The sister cities of Brownsville, Texas and H. Matamoros Tamaulipas represent a microcosm of United States-Mexico border cities. The combined characteristics of urban poverty, an agricultural-based economy and high unemployment, in a predominantly Hispanic population, coupled with a high percentage of illegal aliens produce a situation of poor health status and severe health needs. In 1984, the Brownsville Health Department, Brownsville Community Health Clinic, and the Border Research Institute, with support from the United States Department of Health and Human Services, undertook a health needs assessment survey of its population. An original instrument was developed in English and Spanish and a random sample of low/low-moderate income areas of town were surveyed (n=3,000 families). The survey results provided an analysis of the health needs of the Brownsville area and revealed many health need relationships between the two cities. Twenty-one recommendations were made, which, with the results, will serve as a model to develop more effective health care delivery systems. Following a brief narrative section, results are broken down, discussed by variables, and displayed in both graphic and tabular forms. The survey instrument in English and Spanish, maps, and tables of supportive demographic characteristics for Brownsville neighborhoods from the 1980 census are included. A select bibliography of relevant literature is appended. (Author/PM)