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Dávila-Cervantes CA, Agudelo-Botero M. Young-onset chronic kidney disease in Mexico: Secondary analysis of global burden of disease study, 1990-2019. Prev Med 2024; 181:107901. [PMID: 38387518 DOI: 10.1016/j.ypmed.2024.107901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE To report the burden of young-onset chronic kidney disease (CKD) in Mexico from 1990 to 2019, and to assess the association between young-onset CKD burden with the Socio-Demographic Index (SDI), and the Healthcare Access and Quality Index (HAQ). METHODS Secondary analysis of data using the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) by sex, age groups, states, and subcauses. Mortality, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY), were obtained. RESULTS Between 1990 and 2019, the young-onset CKD mortality rate increased by 87.3% (126.3% for men and 48.1% for women). In 2019, this rate was highest in Tlaxcala, Estado de México, Puebla, Veracruz, Jalisco, and Guanajuato (all above 8 deaths per 100,000 inhabitants); Sinaloa and Quintana Roo had the lowest mortality rates (under 3.5 deaths per 100,000 inhabitants). While men had a higher rate of YLL, women were more likely to present YLD due to CKD. In 1990 there was a negative and statistically significant correlation between the HAQ Index and the young-onset CKD DALY rate. CONCLUSIONS In the last 30 years, the burden of early-onset chronic CKD has had an unprecedented increase among the Mexican population, compromising the fulfillment of the Sustainable Development Goals. This will be unattainable if actions to promote healthy lifestyles and prevent kidney disease are not immediately established and articulated, starting with the youngest age groups.
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Affiliation(s)
| | - Marcela Agudelo-Botero
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
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Medina-Gómez OS. [Impact of the COVID-19 pandemic on cardiovascular disease mortality trends in Mexico, 2000-2022]. Semergen 2024; 50:102170. [PMID: 38306759 DOI: 10.1016/j.semerg.2023.102170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To estimate the impact of the COVID-19 pandemic on cardiovascular disease (CVD) mortality trends in Mexico. METHODS An ecological study was conducted where deaths from CVD reported in Mexico under the ICD-10 classification with codes I10 to I99 for the period 2000-2022 were analyzed. Age-standardized mortality rates were calculated at the national and state levels, then the annual percentage variation was estimated using joinpoint analysis to know the changes in the mortality trend in the period studied. RESULTS There was an increase of 27.96 deaths per 100,000 inhabitants from 2000 to 2022 in Mexico. The joinpoint analysis shows in the period 2019-2021 an annual percentage change at the national level of 17,398 and subsequently a negative trend is presented between the years 2021-2022. The states of Guanajuato, Tlaxcala and Querétaro showed the largest increases in CVD mortality trends during the COVID-19 pandemic. CONCLUSIONS The trend in CVD mortality in Mexico increased significantly during the COVID-19 pandemic.
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Affiliation(s)
- O S Medina-Gómez
- Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Ciudad de México, México.
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Agudelo-Botero M, Aguilar-González A, Vergara-Jiménez I, Pizzolato E, Giraldo-Rodríguez L. Achievements and challenges in the health of Mexican women, 1990 and 2019: ecological analysis based on the global burden of disease data. Public Health 2024; 228:8-17. [PMID: 38246129 DOI: 10.1016/j.puhe.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/17/2023] [Accepted: 12/08/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVES To describe the burden and causes of disease in Mexican women in 1990 and 2019, based on the data disaggregation by age groups and states. Also, to evaluate the relationship of years of healthy life lost with the Socio-demographic Index (SDI) and with the Healthcare Access and Quality (HAQ) Index. STUDY DESIGN This was an ecological descriptive study. METHODS Based on the Global Burden of Disease, Injuries, and Risk Factors Study study, the age-standardized and age-specific rates for mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) were reported. RESULTS At the national level, the all-cause age-standardized rates for Mexican women decreased in mortality -28.8%; YLLs -39.8%; YLDs -1.3%; and DALYs -26.2%. For 2019, the indicators analyzed had the worst performances in Chiapas and Chihuahua, while women in Sinaloa had the lowest age-standardized rates. In 1990, it is worth noting that there was a remarkable presence of CDs, mainly in YLLs. In all age groups, diabetes mellitus was the leading cause of DALYs in Mexico's 32 states, followed by CKD (in 24 states), and ischemic heart disease (in 18 states). In both 1990 and 2019, a negative and statistically significant correlation between DALYs and the HAQ Index was evident. The correlation between DALYs and the SDI was only significant in 1990. CONCLUSION In the last 30 years, the burden of disease on Mexican women has undergone substantial changes that reflect progress in the improvement of their health conditions. However, the current scenario is complex because the convergence of communicable diseases, non-communicable diseases, and injuries is evident, which implies important challenges that must be addressed as soon as possible.
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Affiliation(s)
- M Agudelo-Botero
- Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - A Aguilar-González
- Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - I Vergara-Jiménez
- Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - E Pizzolato
- Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Dávila-Cervantes CA. The burden of type 2 diabetes in adolescents and young adults in Mexico: analysis from the Global Burden of Disease Study, 1990 to 2019. J Diabetes Metab Disord 2023; 22:1673-1684. [PMID: 37975094 PMCID: PMC10638125 DOI: 10.1007/s40200-023-01299-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/03/2023] [Indexed: 11/19/2023]
Abstract
Purpose The aim was to analyze the findings from the 2019 Global Burden of Disease (GBD-2019) study on type-2 diabetes in Mexico's adolescents and young adults, at a national and subnational scale from 1990 to 2019, and to assess its association with the socio-demographic, and the healthcare access and quality indices. Methods Following the GBD-2019 study, young-onset type 2 diabetes mortality, premature mortality, years lived with disability and disability-adjusted life-years (DALYs) are reported. Results A significant increase in the overall number of deaths attributed to young-onset T2D was found. There was a non-significant decrease in mortality rates for both sexes across most age groups. DALYs in men were greater than that in women, with almost half attributed to premature death in males, while disability accounted for two thirds of DALYs in females. The DALY rate increased significantly in most states. Premature mortality decreased, while disability increased across all age-groups, and in all states for both sexes. Conclusion The surge in disability corresponded to the upsurge in obesity and overweight rates in Mexico among the younger population. This happened despite improvements in socio-economic status and healthcare access in Mexico which underscores the need for diabetes education in the public health sector.
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Affiliation(s)
- Claudio Alberto Dávila-Cervantes
- Latin American Faculty of Social Sciences (FLACSO-Mexico), Carretera al Ajusco 377, Colonia Héroes de Padierna Tlalpan, C.P. 14200 Ciudad de México, México
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Agudelo-Botero M, Dávila-Cervantes CA, Velasco-Calderón O, Giraldo-Rodríguez L. Divergences and gaps in life expectancy and health-adjusted life expectancy in Mexico: Contribution analysis of the Global Burden of Disease Study 2019. PLoS One 2023; 18:e0293881. [PMID: 37930966 PMCID: PMC10627469 DOI: 10.1371/journal.pone.0293881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/10/2023] [Indexed: 11/08/2023] Open
Abstract
INTRODUCTION Life expectancy (LE) and Health-adjusted life expectancy (HALE) are summary indicators that reflect a population's general life conditions and measure inequities in health outcomes. The objective of this study was to identify the differences in LE and HALE by sex, age group, and state in Mexico from 1990 to 2019. Also, to evaluate whether the changes in HALE are related to sociodemographic indicators and indicators of access to and quality of health services. METHODS A secondary analysis was performed based on the Global Burden of Disease, Injuries, and Risk Factors Study (GBD). Data were obtained for LE (by sex and state) and HALE (by sex, age group, and state) for the years 1990, 2010, and 2019. The correlations between HALE with the Socio-Demographic Index (SDI) and with the Healthcare Access and Quality (HAQ) Index were estimated for 1990 and 2019 (by total population and sex). RESULTS LE and HALE had an absolute increase of 6.7% and 6.4% from 1990 to 2019, mainly among women, although they spent more years in poor health (11.8 years) than men. The patterns of LE and HALE were heterogeneous and divergent by state. In 2019, the difference in HALE (for both sex) between the states with the highest (Hidalgo) and the lowest (Chiapas) value was 4.6 years. CONCLUSIONS Progress in LE and HALE has slowed in recent years; HALE has even had setbacks in some states. Gaps between men and women, as well as between states, are persistent. Public and population policymaking should seek to lengthen LE and focus on ensuring that such years are spent in good health and with good quality of life.
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Affiliation(s)
- Marcela Agudelo-Botero
- Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Omar Velasco-Calderón
- Plan de Estudios Combinados en Medicina, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Sato Y, Yoshihisa A, Ide T, Tohyama T, Enzan N, Matsushima S, Tsutsui H, Takeishi Y. Regional Variation in the Clinical Practice and Prognosis in Patients With Heart Failure With Reduced Ejection Fraction in Japan - A Report From the Japanese Registry of Acute Decompensated Heart Failure (JROADHF). Circ J 2023; 87:1380-1391. [PMID: 37121703 DOI: 10.1253/circj.cj-22-0774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND The present study aimed to clarify the regional variations in clinical practice and the prognosis of patients with heart failure with reduced ejection fraction (HFrEF) in Japan using the Japanese Registry of Acute Decompensated Heart Failure (JROADHF).Methods and Results: We recruited data of hospitalized patients with HFrEF (n=4,329) from the JROADHF. The patients were divided into 6 groups based on the region of Japan where they were hospitalized: Hokkaido-Tohoku (n=504), Kanto (n=958), Chubu (n=779), Kinki (n=902), Chugoku-Shikoku (n=446), and Kyushu (n=740). We compared the patients' characteristics, including etiology of HF and prognosis after discharge. The age of the patients was lowest in the Kanto and Kinki regions. In contrast, there were no differences in the prevalence of comorbidities, levels of B-type natriuretic peptide, or left ventricular EF among the 6 groups. Post-discharge cardiospecific prognosis, specifically, the composite of cardiac death or HF hospitalization, cardiac death, and HF hospitalization, was comparable among the 6 regions. CONCLUSIONS There were no differences in cardiospecific prognosis in patients with HFrEF among the 6 regions in Japan.
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Affiliation(s)
- Yu Sato
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Akiomi Yoshihisa
- Department of Cardiovascular Medicine, Fukushima Medical University
- Department of Clinical Laboratory Sciences, Fukushima Medical University
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Takeshi Tohyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
- Center for Clinical and Translational Research, Kyushu University Hospital
| | - Nobuyuki Enzan
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
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Huffman C, Ortega-Avila AG, Nájera H. An Entropy-Based Approach to Measuring Diet Adherence. ENTROPY (BASEL, SWITZERLAND) 2023; 25:1258. [PMID: 37761557 PMCID: PMC10528816 DOI: 10.3390/e25091258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/25/2023] [Accepted: 02/15/2023] [Indexed: 09/29/2023]
Abstract
The aim of this study is to put forward an approach designed to calculate and sum up discrepancies between the actual food acquisition or intake and any standard or norm. Based on secondary analysis of cross-sectional data from the Mexican National Survey of Household Income and Expenditure, our proposed method to produce classes of entropy-based Diet Adherence Indices generates a Food Basket Adherence Index (FBAI) for Mexico City (2129 households). Findings suggest that it is possible to measure and decompose diet adherence using a cross entropy measure. Using food expenditure data and a normative food basket for Mexico City results, we show households' deviations from the suggested norm for different food groups. The average FBAI was 0.44, far above the minimum score of 0 which would indicate full adherence to the normative food basket. Our measure has a distribution wide enough to detect meaningful changes and distinguish between groups with known differences, providing important new insights on the linkages between home food environments and income distribution, and food insecurity and household distribution.
