Health and Migration along the U.S.-Mexico Border

Examining health through the lens of international migration exposes a lack of support for migrants in national healthcare systems, fear of the spread of infectious disease, and issues of culturally appropriate care. Socioeconomic factors and political climates complicate migrant health, making these populations more susceptible to illness. For migrants moving from South and Central American to the United States, there are barriers to accessing healthcare, particularly for migrants living in border settlements. Unfortunately, there is an astounding lack of collaboration between governmental health agencies across the border despite shared concerns. Additionally, it is notable to discuss the stereotypes and stigma associated with migrant health. Through acknowledgement of the immigrant health paradox, which shows that migrants are often healthier than their non-migrant peers, and recognition the role of anti-immigrant fear and rhetoric in exaggerating the risk of transmission of infectious disease through migration, we see the role of stigma in distorting our view of migration and health.

In Latin America there is a large flow of interregional and intercontinental migrants presenting unique health concerns across North and South America. One of the largest and most publicized immigration trends is migrants moving from South and Central American and the Caribbean to the United States. Many of these migrants are in search of work; migrant workers face particular health concerns stemming from dangerous work, low wages, and poor working conditions (Migration Data Portal, 2019). In particular, workers in agriculture, an industry which employs many migrant workers, face exposure to pesticides (Sargent & Larchanché, 2011). Seth Holmes describes how agricultural chemicals are routinely sprayed in fields where migrants work and eat with limited information on their harmful effects, playing into a larger system of disregard for migrant health (2013).

Many Latin American migrants to the U.S. cross Mexico to the U.S. border, where they either cross into the U.S. or stay in the area around the border. The US-Mexico border stretches approximately 2000 miles from California to Texas. The settlements along the border, where many migrants live, lack infrastructure and have poor health outcomes (Lady et al., 2017). There is a shortage of healthcare workers serving these communities in both the U.S. and Mexico (Lady et al., 2017). Due to this shortage, high rates of uninsurance, poverty, and structural barriers to care, such as lack of transportation, border regions have higher rates of communicable disease compared to national statistics in the U.S. (Lady et al., 2017). For migrants residing on the U.S. side of the border, linguistic and cultural differences and distrust of the U.S. government contribute to poor health outcomes (Lady et al., 2017). In colonias, settlements on the U.S. side of the border with substandard living conditions, living in the border community for more than 10 years was a predictor of poor mental and physical health, particularly for migrants coping with the stress of living in the U.S (Mier et al., 2008). Due to a lack of infrastructure, access and outreach, migrant communities in border regions have poor health outcomes.

Considering the shared border and health concerns, initiatives addressing health outcomes along the U.S.-Mexico border would benefit settlements in the region. In both the U.S. and Mexico, border residents experience problems including low air quality, lack of clean water, and animal control issues (Homedes & Ugalde, 2003). Moreover, border residents often cross the border to access medical care and purchase pharmaceuticals (Homedes & Ugalde, 2003). Despite shared concerns and border crossing to access healthcare, cooperation between the U.S. and Mexican governments is extremely limited. Political constraints impede any form of cooperation between health practitioners and officials in the U.S. and Mexico (Homedes & Ugalde, 2003). This lack of collaboration impacts migrant populations and demonstrates the difficulty of accessing healthcare systems as a migrant.

Migration has long-lasting impacts on the health and wellbeing of individuals and families. Although migration involves health risks, migration to the United States may entail benefits for the families of migrants, particularly children. One of the primary channels through which health is improved is increased household income (Hildebrandt & Mckenzie, 2005). Migration of family members to the U.S. was shown to positively impact the health of children of that family in Mexico through an increase in income (Hildebrandt & Mckenzie, 2005). Moreover, migration to the U.S. was shown to increase health knowledge (Hildebrandt & Mckenzie, 2005). This knowledge may include improved understanding of contraceptive use, sanitation, and exercise and diet (Hildebrandt & Mckenzie, 2005). Among Guatemalan immigrants in the U.S., transmission of health knowledge was found to be a regular practice (Hildebrandt & Mckenzie, 2005). This information may be transmitted to friends in family in the country of origin as well. Children whose families have immigrated to the U.S. were found to have better health, possibly due to income increase and health knowledge, when compared to their nonimmigrant peers (Donato & Duncan, 2011). This relates to the immigrant health paradox: the finding that immigrants to the U.S., including Latin American immigrants, have better health outcomes than their non-immigrant counterparts, countering assumptions of poor health in this group (Hummer et al., 2007). The benefits associated with migration to the U.S. illuminate a different image of health and migration, one which improves wellbeing through increased economic opportunity and transmission of health knowledge.

