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In the last twenty years, a particular socio-economic dynamic on the United States- Mexico border has been observed, characterized by an accelerated population growth in urban areas, an extensive industrial and agricultural development, an increase of ground transportation, migrations, poverty and growth of informal human settlements. All these factors have contributed to air, soil, and water pollution, without ignoring the influence of the various cultures that are conjugated in the border areas. The result of this complexity has been a modification of the pathologies that are observed in the border and of their own clinical manifestations. Several efforts have been made in order to learn the effects of the environmental alterations on human health and to understand the associated morbid processes. Among them, the binational initiative of Border XXI Program joined the different sectors and institutions to exchange information that could be of interest in order to generate policies and define actions that lead to a healthy and productive environment. These concerns place the exchange of information as an important element for the definition of activities and binational programs. The distribution of epidemiological and public health information is one of the technical cooperation priorities that has been assigned by the federal governments to the United States – Mexico Border Field Office of the Pan American Health Organization (PAHO). Within this priority, important initiatives have been developed that are focused on the collection of information for the analysis and orientation of the social and sanitary policies, as well as for the use of decision makers that determine the future of the population health along the border. Among them, it is worth to mention the Mortality Profiles, the Health Core Data of the Sister Cities, and the Survey of Environmental Health Resources. These initiatives of information are complementary to each other. In addition, the Border XXI Program, established a framework of sustainable collaborative work for health and environment protection as well as the proper management of natural resources of the two countries, seeking a balance among the social and economic factors and the protection of the environment in border communities. This challenge involves the exchange of epidemiological and environmental information for a better interpretation of the effects the environment has on the health of the individual and of the population. This data is obtained and driven by different institutions and sectors. In response to this challenge, I am pleased to make available the present document on “Environmental Public Health Indicators” that has been jointly prepared by experts of Mexico and the United States with the valuable collaboration of our PAHO/WHO Collaborating Center in Environmental and Occupational Health in Canada. This document establishes a conceptual framework for the collection, exchange, interpretation, and use of indicators that orient the politics on environmental and health issues in the border populations and are also used to evaluate the effectiveness of future developed interventions in the border localities. Similarly, it proposes a basic group of indicators, so that the local authorities of the various sectors select those of mutual interest or include others unspecified. As a result, it is not intended that the sister cities address all the indicators that the document contains from the beginning, but that they may adopt the ones in which they are interested or they appertain to and have the capacity and the resources to approach. The foregoing implies the development of a local participatory binational process, which is fundamental to involve the greatest possible number of institutions of the various sectors that obtain and maintain information on health and the environment. The Pan American Health Organization jointly with the Center of Disease Control and Prevention (CDC) and the Environmental Protection Agency (EPA) of the United States, SEMARNAT, of the Secretary of Environment and Natural Resources and the General Environmental Health Directorate (DGSA), the General Bureau of Epidemiology (DGE) of the Secretary Health of Mexico, are jointly committed to put in action this process and the necessary monitoring systems for a healthy and productive border.
ALFONSO RUIZ DVM, MS, Ph. D |