Public Health in a Globalizing World, Research Paper Example

Introduction

Our survey of the literature will address the effects of globalization and public health issues on the border economy, the availability and quality of health care resources in the border region, and the current health policies and institutions of the border. Unless otherwise noted, any references to the border or the border region(s) are referring to the United States-Mexico border regions in North America; however, the issues identified can be easily recognized as occurring between other developed and developing nations that border each other. In the early 1990s, the border has been opened to both people and goods. The population along the border has increased substantially for two primary reasons: 1. People seeking to cross the border for work, and 2. People attracted to manufacturing and service jobs established by US companies seeking to lower the cost of labor. This form of industry seeks out the wealthy foreign investor and is housed in globalization-friendly buildings, factories, or companies called maquiladoras.

In addition, the prosperous US economy has continually attracted large numbers of immigrants seeking work- whether legally or illegally. This increased integration has led to public health issues being transmitted across the border and, thus, to a heated debate about funding public health for Mexican immigrants in America and has recently seen an increase in the number of American border inhabitants venturing into Mexico for the sole purpose of obtaining health care services.

How does globalization affect the economy in the border region?

With the passing of the North American Free Trade Agreement (NAFTA), tariffs on

trade between Canada, the United States, and Mexico were lowered or eliminated in the hopes of encouraging continental trade and trust.[1] Homedes and Ugalde define globalization as “a process characterized by the economic interdependence among nations created by increasing cross-border transactions of goods and services and of international capital flows.”[2] On the other hand, Chiro defined it as “unrestrained flows of capital, commodities, ideas, technologies, people, and pollution across international borders,”[3] and one noted historian called it the “virtual annihilation of time and distance”.[4] For our purposes, globalization will include the flow and interdependence of goods, services, capital, and commodities across the United States-Mexico border. Recent governmental initiatives, such as the North American Free Trade Agreement (NAFTA) of 1994, have contributed to the elevated levels of employment influx and outsourcing.[5] The subsequent free flow of labor is conducive to continued growth and centralization of capital.[6]

Globalization has expanded financial interdependence as well, rendering the geographic assignment of territory a legal and governmental safeguard.[7] After years of marginalization, it is not uncommon for Latino border inhabitants to view this action as a deliberate socially-motivated exclusion.[8] Doctors McGuire and Georges describe the view from south of the border:

Contemporary borders also juxtapose colonial pasts with postcolonial presents and anticolonial struggles for an imagined more hopeful future. They are geographic regions of contestation by the world’s transnational migrants and their advocates, especially when those borders are designed to protect White wealth, power, and privilege from excluded others.[9]

The social legacies have the past inhibit the potential for globalization in the future and for posterity. This economic flow can never fully be exploited due to separate national treasury, policy, and health legislation and practices.[10] Wu lists five key concepts of economic globalization: economic complementarity, private-sector interest, government interventions, availability of institutional framework, and cultural factors.[11] Towards this end, globalization necessitated an easier form of international financing and spurred the success of the North American Development Bank (NADBank).[12]

It is initially difficult to imagine that the border flow and interdependence have drawbacks also. The $200 billion annual investments hike post-NAFTA certainly supports the agreement’s continuance.[13] Despite the decreased tariffs, security measures since September 11^th have been tightened, and stricter passport regulations and monitoring have been implemented in recent years.[14] As we discussed earlier, cost-cutting across the borders often leads to the establishment of maquiladoras. While the wages are not high, these investments provide steady income to persons who would otherwise be unemployed. In 2006, an estimated 225.5 million people illegally immigrated from Mexico to America.[15] Still, the maquiladoras have seen a ten-year, drastic decline in the buying power of these wages.[16] In Harvey’s book Spaces of Capital, the author explained that “profit has its origin in the exploitation of living labor in production. ‘Exploitation’ denotes a moral condition in which living labor is treated as a ‘factor’ of production and a technical condition in which it is possible for labor to create more in production than it gets through the exchange of its labor power as a commodity”.[17]

The gap between the value of border labor and the wages paid to the laborers denotes the lack of formal transnational recognition of the value of the services which these laborers provide, because a higher standard of living and increased exploitation are not mutually exclusive.[18] The concept of globalization had evolved into an either/or terminology not completely suited to the nature of the complex factors at work. The research presents a mixed reality- about which Garrett Brown’s 2008 article in Political Studies Review had the following input:

This is because the processes of globalization are dialectic, in that they often have two contradictory sides: one side that promotes more interconnectedness, resulting in greater  economic markets, democracy and peace between democratic states, while on the other side it simultaneously promotes the possibility for greater economic inequality, ideological ethnic conflict and a failure to secure human development. In addition, globalization makes promises for human progress and development which, depending upon its context, is either something that is fulfilling one’s expectation or… something that is perceived as leaving one behind.[19]

Thus it might be said that the reality of globalization lies in the perspective through which the research is viewed. The governmental policies which are enacted are based upon no personal experience with the dualistic nature of globalization. Lawmakers are often hundreds of miles away, basing these important decisions upon a lengthy report. Their decisions are often heavily swayed by political agendas and by the promise of profit which may or may not be realized.

In this regard, they face the same cost-benefit risk as an investor, except that foreign investors face additional regulatory barriers. Anticipated output of commodities, governmental regulation, and corporate debts have all become necessary components of foreign investing. While these components complicate the factors involved, there is no mistake that the potential for a large return is implicit in the greater risk. There are a great many hoaxes today, so proper research and reliable statistics are often necessary to investors to take these risks.[20] Both research and statistics are in shorter supply on the Mexico side of the border- making it an even more high-risk, high-return opportunity.

Globalization of economics and the labor force is directly related to feelings of nationalism and leadership among border citizens and certain locales and instigates much debate concerning its viability and fairness.[21] Along the border, the inhabitants of the colonias (the no-man’s-land of poor recent immigrants who have banded together) are comparatively rich when compared with their counterparts still living in Mexico.[22] When globalization brought big business to Mexico, it also brought higher wages and a steady trading relationship with the US. [23] Economically, globalization strengthens the both nations and their cities near the border especially.[24]

However, individual capitalists sell inexpensive products and cheapen the contributions of the labor utilized during production. The balance creates an inequality of financial opportunity and benefit.[25] This inequality and social stratification are two of the social challenges directly related to the increasing influence of globalization near the US-Mexico border.[26] Late into the 1980s, Mexican peasant farmers were socially protected by the ruling political groups. Since the farmers’ livelihood and social status was entirely dependent upon the land, credit, prices, and subsidized services, which the government and political parties had provided. The Mexican farmers in the sugar industry often experiences some of the worst conditions and less protection than that which was traditionally provided to other agricultural producers.[27] The variations in individual experiences with industrial growth create a large range of human experience with economic globalization of the border. Different experiences create a diverse body of needs- many of which relate to their mental and physical health.

