study is to examine how residents feel about the repercussions of water pollution within the Ciudad Juarez, Mexico and El Paso, Texas areas and to determine their perceptions on the health condition of residents living within these areas due to water pollution. The research questions are as follows: 1. How do residents feel about water pollution in their areas? 2. How have their lives and living conditions affected by water pollution? 3. What do they think and feel should be done about water pollution in their areas? D. Variables/Issues The issues to be researched are the perceptions and feeling of the residents regarding water pollution that predominantly contribute to the water-related diseases that were inflicted on the community residents for the last two years. The respective respondents would be interviewed to validate the information and establish accuracy and reliability based on their responses to the research questions. Case studies of diseases reported from community health centers would also be examined to provide authoritative support on the incidences of water-borne illnesses in their respective communities and how the residents feel about this and what they propose that local governments (or even residents) should do to address these health concerns, E. Data Collection Transcripts of interview would be noted and preserved for re-assessment and review. In conjunction, reports of observation and documents from case studies would be used to interpret findings and for analysis. After the results from the survey questionnaires are collected, gathered, and tabulated, any significant relationships established between environmental issues (water pollution, safety in drinking water) and health status (incidence of water-borne illnesses) would be verified through interviews. The respondents would be contacted, approvals sought, confidentiality and privacy ensured and the interview would be transcribed and noted with the help of observation method. F. Data Analysis The data would be analyzed through establishment of patterns and to be supported by secondary and authoritative research gathered from the CDC and from the Department of Health. Through the information gathered and collected from the quantitative method, the data would be further validated using interview method. Significant patterns from frequency tables and percentages that reveal significant patterns and trends over the period under study would be interpreted with the assistance of other reliable references. Therefore, credibility and reliability would be established through cross-examination and reference to supportive and authoritative secondary sources and integrating the findings with those gathered, collected, and interpreted under the quantitative method of research. References Border Information and Outreach Service. (2001, August). Binational Border Health Commission Comes Online. Retrieved July 18, 2012, from Borderlines: http://www.us-mex.org/borderlines/2001/bl80/bl80bhc.html Cardenas, V. M., Ortiz, M., Karri, S., Variyam, E., Behravesh, C., Snowden, K., et al. (2010). Hyperendemic H. pylori and Tapeworm Infections in a U.S.-Mexico Border Population. Public Health Reports, Vol. 125, 441-447. Chacon-Cruz, E., Sugerman, D.E., Ginsberg, M.M., Hopkins, J., Jose Hurtado- Montalvo, A., Jose Luis Lopez-Viera, J.L., et al. (2011). “Surveillance for invasive meningococcal disease in children, US–Mexico border, 2005–2008.” Emerg Infect Dis [serial on the Internet]. Retrieved 17 July 2012, from http://dx.doi.org/10.3201/eid1703.101254External Web Site Icon Environmental Protection Agency. (2011, May). Border 2012: U.S. - Mexico Environmental Program. Retrieved July 16, 2012, from http://www.epa.gov/usmexicoborder/indicators/docs/border-2012_indicator-rpt_eng.pdf Environmental Protection Agency. (2012, March 6). Status Report on the Water and Waste Water Infrastructure Program for the U.S./Mexico Borderlands. Retrieved July 16, 2012, from epa.gov: http://water.epa.gov/infrastructure/wastewater/mexican/mxsumrpt.cfm Good Neighbor Environmental Board. (2010, June). A Blueprint for Action on the U.S. - Mexico Border. Retrieved July 15, 2012, from epa.gov: http://www.epa.gov/ocem/gneb/gneb13threport/English-GNEB-13th-Report.pdf Paddack, C. (2011, July 27). Rare Paralyzing Disease GBS Affecting People On US- Mexico Border. Retrieved July 16, 2012, from Medical News Today: http://www.medicalnewstoday.com/articles/231802.php Warner, D., & Jahnke, L. (2003, April). U.S./Mexico Border Health Issues: The Texas Rio Grande Valley. Retrieved July 15, 2012, from The University of Texas Health Science Center at San Antonio: http://www.uthscsa.edu/rchws/Reports/NAFTA2.pdf Western Sustainability and Pollution Prevention . (2011, September 23). U.S. – Mexico Border. Retrieved July 15, 2012, from wsppn.org: http://wsppn.org/resources/u-s-mexico-border/ Read More