Abstract
Background: The U.S.-Mexico Border is an area of opportunity for improved health care access; however, gaps remain as to how and where U.S. border residents, particularly those who are underinsured, obtain care. Antibiotics are one of the most common reported drivers of cross-border healthcare access and a medication of particular concern since indiscriminate or inappropriate use is associated with antimicrobial resistance. In addition, many studies assessing preferences for Mexican pharmaceuticals and healthcare in U.S. border residents were done prior to 2010 when many prescription medications, including antibiotics, were available over the counter in Mexico. Methods: Data used in this study were collected during the baseline examination of an ongoing longitudinal cohort study in Starr Country, Texas, one of 14 counties on the Texas-Mexico border. Participants self-reported the name, date of use, and the source country of each antibiotic used in the past 12 months. Logistic regression was used to determine social, cultural, and clinical features associated with cross-border procurement of antibiotics. Results: Over 10% of the study cohort reported using antibiotics in the past 30 days with over 60% of all rounds used in the past 12 months sourced from Mexico. A lack of health insurance and generation score, a measure of acculturation, were the strongest predictors of cross-border procurement of antibiotics. Conclusions: Factors previously associated with cross-border acquisition of antibiotics are still present despite changes in 2010 to prescription drug regulations in Mexico. These results may be used to inform future public health initiatives to provide culturally sensitive education about responsible antibiotic stewardship and to address barriers to U.S. healthcare and pharmaceutical access in medically underserved, impoverished U.S.-Mexico border communities.
Original language | English |
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Article number | 832266 |
Journal | Frontiers in Public Health |
Volume | 10 |
DOIs | |
State | Published - Mar 10 2022 |
Bibliographical note
Publisher Copyright:Copyright © 2022 Essigmann, Aguilar, Perkison, Bay, Deaton, Brown, Hanis and Brown.
Funding
This work was supported by National Institutes of Health grants R01DK116378 to EB, R01DK116378 to SB and CH, and grant 5T42OH008421 from NIOSH/Centers for Disease Control and Prevention to WP.
Funders | Funder number |
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National Institutes of Health (NIH) | R01DK116378, 5T42OH008421 |
National Institute for Occupational Safety and Health | T42OH008421 |
National Natural Science Foundation of China-Shandong Joint Fund for Marine Science Research Centers |
Keywords
- U.S.-Mexico border
- acculturation
- antibiotics
- border health
- health care
- insurance
- socioeconomic status
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health