As we mentioned earlier, the globalization of economics is often a matter of national confidence and pride. After the Cold War ended, the collective belief in Marxism and in dependency theory- and the Mexican role of labor production as dependence upon American industry and trade- waned. Support for American border dominance in globalization reached an impasse which has yet to be shaken off.[28] This effect can be seen vividly in the state of the sugar mills, which normally experience worse conditions anyway. Recently, they have also undergone a series of changes and fluctuations. Researchers described the impact on the sugar mills:

…Having gone through the cycle of nationalization and reprivatization, as have most other mills, finds its present situation is precarious. Now owned by Pepsi, a strong advocate of the use of corn sweeteners (see below), the mill has an abandoned look. When interviewed, the management expressed fears about closure and emphasized that an inability to acquire modern machinery is aggravating an already desperate situation.[29]

Clearly, the will of the individual workers is subjugated to the collective good of the mill- despite the harsh conditions. On the Mexico side of the border in particular, unemployment is high, and lower wages are accepted by the people as an acceptable trade for steady income. On the US side, stricter federal wage requirements have reinforced the Mexican borders’ exploitation of labor to fulfill outsourced orders.

In response to the backlash against both capitalism and socialism, the American presidential team of Clinton and Gore proposed what has come to be known as the ‘Third Way’.[30] This way was meant to demonstrate the middle-class values of Democrats who believed in “individual responsibility, hard work, equal opportunity- rather than the language of compensation”.[31] In other words, the new vision of globalization was to include a middle way between the capitalist and socialist extremes- each of which had their own pitfalls. They encouraged their followers to abolish welfare as an initiative which creates dependency- instead of providing aid. This concept of globalization shows few distinctions from the concept of cosmopolitanism, which appears to form the basis of the modernized conceptualization of acceptable principles of interdependence.[32]

What public health issues are commonly found in the border region?

The globalization of resources has also complicated the regulation of environmental factors, which, in turn, exposes border residents to a multitude of additional public health issues. Near the Arizona-Mexico border, social activist Teresa Leal researched the relationship of globalization to the local water shortages and illegal sewage, mining, and toxin dumps in the local water source of the Santa Cruz River.[33] While the amounts of illegal waste dumped are relatively meager, the Arizona-Nogales area and the Santa Cruz River have in common a low annual rainfall. The toxicity of the water is thus compounded by the scarcity of the water itself and creates a highly-concentrated poisonous water flow.[34] With the shortage of water, thirsty, impoverished border inhabitants often have to settle for resources which are acknowledged to be harmful. In Monterey, over forty percent of participants in a comprehensive qualitative study were discovered to concurrently live near the water and to exhibit abnormally elevated levels of lead in their blood. These high levels were later quantifiably linked with the local food supply, which also depended upon the polluted water.[35]

In 1996, the US Institute of Medicine summed up the health challenges of the transnational border, stating that “distinctions between domestic and international health problems are losing their usefulness and are often misleading.”[36] More than seven million people live in the binary border cities, which provide the majority of the direct globalization in these areas.[37]

Although not as large as the binary cities of San Diego and Tijuana,[38] El Paso and Juarez are two of the largest US- Mexico border cities, and the majority of the research highlights the interrelationship of the cities as a key component in border globalization.[39] This also makes El Paso and Juarez prime locations for a variety of illegal activities. (Some accounts have also included the colonias of Las Cruces.)[40] All border cities may be subject to overlapping issues, but the San Diego-Tijuana and Tucson-Nogales binary cities are the only two examples which represent a large mix of identities other than that of Caucasian and Latino.[41]

In 1992, a truck filled with 170 barrels of highly toxic waste was prevented from crossing the border (at El Paso) and dumping it somewhere near Juarez. Even more alarming, similar barrels were found in the colonias two days later and had been used to store household water.[42] The same article follows an epidemiologist who takes samples from colonias on both sides of the border and discovers that one of three wells had high levels of fecal matter and another had large quantities of arsenic.[43]

Naturally, exposure to high levels of polluted border water or food has long-term adverse effects upon the health of the community. Approximately thirteen million people live in the border regions.[44] The link between globalization and pollution is undeniable, and both sides of the border are worried. This phenomenon of shared barriers to better health is termed as the international transfer of risk.[45] As was demonstrated by the example above,

Americans are concerned that pollution may cross from Mexico to the U.S. and that companies expanding into Mexico may get an economic advantage from less stringent environmental enforcement; Mexicans are concerned that industrial expansion from American companies will increase hazardous waste problems.[46]

The research has continually shown that the majority of the intentional ecological pollution has been committed against the Mexican border cities- by Americans.[47] The brunt of adverse health effects of globalization and industrialization are not shared equally. Mexico is attempting to address the inequity- without the extensive resources present in the US.[48] Globalization’s creation of a cultural pecking order has marginalized the Mexican economy as a slum dependent upon favorable public relations with the US. Qualitative studies are frequently written from the American perspective, which can limit the scope of the elements studied and further marginalize the importance of the Mexican perspective. The maquiladoras, focused on cost-effective solutions, are only adding to a problem begun years earlier, and the enforcement of environmental policies in labor housing has not been a priority of the Mexican government thus far.[49]

However, the border citizens also have the unique vantage point for exploitation of dual health care resources and diverse treatment options.[50] This fortifies Harvey’s supposition that such an inequity as health insurance creates a new class relationship of “opposition, antagonism, and struggle.” In such a scenario, Harvey asks, first, how much do the leaders sacrifice to secure labor rights and what is implicit in this arrangement?[51] These two questions bear a poignant relevance to the discussion of border health care.