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Affiliation(s)
- Curtis Huffman
- Programa Universitario de Estudios del Desarrollo, Antigua Unidad de Posgrado, Campus Central, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City 04510, Mexico
| | - Ana G. Ortega-Avila
- Instituto de Geografía, Circuito de la Investigación Científica, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City 04510, Mexico
| | - Héctor Nájera
- Programa Universitario de Estudios del Desarrollo, Antigua Unidad de Posgrado, Campus Central, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City 04510, Mexico
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Wang F, Hu D, Sun H, Yan Z, Wang Y, Wang L, Zhang T, Meng N, Zhai C, Zong Q, Hu W, Yu G, Zou Y. Global, regional, and national burden of digestive diseases: findings from the global burden of disease study 2019. Front Public Health 2023; 11:1202980. [PMID: 37693711 PMCID: PMC10483149 DOI: 10.3389/fpubh.2023.1202980] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023] Open
Abstract
Background The global burden of digestive diseases has been rising in the last 30 years. The rates and trends of incidence, deaths, and disability-adjusted life-years (DALYs) for digestive diseases need to be investigated. Methods We extracted the data on overall digestive diseases and by cause between 1990-2019 from the Global Burden of Diseases 2019 website, including the absolute number and the corresponding age-standardized rates of incidence (ASIR), deaths (ASDR), and DALYs (ASDALYs). Results Globally, the incident cases, deaths, and DALYs of digestive diseases in 2019 increased by 74.44, 37.85, and 23.46%, respectively, compared with that in 1990, with an increasing ASIR of 0.09%, as well as decreasing ASDR and ASDALYs of 1.38 and 1.32% annually. The sociodemographic index (SDI) of overall digestive diseases showed a slight increase in ASIR from low to middle-low regions. The downtrend in ASDR and ASDALYs was found in all SDI regions. The burden of incidence was higher in females, while the burden of deaths and DALYs was higher in males for the overall digestive diseases and most causes. The estimated annual percentage changes were significantly associated with the baseline ASIR, ASDR, and ASDALYs for the overall digestive diseases, and the negative correlations between ASDR, ASDALYs, and human development index both in 1990 (R = -0.68, R = -0.69) and 2019 (R = -0.71, R = -0.73) were noticed. Conclusion The findings indicate that digestive diseases remain a significant public health burden, with substantial variation across countries, sexes, and age groups. Therefore, implementing age, gender, and country-specific policies for early screening and targeted interventions could significantly reduce the global burden of digestive diseases.
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Affiliation(s)
- Fang Wang
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Dingtao Hu
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Clinical Cancer Institute, Center for Translational Medicine, Second Military Medical University, Shanghai, China
| | - Hongyu Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Ziye Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yuhua Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Linlin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Tingyu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Nana Meng
- Department of Quality Management Office, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Chunxia Zhai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Qiqun Zong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Wanqin Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Guanghui Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yanfeng Zou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
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Guerrero-López CM, Serván-Mori E, Miranda JJ, Jan S, Orozco-Núñez E, Downey L, Feeny E, Heredia-Pi I, Flamand L, Nigenda G, Norton R. Burden of non-communicable diseases and behavioural risk factors in Mexico: Trends and gender observational analysis. J Glob Health 2023; 13:04054. [PMID: 37326368 DOI: 10.7189/jogh.13.04054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
Background There is scarce gender-disaggregated evidence on the burden of disease (BD) worldwide and this is particularly prominent in low- and middle-income countries. The objective of this study is to compare the BD caused by non-communicable diseases (NCDs) and related risk factors by gender in Mexican adults. Methods We retrieved disability-adjusted life years (DALYs) estimates for diabetes, cancers and neoplasms, chronic cardiovascular diseases (CVDs), chronic respiratory diseases (CRDs), and chronic kidney disease (CKD) from the Global Burden of Disease (GBD) Study from 1990-2019. Age-standardized death rates were calculated using official mortality microdata from 2000 to 2020. Then, we analysed national health surveys to depict tobacco and alcohol use and physical inactivity from 2000-2018. Women-to-men DALYs and mortality rates and prevalence ratios (WMR) were calculated as a measure of gender gap. Findings Regarding DALYs, WMR was >1 for diabetes, cancers, and CKD in 1990, indicating a higher burden in women. WMR decreased over time in all NCDs, except for CRDs, which increased to 0.78. However, WMR was <1 for all in 2019. The mortality-WMR was >1 for diabetes and cardiovascular diseases in 2000 and <1 for the rest of the conditions. The WMR decreased in all cases, except for CRDs, which was <1 in 2020. The WMR for tobacco and alcohol use remained under 1. For physical inactivity, it was >1 and increasing. Conclusions The gender gap has changed for selected NCDs in favour of women, except for CRDs. Women face a lower BD and are less affected by tobacco and alcohol use but face a higher risk of physical inactivity. Policymakers should consider a gendered approach for designing effective policies to reduce the burden of NCDs and health inequities.
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Affiliation(s)
- Carlos M Guerrero-López
- Center for Health Systems Research, the National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Edson Serván-Mori
- Center for Health Systems Research, the National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - J Jaime Miranda
- The George Institute for Global Health, UNSW, Sydney, Australia
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Stephen Jan
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Emanuel Orozco-Núñez
- Center for Health Systems Research, the National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Laura Downey
- The George Institute for Global Health, UNSW, Sydney, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
| | - Emma Feeny
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Ileana Heredia-Pi
- Center for Health Systems Research, the National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Laura Flamand
- Center for International Studies, College of Mexico A.C, Mexico City, Mexico
| | - Gustavo Nigenda
- National School of Nursing and Obstetrics, the National Autonomous University of Mexico, Mexico City, Mexico
| | - Robyn Norton
- The George Institute for Global Health, UNSW, Sydney, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
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Gallardo-Rincón H, Ríos-Blancas MJ, Montoya A, Saucedo-Martínez R, Morales-Juárez L, Mujica R, Cantoral A, Idueta LS, Lozano R, Tapia-Conyer R. Evaluation of effective coverage for type 2 diabetes in Mexican primary care health information systems: a retrospective registry analysis. Int J Equity Health 2023; 22:61. [PMID: 37016386 PMCID: PMC10074724 DOI: 10.1186/s12939-023-01878-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND As the leading cause of disability and the fourth leading cause of premature death in Mexico, type 2 diabetes (T2D) represents a serious public health concern. The incidence of diabetes has increased dramatically in recent years, and data from the Mexican National Health and Nutrition Survey (ENSANUT) indicate that many people remain undiagnosed. Persistent socioeconomic health care barriers exacerbate this situation, as T2D morbidity and mortality are worsened in vulnerable populations, such as those without social security. We evaluated the performance of public primary health centers (PHCs) in T2D medical attention through the measure of effective coverage (EC, a combined measure of health care need, use, and quality) at national, state, health jurisdiction, and municipality levels. METHODS This retrospective analysis used blinded data recorded during 2017 in the Non-communicable Diseases National Information System (SIC) and T2D prevalence reported in 2018 ENSANUT to evaluate the EC achieved. We included individuals ≥ 20 years old without social security who did not declare the use of private health care services. Each EC component (need, use, and quality) was estimated based on the Shengelia adapted framework. The Kruskal-Wallis test was applied to evaluate the associations among EC quintiles and demographics. RESULTS In 2017, 26.5 million individuals, aged ≥ 20 years, without social security, and without the use of private health care services, were under the care of 12,086 PHCs. The national prevalence of T2D was 10.3%, equivalent to 2.6 million people living with T2D in need of primary health care. Large contrasts were seen among EC components between and within Mexican states. We found that only 37.1% of the above individuals received health services at PHCs and of them, 25.8% improved their metabolic condition. The national EC was 9.3%, and the range (by health jurisdiction) was 0.2%-38.6%, representing a large geographic disparity in EC. We found an evident disconnect among need, utilization, and quality rates across the country. CONCLUSIONS Expansion and improvement of EC are urgently needed to address the growing number of people living with T2D in Mexico, particularly in states with vulnerable populations.
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Affiliation(s)
- Héctor Gallardo-Rincón
- Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico
| | - María Jesús Ríos-Blancas
- Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico
- National Institute of Public Health, Av. Universidad 655, Cuernavaca, 62100, México
| | - Alejandra Montoya
- Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico.
| | - Rodrigo Saucedo-Martínez
- Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico
| | - Linda Morales-Juárez
- Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico
| | - Ricardo Mujica
- Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico
| | - Alejandra Cantoral
- Health Department, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico
| | - Lorena Suarez Idueta
- Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico
| | - Rafael Lozano
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA
| | - Roberto Tapia-Conyer
- School of Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Circuito Escolar CU, Edificio B 1Er Piso, Coyoacan, 04510, Mexico City, Mexico
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Cervantes A, Jhunjhunwala R, Castañeda Alcántara ID, Elizundia Cisneros ME, Ringel R, Cortes Rodriguez A, Del Valle D, Hill S, Meara JG, Uribe-Leitz T. Estimating the economic impact of interpersonal violence in Mexico in 2021: projecting three hypothetical scenarios for 2030. Rev Panam Salud Publica 2023; 47:e39. [PMID: 36909811 PMCID: PMC9976230 DOI: 10.26633/rpsp.2023.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 12/01/2022] [Indexed: 03/05/2023] Open
Abstract
Objective To calculate the economic impact of violence across Mexico in 2021 and project costs for 2021-2030. Methods Incidence data was obtained from the Executive Secretariat of the National Public Security System, (SESNSP), National Population Council (CONAPO), National Institute of Statistics and Geography (INEGI), and the National Survey of Victimization and Perception of Public Safety (ENVIPE). Our model incorporates incidence estimates of the costs of events associated with violence (e.g., homicides, hospitalizations, rapes, extortions, robbery, etc). Results The economic impact of crime and violence in Mexico for the year 2021 has been estimated at about $192 billion US dollars, which corresponds to 14.6% of the national GDP. By reducing violence 50% by 2030, we estimate savings of at least US$110 billion dollars. This represents a saving of US$1 376 372 for each company and more than US$66 771 for each Mexican. Conclusion Violence and homicides have become one of the most pressing public health and economic concerns for their effect on health, development, and economic growth. Due to low cost and high impact, prevention is the most efficient way to respond to crime and violence while also being an essential component of sustainable strategies aimed at improving citizen security.
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Affiliation(s)
- Arturo Cervantes
- Faculty of Health Sciences Universidad Anahuac Mexico Mexico City Mexico Faculty of Health Sciences, Universidad Anahuac Mexico, Mexico City, Mexico
| | - Rashi Jhunjhunwala
- Program in Global Surgery and Social Change Harvard Medical School Program in Global Surgery and Social Change, Harvard Medical School
| | - Isaac Deneb Castañeda Alcántara
- Faculty of Health Sciences Universidad Anahuac Mexico Mexico City Mexico Faculty of Health Sciences, Universidad Anahuac Mexico, Mexico City, Mexico
| | - María Eugenia Elizundia Cisneros
- School of Economics & Business Anahuac University Mexico Mexico City Mexico School of Economics & Business, Anahuac University Mexico, Mexico City, Mexico
| | - Roey Ringel
- Boston University School of Medicine Boston United States of America Boston University School of Medicine, Boston, United States of America
| | - Alejandra Cortes Rodriguez
- Faculty of Health Sciences Universidad Anahuac Mexico Mexico City Mexico Faculty of Health Sciences, Universidad Anahuac Mexico, Mexico City, Mexico
| | - Diana Del Valle
- Program in Global Surgery and Social Change Harvard Medical School Program in Global Surgery and Social Change, Harvard Medical School
| | - Sarah Hill
- Program in Global Surgery and Social Change Harvard Medical School Program in Global Surgery and Social Change, Harvard Medical School
| | - John Gerard Meara
- Program in Global Surgery and Social Change Harvard Medical School Program in Global Surgery and Social Change, Harvard Medical School
| | - Tarsicio Uribe-Leitz
- Department of Plastic & Oral Surgery Boston Children's Hospital Boston United States of America Department of Plastic & Oral Surgery, Boston Children's Hospital, Boston, United States of America
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A clinical decision support system in back pain helps to find the diagnosis: a prospective correlation study. Arch Orthop Trauma Surg 2023; 143:621-625. [PMID: 34347121 PMCID: PMC9925533 DOI: 10.1007/s00402-021-04080-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
The aim of this study is to show the concordance of an app-based decision support system and the diagnosis given by spinal surgeons in cases of back pain. 86 patients took part within 2 months. They were seen by spine surgeons in the daily routine and then completed an app-based questionnaire that also led to a diagnosis independently. The results showed a Cramer's V = .711 (p < .001), which can be taken as a strong relation between the tool and the diagnosis of the medical doctor. Besides, in 67.4% of the cases, the diagnosis was concordant. An overestimation of the severity of the diagnosis occurred more often than underestimation (15.1% vs. 7%). The app-based tool is a safe tool to support healthcare professionals in back pain diagnosis.
