▪ Abstract  The US-Mexico border region illustrates the challenges of binational environmental management in the context of a harsh physical environment, rapid growth, and economic integration. Transboundary and shared resources and conflicts include limited surface water supplies, depletion of groundwater, air and water pollution, hazardous waste, and conservation of important natural ecosystems. Public policy responses to environmental problems on the border include binational institutions such as the IBWC, BECC and CEC, the latter two established in response to environmental concerns about the North American Free Trade Agreement (NAFTA). Environmental social movements and nongovernmental organizations have also become important agents in the region. These new institutions and social movements are especially interesting on the Mexican side of the border where political and economic conditions have often limited environmental enforcement and conservation, and where recent policy changes also include changes in land and water law, political democratization, and government decentralization.

Leptospirosis is an epidemic-prone zoonotic disease that occurs worldwide, with more than 500,000 human cases reported annually. It is influenced by environmental and socioeconomic factors that affect the occurrence of outbreaks and the incidence of the disease. Critical areas and potential drivers for leptospirosis outbreaks have been identified in Nicaragua, where several conditions converge and create an appropriate scenario for the development of leptospirosis. The objectives of this study were to explore possible socioeconomic variables related to leptospirosis critical areas and to construct and validate a vulnerability index based on municipal socioeconomic indicators. Municipalities with lower socioeconomic status (greater unsatisfied basic needs for quality of the household and for sanitary services, and higher extreme poverty and illiteracy rates) were identified with the highest leptospirosis rates. The municipalities with highest local vulnerability index should be the priority for intervention. A distinction between risk given by environmental factors and vulnerability to risk given by socioeconomic conditions was shown as important, which also applies to the “causes of outbreaks” and “causes of cases”.