Recent immigrants from Mexico often underestimate the sheer number and complexity of stressful situations that they will encounter as they adjust and prepare to enter the American workforce. Contrary to popular opinion, high levels of stress are common to illegal and legal immigrants alike.[52] Combined with routine exposure to harmful substances, these stressors increase the immigrants’ susceptibility to risk-taking behaviors and- by extension- health threats. The border is thought to be an environment which fosters such behaviors through “drug trafficking, relatively easy access to pharmaceuticals in Mexico, socioeconomic stress, rapid and dynamic population growth, the interrelationship of cultures, and a young population.”[53]

Other common risk-taking behaviors include alcoholism and substance abuse and/or trafficking. It should be noted that the frequency of substance abuse is statistically much higher in the native-born Americans in all areas of the country, but that does not detract from the large portion of border citizens who form a large body of the statistics of substance abuse.[54] However, alcohol and substance abuse users are less likely to seek treatment- due to a lack of awareness of options, insurance complications, or even cultural norms of the population which glamorize heavy drinking.[55]

Despite the debates about access and efficacy of border health care resources (which will be discussed in the next section of the Review of the Literature), a variety of research has confirmed that recent immigrants to America display a different set of specific health problems, most commonly diabetes,[56] tuberculosis,[57] and sexually-transmitted diseases[58]. Generally, the immigrants’ health problems are caused or exacerbated by the availability of information- as was discussed earlier.[59]

Acculturation is defined as “the process through which minority individuals adapt to and assimilate into the mainstream culture”.[60] It should be noted that acculturation accepts the majority rule of culture as the dominating contributor to the determination of social adaptability and acceptance. As Mexican immigrants begin acculturation, they are less likely to continue in their previous healthy habits- but are more conscientious of this shift, which implies that either a higher portion of fatty foods or a lower portion of fruits and vegetables is consumed on a regular basis.[61] The main cause of death in the Latino population (in its entirety) is heart disease.[62] While diabetes can also be affected by genetic factors, the lack of availability of healthy foods and of health care has increased the likelihood of developing the condition and of needing immediate care.[63]

The four major American border states alone comprised fifty-two percent of the confirmed cases of tuberculosis (TB) in the US in 1997.[64]  In California, the percentage of TB users is even higher. In an attempt to control the possible damage, the US Center for Diseases Control and Prevention recommend the screening of immigrants from Latin American countries. In one study, seventy percent of injectable-drug users travelling back and forth from Tijuana had been diagnosed with a latent form of tuberculosis.[65]

One case study related the story of Nataniel, a worker who relocated to the border city of Juarez in the hopes of gaining employment at a maquiladora and earning money for his family. Instead, he was forced to share a small, unheated room and still could not save the money to send home. Desperate, he began to engage in male prostitution to supplement his income. Unaware of the necessity for condom use, Nataniel contracted gonorrhea and HIV. He could not illegally cross the border- as he had attempted- because his English was “pobre”- or poor- and could not earn the money to return home. Drawn to the promise of the maquiladoras in Juarez, he did not realize at the time that there were many available jobs near his hometown[66]– or that wages exhibit a diminishing difference in cross-border regions.[67] The lack of available information is a continuing problem in the border regions, and Moya and Shedlin’s interviews of substance abuse users revealed that one-third of the participants (of both American and Mexican origin) had received no secondary education.[68]

How available and sufficient are health care resources in the border region?

There is a vast difference between the health care options of legal and of illegal immigrants. In America, undocumented individuals reportedly have little- if any- access to public health resources.[69] The psychological aspects of living with “fear concerning the immigration status” no doubt have their own effects upon the general well-being of illegal immigrants on both sides of the border.[70] It is likely that they represent a large portion of uninsured border occupants.[71] Others simply cannot afford the mounting costs.

One study claims that ninety percent of their participants had been in no way affiliated with the border’s public health care.[72] Another study claims that nearly half of Mexican immigrants in America had health insurance, and seventy-five percent of Mexican, adult respondents also went without health insurance or care.[73] However, it is unclear what portion of this percentage is comprised of illegal immigrants. Regardless, the average Mexican immigrant is less likely to have access to health information and care than are their counterparts who remained in Mexico.[74] Location, distance, and cultural and linguistic obstacles further complicate cross-border health care, [75] and thus forty-four percent of residents in Texan borderlands are uninsured.[76]

“The globalization of health goes beyond diseases and risk factors to include health care and its inputs.”[77] This limited health care has had a profound effect on border life. Sexually-transmitted diseases aside, the number of infections and diseases in the Mexico side of the border have been on the rise. A large number of these could easily be prevented or cured with vaccination- but, for now, are not.[78] In Epstein’s commentary Emerging Diseases and Ecosystem Instability: New Threats to Public Health, the author focuses on the two emerging diseases currently found in Mexico: the hantavirus and a new variation of cholera.[79] The hantavirus killed nearly one half of the 94 persons in the United States who were afflicted and had previously affected only rodents- as did the infamous Black Death plague of 1347.[80] Despite the extensive research and attempts to eradicate the threat, no explanation could be found as to why the viral strain suddenly evolved.[81] Nonetheless, it stood to reason that the living conditions are directly related to number of rodents who find an area hospitable, directly linking the economy with health. This link was further supported by the choleric emergence from areas of stagnant water, such as reservoirs and wetlands.[82]

In order to account for the differences in national border policies, researchers have pointed to the differences of surveillance, general sanitation and quality of life, and the disposal of sewage and other undesirable products.[83] “Researchers have documented the fact that border residents frequently cross the border to seek dental and medical services and to purchase pharmaceuticals.”[84] US residents of all walks of life cross the border to undergo health care in Mexico, because it is affordable, medically liberal, and/or culturally preferred.[85] The larger number of available pain killers is the second most popular cause for favoring health care in Mexico over that of the United States.[86] Eighty percent of doctors in Mexico speak Spanish, and, therefore, may feel more comfortable without the limitations of understanding and interpretation across bilingual lines.[87]

The lax medical regulations and charges of Mexican health care do not come without a catch. Rates of Hepatitis A, salmonella, and shigella are higher south of the border. Other ailments, such as tuberculosis, dengue, leprosy, and rabies are equally prevalent in the United States. [88]

What are the current health policies and institutions of the border region?

