U.S.-Mexico Border Environmental Health Training Project

Purpose: Rapid industrialization and population growth have produced profound environmental stresses along the United States-Mexican border. Despite efforts by both governments through joint projects such as Border XXI and Border 2012, risks to human health remain a significant problem. This training project endeavors to reduce health risks, especially in children, by improving the capacity of lay community health workers, called promotores, in U.S. communities located along the U.S.-Mexico border.

Promotores perform outreach and community education at convenient sites in U.S. border communities such as community health centers and churches. Promotores have been vital in developing outreach activities that encourage cross-border sharing of environmental health information, strengthening public participation, and empowering community members to prevent and minimize health risks. Their efforts focus on potential sources of environmental health hazards, including ways to avoid or minimize exposure to contaminated drinking water, inadequate waste disposal, lead, agricultural pesticides, and pollutants that trigger asthma.

Promotores also learn about referral resources including medical care, legal assistance, and state environmental resources. This project expands efforts to achieve the international goals contained in the United Nations Millennium Declaration and the Johannesburg Plan of Implementation to halve, by the year 2015, “the proportion of people who are unable to reach or afford safe drinking water” and “the proportion of people without access to basic sanitation.” Lessons learned from this project may have application for other countries sharing an international border where the cross-border dynamic, in both directions, affects human health.

Resources: Funding and technical support have been provided by the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) and the U.S. Environmental Protection Agency’s (EPA) Office of Research and Development. Other resources include use of public informational materials developed by EPA and HRSA funded community and migrant health center networks.

Partners: Governments: The United States (Department of Health and Human Services and the Environmental Protection Agency); Civil Society: Texas Rural Legal Aid, Puentes de Amistad, Organizacion en California de Lideres Campesinas, Las Americas Immigrant Advocacy Center, Nuestra Clinica del Valle, Sunset Community Health Center, La Clinica de Familia, Ben Archer Health Center, Centro Familiar de Salud San Vicente, Clinica de Salud del Pueblo, Farmworker Justice Fund, Inc. Universities: University of Arizona, Texas A&M University.

Partnership Efforts To Date: Since its inception in 1999, project efforts have resulted in community mobilization activities bringing together local health professionals, promotores, and community members to serve on community environmental health advisory committees. These advisory committees provide a bridge between project efforts and local environmental health activities, and help with developing and implementing community-based needs assessments, local training programs, and with recruiting and supervising promotores. To date, community-based needs assessments have been completed at four U.S. participating locations. Next steps include development of curricula specific to each community’s environmental health training needs using a ‘train the trainer’ model. HRSA is interested in sharing lessons learned and resources developed with appropriate entities in Mexican sister cities and with communities in other countries sharing an international border.

USG Primary Point of Contact: DHHS/HRSA/Office of International Health Affairs, Mr. Howard Lerner, Director. Phone: 301-443-3573, E-mail: hlerner@hrsa.gov