The US deports more Mexicans to Tijuana than any other borderland city. Returning involuntarily as members of a stigmatized underclass, many find themselves homeless and de-facto stateless. Subject to routinized police victimization, many take refuge in the Tijuana River Canal (El Bordo). Previous reports suggest Tijuana River water may be contaminated but prior studies have not accessed the health effects or contamination of the water closest to the river residents. A binational, transdisciplinary team undertook a socio-environmental, mixed methods assessment to simultaneously characterize Tijuana River water quality with chemical testing, assess the frequency of El Bordo residents’ water-related diseases, and trace water contacts with epidemiological survey methods (n = 85 adults, 18+) in 2019, and ethnographic methods in 2019–2021. Our analysis brings the structural violence framework into conversation with an environmental injustice perspective to documented how social forces drive poor health outcomes enacted through the environment. The Tijuana River water most proximate to its human inhabitants fails numerous water-quality standards, posing acute health risks. Escherichia coli values were ∼40,000 times the Mexican regulatory standard for directly contacted water. Skin infections (47%), dehydration (40%) and diarrhea (28%) were commonly reported among El Bordo residents. Residents are aware the water is contaminated and strive to minimize harm to their health by differentially using local water sources. Their numerous survival constraints, however, are exacerbated by routine police violence which propels residents and other people who inject drugs into involuntary contact with contaminated water. Human rights to drinking water, sanitation and hygiene are routinely violated among El Bordo in-habitants. This is exacerbated by violent policing practices that force unhoused deportees to seek refuge in waterways, and drive water contacts. Furthermore, US-Mexico ‘free-trade’ agreements drive rapid growth in Tijuana, restrict Mexican environmental regulation enforcement, and drive underinvestment in sewage systems and infrastructure.

Background: The association of green spaces such as urban public parks and mental health might vary according to personal characteristics and characteristics of the park and be mediated by the use of the park. Aims: We investigate the association between urban public park coverage and mental health in adult women, the moderation of this association by personal and park-related characteristics, and the mediation of the association by use of public space. Methods: Combining data from a cross-sectional survey of the adult female population of Tijuana (Mexico) in 2014, and a study of public spaces in 2013, we analyzed the association between park coverage in buffers of 400 and 800 m from participants’ homes and score in the Center for Epidemiologic Studies-Depression scale (CES-D). We tested for mediation by use of park and interaction of urban park coverage with personal and park characteristics. Results: Urban public park coverage in the 400-m buffer had an inverse association with CES-D score that was moderated by age (significant only for younger participants), with no evidence of mediation. Park coverage in the 800-m buffer also had an inverse association with CES-D score, moderated by age and occupation (significant for younger participants and homemakers), and a mediated association was also observed. There was no interaction between park coverage and park characteristics in their association with CES-D score. Conclusion: Our results confirm the potential of public parks to improve mental health and suggest that this effect could be more important at some stages in the life course for women. The upper-middle-income, Latin American country setting adds to the current knowledge that is mostly based on high-income countries.

Background: Migrants in Mexico are entitled to care at all levels, independently of their migration status. However, previous studies show that access to care is difficult for this population. As the movement of in-transit migrants and asylum seekers has been interrupted at the Mexico-United States border by migration policies such as the “Remain in Mexico” program, and by border closures due to the COVID-19 pandemic, the Mexican health system has the challenge of providing them with health care. Levesque et al.'s framework, according to which access occurs at the interface of health system characteristics and potential users' abilities to interact with it, is a useful theoretical tool to analyze the barriers faced by migrants.Objective: The objective of this article is to analyze the barriers to access the public Mexican health system, encountered by migrants in cities in Mexican states at the Mexico-United States border during the COVID-19 pandemic.Methods: Data came from a multiple case study of the response of migrant shelters to health care needs during the COVID-19 pandemic. The study consisted of a non-probability survey of migrants with a recent health need, and interviews with persons working in civil society organizations providing services to migrants, governmental actors involved in the response to migration, and academics with expertise in the subject. We analyzed the quantitative and qualitative results according to Levesque et al.'s framework.Results: 36/189 migrants surveyed had sought health care in a public service. The main limitations to access were in the availability and accommodation dimension (administrative barriers decreasing migrants' ability to reach the system), and the affordability dimension (out-of-pocket costs limiting migrants' ability to pay). Civil society organizations were a major source of social support, helping migrants overcome some of the barriers identified.Conclusions: While Mexico's health regulations are inclusive of migrants, in practice there are major barriers to access public health services, which might inhibit migrants from seeking those services. In order to comply with its commitment to guarantee the right to health of all persons, the Mexican health authorities should address the implementation gap between an inclusive policy, and the barriers to access that still remain.