Harvey’s discussions of labor, production, and goods asserts that “surpluses that cannot be absorbed are devalued, sometimes even physically destroyed.”[89] In the balance hangs the standard of living, security, chances, and life expectancy of the laborers. Where laborers are devalued, “the physical and social infrastructures that serve as crucial supports to the circulation of capital and the reproduction of labor power, may also be neglected… They often spawn acute social and political tensions. And out of the associated ferment new political forms and ideologies can spring.” Capitalism depends upon the interrelationship of productive capacity and physical labor to reach the highest economic potential.[90]

In 2000, the average factory worker’s wage was not quite twenty percent of the income needed to support a family of 2 adults and 2 children. Thus, even if the children were of working age and all members of the household earned at least the average wage, the household would earn about three-fourths of what was considered necessary to provide an acceptable standard of living. For this reason, there has been considerable support for raising the minimum wage in Mexico.[91] With the need for economic balance and the escalations in prices, even this effort would be short-term.[92]

The Latino community has viewed the inaction as a deliberate oversight. As Carter et al. wrote: “Border communities, long ignored by distant policy makers and administrators, have become accustomed to what they perceive as environmental neglect and associated health problems.”[93] The research confirms that governmental interference will likely be necessary to produce a tangible change. These may be described as infrastructure-led approaches.[94] In 1983, one of the first modern attempts at pollution control, the La Paz Agreement (or Reagan-de la Madrid Accord), began to recognize the difficulties of a shared and informal border and its impact upon pollution and waste disposal.[95] Through the cooperation of national and working groups, the sewage disposal dilemmas faced by San Diego and Tijuana, as well as the air pollution of Arizona-Sonora, were finally formally addressed during President Reagan’s administration.[96] Estimations in the late 1990’s placed the estimated cost of cleaning the hazardous waste at a staggering 1 billion US dollars.[97]

The clearest and most recent example is that of NAFTA.[98] In 1993, the Centers for Disease Control and Prevention (CDC) launched a new program for combating the spread of the new viral and choleric strains.[99] In 1994, US-Mexico’s own Border Health Commission (BHC) recommended that new public health and prevention programs be integrated into the existing measures, that the governments and investors work together, that clear community health and urban planning standards be established, and that new designs for the assessment and implementation of border health initiatives be assessed and ultimately implemented.[100] Any initiatives taken by private parties on behalf- and with the approval- of the Border Health Commission would be reimbursed by the government at a later date.[101] No funds had yet been utilized, but border universities often expanded their graduate degree offerings to meet the need of the local public.[102] More recently, in 2000, the BHC released another governmental agreement citing intended research.[103]

The Border Environment Cooperation Commission (BECC), on the other hand, had utilized its connections with the previously-mentioned NADBank to secure funding for environmentally worthy border projects.[104] The Commission on Environmental Cooperation (CEC) sought to represent the grassroots movements during the large-scale overhaul of environmental financing for these initiatives.[105] The Environmental Protection Agency (EPA) has also become a guiding force during the negotiation of international policy and has itself been guided by concerns for the environment and ecology.[106] Independent, private-sector groups often seek to partially fund the research, clean-up, or health care initiatives. However, they do not have the authority to navigate the cross-border governmental negotiations and are frequently hindered by “the uniqueness of the national border area”- and its political environment.[107]

These two decades of emergent interest in the border economy and health care began to reach the phase of recommendations- across several different governmental and private sectors-  in the late 1990’s.[108]  In 1996, the Annual Binational Committee Meeting identified its border priorities, and three of the primary foci were migrant health, women’s health, and immunization.[109] The cost-effective AIDS medications of this time would not be mobilized for use at the border until the early part of 2001. This was partially in response to the increased pressure that a United Nations Special Session placed on this action.[110] Post September 11^th, American attempts at globalization were much more focused on procuring the good will of their neighboring countries and the security of their borders. The World Health Organization (WHO) assessed 191 world health systems and sought to increase intergovernmental efforts at environmental mitigation. Many of these private organizations hope to see a greater return (of public well-being, that is) on their investment in health- due to what is known as the ripple effect.  This effect assumes that a change in one area of life will inevitably manifest in other areas as well. The strength of the ripple effect depends upon its proximity of relevance to the initial health effort.[111]

If these private investors hoped to see the ripple effect for a lengthy amount of time, then they were surely disappointed by Mexico’s political changing of the guard, which occurred in the late 1980’s. Worried that NAFTA’s abolishment of tariffs would eliminate the viability of the smaller farm workers, in 2002 Mexican officials refused further negotiations regarding border tariffs.[112] Although various non-governmental organizations have persevered, the strength of the globalization movement is not what it once was.

Discussion

The philosopher Diogenes first used the phrasing “citizen of the world” in the fourth century.[113] After the terrorist attacks of September 11^th, British Prime Minister Tony Blair spoke of globalization as the “shift of human affairs from the restricted frame of the nation-state to the vast theater of planet Earth…affecting trade, finance, science, the environment, crime, and terrorism.” He also spoke of the impact of changing health care needs and access.[114] Whether speaking of the geographically-defined or arbitrarily-assigned lines of the border, today’s borders have become a relic symbolic of the times when maintaining an entirely separate national identity was possible.[115] However, people, diseases, and money are not confined by these borders, and the events of September 11^th highlighted both the growing nature of the “vast theater of planet Earth” and the subsequent need for tightened security measures and a stricter vigil.[116]

Regardless, the supporters have painted globalization as the Promised Land of the modern age, the critics have accused the term of being a smoke screen of crossed theories, intentions, and subjects. While academia argues about semantics and accuracy, the border inhabitants wait- frozen in much the same situation as they were in during the later part of the 1990’s. While the importance of cooperative, cross-border progress has been emphasized by the 2001 acts of terrorism against the US, most of the action has been taken on behalf of private groups. The highly-lauded Border Health Commission promised the research twenty years ago, and it is only now a likely possibility- despite the best efforts of some enthusiastic supporters.

Despite the multitude of available resources regarding the US-Mexico economic and ecological globalization, the studies favor the American perspective and also generally draw from very limited pools of participants. Most individuals are not the embodiment of the national opinions. Thus, interviewing three grown men in substance abuse clinics is a very biased and selective way to limit the findings of the academic measurements.

