Deportation and Homelessness in a Mexico-US Border City: An Assessment of Health Status and Health Care

Introduction: Every year, hundreds of thousands of Mexican migrants arrive at the Mexico- United States (US) border, after being removed or returned by the US migration authorities. In Tijuana, a Mexican city across the border from California, returnees have become part of the homeless population, subsisting in conditions of limited access to health and social services.

Objective: To characterize the physical and mental health profile, and access to health services of homeless returnees, and to compare it with the characteristics of persons with no migratory experience, among a homeless population in Tijuana.

Methods: We conducted a survey in a temporary camp for returned migrants and homeless people in Tijuana in December 2013. Aiming to survey all persons sleeping in the camp during a 3 week period, and who had not answered to the survey before, we approached 460 persons, of which 435 (94.6%) agreed to respond. The questionnaire explored self-perceived health, previous diagnosis of chronic and infectious diseases, mental health with the 10-item version of the Center for Epidemiological Studies-depression (CES-D) and three questions regarding suicide ideation, and questions on health insurance and use of services. We compared the distribution of health-related variables between forced returnees (removed or returned), voluntary returnees, and those without experience of migration to the US.

Results: Of 435 persons living in the camp who responded the survey, 79.1% were forced-return migrants, 11.0% voluntary returnees, and 9.9% persons without international migratory experience. The percentage of respondents perceiving their health as very good-good was 12.79% among forced-return migrants, 22.92% among voluntary returnees, and 13.95% among those without migratory experience (chi2 p=0.20). The prevalence of chronic conditions (hypertension and diabetes) was similar between the three groups. The prevalence of depressive symptoms (CES-D >=10) was 48.38% for the whole sample, 49.11% for forced-return migrants, 52.08% for voluntary returnees, and 40.48% for those without migratory experience (chi2 p=0.50). A multivarite logistic regression showed that forced returnees were more likely to score over the cut-off point of the CES-D (OR 3.67, 95% CI 0.58-23.45). 55.39% of the forced-return migrants, 37.50% of voluntary returnees, and 55.81% of those without migratory experience had no medical insurance (chi2 p=0.06).

Conclusions: In the Mexico-US border, return migrants are part of the homeless population, and they present important health needs. New health, social and economical policies are required.