Cross-border cooperation in public health research: A binational experience between Mexico and the USA

Background: The USA-Mx Border diabetes prevention and control project is an ongoing cross-border cooperation that started in 1999 to measure the burden of diabetes and risk factors of chronic diseases in the cross-border region between US and Mexico.

Objective: Promoting the cooperation between neighboring border region through the collaboration of federal, state and local health institutions of both countries.

Methods: A model of equal representation, participation, consensus and shared leadership in the region was used to implement a cross-sectional study by establishing cross border working agreements and partnership. More than 130 cross-border institutions already established were coordinated and a fiduciary agency selected by committees assisted with the administration. A stratified random sample of 4020 individuals 18 years and older was obtained by a multistage cluster sample design. A survey on health related characteristics was carried out.

Results: Disease and risk factors prevalence were similar across the border. Findings triggered community interventions. Differences in legislative, financial and software environment challenged the operational procedures. The study principle of equal cooperation, participation and benefits as well as the mobilization of resources across the border was challenged by the lack of appropriate across the border legislation.

Conclusions: The US-Mx border has been considered for the first time as one epidemiological unit in public health research and in the America's Region. The understanding of each other socio-political structure and procedures is required to efficiently search for relevant partners to practice cross- border public health.