For any number of reasons, governmental assistance has more often led to interference, confusion, and further delay, and there is still much to be done. Many of the health problems in the border areas are a direct result of air, waste, or toxic pollution. Even imported tortillas, a Latino food staple, were correlated with higher levels of lead presence in the blood.[117] Other sources of ill health generally are work conditions and economic unavailability of healthy dietary resources. For others, it is the product of ignorance regarding- or lack of access to- health care resources. Mortality rates remain higher in Texas than in any other American state.[118]

Warner was quoted as saying that “there can probably be no improvement in general health unless the more basic problems of the environment, sanitation, and safe drinking water are resolved”.[119] A variety of ailments is based in these unsafe conditions and is often easily prevented. As we have discussed, the hantavirus, cholera, tuberculosis, diabetes, and sexually-transmitted diseases are among the most common threats to the health of border inhabitants. The study of Handley et al. points to the ceramic cookware as a possible source of adverse health- due to the presence and inevitable transference of minute lead particles.[120] The American Medical Association called the United States-Mexico border a fertile ground for the development of various diseases and infections.

To avoid doing too little as a result of the pursuit of perfectionism or of a desire to test the efficacy of the ripple effect, perhaps the various organizations should, instead, focus on smaller initial steps which are unlikely to meet with any protestation or incident. The two most basic and essential mitigation strategies are to make health and community knowledge a primary objective in the early school years of all citizens and to monitor and enforce the regulations set forth by both governments, the Border Health Commission, and the Environmental Protection Agency. If these three groups could work together, then perhaps a solution or slowing of the adverse effects would be achieved. Is the governmental interference an indication of a tide now turning against globalization- or even an attempt to establish a different cross-border political dynamic?

Conclusion

Throughout the review of the literature, debate and conflict are constant underlying factors. There is no consensus about what globalization is, about its overall worthiness as a policy goal, or even as its viability in a politically-charged world. Even when non-governmental organizations and other private groups attempt to contribute that which is in their power, there is inevitably a power struggle. Meanwhile, the laborers are suffering, and the problem is growing.

After reviewing the literature, the cross-border mutual reliance (in certain spheres) is apparent. America depends on Mexico for inexpensive labor alternatives and competitive capitalist supply and demand, Mexico depends on America for business opportunities and political alliance, and the border cities’ inhabitants depend on the presence of these jobs and health care options that the privileged do not want. Indeed, it is a flawed system, but it allows for growth and progress. Globalization can and should be defined by potential.

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

Lara, Antonio, and Paul Rich. 2003. “Commodity Policy in an Era of Globalization: The Mexican Sugar Industry and Its Problems Under NAFTA.” Policy Studies Journal 31, no. 1: 101. Academic Search Complete, EBSCOhost (accessed November 26, 2010).

Lemus-Ruiz, B. E. (1999). “The local impact of globalization: worker health and safety in Mexico’s sugar industry.” Int J Occup Environ Health 5(1): 56-60.

McGuire Sr, S. and J. Georges (2003). “Undocumentedness and liminality as health variables.” Advances in Nursing Science 26(3): 185-195.

Mittleman, James H.  1995. “Rethinking the International Division of Labour in the Context of Globalization.”  Third World Quarterly 16, no. 2: 273

Moya, E., & Shedlin, M. (2008). Policies and Laws Affecting Mexican-Origin Immigrant Access and Utilization of Substance Abuse Treatment: Obstacles to Recovery and Immigrant Health. Substance Use & Misuse, 43(12/13), 1747-1769. doi:10.1080/10826080802297294.

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Varady, Robert. Mack, G. and Maura D. (1995) “Transboundary water resources and public health in the U.S.-Mexico border region.” Journal of Environmental Health. 57(8): 8.

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Villa-Caballero, L., V. M. Caballero-Solano, et al. (2008). “Health and globalization in the San Diego-Tijuana region.” Globalización y salud en la región San Diego-Tijuana. 144(5): 389-394.

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Wu, Chung-Tong. “Cross-Border Development in a Changing World: Redefining Regional Development Policies.” In New Regional Development Paradigms, Vol. 2, ed. David W. Edgington, Antonio L. Fernandez, and Claudia Hoshino, Ch. 2. Westport, Connecticut: Greenwood Press, 2001.

[1] Olson, T., & Tapia, S. (2009). Nataniel, NAFTA, and Public Health at the U.S.-Mexico Border. Public Health Nursing, 26(6), 561-567. doi:10.1111/j.1525-1446.2009.00815.x.

[2] Homedes, N. and A. Ugalde (2003). “Globalization and Health at the United States-Mexico Border.” American Journal of Public Health 93(12): 2016-2022.

[3] Chiro, G. D. (2004). “”Living is for everyone”: border crossings for community, environment, and health.” Osiris 19: 112-129.

[4] Frenk, J. and O. Gomez-Dantes (2002). “Globalization and the challenges to health systems.” Health Aff (Millwood) 21(3): 160-165.

[5] Olson, T., & Tapia, S. (2009). Nataniel, NAFTA, and Public Health at the U.S.-Mexico Border. Public Health Nursing, 26(6), 561-567. doi:10.1111/j.1525-1446.2009.00815.x.

[6] Harvey, David. “The Geopolitics of Capitalism.” In Spaces of Capital: Towards a Critical Geography, Ch. 15. New York: Routledge, 2001.

[7] Wu, Chung-Tong. “Cross-Border Development in a Changing World: Redefining Regional Development Policies.” In New Regional Development Paradigms, Vol. 2, ed. David W. Edgington, Antonio L. Fernandez, and Claudia Hoshino, Ch. 2. Westport, Connecticut: Greenwood Press, 2001.

[8] McGuire Sr, S. and J. Georges (2003). “Undocumentedness and liminality as health variables.” Advances in Nursing Science 26(3): 185-195.

[9] Ibid.

[10] Chiro, G. D. (2004). “”Living is for everyone”: border crossings for community, environment, and health.” Osiris 19: 112-129.

[11] Wu, Chung-Tong. “Cross-Border Development in a Changing World: Redefining Regional Development Policies.” In New Regional Development Paradigms, Vol. 2, ed. David W. Edgington, Antonio L. Fernandez, and Claudia Hoshino, Ch. 2. Westport, Connecticut: Greenwood Press, 2001.

