RESUMO
INTRODUCTION: Increased enforcement at U.S.-Mexico border-crossing sites may lead migrants to cross in remote desert areas. METHODS: We reviewed data on migrants' bodies found along the Arizona-Mexico border from 2001 to 2020. We analyzed causes of death, condition of bodies, age, and sex, and the relationship of deaths to enforcement (arrests) by U.S. Border Patrol. RESULTS: From 2001-2020, 3,378 border-crosser bodies were found in the desert. As enforcement increased, bodies were found in more remote areas and later stages of decomposition. Skeletonized bodies increased from 19% in 2001-2004 to 49.1% in 2017-2020. When the cause of death could be identified, exposure to the elements was the most common cause. Abrupt increases in arrests and deaths over the immediately preceding period of 2013-2016 occurred in 2017-2020. CONCLUSIONS: Undetermined cause of death and increased skeletonization became more common, indicating bodies are discovered later. Enforcement does not decrease individuals crossing the border; rather, individuals cross in more remote areas.
Assuntos
Emigração e Imigração , Migrantes , Arizona/epidemiologia , Humanos , México/epidemiologiaRESUMO
To quantify the number of Border Crossers seen at our hospitals, broken down by diagnoses and age. We used our electronic medical record to identify the number of patients in custody of the United States Border Patrol who were seen at Banner-University: South and University Campuses during the calendar year 2016. 734 patients were identified, and the electronic medical record was used to identify the primary diagnosis and age for each one. We then manually categorized them into groups of common diagnoses. We also compared the number of border crosser emergency department (ED) visits to overall ED visits. Of 734 patients, 77% were male, 60% were between 16 and 40 years of age, and 18% were under age 18 years. They made up 1.3% of ED visits to South Campus, but less than 0.1% to University Campus. The top categories were musculoskeletal trauma (n = 235, 32%), and dehydration and rhabdomyolysis (n = 95, 13%). The age range of border crossers brought to our EDs varies widely, as do their primary diagnoses, although trends can be seen. They make up a 1.3% of overall emergency department visits at South Campus hospital.
Assuntos
Desidratação , Emigrantes e Imigrantes , Fraturas Ósseas , Ferimentos e Lesões , Adolescente , Adulto , Criança , Pré-Escolar , Desidratação/epidemiologia , Registros Eletrônicos de Saúde , Feminino , Fraturas Ósseas/epidemiologia , Nível de Saúde , Humanos , Lactente , Masculino , México , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Ferimentos e Lesões/epidemiologia , Adulto JovemRESUMO
Ecuador is a country with few resources to spend on health care. Historically, Ecuador has struggled to find a model for health care that is efficient, effective, and available to all people in the country, even those in underserved and rural communities. In 2000, the Ecuador Ministry of Public Health implemented a new system of health care that used primary care as its platform. Since then, Ecuador has been able to increase its health care efficiency, increasing its ranking from 111 of 211 countries worldwide in 2000, to 20 of 211 countries in 2014. This article briefly reviews the new components of the system implemented in Ecuador and examines the tools used to accomplish this. The discussion also compares and contrasts the Ecuador and US systems, and identifies concepts and policies from Ecuador that could improve the US system.