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A higher risk of infectious disease – complicated by disparate efforts to combat it – create a “dismal scene” for public health along the San Diego-Tijuana border region, according to a report released yesterday by the San Diego-based International Community Foundation.

The report illustrates that assertion by pointing to above-average rates of tuberculosis in the region; HIV-infection rates in Tijuana three times above the Mexican national average; and a lack of health insurance among Latinos living in San Diego, where nearly 27 percent of Latino children lack it. More than 93 percent of white and black children in San Diego have health insurance.

Among the other problems: Intergovernmental health programs have failed to overcome the border’s challenges, the report says, as each country pursues parallel goals – “hoping that their independent pursuits will reach parallel outcomes.”

“These government-to-government programs have generated far more hope and expectation,” the report says, “than they have delivered on-the-ground assistance.”

Disease is spread more easily by the heavy flow of migrants through the region. And it has a breeding ground in Tijuana’s colonias, the shantytowns where many live without indoor plumbing.

The report calls for an expansion – and reshaping – of cross-border health services. And with poverty as an underlying cause of many of these issues, it suggests a border-crossing fee as a possible funding source. A regional health summit later this year is suggested as a catalyst for improvement.

“We are not just going to do another assessment (and) repeat research,” said Rosemarie Marshall Johnson, a member of the U.S.-Mexico Border Health Commission, who advises the foundation. “We want action.”

ROB DAVIS

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