[12] Carter, Dean, C. Pena, R.  Varady, and W. Suk. (June 1996). Environmental Health and Hazardous Waste Related to the U.S.-Mexico Border. Environmental Health Perspectives, 104(6), 590-594.

[13] Olson, T., & Tapia, S. (2009). Nataniel, NAFTA, and Public Health at the U.S.-Mexico Border. Public Health Nursing, 26(6), 561-567. doi:10.1111/j.1525-1446.2009.00815.x.

[14] Byrd, T., & Law, J. (2009). Cross-border utilization of health care services by United States residents living near the Mexican border. Pan American Journal of Public Health, 26(2), 95-100. Retrieved from Academic Search Complete database.

[15] Ibid.

[16] Ibid.

[17] Harvey, David. “The Geopolitics of Capitalism.” In Spaces of Capital: Towards a Critical Geography, Ch. 15. New York: Routledge, 2001.

[18] Ibid.

[19] Brown, Garrett Wallace. 2008. “Globalization is What We Make of It: Contemporary Globalization Theory and the Future Construction of Global Interconnection.” Political Studies Review 6, no. 1: 42-53. Academic Search Complete, EBSCOhost (accessed November 20, 2010).

[20] Harvey, David. “The Geopolitics of Capitalism.” In Spaces of Capital: Towards a Critical Geography, Ch. 15. New York: Routledge, 2001.

[21] Wu, Chung-Tong. “Cross-Border Development in a Changing World: Redefining Regional Development Policies.” In New Regional Development Paradigms, Vol. 2, ed. David W. Edgington, Antonio L. Fernandez, and Claudia Hoshino, Ch. 2. Westport, Connecticut: Greenwood Press, 2001.

[22] Olson, T., & Tapia, S. (2009). Nataniel, NAFTA, and Public Health at the U.S.-Mexico Border. Public Health Nursing, 26(6), 561-567. doi:10.1111/j.1525-1446.2009.00815.x.

[23] Ibid.

[24] Ibid.

[25] Harvey, David. “The Geopolitics of Capitalism.” In Spaces of Capital: Towards a Critical Geography, Ch. 15. New York: Routledge, 2001.

[26] Frenk, J. and O. Gomez-Dantes (2002). “Globalization and the challenges to health systems.” Health Aff (Millwood) 21(3): 160-165.

[27] Lara, Antonio, and Paul Rich. 2003. “Commodity Policy in an Era of Globalization: The Mexican Sugar Industry and Its Problems Under NAFTA.” Policy Studies Journal 31, no. 1: 101. Academic Search Complete, EBSCOhost (accessed November 26, 2010).

[28] Ibid.

[29] Ibid., 103.

[30] Brennan, T. (2001). “Which third way?” Thesis Eleven 64(1): 39-64.

[31] Ibid.

[32] Ibid.

[33] Chiro, G. D. (2004). “”Living is for everyone”: border crossings for community, environment, and health.” Osiris 19: 112-129.

[34] Varady, Robert. Mack, G. and Maura D. (1995) “Transboundary water resources and public health in the U.S.-Mexico border region.” Journal of Environmental Health. 57(8): 8.

[35] Handley, M. A., C. Hall, et al. (2007). “Globalization, bi-national communities, and imported food risks: Results of an outbreak investigation of lead poisoning in Monterey County, California.” American Journal of Public Health 97(5): 900-906.

[36] Frenk, J. and O. Gomez-Dantes (2002). “Globalization and the challenges to health systems.” Health Aff (Millwood) 21(3): 160-165.

[37] Brandon, J.E., Crespin, F.H., Levy, C., & Reyna, D.M. (1997). Border health issues. IN: J.Bruhn and JE Brandon’s (Eds) Border health: Challenges along the U.S.-Mexico Border. NY: Garland Press.

[38] Ibid.

[39] Moya, E., & Shedlin, M. (2008). Policies and Laws Affecting Mexican-Origin Immigrant Access and Utilization of Substance Abuse Treatment: Obstacles to Recovery and Immigrant Health. Substance Use & Misuse, 43(12/13), 1747-1769. doi:10.1080/10826080802297294.

[40] Brandon, J.E., Crespin, F.H., Levy, C., & Reyna, D.M. (1997). Border health issues. IN: J.Bruhn and JE Brandon’s (Eds) Border health: Challenges along the U.S.-Mexico Border. NY: Garland Press.

[41] Warner, David. (2010). “Health Issues at the US-Mexican Border.” University of Cincinnati. Retrieved November 1, 2010 from www.jama.com.

[42] Anders, J. 1995. Along US Southern Border, Pollution, Poverty, Ignorance, and Greed Threaten Nation’s Health. Medical News & Perspectives 273(19): 1478-1483.

[43] Ibid.

[44] Vijayaraghavan, M., He, G., Stoddard, P., & Schillinger, D. (2010). Blood pressure control, hypertension, awareness, and treatment in adults with diabetes in the United States-Mexico border region. Pan American Journal of Public Health, 28(3), 164-173.

[45] Frenk, J. and O. Gomez-Dantes (2002). “Globalization and the challenges to health systems.” Health Aff (Millwood) 21(3): 160-165.

[46] Vijayaraghavan, M., He, G., Stoddard, P., & Schillinger, D. (2010). Blood pressure control, hypertension, awareness, and treatment in adults with diabetes in the United States-Mexico border region. Pan American Journal of Public Health, 28(3), 164-173.

[47] Grineski, Sara, and Timothy Collins. 2008. “Exploring patterns of environmental injustice in the Global South: Maquiladoras in Ciudad Juárez, Mexico.” Population & Environment 29, no. 6: 247-270. Academic Search Complete, EBSCOhost (accessed November 19, 2010).

[48] Chiro, G. D. (2004). “”Living is for everyone”: border crossings for community, environment, and health.” Osiris 19: 112-129.

[49] Grineski, Sara, and Timothy Collins. 2008. “Exploring patterns of environmental injustice in the Global South: Maquiladoras in Ciudad Juárez, Mexico.” Population & Environment 29, no. 6: 247-270. Academic Search Complete, EBSCOhost (accessed November 19, 2010).

[50] Byrd, T., & Law, J. (2009). Cross-border utilization of health care services by United States residents living near the Mexican border. Pan American Journal of Public Health, 26(2), 95-100. Retrieved from Academic Search Complete database.