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Agudelo-Botero M, Giraldo-Rodríguez L, Dávila-Cervantes CA. Type 2 diabetes and depressive symptoms in the adult population in Mexico: a syndemic approach based on National Health and Nutrition Survey. BMC Public Health 2022; 22:2049. [PMID: 36352364 PMCID: PMC9643915 DOI: 10.1186/s12889-022-14405-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/20/2022] [Indexed: 11/11/2022] Open
Abstract
Background The syndemic approach allows the analysis of clusters of diseases that affect a population in contexts of geographic, social and economic inequalities at the same moment and time. This study aims to analyze, from a syndemic perspective, the relationship between type 2 diabetes (T2D) and depressive symptoms in Mexican adults and its association with individual, contextual and structural factors. Methods Observational, cross-sectional study based on secondary data from Mexico’s National Health and Nutrition Survey 2018–19. The sample of this study consisted of 16 835 adults, which represented a total of 78 463 734 persons aged ≥ 20 years. Bivariate descriptive analyses were performed and logistic regression models were estimated to analyze the association between T2D and depressive symptoms with various co-variables. In addition, interactions between T2D and depressive symptoms with obesity, educational level, and socioeconomic status were tested. Results In the study population, 12.2% of adults aged 20 years and older self-reported having T2D, 14.7% had depressive symptoms and 2.8% had both diseases. There was a statistically significant relationship between T2D and depressive symptoms. The prevalence of T2D and depressive symptoms was higher compared to people who did not have these two conditions. Obesity increased the probability of having T2D, while violence was statistically associated with people having depressive symptoms. A low level of education increased the odds ratio of having T2D and depressive symptoms. Conclusion The availability of analytical frameworks such as the syndemic perspective could help to identify areas of opportunity for decision making and actions for population groups that–because of their individual, contextual and structural disadvantages–are at greater risk of experiencing poorer health outcomes due to the presence of T2D and depressive symptoms.
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14
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Colli VA, González-Rocha A, Canales D, Hernández-Alcáraz C, Pedroza A, Pérez-Chan M, Barquera S, Denova-Gutierrez E. Chronic kidney disease risk prediction scores assessment and development in Mexican adult population. Front Med (Lausanne) 2022; 9:903090. [PMID: 36341240 PMCID: PMC9631933 DOI: 10.3389/fmed.2022.903090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Chronic kidney disease (CKD) is a major public health problem, with considerable growth in prevalence and mortality in recent years. Screening of CKD at primary care is crucial for the implementation of prevention strategies. The aims of this study are to assess CKD risk prediction scores and to develop a risk prediction score for the Mexican adult population. Methods Data from the Mexican National Health and Nutrition Survey 2016 was utilized and 3463 participants ≥ 20 years old were included. Reduced renal function with Glomerular filtration rate and/or the presence of albuminuria was defined as CKD. Multiple logistic regression models were performed for the creation of a training and validation model. Additionally, several models were validated in our Mexican population. Results The developed training model included sex, age, body mass index, fast plasma glucose, systolic blood pressure, and triglycerides, as did the validation model. The area under the curve (AUC) was 0.78 (95% CI: 0.72, 0.79) for training model, and 0.76 (95% CI: 0.71, 0.80) in validation model for Mexican adult population. Age, female gender, presence of diabetes and hypertension, elevated systolic and diastolic blood pressure, serum and urinary creatinine, and higher HbA1c were significantly associated with the prevalent chronic kidney disease. Previous CKD risk predictive models were evaluated with a representative sample of the Mexican adult population, their AUC was between 0.61 and 0.78. Conclusion The designed CKD risk predictive model satisfactorily predicts using simple and common variables in primary medical care. This model could have multiple benefits; such as, the identification of the population at risk, and prevention of CKD.
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Affiliation(s)
- Victor A. Colli
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Alejandra González-Rocha
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - David Canales
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Cesar Hernández-Alcáraz
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Andrea Pedroza
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Manuel Pérez-Chan
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Edgar Denova-Gutierrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- *Correspondence: Edgar Denova-Gutierrez,
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15
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Barquera S. Intersection of public health, nutrition, and mental health: Challenges to progress. SALUD MENTAL 2022. [DOI: 10.17711/sm.0185-3325.2022.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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16
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Borges G, Orozco R, Becerril Z, Ortega BE, Flores J. Injury, alcohol, and drug use in an emergency department in Mexico City. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2098844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Guilherme Borges
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Ricardo Orozco
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Zaide Becerril
- Nursing Department, Hospital General Regional No. 2 “Guillermo Fajardo Ortiz,” Mexican Institute of Social Security, Mexico City, Mexico
- Doctorate Program in Medical, Odontology and Health Sciences of the National Autonomous University of Mexico, Mexico City, Mexico
| | - Brenda E. Ortega
- Doctorate Program in Psychology of the National Autonomous University of Mexico, Mexico City, Mexico
| | - Julio Flores
- Master Program in Addictive Behaviours of the National Autonomous University of Mexico, Mexico City, Mexico
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Clarsen B, Nylenna M, Klitkou ST, Vollset SE, Baravelli CM, Bølling AK, Aasvang GM, Sulo G, Naghavi M, Pasovic M, Asaduzzaman M, Bjørge T, Eggen AE, Eikemo TA, Ellingsen CL, Haaland ØA, Hailu A, Hassan S, Hay SI, Juliusson PB, Kisa A, Kisa S, Månsson J, Mekonnen T, Murray CJL, Norheim OF, Ottersen T, Sagoe D, Sripada K, Winkler AS, Knudsen AKS. Changes in life expectancy and disease burden in Norway, 1990–2019: an analysis of the Global Burden of Disease Study 2019. THE LANCET PUBLIC HEALTH 2022; 7:e593-e605. [PMID: 35779543 PMCID: PMC9253891 DOI: 10.1016/s2468-2667(22)00092-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 01/04/2023] Open
Abstract
Background Methods Findings Interpretation Funding
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Soft drink and non-caloric soft drink intake and their association with blood pressure: the Health Workers Cohort Study. Nutr J 2022; 21:37. [PMID: 35668525 PMCID: PMC9171938 DOI: 10.1186/s12937-022-00792-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 05/31/2022] [Indexed: 01/09/2023] Open
Abstract
Background A few prospective studies have investigated the potential association of soft drink and non-caloric soft drink intake with high blood pressure using methods that adequately consider changes in intake over time and hypertensive status at baseline. Objective To prospectively examine the association of soft drink and non-caloric soft drink intake with systolic and diastolic blood pressure in a sample of Mexican adults, overall and by hypertension status. Methods We used data from the Health Workers Cohort Study spanning from 2004 to 2018 (n = 1,324 adults). Soft drink and non-caloric soft drink intake were assessed with a semiquantitative food frequency questionnaire. We fit multivariable-adjusted fixed-effects models to test the association of soft drink and non-caloric soft drink intake with systolic and diastolic blood pressure. The models were adjusted for potential confounders and considering the potential modifying effect of hypertension status at baseline. Results A one-serving increase in soft drink intake was associated with a 2.08 mm Hg (95% CI: 0.21, 3.94) increase in systolic blood pressure and 2.09 mm Hg (95% CI: 0.81, 3.36) increase in diastolic blood pressure over ten years. A stronger association between soft drink intake and diastolic pressure was observed among participants with versus without hypertension at baseline. We found no association between non-caloric soft drink intake and blood pressure. Conclusions Our findings support the hypothesis that soft drink intake increases blood pressure. While further studies should be conducted to confirm our findings, food policies and recommendations to limit soft drink intake are likely to help reduce blood pressure at the population level. We probably did not find an association between non-caloric soft drink intake and blood pressure because of the low consumption of this type of beverage in the cohort. More studies will be needed to understand the potential effect of non-caloric beverages on blood pressure. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-022-00792-y.
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Habboush S, Sofy AA, Masoud AT, Cherfaoui O, Farhat AM, Abdelsattar AT, Elmoursi A. Efficacy of Single-Pill, Triple Antihypertensive Therapy in Patients with Uncontrolled Hypertension: A Systematic Review and Meta-analysis. High Blood Press Cardiovasc Prev 2022; 29:245-252. [PMID: 35325410 DOI: 10.1007/s40292-022-00511-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/04/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Systemic arterial hypertension is the most common preventable risk factor for all causes of morbidity and mortality worldwide with a prevalence of 35-40% of the adults. Despite the wide variety of effective antihypertensive medications, most hypertensive patients remain uncontrolled. However, the combination of ACE inhibitor, diuretics, and calcium antagonist for the triple therapy in a single Pill Combination (SPC) is an efficient regimen in hypertension management. It is recommended by the ESH 2018 guideline, which offers better efficacy and compliance to treatment. AIM To evaluate the efficacy of perindopril/indapamide/amlodipine single-pill combination in patients with uncontrolled hypertension. METHODS We searched PubMed, Scopus, Web of Science, and Cochrane CENTRAL for relevant clinical trials. We conducted the risk of bias assessment using Cochrane's risk of bias tool. We performed the analysis of continuous data using mean difference (MD) and relative 95% confidence interval (CI), while dichotomous data were analyzed using risk ratio (RR) and relative 95% CI. We included the analysis of the following outcomes: systolic blood pressure (SBP), Diastolic blood pressure (DBP), Heart rate (HR), 24 h Ambulatory blood pressure monitoring (ABPM) for SBP, and 24 h ABPM for DBP. RESULTS We included six clinical trials. We found that the triple therapy significantly reduces SBP by 24 mmHg (MD = - 24.65 [22.41, 26.89], (P < 0.01)), DBP by 12 mmHg (MD = 12.41 [11.53, 13.29], (P < 0.01)), 24-h ABPM for SBP by 14 mmHg (MD = 14.08 [9.10, 19.05], (P < 0.01)), and ABPM 24 h DBP by 7 mmHg (MD = 7.01 [5.37, 8.65], (P < 0.01)). We noted no significant difference of the single pill on heart rate (MD = 0.81 [- 0.04, 1.67], (P = 0.06). CONCLUSION perindopril/indapamide/amlodipine is effective in reducing systolic and diastolic blood pressures by 24 and 12 mmHg respectively. Over 24 h, the combination reduced systolic and diastolic blood pressures by 14 and 7 mmHg respectively.
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Affiliation(s)
| | | | | | | | | | | | - Ahmed Elmoursi
- Department of Internal Medicine, College of Medicine, University of Kentucky, 800 Rose St, Lexington, KY, 40508, USA.
