Octavio N. Martinez, Jr., MD, MPH, MBA, FAPA., is executive director of the Hogg Foundation for Mental Health at The University of Texas at Austin. Martinez is also a Senior Associate Vice-President within the Division of Diversity and Community Engagement, where he heads up the Community Integrated Health Initiatives program for the university. He is the Associate Chair of Diversity, Equity and Inclusion for the Dell Medical School Department of Psychiatry and Behavioral Sciences, a Professor of Psychiatry at DMS, Clinical Professor at the Steve Hicks School of Social Work, Faculty Affiliate of the Rapoport Center for Human Rights and Justice in the School of Law, and Adjunct Professor of Psychiatry at the Long School of Medicine, UT Health San Antonio. Internationally, Martinez is a member of the International Initiative for Mental Health Leadership. Nationally, he is a member of the Advisory Committee to the Director of the Centers for Disease Control and Prevention, and a member of the ADC’s Health Equity Workgroup. He is also a board member of Trust for America’s Health, a member of the Psychiatric Services Journal editorial board, and current member and former chair of the National Hispanic Council on Aging. Martinez recently served on the Presidential COVID-19 Health Equity Task Force for the White House and served on the National Advisory Committee for Rural Health and Human Services for HHS. At the Texas state level, he is a commissioner for the Judicial Commission on Mental Health and executive committee member for the Texas Child Mental Health Care Consortium.
Octavio N. Martinez Jr., MD, MPH, MBA, FAPA
Senior Associate Vice President, Division of Diversity and Community Engagement; Executive Director, Hogg Foundation for Mental Health; Clinical Professor, Steve Hicks School of Social Work; Adjunct Professor of Psychiatry, Dell Medical School, The University of Texas at Austin, Austin, TX
Infectious Disease, Surveillance and Response along the United States-Mexico Border: Adequate or Inadequate?
The September 11, 2001, terrorist attack has energized the United States to expand and upgrade its ability to detect and respond to the threat of bioterrorism. Improving the nation’s public health infrastructure is integral to achieving this goal; as well as ensuring the public’s health, regardless if the threat is natural or intentionally induced. The four states (California, Arizona, New Mexico, and Texas) along the United States-Mexico border are part of this bioterrorism initiative. This region is particularly unique when compared to the rest of the country.
For instance, the United States-Mexico border is one of the busiest borders in the world. Over 400 million legal northbound border crossings occur yearly along this 2000-mile frontier. A total of 78 million people live in the ten border states (four states in the U.S. and six states in Mexico). This juxtaposition between the U.S. and Mexico has created incredible economic, cultural, and social opportunities; and with this opportunity has come tremendous growth. Unfortunately, the public health infrastructure has not kept pace. On the U.S. side alone more than 30% of families live at or below the poverty level; and over 3 million residents are uninsured. The majority of these are Hispanic or Native American.
These U.S. border communities are exposed to environmental hazards; lack access to health care; have unincorporated settlements, known as Colonias, that are without running water, sewers, storm drainage, electricity, and paved roads; and have rates of communicable diseases that are several fold the national averages. Preventing, monitoring, and treating infectious diseases are severely hampered by the frequent movement between the two countries. This environment will challenge the effectiveness of the surveillance and communication systems currently in development. For this reason, the United States-Mexico Border Health Commission (USMBHC) is in the process of reviewing these systems. And, as part of this effort, an evaluation to determine where weaknesses exist was initiated.
Multiple data bases were researched and an extensive literature review was accomplished. Telephone and on-site visit interviews were conducted. In addition, a comparative analysis of the United States-Mexico border region to state and national averages was performed.
At this point in time, the United States does not have an operational nationwide surveillance or alert system. The current focus is mostly concentrated on enhancing network technology. But, how effective will these system changes be, once they are operational, if we do not have adequate number of health providers and sufficient hospital capacity. The United States-Mexico border region is significantly below the national average on these parameters.
Therefore, it is recommended that the USMBHC collaborate with the U.S. Department of Health and Human Services to strategically place community health centers along the U.S.-Mexico border region; partner and develop criteria with the National Health Service Corps to increase health providers along the U.S.-Mexico border region; ensure that the surveillance and communication network technology being developed is equitably applied within the U.S.-Mexico border region; and cooperate with Mexico’s initiatives as they relate to the Mexico-United States border area.
Russell, E. Bennett, Executive Director, U.S. Section, United States-Mexico Border Health Commission, El Paso, TX
The Commonwealth Fund/Harvard University Fellowship in Minority Health Policy is truly a unique experience. It embodies the true meaning of fellowship, not only from an academic perspective, but even more so from a humanistic perspective. You are among a company of equals and are provided with the skills and tools to rise above the din and take your "seat at the table." The academic program is invigorating and challenging. The exposure to public, private, and government leaders at the national, state, and community level is outstanding. A lifetime of networking is consolidated into twelve months. This in and of itself makes the Fellowship priceless. The interdisciplinary approach taken by the Fellowship is a valuable model well suited to address the challenging public health issues facing minorities, disadvantaged populations, and all communities in general. This approach is especially pertinent to the unique mental health issues facing our communities. This model nicely complements the biopsychosocial model learned by mental health professionals during their formal training. Both models promote a comprehensive understanding of relevant problems. Together, these two models provide a strong foundation from which a mental health professional can build a career dedicated to improving mental health policy. The Fellowship encourages and challenges one to absorb, integrate, and formulate solutions to major issues. These issues are formidable, but the Fellowship teaches one that they are not insurmountable.
The knowledge acquired, the skills learned, and the confidence instilled has provided me with exciting opportunities to give back to the community and enhance my career. In the first twelve months since I completed the Fellowship, I have had the privilege of serving on several grant review committees for the NIH, conduct peer reviews for academic journals, participate in strategic planning to improve the mental health clinic of a local federally funded community health center, establish an alliance with a regional public mental health foundation, enhance the health disparities curriculum for the medical school of which I am a faculty member, and have been asked to join hospital policy committees usually reserved for more senior staff.
I feel these opportunities came to fruition because of the knowledge, skills, and confidence imparted by my education and fellowship experience. Therefore, I encourage all mental health professionals, who want to make a contribution to humanity, who want to further enlighten their fellow man, and who want to experience personal growth, to apply to the Fellowship. It can be the beginning of a wondrous journey.
The combination of the Fellowship and the Health Policy and Management Department of the Harvard School of Public Health showed me the value of and gave me the tools to pursue a future molding America's health policy. They exposed me to the importance of networking with and learning from experts already established in high places. They made me understand what leadership entails and that there is a leader in me. This experience will remain invaluable throughout my life.
"Knowing is not enough; we must apply. Willing is not enough: we must do." (Quote from Goethe printed in the 2002 Institute of Medicine's report Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare.)