Migrants have always occupied a marginalized position in society. Due to xenophobia and racism, migrant groups are often singled out as carriers of infectious disease (Carter, 2016). This leads to tactics such as increased screening of migrants and travelers, limiting entry to the country, or even closing borders and barring migrants. However, closing borders or limiting travel are often ineffective in preventing the spread of infectious disease. For one, screening of travelers is often easy to evade (Carter, 2016). Moreover, if the disease is a serious threat, there are often enough cases already in the country to sustain domestic transmission (Carter, 2016). Migrants have not been shown to increase transmission of infectious disease (Vignier & Bouchard, 2018). Apart from a few rare cases, increases in infectious disease are attributed to urbanization, disruption of ecological systems, and global commerce, rather than migration (Vignier & Bouchard, 2018). Measures to limit travel and migration are often a response to fear, rather than an effective means of limiting transmission.

Considering the vulnerable position of migrants, it is important to consider the nuances of migrant health, from substandard infrastructure in border areas, challenges faced by migrant workers, and the benefits of health knowledge and income increase associated with migration.

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Additional Resources

Martinez-Donate, A. P., Ejebe, I., Zhang, X., Guendelman, S., Lê-Scherban, F., Rangel, G., Amuedo-Dorantes, C. (2017). Access to Health Care among Mexican Migrants and Immigrants: A Comparison across Migration Phases. Journal of health care for the poor and underserved, 28(4), 1314–1326.

Migration Data Portal.

Migration Policy Institute.

Miller-Thayer, J. (2010). Health migration: crossing borders for affordable health care. Field Actions Science Reports. The journal of field actions, (Special Issue 2).

References

Carter, E. D. (2016). When Outbreaks Go Global: Migration and Public Health in a Time of Zika. Migration Policy Institute. https://www.migrationpolicy.org/article/when-outbreaks-go-global-migration-and-public-health-time-zika. Last Accessed: 8 May, 2019

Donato, K., & Duncan, E. (2011). Migration, Social Networks, and Child Health in Mexican Families. Journal of Marriage and Family,73(4), 713-728.

Hildebrandt, N., & Mckenzie, D. J. (2005). The Effects of Migration on Child Health in Mexico. Policy Research Working Papers.

Holmes, S. (2013). Fresh fruit, broken bodies: migrant farmworkers in the United States. Berkeley, Calif.: University of California Press.

Homedes, N., & Ugalde, A. (2003). Globalization and Health at the United States–Mexico Border. American Journal of Public Health, 93(12), 2016-2022.

Hummer, R. A., Powers, D. A., Pullum, S. G., Gossman, G. L., & Frisbie, W. P. (2007). Paradox found (again): Infant mortality among the Mexican-origin population in the United States. Demography, 44(3), 441-457.

Lady, B., Henning-Smith, C., & Kunz, S. (2017). Addressing Health and Health Care Needs in the United States-México Border Region: Executive Summary. National Rural Health Association Policy Brief.

Mier, N., Ory, M. G., Zhan, D., Conkling, M., Sharkey, J. R., & Burdine, J. N. (2008). Health- elated quality of life among Mexican Americans living in colonias at the Texas–Mexico order. Social Science & Medicine, 66(8), 1760-1771.

Migration Data Portal (2019) Migration and health. https://migrationdataportal.org/themes/migration-and-health Last Accessed: 1 May, 2019

Sargent, C., & Larchanché, S. (2011). Transnational Migration and Global Health: The roduction and Management of Risk, Illness, and Access to Care. Annual Review of Anthropology, 40, 345-361.

Vignier, N., & Bouchaud, O. (2018). Travel, migration and emerging infectious iseases. National Center for Biotechnology Information, 29(3), 175.