California Department of Public Health Office of Binational Border Health (OBBH)

1. I do not have any financial arrangements or affiliations with commercial sponsors which have direct interest in the subject matter:

2. California Department of Public HealthOffice of Binational Border Health (OBBH) Prisci Quijada Orozovich,MPH Connie Lafuente BORDER HEALTH CHALLENGES June 20, 2014

3. OBBH Core Program Background • Established in 1999 by State Legislation (AB 63, Ducheny) as a unit of the California Department of Public Health Services • Focus Area: Border and binational communities throughout California and Baja California

4. Office Of Binational Border Health Core Program Focus Area: Borderand Binational Communities In California And Baja California

5. Mandate: Produce an Annual Border Health Status Report to the Legislature With contributions and cooperation from CDPH branches

6. Mandate: Convene an OBBH Statewide Advisory Group Jim Arriola, MBA Paula Kriner, MPH President/Chief Executive Officer Senior EpidemiologistSekure Healthcare Imperial County Public Health Dept. Rosemarie Johnson, MD Blanca Lomeli, MD Medical Community Liasion Regional Director, North America External Relations Project Director TB Solution San Diego Medical Society Foundation Project Concern International Alberto Manetta, MD Gil Ojeda Professor Emeritus Board President University of California, Irvine Latino Coalition for a Healthy California Alvaro Garza, MD, MPH Carmen Nevarez, MD, MPHRepresentative Vice President of External Relations California Conference of Local Health Officers and Preventative Medicine Advisor (CCLHO) Public Health Institute Mario Gutiérrez, MPH Interim CEO Barbara Jimenez Center for Connected Health Policy Deputy Director for Central and South Regions San Diego County Health and Human Rose Anne Rodriguez, Esq. Director Communications County of Los Angeles Department of Public Health Services Agency

7. Mission To facilitate communication, coordination, and collaboration between California and Mexico health officials, health professionals and communities in order to optimize border and binational health.

8. California Department of Public Health Center for Infectious Disease California Office of Binational Border Health Chief April Fernández Health Program Manager II (619) 688-0159 Operations & Finance Staff Services Manager I Maria Celaya (619) 688-0267 OBBH Program Manager Prisci Quijada Orozovich (619) 688-0218 USMBHC-COO Program Manager (619) 688-0178 Infectious Disease Epidemiology Program Esmeralda Iniguez-Stevens Ph.D., MPH (619) 688-0111 CA BIDS Imperial County Public Health Dept. CA BIDS Imperial County Public Health Dept. Administrative Assistant(s) Diane Velez (.5 FTE) Vacant (.5 FTE) (619) 688-0252 Administrative Assistant Katiana Sánchez (619) 688-0263 Border Health Outreach Coordinator Connie Lafuente (619) 688-4285 Epidemiologist Margarita Santibañez MPH,MD (619) 688-6483 Surveillance Officer Maria Fierro (760) 482-4702 Surveillance Officer Maria Fierro (760) 482-4702 Project Assistant Abel Martinez (619) 688-0154 Project Assistant Natalie Svistoonoff (619) 688-0142 Surveillance Officer Maria Fierro (760) 482-4702 Surveillance Officer Maria Fierro (760) 482-4702 =CDPH Employee TB Branch Comm. Disease Manager II Anne Cass (619) 688-0253 STD Branch Disease Intervention Section Comm. Disease Specialist I Patricia Gonzales (619) 688-0234 STD Branch HIV Partner Services Jeffrey Egan (619) 688-3187 Student Intern Vacant (619) 688-0110 =Contract Employee April 28, 2014

9. US-Mexico Border Region is unique

10. How many crossings a day approximately occur between the San Diego/Imperial & Baja California Border? • A.)175,000 • B.) 120,000 • C.) 60,000 • D.) 10,000

11. Which County in California has the highest unemployment rate? • A. Los Angeles County • B. San Diego County • C. Imperial County • D. none of the above

12. What % of the population in Imperial County is living below the 200% Federal Poverty Level? • A.) 10.3% • B.) 30.4% • C.) 61.2% • D.) 80.3%

13. What are some of the challenges? • Social • Political • Environmental • Health

14. Social Challenges • Population Growth in both U.S & Mexico border counties • Unemployment rates • Higher Poverty rates • Deportation • Education

15. Political • Border Security • Economic

16. Environment • Agricultural operations • Vehicular pollution • Industrial facilities • Power plants • Dust from unpaved roads • Trash burning

17. Why is it important to focus on Public Health? • Inequitable health conditions • Higher rates of infectious diseases • Higher rates of chronic diseases • Other adverse health outcomes

18. Office of Binational Border Health Core Program What are our Goals & Current Activities?

19. Assess, monitor, and report on border and binational public health issues • Health Status Report • Binational Infectious Disease Surveillance collaboration • Influenza-Like-Illness Surveillance • Health Briefs • Binational Communication during Emergencies

20. Binational Emergencies • Mercury in Face Cream: Notification to Mexico and Outreach Materials • Communicate and collaborate during disease outbreaks and/or increase of cases e.g, Meningococcal, Influenza etc.