[51] Harvey, David. “The Geopolitics of Capitalism.” In Spaces of Capital: Towards a Critical Geography, Ch. 15. New York: Routledge, 2001.

[52] Moya, E., & Shedlin, M. (2008). Policies and Laws Affecting Mexican-Origin Immigrant Access and Utilization of Substance Abuse Treatment: Obstacles to Recovery and Immigrant Health. Substance Use & Misuse, 43(12/13), 1747-1769. doi:10.1080/10826080802297294.

[53] Ibid.

[54] Ibid.

[55] Ibid.

[56] Vijayaraghavan, M., He, G., Stoddard, P., & Schillinger, D. (2010). Blood pressure control, hypertension, awareness, and treatment in adults with diabetes in the United States-Mexico border region. Pan American Journal of Public Health, 28(3), 164-173.

[57] Moya, E., & Shedlin, M. (2008). Policies and Laws Affecting Mexican-Origin Immigrant Access and Utilization of Substance Abuse Treatment: Obstacles to Recovery and Immigrant Health. Substance Use & Misuse, 43(12/13), 1747-1769. doi:10.1080/10826080802297294.

[58] Olson, T., & Tapia, S. (2009). Nataniel, NAFTA, and Public Health at the U.S.-Mexico Border. Public Health Nursing, 26(6), 561-567. doi:10.1111/j.1525-1446.2009.00815.x.

[59] Vijayaraghavan, M., He, G., Stoddard, P., & Schillinger, D. (2010). Blood pressure control, hypertension, awareness, and treatment in adults with diabetes in the United States-Mexico border region. Pan American Journal of Public Health, 28(3), 164-173.

[60] Ghaddar, S., Brown, C., Pagán, J., & Díaz, V. (2010). Acculturation and healthy lifestyle habits among Hispanics in United States-Mexico border communities. Pan American Journal of Public Health, 28(3), 190-197. Retrieved from Academic Search Complete database.

[61] Ibid.

[62] Pria, M. 2003. “Health and cultural diversity among the migrant population: Another challenge of globalization.” Journal of Transcultural Nursing 14(3): 177-179.

[63] Brandon, J.E., Crespin, F.H., Levy, C., & Reyna, D.M. (1997). Border health issues. IN: J.Bruhn and JE Brandon’s (Eds) Border health: Challenges along the U.S.-Mexico Border. NY: Garland Press.

[64] Pria, M. 2003. “Health and cultural diversity among the migrant population: Another challenge of globalization.” Journal of Transcultural Nursing 14(3): 177-179.

[65] Deiss, Robert, Richard S. Garfein, Remedios Lozada, Jose Luis Burgos, Kimberly C. Brouwer, Kathleen S. Moser, Maria Luisa Zuniga, Timothy C. Rodwell, Victoria D. Ojeda, and Steffanie A. Strathdee. 2009. “Influences of Cross-Border Mobility on Tuberculosis Diagnoses and Treatment Interruption Among Injection Drug Users in Tijuana, Mexico.” American Journal of Public Health 99, no. 8: 1491-1495. Academic Search Complete, EBSCOhost (accessed November 22, 2010).

[66] Olson, T., & Tapia, S. (2009). Nataniel, NAFTA, and Public Health at the U.S.-Mexico Border. Public Health Nursing, 26(6), 561-567. doi:10.1111/j.1525-1446.2009.00815.x.

[67] Wu, Chung-Tong. “Cross-Border Development in a Changing World: Redefining Regional Development Policies.” In New Regional Development Paradigms, Vol. 2, ed. David W. Edgington, Antonio L. Fernandez, and Claudia Hoshino, Ch. 2. Westport, Connecticut: Greenwood Press, 2001.

[68] Moya, E., & Shedlin, M. (2008). Policies and Laws Affecting Mexican-Origin Immigrant Access and Utilization of Substance Abuse Treatment: Obstacles to Recovery and Immigrant Health. Substance Use & Misuse, 43(12/13), 1747-1769. doi:10.1080/10826080802297294.

[69] Moya, E., & Shedlin, M. (2008). Policies and Laws Affecting Mexican-Origin Immigrant Access and Utilization of Substance Abuse Treatment: Obstacles to Recovery and Immigrant Health. Substance Use & Misuse, 43(12/13), 1747-1769. doi:10.1080/10826080802297294.

[70] Brandon, J.E., Crespin, F.H., Levy, C., & Reyna, D.M. (1997). Border health issues. IN: J.Bruhn and JE Brandon’s (Eds) Border health: Challenges along the U.S.-Mexico Border. NY: Garland Press.

[71] Byrd, T., & Law, J. (2009). Cross-border utilization of health care services by United States residents living near the Mexican border. Pan American Journal of Public Health, 26(2), 95-100. Retrieved from Academic Search Complete database.

[72] Brandon, J.E., Crespin, F.H., Levy, C., & Reyna, D.M. (1997). Border health issues. IN: J.Bruhn and JE Brandon’s (Eds) Border health: Challenges along the U.S.-Mexico Border. NY: Garland Press.

[73] Vijayaraghavan, M., He, G., Stoddard, P., & Schillinger, D. (2010). Blood pressure control, hypertension, awareness, and treatment in adults with diabetes in the United States-Mexico border region. Pan American Journal of Public Health, 28(3), 164-173.

[74] Ibid.

[75] Brandon, J.E., Crespin, F.H., Levy, C., & Reyna, D.M. (1997). Border health issues. IN: J.Bruhn and JE Brandon’s (Eds) Border health: Challenges along the U.S.-Mexico Border. NY: Garland Press.

[76] Byrd, T., & Law, J. (2009). Cross-border utilization of health care services by United States residents living near the Mexican border. Pan American Journal of Public Health, 26(2), 95-100. Retrieved from Academic Search Complete database.

[77] Frenk, J. and O. Gomez-Dantes (2002). “Globalization and the challenges to health systems.” Health Aff (Millwood) 21(3): 160-165.

[78] Brandon, J.E., Crespin, F.H., Levy, C., & Reyna, D.M. (1997). Border health issues. IN: J.Bruhn and JE Brandon’s (Eds) Border health: Challenges along the U.S.-Mexico Border. NY: Garland Press.

