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Mexican Us border is only 2000 miles...
Excerpted from the US Dept. of Heath and Human Services website
"Residents living along the U.S.-Mexico Border experience greater rates of communicable illnesses such as tuberculosis and vaccine preventable illnesses than other groups of people across the Nation. High rates of hepatitis and other intestinal infections, due to a lack of clean water and proper sewage disposal, are also a concern. Frequent movement between both countries and within the U.S. compromises continuity of health care for residents of this area. Additionally, the four States in the border area have some of the highest rates of poverty, unemployment, and uninsured people in the Nation.
Border Region

The U.S.-Mexico border region is 2,000 miles long, stretching from San Ysidro, California, to Brownsville, Texas, and extending 62 miles north of the border in to the U.S. This border is approximately half the length of the U.S.-Canada border, and represents the distance from Washington, DC, to Phoenix, Arizona, in direct miles.

The border area consists of 48 counties in four states. Some of the poorest counties in the United States are located in this border area. More than a third of U.S. border families live at or below the poverty line. An estimated 350,000 people live in colonias, which are un-zoned, semi-rural communities without access to public drinking water or wastewater systems. The unemployment rate along the border is 250-300 percent higher than in the rest of the country.
Border Health Issues

Sanitation:
The sanitation infrastructure deficiencies of the border area are enormous. Forty-six million liters of raw sewage flow daily into the Tijuana River. Another 76 million are dumped in to the New and Rio Grande Rivers. The management of water use is governed by treaties, but they do not deal with pollution management, such as sewage and pesticide runoff. Communities that use this water for cooking and drinking face serious health threats.

Air Pollution:
Air pollution is also a very serious problem in major metropolitan areas like El Paso/Cuidad Juarez, where meteorological conditions often fail to sweep the atmosphere of pollutants. Industry compliance with environmental regulations is spotty, and the poor often burn highly polluting materials for cooking and warmth. As a result, high lead levels in children and frequent respiratory illnesses are common.

These environmentally linked problems contribute to overall health conditions along the border that resemble those of many Third World countries. According to measures developed by the National Association of Community Health Centers, 10 of 24 counties evaluated along the U.S.-Mexico border are in "double jeopardy" because they are both medically underserved and poor. These counties face both a poor overall health status among their residents and a shortage of primary care physicians.

Access to Health Care:
Lack of access to health care is a significant problem along the border. While the access problem is in part due to a lack of insurance, especially among the Mexican-American population, it is also attributable to non-financial barriers to access. These include an uneven distribution of physicians, other health professionals, and hospitals; inadequate transportation; a shortage of bilinqual health information and health providers; and culturally insensitive systems of care. Standard health indicators bear out the consequences of this lack of access.

Communicable Diseases:
Hepatitis A is two to three times more prevalent along the border than in the United States as a whole. Tuberculosis, a growing threat in the U.S., appears along the border at twice the national average. In addition, non-communicable diseases such as diabetes are problems in the border area because they have a high incidence among Mexican-Americans, who make up over 50 percent of the population of the U.S. border counties. These diseases can be controlled through early intervention and the provision of consistent health care.

The public health problems of the U.S.-Mexico border region are longstanding and profound. Of critical importance to understanding their significance today, however, is the fact that border counties continue to experience rapid population growth. During the 1980s, this region experienced a 25 to 30 percent increase in population, compared to a less than 10 percent increase for the U.S. population. Accounting for this higher increase in population are a higher fertility rate, lower age-specific death rates, and a high rate of immigration. The population on the border is also younger than that of the respective border states and the nation as a whole.

The most immediate implication of this demographic pyramid is a higher birth rate and an increase in the existing need for maternal and child care services. But high dependency ratios and population growth rates also have serious implications for the poverty, environmental pollution, and disease that now plague residents struggling without adequate housing, sewage management, water, and health care in a region whose growing industrialization draws increasing numbers of the desperately poor.

The incidence of several types of communicable diseases is very high in border areas. The areas show high incidences of water borne diseases, such as shigellosis. The rates of hepatitis A infection, tuberculoss, and measles are also very high when compared to the general U.S. population. The incidence of AIDS is partcularly high in San Diego. In general, the ranking of leading causes of death is higher for accidents, diabetes, and infectious diseases in this region than in the rest of the country."

Sorry for the long post, but important to illuminate problems in border states