21. Promote and optimize communication, coordination, and collaboration • Meetings with Baja CA Health Officials • Border Health Consortium of the Californias: To enhance communication, coordination, and collaboration among public, private, and academic institutions in order to improve the quality of life in the border region 35 + public, private, academic institutions • US-Mexico Border Health Commission

22. Meetings with Baja California Health officials

23. Border Health Consortium of the CaliforniasBinational Engagement Meeting

24. Build capacity to effectively address border and binational public health issues • American Diabetes Association “Por tu Familia”-2014 • “Adelante Promotores” Conference to build Capacity-July 2014 • Promotores Education Conference-Oct 2014 • Cervical Cancer DVD • Baja California Pediatric Oncology Conference • Jornadas Epidemiológicas

25. Trainings

26. Increase awareness about border and binational public health issues and the role of OBBH • Collaboration with US, Mexico, and Canada to Plan and Coordinate Binational Health Week 2014 • Conference Coordination and Participation: • Sexual Reproductive Health Summit-2014 • US Mexico Border Binational Infectious Disease Conference-2014 • Adelante Promotores Conference-2014 • Annual Promotores Education Conference-2014 • National HIV/AIDS Conference-2014

27. Binational Health Week Kick-off @ Consulate of Mexico

28. Poster Presentations

29. United States-México Border Health Commission (BHC)

30. Mission and Goals Goals • Institutionalize a domestic focuson border health that can transcend political changes • Create an effective venuefor binational discussion to address key public health issues at the border Mission To provide international leadership to optimize health and quality of life along the United States – México border

31. BHC Roles • Serves as a unique binational and horizontal framework that brings together two federal governments,10 states and a multitude of other public and private partners to address border and binational health issues. • Serves as a catalyst to identify, convene, and encourage action on key strategic binational issues that also brings focus to diverse populations. • Serves as a focal point to assist federal and state agencies in both countries in addressing specific border health related issues.

32. BHC Partners • U.S. and México Federal Governments • 10 State Health Departments • 4 Offices of Border Health • 10 BHC Outreach Offices • 90 Local Health Departments • Mexican Consulates • Binational Health Councils • Clinics, Hospitals, and Health Service Providers • Community-based Organizations • Promotores Organizations • Academic Institutions • Pan American Health Organization • Border Governors Conference • National Rural Health Association • U.S. and Mexico Media Outlets

33. BHC Challenges • Operates along the busiest and most complex binational borders in the world in support of diverse national, state, and local public health systems. • Has limited resources to address the whole host of border health issues • Identify unified priorities from each government • Focus health system to address chronic diseases as well as infectious disease • Utilize comprehensive approaches that includes health care systems, policy makers, academia, media, and public health • Focus resources to the border region • Expand focus to include preventive and health promotion strategies • Promote sustainable partnerships among various sectors

34. Strategic Priorities • Access to Care • Research, Data Collection, and Academic Alliances • Tuberculosis • Obesity/Diabetes

35. Access to Care Binational Mammography Day • January 1- February 1, 2014 Cancer Resource Center of the Desert- Community Symposium: Utilization of Health Services by Mexican Immigrants With Breast Cancer On the U.S./Mexico Border: Struggles and Aspirations • September 7, 2013 Promotores Conference 2013 • October 18, 2013 Town hall Resource Fair- Chula Vista & San Ysidro • November 5, 2013 and January 11, 2014

36. Research, Data Collection and Academic Alliances Border Reproductive Health Symposium - March 19, 2014 PPPSW 5th Annual Binational Dialogue - October 3, 2013 Affordable Care Act Webinar - September 8, 2013

37. Tuberculosis 5th annual United States Mexico Border Tuberculosis Consortium Meeting (TB Consortium) –July 14-15, 2014

38. Obesity and Diabetes American Diabetes Association Promotores Training: Prevention and management of diabetes

39. Upcoming Events: • Vulnerable Populations Network meeting – Imperial County • July 10, 2014 • Power of Collaboration • August 6 & 7 • Border Health Research Workgroup and Expert panel • TBD

40. Thank You! Office of Binational Border Health 5353 Mission Center Rd., Suite 215 San Diego, CA 92108 619-688-0218 http://www.cdph.ca.gov/programs/cobbh