Blurred Borders - International Community Foundation

public and private partnerships) work together, the more effectively our binational region will
function to provide the best healthcare at the least cost for all its residents.
Another aspect of border health issues that requires more attention is the fact that, within
borders of each country, there are pockets of neglected, or under-served communities. As
alluded to in Chapter 1 and 2, some parts of San Diego have very high indices of poverty, a fact
that contradicts, and too often is masked by, the overall image of San Diego as a prosperous
city. Tijuana, too, is considered one of the richer cities in Mexico, and yet many colonias
populares lack basic services, making them vulnerable to infectious or preventable diseases.
This chapter will highlight non-profit groups and initiatives that seek to meet the medical needs
of the particularly underserved communities in the San Diego-Tijuana region.
Healthcare in the Border Region
San Diego’s healthcare system includes an estimated 7,000 licensed physicians, nurses and nurse
practitioners, 27 hospitals, 59 community clinics, 6 trauma centers, for-profit urgent care
centers, various ambulance services, paramedics, and nearly 7,000 hospital beds tied together
by an award-winning county-operated Emergency Medical Services system. 225 In rough
estimates, over $1.3 billion is spent annually on healthcare in San Diego County, or
alternatively, on average, each San Diegan spends $3,759. 226 Although health care spending is
comparatively high in San Diego, still 21% of the non-elderly (ages 0-64) population had only
partial or no health insurance during year 2001. 227 Whereas in Tijuana, the 2000 census data
show that 47.9% of residents have health insurance coverage, and the vast majority (over 90%)
of the coverage is through a public healthcare program. 228
In the state of California, with a population of roughly 35 million, 6.3 million residents had no
health insurance for all or part of year 2001. 229 3.3 million people had been uninsured for more
than a year. 230 Lower income Californians are more likely to be uninsured for a long time.
Although an average of 86% of children (ages 0-17) have health insurance, this figure is much
lower for children in poorer households. Among children in poverty, i.e., in families earning
below 100% of Federal Poverty Level (FPL), a shocking 14.4% had no insurance at all, and
another 10.4% was covered only part of the year. 231 In other words, about one in four of
California’s children in poverty was lacking continuous health insurance coverage. Children in
poor or near poor (below 200% of FPL) households accounted for 80% of children without any
health insurance. 232 Health insurance coverage was even lower for the adult (ages 18-64)
population: just over 50% of adults in poverty had insurance all year, compared to 88% of those
households earning 300% of more of FPL. 233
225
San Diego Book of Facts - 2001
226
Health Affairs (July/August 2002)
227
Brown, et.al. (2003), p. 23.
228
Lomelí (2001), p. 2.
229
Brown, et.al (2003), p. 11.
230
Ibid, p. 12.
231
Ibid, p. 15.
232
Ibid, p. 17.
233
Ibid., p. 16.
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