Office of Border Public Health

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Texas – México border area

The Texas – México border is defined as the area 100 kilometers (62.5 miles) north and south of the international boundary (La Paz Agreement).  It stretches 1,254 miles from the Gulf of México to El Paso, Texas.  Additionally the border area includes two Native American Nations, creating a tri-national region (Kickapoo Traditional Tribe of Texas and Ysleta Pueblo del Sur).  There are 8 sister-city pairs from El Paso-Ciudad Juarez to Brownsville-Matamoros.

Population and demographics

The Texas border currently has a population of 2.7 million residents, considered to be one of the busiest international boundaries in the world, and negatively defined by health disparities and social determinants of health. 

Most border residents are Hispanic (87.8%), compared to only 33.1% of Texas non-border residents (2014 Census projections from DSHS Center for Health Statistics).  The population is characterized by high rates of poverty, 29.8% of border residents below poverty level, compared to only 16.4% of Texas non-border residents (See: Small Area Income and Poverty Estimates (SAIPE), U.S. Census Bureau, 2012 data, using 2012 population projections as denominators).

According to the 2012 Behavioral Risk Factor Surveillance System age-adjusted estimates, 47.5% of Texas border residents ages 18 and older lacked health insurance, compared to only 28.1% in the non-border counties of Texas. In Texas border counties, 32.9% of residents do not speak English well, compared to only 12.3% in Texas non-border counties (American Community Survey, computed from 5-year estimates based on 2008-2012 data).  More than one-third of Texas border residents ages 25 and older did not complete a high school diploma or a GED, which was about twice as high as the rate for the Texas non-border counties (34.6% of border residents, compared to 17.6% of non-border residents; American Community Survey, computed from 5-year estimates based on 2008-2012 data).

Dynamics, needs and assets

Texas border residents have diverse characteristics and are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings.  Development of innovative health program models; improved infrastructure; and, a culturally competent health workforce would be of great benefit to this area.

Border Health Issues

  • Despite high poverty rates, complex barriers to accessing health care, multiple socioeconomic, cultural, and environmental challenges, and a complex political and regulatory environment, the border population fares well on several leading health indicators, including infant mortality and heart disease and stroke.
  • However, the Texas border population is disproportionately affected by higher obesity, diabetes mellitus, cervical cancer, rates of caesarian section delivery rates, and certain communicable diseases including tuberculosis.
  • The rapid growth of the border population poses multiple challenges to development of a sufficient health workforce in the border region and access to primary, preventive, and specialty care.
  • In the border region, socioeconomic factors, linguistic and cultural barriers, low population densities, and lack of health insurance combine to impede residents’ ability to access health care.
  • There is a critical need for increased surveillance and tracking of communicable diseases, environmental factors, and other influences on health.
  • There is a need for standardization of data to ensure compatibility with data being collected by border states on both sides of the U.S.-Mexico border, as well as by both nations.
  • Public health infrastructure is sorely needed throughout the border region, including educational and research institutions that can train culturally competent health care providers.
  • While many successful public health programs have been implemented in the border region, these programs need to be replicated.

For additional information, contact:

Email Office of Border Public Health

Office of Border Public Health - M/C 1962

Texas Department of State Health Services

P.O. Box 149347

Austin, Texas 78714-9347

Phone: (512) 776-7675

Fax: (512) 776-7262


Toll free:          1-800-693-6699 (in United States)
                        001-800-693-6699 (in Mexico)

Last updated November 21, 2017