Shakespeare's "Measure for Measure"

by George Humphrey
AHSC Public Affairs
The Arizona Prevention Center at the University of Arizona Health Sciences Center will receive $1 .25 million in federal funds to develop a much-needed collaborative project to improve health care delivery along the U.S.-Mexico border.

This major public health research project first will determine the extent of health problems and health care delivery issues in selected underserved border communities. Then, in partnership with the communities, will devise intervention programs to address them. U.S. Sen. Jon Kyl, R-Ariz., and U.S. Rep. Ed Pastor, D-Ariz., respective members of the Senate and House Appropriations Committees, supported this provision and were instrumental in its inclusion in the final appropriations bill, passed by Congress and signed by President Bill Clinton in November, 1999.

The consortium will assess the impediments to screening and treatment for the leading causes of premature death and disability - heart disease, diabetes, cancer and hypertension - among residents of selected border communities and will develop model programs to deliver these services in target communities. The consortium will collaborate with the University of Texas School of Public Health at Houston and its satellite in San Antonio to promote such assessments and model development. Proposed intervention programs will focus on development of a disease surveillance system and on community-based prevention approaches to address urgent needs and involve the communities in planning for future programs to prevent disease.

The universities have extensive experience in border health and the new federal support will make possible a more integrated approach to these public health problems. "The net result will be to reduce these problems from the current crisis situation to a manageable, sustainable system of surveillance, prevention programs, screening and treatment," says Dr. Kent Campbell, head of the Arizona Prevention Center.

Border communities have complex chronic and emerging economic and health problems, including inadequate medical care, infectious diseases and environmental problems.

About 65 million people live in the four U.S. and six Mexican border states, including more than 9 million living in border towns and communities, according to the most recent U.S. census figures. U.S. border towns are located in four of the seven poorest counties in the United States. About 30 percent of the residents of U.S. border towns lack medical insurance, and at least 18 percent of the children in all four border states lack access to a primary care provider, according to a recent UA study.

In addition, the incidence of chronic diseases (such as diabetes and cervical cancer) and re-emerging infectious diseases (such as tuberculosis) is two to three times higher for border communities than for the United States as a whole. "If not addressed, these problems will create a major economic and health crisis in our nation," Campbell says. "A comprehensive multi-state program of research and program implementation is required to prevent this impending disaster."

Dr. James E. Dalen, UA vice president for health sciences and dean of the UA College of Medicine, says, "Our border communities are confronted by an array of serious public health challenges. We greatly appreciate the support of Congressman Pastor and Senator Kyl in securing this funding, which will allow the Arizona Prevention Center and the Arizona Health Sciences Center to more effectively address the health needs of these communities."