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Cruz-Góngora VDL, Chiquete E, Gómez–Dantés H, Cahuana-Hurtado L, Cantú-Brito C. Trends in the burden of stroke in Mexico: A national and subnational analysis of the global burden of disease 1990-2019. LANCET REGIONAL HEALTH. AMERICAS 2022; 10:100204. [PMID: 36777683 PMCID: PMC9904132 DOI: 10.1016/j.lana.2022.100204] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background Scarce epidemiological information on stroke in Mexico impedes evidence-based decisions and debilitates the design of effective prevention programmes at the local level. Methods Ecological and secondary analysis of Global Burden of Disease national and subnational data for Mexico, from 1990 to 2019. We analysed the incidence, prevalence, deaths, premature mortality, disability, and DALYs due to cerebrovascular disease included to identify the differences in the burden of stroke in Mexico by type of stroke (ischaemic [IS], intracerebral haemorrhage [ICH] and subarachnoid haemorrhage [SAH]), sex, age groups, and state levels ordered by quartiles of Sociodemographic Index (SDI). Means and 95% uncertainty intervals are reported. Findings Reductions in all metrics of total stroke occurred during the 1990 to 2005 period; however, this declining trend was followed up by stagnation of progress from 2006 to 2019, except for premature mortality. This pattern of the declining trend was observed also for IS and to a lesser extent for ICH, while SAH showed no major changes during the 1990-2019 period. The magnitude of decline was higher in females for total stroke for incidence, prevalence and YLDs rates. The less developed states by SDI exhibited the lowest improvements during the period, particularly for ICH metrics. Interpretation The reduction in stroke burden in Mexico did not follow the same pace for all types of stroke, with regional differences by SDI and by sex. Study findings reveal the need for strengthening prevention policies to address health disparities in the burden of stroke by sex and states, within the fragmented Mexican Healthcare System. Funding Bill & Melinda Gates Foundation.
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Affiliation(s)
| | - Erwin Chiquete
- Department of Neurology, The Salvador Zubirán National Institute of Medical Sciences and Nutrition, Mexico City, México
| | - Héctor Gómez–Dantés
- Health Systems Research Centre, National Institute of Public Health, Cuernavaca, Mexico
| | - Lucero Cahuana-Hurtado
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carlos Cantú-Brito
- Department of Neurology, The Salvador Zubirán National Institute of Medical Sciences and Nutrition, Mexico City, México,Corresponding author at: Departamento de Neurología y Psiquiatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga #15, Col. Sección XVI, Tlalpan. Ciudad de México, México.
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Unger-Saldaña K, Contreras-Manzano A, Lamadrid-Figueroa H, Mohar A, Suazo-Zepeda E, Espinosa-Tamez P, Lajous M, Reich MR. Reduction in the Treatment Gap for Breast Cancer in Mexico under Seguro Popular, 2007 to 2016. Health Syst Reform 2022; 8:e2064794. [PMID: 35731961 DOI: 10.1080/23288604.2022.2064794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
As Mexico's government restructures the health system, a comprehensive assessment of Seguro Popular's Fund for Protection against Catastrophic Expenses (FPGC) can help inform decision makers to improve breast cancer outcomes and health system performance. This study aimed to estimate the treatment gap for breast cancer patients treated under FPGC and assess changes in this gap between 2007 (when coverage started for breast cancer treatment) and 2016. We used a nationwide administrative claims database for patients whose breast cancer treatment was financed by FPGC in this period (56,847 women), Global Burden of Disease breast cancer incidence estimates, and other databases to estimate the population not covered by social security. We compared the observed number of patients who received treatment under FPGC to the expected number of breast cancer cases among women not covered by social security to estimate the treatment gap. Nationwide, the treatment gap was reduced by more than half: from 0.71, 95% CI (0.69, 0.73) in 2007 to 0.15, 95%CI (0.09, 0.22) in 2016. Reductions were observed across all states . This is the first study to assess the treatment gap for breast cancer patients covered under Seguro Popular. Expanded financing through FPGC sharply increased access to treatment for breast cancer. This was an important step toward improving breast cancer care, but high mortality remains a problem in Mexico. Increased access to treatment needs to be coupled with effective interventions to assure earlier cancer diagnosis and earlier initiation of high-quality treatment.
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Affiliation(s)
- Karla Unger-Saldaña
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, USA.,Epidemiology Research Unit, National Institute of Cancer, Mexico City, Mexico
| | | | | | - Alejandro Mohar
- Epidemiology Unit, Instituto de Investigaciones Biomédicas Universidad Nacional Autónoma de México and National Cancer Institute, Mexico City, Mexico
| | - Erick Suazo-Zepeda
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Priscilla Espinosa-Tamez
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Martin Lajous
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Michael R Reich
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, USA.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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22
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Prevalence, incidence and years of life adjusted for disability due to depressive disorders in Mexico: Results of the Global Burden of Disease Study 2019. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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De la Cruz-Góngora V, Salinas-Rodríguez A, Flores-Aldana M, Villalpando S. Etiology of Anemia in Older Mexican Adults: The Role of Hepcidin, Vitamin A and Vitamin D. Nutrients 2021; 13:3814. [PMID: 34836070 PMCID: PMC8622982 DOI: 10.3390/nu13113814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 12/18/2022] Open
Abstract
Anemia in older adults is a growing public health issue in Mexico; however, its etiology remains largely unknown. Vitamin A deficiency (VAD) and vitamin D deficiency (VDD) have been implicated in the development of anemia, though by different mechanisms. The aim of this study is to analyze the etiology of anemia and anemia-related factors in older Mexican adults. This is a cross-sectional study of 803 older adults from the southern region of Mexico in 2015. The anemia etiologies analyzed were chronic kidney disease (CKD), nutritional deficiencies (ND), anemia of inflammation (AI), anemia of multiple causes (AMC) and unexplained anemia (UEA). VAD was considered to be s-retinol ≤ 20 μg/dL, and VDD if 25(OH)D < 50 nmol/L. IL-6 and hepcidin were also measured. Multinomial regression models were generated and adjusted for confounders. Anemia was present in 35.7% of OA, independent of sex. UEA, CKD, AI and ND were confirmed in 45%, 29.3%, 14.6% and 7% of older adults with anemia, respectively. Hepcidin and log IL-6 were associated with AI (p < 0.05) and CKD (p < 0.001). VAD was associated with AI (p < 0.001), and VDD with ND and AMC (p < 0.05). Log-IL6 was associated with UEA (p < 0.001). In conclusion, anemia in older adults has an inflammatory component. VAD was associated to AI and VDD with ND and AMC.
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Affiliation(s)
- Vanessa De la Cruz-Góngora
- Center for Evaluation and Survey Research, Instituto Nacional de Salud Pública (National Institute of Public Health), Cuernavaca 62100, Mexico;
| | - Aarón Salinas-Rodríguez
- Center for Evaluation and Survey Research, Instituto Nacional de Salud Pública (National Institute of Public Health), Cuernavaca 62100, Mexico;
| | - Mario Flores-Aldana
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública (National Institute of Public Health), Cuernavaca 62100, Mexico; (M.F.-A.); (S.V.)
| | - Salvador Villalpando
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública (National Institute of Public Health), Cuernavaca 62100, Mexico; (M.F.-A.); (S.V.)
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Geck MS, Lecca D, Marchese G, Casu L, Leonti M. Ethnomedicine and neuropsychopharmacology in Mesoamerica. JOURNAL OF ETHNOPHARMACOLOGY 2021; 278:114243. [PMID: 34129899 DOI: 10.1016/j.jep.2021.114243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/27/2021] [Accepted: 05/24/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The burden of disease caused by mental and neurological disorders is increasing globally, to a disproportionate degree in Latin America. In contrast to the many psychoactive plants with a use history in Mesoamerican cultures, the translation to the wider population of knowledge around numerous botanicals used contemporarily by indigenous Mesoamerican societies to treat psychological and neurological disorders did not receive the same attention. MATERIAL AND METHODS We used the previously published Mesoamerican Medicinal Plant Database to extract species and associated botanical drugs used as treatments for illnesses associated with the nervous system by Mesoamerican cultures in Belize, Guatemala, and Mexico. With the critical use of published pharmacological literature, the cross-culturally most salient genera are systematically reviewed. RESULTS From 2188 plant taxa contained in the database 1324 are used as treatments for illnesses associated with the nervous system. The ethnomedical data was critically confronted with the available biomedical literature for the 58 cross-culturally most salient genera. For a considerable proportion of the frequently used taxa, preclinical data are available, mostly validating ethnomedicinal uses. CONCLUSION This quantitative approach facilitates the prioritization of taxa for future pre-clinical, clinical and treatment outcome studies and gives patients, practitioners, and legislators a fundamental framework of evidence, on which to base decisions regarding phytomedicines.
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Affiliation(s)
- Matthias S Geck
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, CA, Italy; Biovision - Foundation for Ecological Development, Heinrichstrasse 147, 8005, Zurich, Switzerland
| | - Daniele Lecca
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, CA, Italy
| | - Giorgio Marchese
- Institute of Translational Pharmacology UOS of Cagliari National Research Council of Italy, Pula, Cagliari, Italy
| | - Laura Casu
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, CA, Italy
| | - Marco Leonti
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, CA, Italy.
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Traumatic life-events and suicidality among Mexican adolescents as they grow up: A longitudinal community survey. J Psychiatr Res 2021; 142:171-178. [PMID: 34359012 DOI: 10.1016/j.jpsychires.2021.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/07/2021] [Accepted: 08/01/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Limited research exists on the impact of type and number of traumatic events on the incidence of suicide ideation and attempts (suicidality) among adolescents in low/middle income countries where violence is common. METHOD We estimated prospective associations of 7 types of events on the new occurrence of suicidality from a follow-up conducted in 2013 (n = 1071; ages 19-26) of the original Mexican Adolescent Mental Health Survey conducted in 2005 (ages 12-17), by using Hazard Ratios (HR) estimates. RESULTS For new onset of suicide ideation, those reporting "Ever raped or sexually assaulted" had the highest adjusted HR (3.8), followed by "Ever other traumatic event" (HR = 1.9), "Ever committed or witnessed violence" (HR = 1.7) and "Beaten as a child or witnessed physical fights at home" (HR = 1.5). For suicide attempt, those reporting "Ever beaten up by spouse, partner, someone else, mugged with a weapon, or stalked" (HR = 3.8) and "Ever other traumatic event" (HR = 2.0) had the higher hazards. Compared to those without a traumatic event, increased hazards of ideation and attempt were found for those reporting a greater number of types of events. CONCLUSIONS Our sample is representative of the largest metropolitan area in Mexico but does not include other cities or age groups that may differ in risk factors. Traumatic events that happened in the eight years between waves are not considered. Traumatic events increased the risk of suicidality, independent of common mental disorders. Identifying and addressing these events in clinical settings may therefore be important for preventing suicide in this population.
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Dávila-Cervantes CA. Road injury burden in Mexico 1990 to 2019: Secondary data analysis from the Global Burden of Disease Study. ACCIDENT ANALYSIS AND PREVENTION 2021; 160:106316. [PMID: 34332290 DOI: 10.1016/j.aap.2021.106316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/30/2021] [Accepted: 07/16/2021] [Indexed: 02/05/2023]
Abstract
Road injuries have been a major cause of premature mortality and disability in Mexico. The objective of this paper is to report the findings from the Global Burden of Disease study (GBD-2019) on road injuries in Mexico at a national and subnational scale from 1990 to 2019, and to assess the association between road injury burden and the socio-demographic index. Following the 2019 Global Burden of Disease study road injury mortality, premature mortality, the years lived with disability and disability-adjusted life-years (DALYs) are reported. While the number of deaths from road injuries increased between 1990 and 2019, the age-standardized mortality rates declined. Pedestrian road injuries and motor vehicle road injuries accounted for 8 of every 10 deaths from road injury in 2019. Road injury mortality and DALY rates decreased nationally, but stagnated since 2011. The road injury burden was higher for men in all age groups. Pedestrian and motor vehicle road injuries caused the highest DALY rate in both males and females. There was no significant association between the SDI and the road injury age-standardized DALY rates. This study presents a comprehensive report of road injury burden of disease in Mexico. Mexico continues to have an incomplete, fragmented and poorly enforced legislative framework, with a large diversity between its 32 states. Thus, an integrated legislative and juridical effort is needed to continue reducing the road injury disease burden, which is tailored for specific age groups, vulnerable road users and high-burden areas.