[79] Epstein, Paul R. (1995). “Emerging Diseases and Ecosystem Instability: New Threats to Public Health.  American Journal of Public Health. 85(2):168-172.

[80] Frenk, J. and O. Gomez-Dantes (2002). “Globalization and the challenges to health systems.” Health Aff (Millwood) 21(3): 160-165.

[81] Epstein, Paul R. (1995). “Emerging Diseases and Ecosystem Instability: New Threats to Public Health.  American Journal of Public Health. 85(2):168-172.

[82] Ibid.

[83] Ibid.

[84] Homedes, N. and A. Ugalde (2003). “Globalization and Health at the United States-Mexico Border.” American Journal of Public Health 93(12): 2016-2022.

[85] Byrd, T., & Law, J. (2009). Cross-border utilization of health care services by United States residents living near the Mexican border. Pan American Journal of Public Health, 26(2), 95-100. Retrieved from Academic Search Complete database.

[86] Ibid.

[87] Ibid.

[88] Homedes, N. and A. Ugalde (2003). “Globalization and Health at the United States-Mexico Border.” American Journal of Public Health 93(12): 2016-2022.

[89] Harvey, David. “The Geopolitics of Capitalism.” In Spaces of Capital: Towards a Critical Geography, Ch. 15. New York: Routledge, 2001.

[90] Ibid.

[91] Olson, T., & Tapia, S. (2009). Nataniel, NAFTA, and Public Health at the U.S.-Mexico Border. Public Health Nursing, 26(6), 561-567. doi:10.1111/j.1525-1446.2009.00815.x.

[92] Ibid.

[93] Carter, Dean, C. Pena, R.  Varady, and W. Suk. (June 1996). Environmental Health and Hazardous Waste Related to the U.S.-Mexico Border. Environmental Health Perspectives, 104(6), 590-594.

[94] Wu, Chung-Tong. “Cross-Border Development in a Changing World: Redefining Regional Development Policies.” In New Regional Development Paradigms, Vol. 2, ed. David W. Edgington, Antonio L. Fernandez, and Claudia Hoshino, Ch. 2. Westport, Connecticut: Greenwood Press, 2001.

[95] Carter, Dean, C. Pena, R.  Varady, and W. Suk. (June 1996). Environmental Health and Hazardous Waste Related to the U.S.-Mexico Border. Environmental Health Perspectives, 104(6), 590-594.

[96] Ibid.

[97] Ibid.

[98] Olson, T., & Tapia, S. (2009). Nataniel, NAFTA, and Public Health at the U.S.-Mexico Border. Public Health Nursing, 26(6), 561-567. doi:10.1111/j.1525-1446.2009.00815.x.

[99] Epstein, Paul R. (1995). “Emerging Diseases and Ecosystem Instability: New Threats to Public Health.  American Journal of Public Health. 85(2):168-172.

[100] Brandon, J.E., Crespin, F.H., Levy, C., & Reyna, D.M. (1997). Border health issues. IN: J.Bruhn and JE Brandon’s (Eds) Border health: Challenges along the U.S.-Mexico Border. NY: Garland Press.

[101] Carter, Dean, C. Pena, R.  Varady, and W. Suk. (June 1996). Environmental Health and Hazardous Waste Related to the U.S.-Mexico Border. Environmental Health Perspectives, 104(6), 590-594.

[102] Brandon, J.E., Crespin, F.H., Levy, C., & Reyna, D.M. (1997). Border health issues. IN: J.Bruhn and JE Brandon’s (Eds) Border health: Challenges along the U.S.-Mexico Border. NY: Garland Press.

[103] Pria, M. 2003. “Health and cultural diversity among the migrant population: Another challenge of globalization.” Journal of Transcultural Nursing 14(3): 177-179.

[104] Carter, Dean, C. Pena, R.  Varady, and W. Suk. (June 1996). Environmental Health and Hazardous Waste Related to the U.S.-Mexico Border. Environmental Health Perspectives, 104(6), 590-594.

[105] Ibid.

[106] Ibid.

[107] Ibid.

[108] Lara, Antonio, and Paul Rich. 2003. “Commodity Policy in an Era of Globalization: The Mexican Sugar Industry and Its Problems Under NAFTA.” Policy Studies Journal 31, no. 1: 101. Academic Search Complete, EBSCOhost (accessed November 26, 2010).

[109] Pria, M. 2003. “Health and cultural diversity among the migrant population: Another challenge of globalization.” Journal of Transcultural Nursing 14(3): 177-179.

[110] Ibid.

[111] Ibid.

[112] Lara, Antonio, and Paul Rich. 2003. “Commodity Policy in an Era of Globalization: The Mexican Sugar Industry and Its Problems Under NAFTA.” Policy Studies Journal 31, no. 1: 101. Academic Search Complete, EBSCOhost (accessed November 26, 2010).

[113] Frenk, J. and O. Gomez-Dantes (2002). “Globalization and the challenges to health systems.” Health Aff (Millwood) 21(3): 160-165.

[114] Ibid.

[115] Wu, Chung-Tong. “Cross-Border Development in a Changing World: Redefining Regional Development Policies.” In New Regional Development Paradigms, Vol. 2, ed. David W. Edgington, Antonio L. Fernandez, and Claudia Hoshino, Ch. 2. Westport, Connecticut: Greenwood Press, 2001.

[116] Byrd, T., & Law, J. (2009). Cross-border utilization of health care services by United States residents living near the Mexican border. Pan American Journal of Public Health, 26(2), 95-100. Retrieved from Academic Search Complete database.

[117] Handley, M. A., C. Hall, et al. (2007). “Globalization, bi-national communities, and imported food risks: Results of an outbreak investigation of lead poisoning in Monterey County, California.” American Journal of Public Health 97(5): 900-906.

[118] Warner, David. (2010). “Health Issues at the US-Mexican Border.” University of Cincinnati. Retrieved November 1, 2010 from www.jama.com.

[119] Varady, Robert. Mack, G. and Maura D. (1995) “Transboundary water resources and public health in the U.S.-Mexico border region.” Journal of Environmental Health. 57(8): 8.

[120] Handley, M. A., C. Hall, et al. (2007). “Globalization, bi-national communities, and imported food risks: Results of an outbreak investigation of lead poisoning in Monterey County, California.” American Journal of Public Health 97(5): 900-906.