The Mexican Border Industrialization Program and its effects on public health in urban areas along the northern Mexican border, 1979--1998.

摘要

In 1965 Mexico implemented its version of an export processing zone (EPZ); namely, the Border Industrialization Program (BIP). Some of the goals of this program were to alleviate border unemployment and change the area from an economically backwards region into a growth pole. This dissertation examines the impact that the Border Industrialization Program has had on public health in the region. Specifically, it hypothesizes that BIP has had very little effect in reducing mortality and morbidity for communicable (HIV, TB, shigellosis, typhoid, hepatitis, and unidentified intestinal illnesses) and lifestyle diseases (diabetes and lung cancer) in the urban centers along the northern Mexican border. It does so comparatively by using mortality and morbidity data from both border urban municipios where BIP was implemented and similar interior municipios were BIP was not applied. Mortality and morbidity rates for each region (border or interior) were first calculated. These rates were then standardized by age and tested for significance in difference. Previous research on the diseases of interest guided the modeling of hierarchical regression equations. Additionally, ANCOVA values and diagnostics tests were calculated to determine the validity of the models. Most of the hypothesized outcomes were validated. For a number of diseases (shigellosis, typhoid, lung cancer, hepatitis, and unidentified intestinal illnesses) there was no significant difference for risks at the border versus the interior. For some diseases (diabetes, TB) conditions were worse at the border and for HIV/AIDS rates and risks were significantly lower at the border. Public health at the border has both benefited and suffered from the implementation of BIP and in its geographical proximity to the United States. The regions' rising standard of living has not been translated into better living conditions nor has it translated perfectly into better health conditions. The border like many developing countries faces a “double burden” of diseases as it continues to cope with high morbidity rates of communicable diseases and high mortality rates of certain Western lifestyle diseases. Other EPZs that do not share a border with a developed country, such as Mexico's, may not be so fortunate in their health outcomes.