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Seiglie JA, Franco RR, Wirtz VJ, Meigs JB, Mendoza MA, Miranda JJ, Gómez-Dantés H, Lozano R, Wexler DJ, Serván-Mori E. Regional and state-level patterns of type 2 diabetes prevalence in Mexico over the last three decades. Diabetes Res Clin Pract 2021; 177:108927. [PMID: 34186106 PMCID: PMC10835737 DOI: 10.1016/j.diabres.2021.108927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/01/2021] [Accepted: 06/17/2021] [Indexed: 01/03/2023]
Abstract
AIMS We aimed to characterize and illustrate the regional and state-level change in type 2 diabetes (T2D) prevalence in Mexico between 1990 and 2017. METHODS We conducted an ecological and secondary analysis using data from the Global Burden of Disease study on T2D prevalence of the adult Mexican population. We estimated the absolute increase and annual growth rate of T2D prevalence between 1990 and 2017, stratified by age group and region. RESULTS Nationally, between 1990 and 2017, the prevalence of T2D in Mexico increased from 9.5% to 14.3%. The highest increase in T2D prevalence was observed in the East and Southcentral regions, with the lowest absolute change in T2D prevalence observed in Northern states. The highest average annual growth rate in T2D prevalence was observed in Southern Mexico, in the three Southern states with the lowest human development index, and among individuals ages 15-49 years across all regions, compared to those 50 years and older. CONCLUSIONS The prevalence of T2D in Mexico has increased substantially over the past three decades, with a clear shift in T2D prevalence from Northern to Southern states and a faster increase occurring in Southern Mexico among younger adults and in areas with lower economic resources.
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Affiliation(s)
- Jacqueline A Seiglie
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Roxana Rodriguez Franco
- Center for Demographic Urban, and Environmental Studies, El Colegio de Mexico, Mexico City, Mexico
| | - Veronika J Wirtz
- Department of Global Health, Boston University School of Public Health, Boston, MA
| | - James B Meigs
- Department of Medicine, Harvard Medical School, Boston, MA, USA; Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA
| | - Miguel Angel Mendoza
- School of Economics, National Autonomous University of Mexico, Mexico City, Mexico
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; The George Institute for Global Health, Sydney, Australia
| | - Héctor Gómez-Dantés
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Rafael Lozano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Deborah J Wexler
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Edson Serván-Mori
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico.
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Gutierrez JP, Agudelo-Botero M, Garcia-Saiso S, Zepeda-Tena C, Davila-Cervantes CA, Gonzalez-Robledo MC, Fullman N, Razo C, Hernández-Prado B, Martínez G, Barquera S, Lozano R. Advances and challenges on the path toward the SDGs: subnational inequalities in Mexico, 1990-2017. BMJ Glob Health 2021; 5:bmjgh-2020-002382. [PMID: 33122296 PMCID: PMC7597504 DOI: 10.1136/bmjgh-2020-002382] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/07/2020] [Accepted: 05/28/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The sustainable development goals (SDGs) have generated momentum for global health, aligning efforts from governments and international organisations toward a set of goals that are expected to reflect improvements in life conditions across the globe. Mexico has huge social inequalities that can affect access to quality care and health outcomes. The objective of this study is to analyse inequalities among Mexico's 32 states on the health-related SDG indicators (HRSDGIs) from 1990 to 2017. METHODS These analyses rely on the estimation of HRSDGIs as part of the Global Burden of Disease study 2017. We estimated the concentration index for 40+3 HRSDGI stratified by Socio-demographic Index and marginalisation index, and then for indicators where inequalities were identified, we ran decomposition analyses using structural variables such as gross domestic product per capita, poverty and health expenditure. FINDINGS Mexico has made progress on most HRSDGIs, but current trends in improvement do not appear to fast enough to meet 2030 targets. Out of 43 HRSDGIs, we identified evidence of inequality between Mexico's states for 30 indicators; of those, 23 HRSDGIs were unequal distributed affecting states with lower development and seven affecting states with higher development. The decomposition analysis indicates that social determinants of health are major drivers of HRSDGI inequalities in Mexico. INTERPRETATION Modifying current trends for HRSDGIs will require subnational-level and national-level policy action, of which should be informed by the latest available data and monitoring on the health-related SDGs. The SDGs' overarching objective of leaving no-one behind should be prioritised not only for individuals but also for communities and other subnational levels.
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Affiliation(s)
- Juan Pablo Gutierrez
- Center for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, Mexico
| | - Marcela Agudelo-Botero
- Center for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, Mexico
| | - Sebastian Garcia-Saiso
- Center for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, Mexico
| | - Carolina Zepeda-Tena
- Center for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, Mexico
| | | | | | - Nancy Fullman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Christian Razo
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | - Gabriel Martínez
- Departamento Académico de Economía, ITAM, Alvaro Obregon, Mexico
| | | | - Rafael Lozano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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Enriquez-Martinez OG, Martins MCT, Pereira TSS, Pacheco SOS, Pacheco FJ, Lopez KV, Huancahuire-Vega S, Silva DA, Mora-Urda AI, Rodriguez-Vásquez M, Montero López MP, Molina MCB. Diet and Lifestyle Changes During the COVID-19 Pandemic in Ibero-American Countries: Argentina, Brazil, Mexico, Peru, and Spain. Front Nutr 2021; 8:671004. [PMID: 34150828 PMCID: PMC8206276 DOI: 10.3389/fnut.2021.671004] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/28/2021] [Indexed: 12/14/2022] Open
Abstract
This study aimed to evaluate changes in dietary and lifestyle habits during the period of confinement due to the first wave of the COVID-19 pandemic in Ibero-American countries. A cross-sectional investigation was conducted with 6,325 participants of both genders (68% women), over 18 years of age and from five countries: Brazil (N = 2,171), Argentina (N = 1,111), Peru (N = 1,174), Mexico (N = 686), and Spain (N = 1,183). Data were collected during the year 2020, between April 01 and June 30 in Spain and between July 13 and September 26, in the other countries studied using a self-administered online survey designed for the assessment of sociodemographic, employment, physical activity, health status, and dietary habits changes. Most participants (61.6%), mainly those from Spain, remained constant, without improving or worsening their pattern of food consumption. Among those who changed, a pattern of better eating choices prevailed (22.7%) in comparison with those who changed toward less healthy choices (15.7%). Argentina and Brazil showed the highest proportion of changes toward a healthier pattern of food consumption. Peruvians and Mexicans were less likely to make healthy changes in food consumption (OR: 0.51; 95% CI: 0.4-0.6 and OR: 0.69; 95% CI: 0.4-0.8, respectively), when compared to Argentinians. Most respondents did not change their pattern of meal consumption, but those who did reduced their consumption of main meals and increased intake of small meals and snacks. Although most participants affirmed to be doing physical activity at home, about one-half reported perception of weight gain. Individuals with alterations in sleep pattern (either by increasing or decreasing sleep time) were more likely to change their diets to a healthier pattern. In contrast, individuals with confirmed diagnosis of COVID-19 and those who reported feeling anxious were more likely to perform changes to a less healthy eating pattern (OR: 1.72; 95% CI: 1.2-2.3 and OR: 1.21; 95% CI: 1.1-1.4, respectively). In conclusion, although most participants remained constant in their eating habits, lifestyle changes and anxiety feelings were reported. Among those who changed patterns of food consumption, healthier choices prevailed, with differences between countries. However, there were alterations in the distribution of meals, with higher consumption of snacks and small meals. These results can be used to guide policies to prevent deleterious consequences that may affect the incidence of chronic diseases.
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Affiliation(s)
- Oscar G Enriquez-Martinez
- Public Health Program, Health Sciences Center, Federal University of Espírito Santo, Vitória, Brazil
| | - Marcia C T Martins
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Entre Ríos, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Entre Ríos, Argentina.,Master in Science of Human Motricity, Adventist University of Chile, Chillán, Chile
| | - Taisa S S Pereira
- Department of Health Sciences, Universidad de las Américas Puebla, San Andrés Cholula, Puebla, Mexico
| | - Sandaly O S Pacheco
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Entre Ríos, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Entre Ríos, Argentina
| | - Fabio J Pacheco
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Entre Ríos, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Entre Ríos, Argentina
| | - Karen V Lopez
- Department of Health Sciences, Universidad de las Américas Puebla, San Andrés Cholula, Puebla, Mexico
| | - Salomon Huancahuire-Vega
- Department of Basic Sciences, Faculty of Health Sciences, School of Human Medicine, Universidad Peruana Unión, Lima, Peru
| | - Daniela A Silva
- Department of Integrated Health Education, Federal University of Espírito Santo, Vitória, Brazil
| | - Ana I Mora-Urda
- Biology Department, Universidad Autónoma de Madrid, Madrid, Spain
| | - Mery Rodriguez-Vásquez
- Department of Basic Sciences, Faculty of Health Sciences, School of Human Medicine, Universidad Peruana Unión, Lima, Peru
| | | | - Maria C B Molina
- Public Health Program, Health Sciences Center, Federal University of Espírito Santo, Vitória, Brazil.,Health and Nutrition Program, Federal University of Ouro Preto, Ouro Preto, Brazil
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Ibarra-Nava I, Flores-Rodriguez KG, Ruiz-Herrera V, Ochoa-Bayona HC, Salinas-Zertuche A, Padilla-Orozco M, Salazar-Montalvo RG. Ethnic disparities in COVID-19 mortality in Mexico: A cross-sectional study based on national data. PLoS One 2021; 16:e0239168. [PMID: 33690607 PMCID: PMC7946310 DOI: 10.1371/journal.pone.0239168] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/13/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Across the world, the COVID-19 pandemic has disproportionately affected racial and ethnic minorities. How ethnicity affects Indigenous peoples in Mexico is unclear. The aim of this cross-sectional study was to determine the mortality associated with ethnicity, particularly of Indigenous peoples, in a large sample of patients with COVID-19 in Mexico. METHODS We used open access data from the Mexican Ministry of Health, which includes data of all confirmed COVID-19 cases in the country. We used descriptive statistics to compare differences among different groups of patients. Logistic regression was used to calculate odds ratios while adjusting for confounders. RESULTS From February 28 to August 3, 2020, a total of 416546 adult patients were diagnosed with COVID-19. Among these, 4178 were Indigenous peoples. Among all patients with COVID-19, whether hospitalized or not, a higher proportion of Indigenous peoples died compared to non-Indigenous people (16.5% vs 11.1%, respectively). Among hospitalized patients, a higher proportion of Indigenous peoples died (37.1%) compared to non-Indigenous peoples (36.3%). Deaths outside the hospital were also higher among Indigenous peoples (3.7% vs 1.7%). A higher proportion of Indigenous peoples died in both the private and public health care sectors. The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was 1.13 (95% confidence interval 1.03 to 1.24). The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was higher among those who received only ambulatory care (1.55, 95% confidence interval 1.24 to 1.92). DISCUSSION In this large sample of patients with COVID-19, the findings suggest that Indigenous peoples in Mexico have a higher risk of death from COVID-19, especially outside the hospital. These findings suggest Indigenous peoples lack access to care more so than non-Indigenous people during the COVID-19 pandemic in Mexico.
