Ambient air is polluted by various pollutants emitted from power plants, industrial facilities, agricultural operations, motor vehicles, dust from unpaved roads, open burning of trash and many other sources. The Texas-Mexico border region is one of the most rapidly developing areas in the world. Air pollution has been identified as one of the key unfavorable environmental impacts by government entities in both countries. A tool to inform the relationships between environment and health at county-level was developed to help inform decision makers on the status of important factors related to health and environment. The study addressed key issues related to air quality, e.g., health effects. PM2.5 showed slight increasing trend in all Texas border counties while CO concentration was consistently low for all the years. Ozone concentration was stable and no particular trend was observed for Texas border counties. PM10 concentration was greater in Mexican counties compared to Texas border counties. More deaths due to heart disease occurred in Texas border counties than Mexican Counties. A general trend of increase was found for mortality due to heart disease and stroke for all the counties. A definite increasing trend was observed for mortality rates due to lung cancer for Texas border counties. This is an abstract of a paper presented at the 101st AWMA Annual Conference and Exhibition (Portland, OR 6/24-27/2008).