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Affiliation(s)
- Ismael Ibarra-Nava
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Kathia G. Flores-Rodriguez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Violeta Ruiz-Herrera
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Hilda C. Ochoa-Bayona
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Alfonso Salinas-Zertuche
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Magaly Padilla-Orozco
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Raul G. Salazar-Montalvo
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
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Dávila-Cervantes CA, Pardo-Montaño AM. The burden of injuries in Mexico: Secondary data analysis from the Global Burden of Disease Study, 1990 to 2019. Injury 2021; 52:467-477. [PMID: 33612252 DOI: 10.1016/j.injury.2021.02.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/25/2021] [Accepted: 02/12/2021] [Indexed: 02/08/2023]
Abstract
IMPORTANCE Injuries have been a major cause of premature mortality and short-term and long-term disability in Mexico. OBJECTIVE To report the findings from the Global Burden of Disease 2019 study on injuries in Mexico at a national and subnational scale from 1990 to 2019. METHODS Following the 2019 Global Burden of Disease study we examined injury mortality, premature mortality, years lived with disability and disability-adjusted life-years according to 14 subcategories. We calculated the Pearson correlation coefficient between the injury burden and the socio-demographic index. RESULTS While the number of deaths from injuries increased significantly, the changes in the age-standardized mortality rates trended towards declines. Interpersonal violence, road injuries, falls and self-harm accounted for 8 of every 10 deaths from injury in 2019. Injury mortality and the disability-adjusted life-years rates decreased nationally and in most states in the period as a whole, but have increased since 2007. The injury burden was higher for men in all age groups. Interpersonal violence caused the highest disability-adjusted life-years rate in males and road injuries in females. The socio-demographic index increased in all states, while the injury age-standardized disability-adjusted life-years rates between 1990 and 2019 decreased, but there was no statistical association between both indicators. DISCUSSION AND CONCLUSIONS This study represents a comprehensive review of injury burden of disease in Mexico. The injury burden decreased, but improved heterogeneously among states. To further reduce the injury burden of disease, it's necessary for federal, state and local governments to prioritize safety promotion and injury prevention programs, infrastructure improvements, legislation, and enforcement at a national and subnational level. Mexico's injury prevention efforts should also be tailored for specific age groups, such as males aged 20-49 years or females in the younger and older age groups, and high-burden areas.
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Affiliation(s)
- Claudio Alberto Dávila-Cervantes
- Latin American Faculty of Social Sciences Mexico. Carretera al Ajusco 377, Colonia Héroes de Padierna, Tlalpan, Mexico City, Mexico. 14200
| | - Ana Melisa Pardo-Montaño
- Institute of Geography, UNAM. Circuito de la Investigación Científica, Ciudad Universitaria, C.U., Coyoacán, Mexico City, Mexico. 04510.
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Romero Mendoza MP, Gómez-Dantes H, Manríquez Montiel Q, Saldívar Hernández GJ, Campuzano Rincón JC, Lozano R, Medina-Mora Icaza ME. The Invisible Burden of Violence Against Girls and Young Women in Mexico: 1990 to 2015. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:2753-2771. [PMID: 29544392 DOI: 10.1177/0886260517753851] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The increasing burden of interpersonal violence in women in Mexico is a neglected social and health problem that competes with other leading causes of premature death, disability, and health losses in young women. In this article, we focus on revealing the burden of violence in girls and young women and its implications for public policy. This study presents the subnational analysis of Mexico from the Global Burden of Disease study (1990-2015). The global study harmonized information of 195 countries and 79 risk factors. The study analyzed the deaths, years of life lost to premature death (YLL), years lived with disability (YLD), and the healthy years of life lost or disability-adjusted life year (DALY) related to violence. Nationwide, violence in young women accounts for 7% of all deaths in the 10 to 29 years age group and arises as the second most important cause of death in all age groups, except 10 to 14 years old, where it stands in the seventh position from 1990 to 2015. The health losses and social impact related to violence in young women demands firm actions by the government and society. It is urgent for health institutions to focus on the health of girls and young women because gender inequities have an enormous effect on their lives. Girls and women are nearly universally less powerful, less privileged, and have fewer opportunities than men.
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Affiliation(s)
| | | | | | | | | | - Rafael Lozano
- University of Namibia, Windhoek, Namibia
- Institute of Health Metrics and Evaluation (IHME), Washington University, Seattle, Washington
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Bello-Chavolla OY, González-Díaz A, Antonio-Villa NE, Fermín-Martínez CA, Márquez-Salinas A, Vargas-Vázquez A, Bahena-López JP, García-Peña C, Aguilar-Salinas CA, Gutiérrez-Robledo LM. Unequal Impact of Structural Health Determinants and Comorbidity on COVID-19 Severity and Lethality in Older Mexican Adults: Considerations Beyond Chronological Aging. J Gerontol A Biol Sci Med Sci 2021; 76:e52-e59. [PMID: 32598450 PMCID: PMC7337730 DOI: 10.1093/gerona/glaa163] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND COVID-19 has had a disproportionate impact on older adults. Mexico's population is younger, yet COVID-19's impact on older adults is comparable to countries with older population structures. Here, we aim to identify health and structural determinants that increase susceptibility to COVID-19 in older Mexican adults beyond chronological aging. METHODS We analyzed confirmed COVID-19 cases in older adults using data from the General Directorate of Epidemiology of Mexican Ministry of Health. We modeled risk factors for increased COVID-19 severity and mortality, using mixed models to incorporate multilevel data concerning healthcare access and marginalization. We also evaluated structural factors and comorbidity profiles compared to chronological age for COVID-19 mortality risk prediction. RESULTS We analyzed 20 804 confirmed SARS-CoV-2 cases in adults aged 60 and older. Male sex, smoking, diabetes, and obesity were associated with pneumonia, hospitalization, and intensive care unit (ICU) admission in older adults, CKD and COPD were associated with hospitalization. High social lag indexes and access to private care were predictors of COVID-19 severity and mortality. Age was not a predictor of COVID-19 severity in individuals without comorbidities and combination of structural factors and comorbidities were better predictors of COVID-19 lethality and severity compared to chronological age alone. COVID-19 baseline lethality hazards were heterogeneously distributed across Mexican municipalities, particularly when comparing urban and rural areas. CONCLUSIONS Structural factors and comorbidity explain excess risk for COVID-19 severity and mortality over chronological age in older Mexican adults. Clinical decision-making related to COVID-19 should focus away from chronological aging onto more a comprehensive geriatric care approach.
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Affiliation(s)
- Omar Yaxmehen Bello-Chavolla
- Division of Research, Instituto Nacional de Geriatría, Mexico City, Mexico
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Neftali Eduardo Antonio-Villa
- Division of Research, Instituto Nacional de Geriatría, Mexico City, Mexico
- MD/PhD (PECEM), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Carlos A Fermín-Martínez
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- MD/PhD (PECEM), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Alejandro Márquez-Salinas
- Division of Research, Instituto Nacional de Geriatría, Mexico City, Mexico
- MD/PhD (PECEM), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Arsenio Vargas-Vázquez
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- MD/PhD (PECEM), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | | | - Carmen García-Peña
- Division of Research, Instituto Nacional de Geriatría, Mexico City, Mexico
| | - Carlos A Aguilar-Salinas
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Department of Endocrinolgy and Metabolism. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Nuevo León, Mexico
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Braverman-Bronstein A, Hessel P, González-Uribe C, Kroker MF, Diez-Canseco F, Langellier B, Lucumi DI, Rodríguez Osiac L, Trotta A, Diez Roux AV. Association of education level with diabetes prevalence in Latin American cities and its modification by city social environment. J Epidemiol Community Health 2021; 75:874-880. [PMID: 33542029 PMCID: PMC7611487 DOI: 10.1136/jech-2020-216116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/14/2021] [Accepted: 01/23/2021] [Indexed: 11/30/2022]
Abstract
Background Diabetes prevalence continues to increase in urban areas of low-income and middle-income countries (LMIC). Evidence from high-income countries suggests an inverse association between educational attainment and diabetes, but research in LMIC is limited. We investigated educational differences in diabetes prevalence across 232 Latin American (LA) cities, and the extent to which these inequities vary across countries/cities and are modified by city socioeconomic factors. Methods Using harmonised health survey and census data for 110 498 city dwellers from eight LA countries, we estimated the association between education and diabetes. We considered effect modification by city Social Environment Index (SEI) as a proxy for city-level development using multilevel models, considering heterogeneity by sex and country. Results In women, there was an inverse dose–response relationship between education and diabetes (OR: 0.80 per level increase in education, 95% CI 0.75 to 0.85), consistent across countries and not modified by SEI. In men, Argentina, Brazil, Colombia, Chile and Mexico showed an inverse association (pooled OR: 0.92; 95% CI 0.86 to 0.99). Peru, Panama and El Salvador showed a positive relationship (pooled OR 1.24; 95% CI 1.04 to 1.49). For men, these associations were further modified by city-SEI: in countries with an inverse association, it became stronger as city-SEI increased. In countries where the association was positive, it became weaker as city-SEI increased. Conclusion Social inequities in diabetes inequalities increase as cities develop. To achieve non-communicable disease-related sustainable development goals in LMIC, there is an urgent need to develop policies aimed at reducing these educational inequities.
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Affiliation(s)
| | - Philipp Hessel
- School of Government, Universidad de los Andes, Bogota, Colombia
| | | | - Maria F Kroker
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Francisco Diez-Canseco
- CRONICAS, Center of Excellence in Chronic Diseases, University Peruana Cayetano Heredia, Lima, Peru
| | - Brent Langellier
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Diego I Lucumi
- School of Government, Universidad de los Andes, Bogota, Colombia
| | | | - Andrés Trotta
- Institute of Collective Health, National University of Lanus, Buenos Aires, Argentina
| | - Ana V Diez Roux
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
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36
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Life expectancy and mortality in 363 cities of Latin America. Nat Med 2021; 27:463-470. [PMID: 33495602 PMCID: PMC7960508 DOI: 10.1038/s41591-020-01214-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 12/16/2020] [Indexed: 01/02/2023]
Abstract
The concept of a so-called urban advantage in health ignores the possibility of heterogeneity in health outcomes across cities. Using a harmonized dataset from the SALURBAL project, we describe variability and predictors of life expectancy and proportionate mortality in 363 cities across nine Latin American countries. Life expectancy differed substantially across cities within the same country. Cause-specific mortality also varied across cities, with some causes of death (unintentional and violent injuries and deaths) showing large variation within countries, whereas other causes of death (communicable, maternal, neonatal and nutritional, cancer, cardiovascular disease and other noncommunicable diseases) varied substantially between countries. In multivariable mixed models, higher levels of education, water access and sanitation and less overcrowding were associated with longer life expectancy, a relatively lower proportion of communicable, maternal, neonatal and nutritional deaths and a higher proportion of deaths from cancer, cardiovascular disease and other noncommunicable diseases. These results highlight considerable heterogeneity in life expectancy and causes of death across cities of Latin America, revealing modifiable factors that could be amenable to urban policies aimed toward improving urban health in Latin America and more generally in other urban environments. City-level analysis of data from the SALURBAL project shows vast heterogeneity in life expectancy across cities within the same country, in addition to substantive differences in causes of death among nine Latin American countries, revealing modifiable factors that could be leveraged by municipal-level policies aimed toward improving health in urban environments.
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Baca-López K, Fresno C, Espinal-Enríquez J, Flores-Merino MV, Camacho-López MA, Hernández-Lemus E. Metropolitan age-specific mortality trends at borough and neighborhood level: The case of Mexico City. PLoS One 2021; 16:e0244384. [PMID: 33465102 PMCID: PMC7815139 DOI: 10.1371/journal.pone.0244384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 12/08/2020] [Indexed: 11/23/2022] Open
Abstract
Understanding the spatial and temporal patterns of mortality rates in a highly heterogeneous metropolis, is a matter of public policy interest. In this context, there is no, to the best of our knowledge, previous studies that correlate both spatio-temporal and age-specific mortality rates in Mexico City. Spatio-temporal Kriging modeling was used over five age-specific mortality rates (from the years 2000 to 2016 in Mexico City), to gain both spatial (borough and neighborhood) and temporal (year and trimester) data level description. Mortality age-specific patterns have been modeled using multilevel modeling for longitudinal data. Posterior tests were carried out to compare mortality averages between geo-spatial locations. Mortality correlation extends in all study groups for as long as 12 years and as far as 13.27 km. The highest mortality rate takes place in the Cuauhtémoc borough, the commercial, touristic and cultural core downtown of Mexico City. On the contrary, Tlalpan borough is the one with the lowest mortality rates in all the study groups. Post-productive mortality is the first age-specific cause of death, followed by infant, productive, pre-school and scholar groups. The combinations of spatio-temporal Kriging estimation and time-evolution linear mixed-effect models, allowed us to unveil relevant time and location trends that may be useful for public policy planning in Mexico City.
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Affiliation(s)
- Karol Baca-López
- School of Medicine, Autonomous University of the State of Mexico, Toluca, State of Mexico, Mexico
- Computational Genomics Department, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Cristóbal Fresno
- Technology Development Department, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Jesús Espinal-Enríquez
- Computational Genomics Department, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Miriam V Flores-Merino
- School of Chemistry, Autonomous University of the State of Mexico, Toluca, State of Mexico, Mexico
| | - Miguel A Camacho-López
- School of Medicine, Autonomous University of the State of Mexico, Toluca, State of Mexico, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Department, National Institute of Genomic Medicine, Mexico City, Mexico
- Centro de Ciencias de la Complejidad, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
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Félix-Beltrán L, Macinko J, Kuhn R. Maternal height and double-burden of malnutrition households in Mexico: stunted children with overweight or obese mothers. Public Health Nutr 2021; 24:106-116. [PMID: 32867877 PMCID: PMC10049080 DOI: 10.1017/s136898002000292x 10.1017/s136898002000292x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 06/21/2020] [Accepted: 07/23/2020] [Indexed: 09/23/2023]
Abstract
OBJECTIVE To assess the association between short maternal height and four types of mother-child nutritional status groupings within Mexican households. DESIGN We classified mother-child dyads into four groups: stunted child and a non-overweight/non-obese mother (stunting-only), non-stunted child and an overweight/obese mother (overweight-only), stunted child with an overweight/obese mother (double-burden) and households with neither child stunting nor overweight/obese mothers (neither-condition). We assessed the association between maternal height and mother-child nutrition status using multinomial logistic regression, controlling for socio-economic covariates. SETTING Nationally representative cross-section of households from the 2012 Mexican National Health and Nutrition Survey. PARTICIPANTS Children <5 years of age were matched to their mothers, resulting in a sample of 4706 mother-child dyads. RESULTS We found that among children with stunting, 53·3% have an overweight/obese mother. Double-burden was observed in 8·1% of Mexican households. Maternal short stature increased the probability of stunting-only by 3·5% points (p.p.) and double-burden by 9·7 p.p. (P < 0·05). The inverse association was observed for overweight-only and neither-condition households, where the probability of these outcomes decreased by 7·2 and 6 p.p. in households with short-statured mothers (P < 0·05), respectively. CONCLUSIONS Women with short stature are more likely to develop overweight and simultaneously have a stunted child than those who are not short-statured. Our findings underline the challenges faced by public health systems, which have to balance the provision of services for both an undernourished and increasingly overweight/obese population.
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Affiliation(s)
- Lucía Félix-Beltrán
- Department of Health Policy and Management, Fielding School of Public Health, University of California at Los Angeles, 650 Charles E Young Dr S, Los Angeles90095, CA, USA
| | - James Macinko
- Department of Health Policy and Management, Fielding School of Public Health, University of California at Los Angeles, 650 Charles E Young Dr S, Los Angeles90095, CA, USA
- Department of Community Health Sciences, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA, USA
| | - Randall Kuhn
- Department of Community Health Sciences, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA, USA
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Polo-Oteyza E, Gil-Zenteno L. Complementary feeding and future health in Mexico. Introduction to the XI Nestlé Nutrition Conference. Nutr Rev 2020; 78:1-5. [PMID: 33196094 DOI: 10.1093/nutrit/nuaa122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Nutrition in infancy provides an important window of opportunity to shape good health during childhood and adult life. The objective of this manuscript is to provide an introduction to the review articles that bring together the proceedings of the XI Nestlé Nutrition Conference "Complementary Feeding: A Piece of the Puzzle to Understand Future Health". The studies and description of complementary feeding practices in Mexico, from the Mexican National Health and Nutrition Survey 2012 (ENSANUT 2012), support the urgent need for strong policy actions to promote healthy eating and appropriate complementary feeding practices. Early interventions considering a life course approach and maternal and child nutrition are essential to prevent obesity, chronic disease and to ensure better health for the Mexican population.
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Affiliation(s)
- Ernestina Polo-Oteyza
- Fondo Nestlé para la Nutrición, Fundación Mexicana para la Salud, Ciudad de México, México
| | - Lidia Gil-Zenteno
- Fondo Nestlé para la Nutrición, Fundación Mexicana para la Salud, Ciudad de México, México
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40
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Development of an index to assess adherence to the traditional Mexican diet using a modified Delphi method. Public Health Nutr 2020; 24:4387-4396. [PMID: 33183382 DOI: 10.1017/s1368980020004565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Promoting a traditional Mexican diet (TMexD) could potentially reduce high rates of non-communicable diseases (NCD) and support food sustainability in Mexico. This study aimed to develop an index to assess adherence to the TMexD. DESIGN A three-round Delphi study was conducted to examine the food groups, specific foods and food-related habits that would constitute a TMexD index. Participants selected the TMexD items using Likert scales, lists of responses, and yes/no questions. Consensus was determined using percentages of agreement, mean values and/or coefficients of variation. SETTING Online Delphi study. PARTICIPANTS Seventeen nutrition and food experts in Mexico completed all three rounds. RESULTS The resulting index (ranging from 0 to 21 points) consisted of 15 food groups, containing 102 individual foods. Food groups included in higher quantities were maize, other grains, legumes, vegetables, fruits, herbs, nuts and seeds, and tubers. Animal foods, vegetable fats and oils, homemade beverages, maize-based dishes, and plain water were also included, but in lower quantities. The food-related habits included were consuming homemade meals, socialising at meals and buying food in local markets. Consensus was reached for all index items apart from quantities of consumption of six food groups (herbs, nuts, grains, tubers, dairy and eggs). CONCLUSIONS Although future research could improve the measures for which consensus was not reached, the TMexD index proposed in this study potentially displays a healthy and sustainable dietary pattern and could be used to examine links between the TMexD and health outcomes in Mexican populations.
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Machado DB, Pescarini JM, Ramos D, Teixeira R, Lozano R, Pereira VODM, Azeredo C, Paes-Sousa R, Malta DC, Barreto ML. Monitoring the progress of health-related sustainable development goals (SDGs) in Brazilian states using the Global Burden of Disease indicators. Popul Health Metr 2020; 18:7. [PMID: 32993666 PMCID: PMC7526114 DOI: 10.1186/s12963-020-00207-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 06/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Measuring the Global Burden of Disease (GBD) has been the key to verifying the evolution of health indicators worldwide. We analyse subnational GBD data for Brazil in order to monitor the performance of the Brazilian states in the last 28 years on their progress towards meeting the health-related SDGs. METHODS As part of the GBD study, we assessed the 41 health-related indicators from the SDGs in Brazil at the subnational level for all the 26 Brazilian states and the Federal District from 1990 to 2017. The GBD group has rescaled all worldwide indicators from 0 to 100, assuming that for each one of them, the worst value among all countries and overtime is 0, and the best is 100. They also estimate the overall health-related SDG index as a function of all previously estimated health indicators and the SDI index (Socio-Demographic Index) as a function of per capita income, average schooling in the population aged 15 years or over, and total fertility rate under the age of 25 (TFU25). RESULTS From 1990 to 2017, most subnational health-related SDGs, the SDG and SDI indexes improved considerable in most Brazilian states. The observed differences in SDG indicators within Brazilian states, including HIV incidence and health worker density, increased over time. In 2017, health-related indicators that achieved good results globally included the prevalence of child wasting, NTD, household air pollution, conflict mortality, skilled birth attendance, use of modern contraceptive methods, vaccine coverage, and health worker density, but poor results were observed for child overweight and homicide rates. The high rates of overweight, alcohol consumption, and smoking prevalence found in the historically richest regions (i.e., the South and Southeast), contrast with the high rates of tuberculosis, maternal, neonatal, and under-5 mortality and WASH-related mortality found in the poorer regions (i.e., the North and Northeast). CONCLUSIONS The majority of Brazil's health-related SDG indicators have substantially improved over the past 28 years. However, inequalities in health among the Brazilian states and regions remain noticeable negatively affecting the Brazilian population, which can contribute to Brazil not achieving the SDG 2030 targets.
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Affiliation(s)
- Daiane Borges Machado
- Center of Data and Knowledge Integration for Health (Cidacs), Oswaldo Cruz Foundation, Salvador, Brazil.,Centre for Global Mental Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Júlia Moreira Pescarini
- Center of Data and Knowledge Integration for Health (Cidacs), Oswaldo Cruz Foundation, Salvador, Brazil.
| | - Dandara Ramos
- Center of Data and Knowledge Integration for Health (Cidacs), Oswaldo Cruz Foundation, Salvador, Brazil.,Institute of Collective Health (ISC), Federal University of Bahia (UFBA), Salvador, Brazil
| | - Renato Teixeira
- Public Health Graduate Program, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Rafael Lozano
- School of Medicine, Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | - Cimar Azeredo
- Brazilian Institute of Geography and Statistics (IBGE), Rio de Janeiro, Brazil
| | | | - Deborah Carvalho Malta
- Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mauricio L Barreto
- Center of Data and Knowledge Integration for Health (Cidacs), Oswaldo Cruz Foundation, Salvador, Brazil.,Institute of Collective Health (ISC), Federal University of Bahia (UFBA), Salvador, Brazil
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Nomura S, Yoneoka D, Tanaka S, Ishizuka A, Ueda P, Nakamura K, Uneyama H, Hayashi N, Shibuya K. Forecasting disability-adjusted life years for chronic diseases: reference and alternative scenarios of salt intake for 2017-2040 in Japan. BMC Public Health 2020; 20:1475. [PMID: 32993606 PMCID: PMC7526266 DOI: 10.1186/s12889-020-09596-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 09/22/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In Japan, a high-sodium diet is the most important dietary risk factor and is known to cause a range of health problems. This study aimed to forecast Japan's disability-adjusted life year (DALYs) for chronic diseases that would be associated with high-sodium diet in different future scenarios of salt intake. We modelled DALY forecast and alternative future scenarios of salt intake for cardiovascular diseases (CVDs), chronic kidney diseases (CKDs), and stomach cancer (SC) from 2017 to 2040. METHODS We developed a three-component model of disease-specific DALYs: a component on the changes in major behavioural and metabolic risk predictors including salt intake; a component on the income per person, educational attainment, and total fertility rate under 25 years; and an autoregressive integrated moving average model to capture the unexplained component correlated over time. Data on risk predictors were obtained from Japan's National Health and Nutrition Surveys and from the Global Burden of Disease Study 2017. To generate a reference forecast of disease-specific DALY rates for 2017-2040, we modelled the three diseases using the data for 1990-2016. Additionally, we generated better, moderate, and worse scenarios to evaluate the impact of change in salt intake on the DALY rate for the diseases. RESULTS In our reference forecast, the DALY rates across all ages were predicted to be stable for CVDs, continuously increasing for CKDs, and continuously decreasing for SC. Meanwhile, the age group-specific DALY rates for these three diseases were forecasted to decrease, with some exceptions. Except for the ≥70 age group, there were remarkable differences in DALY rates between scenarios, with the best scenario having the lowest DALY rates in 2040 for SC. This represents a wide scope of future trajectories by 2040 with a potential for tremendous decrease in SC burden. CONCLUSIONS The gap between scenarios provides some quantification of the range of policy impacts on future trajectories of salt intake. Even though we do not yet know the policy mix used to achieve these scenarios, the result that there can be differences between scenarios means that policies today can have a significant impact on the future DALYs.
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Affiliation(s)
- Shuhei Nomura
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
| | - Daisuke Yoneoka
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Shiori Tanaka
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Aya Ishizuka
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Peter Ueda
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden
| | - Keiji Nakamura
- Graduate School of Environmental and Information Studies, Tokyo City University, Yokohama, Japan
- Ajinomoto Co., Inc., Tokyo, Japan
| | | | - Naoki Hayashi
- Ajinomoto Co., Inc., Tokyo, Japan
- Department of Applied Biological Chemistry, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Kenji Shibuya
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute for Population Health, King's College London, London, UK
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Maternal height and double-burden of malnutrition households in Mexico: stunted children with overweight or obese mothers. Public Health Nutr 2020; 24:106-116. [PMID: 32867877 PMCID: PMC10049080 DOI: 10.1017/s136898002000292x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess the association between short maternal height and four types of mother-child nutritional status groupings within Mexican households. DESIGN We classified mother-child dyads into four groups: stunted child and a non-overweight/non-obese mother (stunting-only), non-stunted child and an overweight/obese mother (overweight-only), stunted child with an overweight/obese mother (double-burden) and households with neither child stunting nor overweight/obese mothers (neither-condition). We assessed the association between maternal height and mother-child nutrition status using multinomial logistic regression, controlling for socio-economic covariates. SETTING Nationally representative cross-section of households from the 2012 Mexican National Health and Nutrition Survey. PARTICIPANTS Children <5 years of age were matched to their mothers, resulting in a sample of 4706 mother-child dyads. RESULTS We found that among children with stunting, 53·3% have an overweight/obese mother. Double-burden was observed in 8·1% of Mexican households. Maternal short stature increased the probability of stunting-only by 3·5% points (p.p.) and double-burden by 9·7 p.p. (P < 0·05). The inverse association was observed for overweight-only and neither-condition households, where the probability of these outcomes decreased by 7·2 and 6 p.p. in households with short-statured mothers (P < 0·05), respectively. CONCLUSIONS Women with short stature are more likely to develop overweight and simultaneously have a stunted child than those who are not short-statured. Our findings underline the challenges faced by public health systems, which have to balance the provision of services for both an undernourished and increasingly overweight/obese population.
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Barquera S, Rivera JA. Obesity in Mexico: rapid epidemiological transition and food industry interference in health policies. Lancet Diabetes Endocrinol 2020; 8:746-747. [PMID: 32822599 PMCID: PMC7434327 DOI: 10.1016/s2213-8587(20)30269-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Simón Barquera
- Instituto Nacional de Salud Pública, Av. Universidad No. 655. Col. Sta. Ma. Ahuacatitlan, Cuernavaca, Morelos, CP. 62100, Mexico.
| | - Juan A Rivera
- Instituto Nacional de Salud Pública, Av. Universidad No. 655. Col. Sta. Ma. Ahuacatitlan, Cuernavaca, Morelos, CP. 62100, Mexico
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Geck MS, Cristians S, Berger-González M, Casu L, Heinrich M, Leonti M. Traditional Herbal Medicine in Mesoamerica: Toward Its Evidence Base for Improving Universal Health Coverage. Front Pharmacol 2020; 11:1160. [PMID: 32848768 PMCID: PMC7411306 DOI: 10.3389/fphar.2020.01160] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 07/16/2020] [Indexed: 01/28/2023] Open
Abstract
The quality of health care in Mesoamerica is influenced by its rich cultural diversity and characterized by social inequalities. Especially indigenous and rural communities confront diverse barriers to accessing formal health services, leading to often conflicting plurimedical systems. Fostering integrative medicine is a fundamental pillar for achieving universal health coverage (UHC) for marginalized populations. Recent developments toward health sovereignty in the region are concerned with assessing the role of traditional medicines, and particularly herbal medicines, to foster accessible and culturally pertinent healthcare provision models. In Mesoamerica, as in most regions of the world, a wealth of information on traditional and complementary medicine has been recorded. Yet these data are often scattered, making it difficult for policy makers to regulate and integrate traditionally used botanical products into primary health care. This critical review is based on a quantitative analysis of 28 survey papers focusing on the traditional use of botanical drugs in Mesoamerica used for the compilation of the "Mesoamerican Medicinal Plant Database" (MAMPDB), which includes a total of 12,537 use-records for 2188 plant taxa. Our approach presents a fundamental step toward UHC by presenting a pharmacological and toxicological review of the cross-culturally salient plant taxa and associated botanical drugs used in traditional medicine in Mesoamerica. Especially for native herbal drugs, data about safety and effectiveness are limited. Commonly used cross-culturally salient botanical drugs, which are considered safe but for which data on effectiveness is lacking constitute ideal candidates for treatment outcome studies.
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Affiliation(s)
- Matthias S. Geck
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
- Biovision – Foundation for Ecological Development, Zurich, Switzerland
| | - Sol Cristians
- Botanical Garden, Institute of Biology, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Mónica Berger-González
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala, Guatemala
- Department of Epidemiology and Public Heath, Swiss TPH, University of Basel, Basel, Switzerland
| | - Laura Casu
- Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy
| | - Michael Heinrich
- Pharmacognosy and Phytotherapy, UCL School of Pharmacy, London, United Kingdom
| | - Marco Leonti
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
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Cervantes CAD, Montaño AMP. Study of suicide burden of mortality in México 1990-2017. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200069. [PMID: 32638855 DOI: 10.1590/1980-549720200069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/11/2019] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE The primary goal was to analyze the level and trend of the burden of suicide mortality in Mexico between 1990 and 2017 at a national and state scale. METHODS A secondary analysis based on the 2017 global burden of disease study. Mortality rates and years of life lost due to premature death (YLL) were reported here. A joinpoint regression analysis based on a log-linear model was used to analyze the trend of YLL. RESULTS The burden of disease due to suicides increased in Mexico, mainly in young males and females; though the raise that happened in the elderly is an additional challenge for the health system. The burden of disease varied substantially between states. The male mortality rates were higher than those of females during the whole period under study, nonetheless with a trend to reduce the difference between the sexes. A bimodal pattern of the burden of disease due to suicide in Mexico was also observed, with the higher rates located in those aged between 15 and 19 years, and an important increase in people older than 85 years of age. CONCLUSION These results show a worrisome picture, not only from a social, economic and health point of view but also from the needs of public policies. This situation represents a wake-up call about the need to implement timely identification actions, a comprehensive multisectoral prevention strategy and the detailed study of suicide associated risk factors.
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Manzano-Robleda MDC, Espinosa-Tamez P, Potter MB, Lajous M, Van Loon K, Zhang L, Jimenez-Peña A, Sánchez Del Monte J, Mohar A, Hernández-Guerrero A. Fecal Immunologic Test Results and Diagnostic Colonoscopy in a Mexican Population at Average Risk for Colorectal Cancer. Cancer Prev Res (Phila) 2020; 13:959-966. [PMID: 32655008 DOI: 10.1158/1940-6207.capr-20-0076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/02/2020] [Accepted: 07/06/2020] [Indexed: 12/24/2022]
Abstract
Colorectal cancer is preventable and treatable by screening and early detection. Fecal immunochemical tests (FIT) for average risk individuals is an effective strategy for screening. Incidence and mortality in Mexico is increasing and large-scale screening programs do not yet exist. The aim of this study was to evaluate the feasibility of FIT-based colorectal cancer screening program in Mexico City. For more than 15 months, average risk individuals in Mexico City were invited to participate at Mexico's Instituto Nacional de Cancerologia (INCan, Mexico City, Mexico). Participants received an FIT kit for stool collection, results ≥20 ng/mL were referred for high quality colonoscopy. Participants' results were classified according to the most advanced clinical finding as: adenocarcinoma, high-risk adenomas, low-risk adenomas, serrated lesions, hyperplastic polyps, and no polyps. Sequential analyses were performed to assess the positive predictive value (PPV) of FIT. A total of 810 participants were eligible, 737 (91.0%) returned the FIT and 112 (15.2%) had an abnormal result. Of these participants, 87 (77.7%) completed colonoscopy. Clinical findings of participants included: seven (8.1%) adenocarcinomas, 18 (20.7%) high-risk adenomas, 23 (26.4%) low-risk adenomas, one (1.2%) serrated lesions, 14 (16.1%) hyperplasic polyps, and 24 (27.6%) no polyps. The PPV of FIT using the ≥20 ng/mL was 8.1% for cancer and 20.7% for high-risk adenomas. In conclusion, colorectal cancer screening with FIT is feasible at INCan in Mexico City, where resources are available. Further studies are needed to determine feasibility of colorectal cancer screening in other settings, as well as optimal hemoglobin detection cut-off points to maximize the population benefits of colorectal cancer screening with FIT in Mexico.
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Affiliation(s)
- Maria Del Carmen Manzano-Robleda
- Servicio de Endoscopía, Instituto Nacional de Cancerología, Mexico City, Mexico.,Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Priscilla Espinosa-Tamez
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Mexico City, Mexico
| | - Michael B Potter
- University of California, San Francisco, San Francisco, California
| | - Martin Lajous
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Mexico City, Mexico.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Li Zhang
- University of California, San Francisco, San Francisco, California
| | - Alejandro Jimenez-Peña
- Servicio de Endoscopía, Instituto Nacional de Cancerología, Mexico City, Mexico.,Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Julio Sánchez Del Monte
- Servicio de Endoscopía, Instituto Nacional de Cancerología, Mexico City, Mexico.,Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | - Angélica Hernández-Guerrero
- Servicio de Endoscopía, Instituto Nacional de Cancerología, Mexico City, Mexico. .,Instituto Nacional de Cancerología, Mexico City, Mexico
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Cardiovascular and diabetes burden attributable to physical inactivity in Mexico. Cardiovasc Diabetol 2020; 19:99. [PMID: 32600339 PMCID: PMC7325101 DOI: 10.1186/s12933-020-01050-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/05/2020] [Indexed: 01/17/2023] Open
Abstract
Background Physical inactivity (PI) is associated with the development of non-communicable chronic diseases. The purposes of this study were to estimate the extent to which the 31% relative increase in PI among 35–64 years old Mexicans between 2006 and 2012 influenced diabetes (T2D) and cardiovascular disease (CVD) incidence and mortality, and to estimate the impact of the World Health Organization recommended 10% and 15% relative decrease in PI on CVD and T2D incidence and mortality by 2025 and 2030, respectively. Methods Estimates were derived using the Cardiovascular Disease Policy Model-Mexico, a computer simulation, Markov model. Model inputs included cross-national data on PI levels from 2006 and 2012 measured using the International Physical Activity Questionnaire and the published literature review on the independent relationship between PI and cardiometabolic risk. Results The models estimated that the 31% increase in PI resulted in an increase in the number of cases of T2D (27,100), coronary heart disease (10,300), stroke (2200), myocardial infarction (1500), stroke deaths (400) and coronary heart disease deaths (350). A hypothetical 10% lowering of PI by 2025 compared to status quo is projected to prevent 8400 cases of T2D, 4200 cases of CHD, 1000 cases of stroke, 700 cases of MI, and 200 deaths of CHD and stroke, respectively. A 15% reduction resulted in larger decreases. Conclusions While the burden of T2D and CVD raised from 2006 to 2012 in association with increased PI, achieving the WHO targets by 2030 could help reverse these trends.
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Downer B, Milani S, Wong R. The Sequence of Physical and Cognitive Impairment and the Association with Mortality Among Unimpaired Older Mexican Adults. J Gerontol A Biol Sci Med Sci 2020; 75:1386-1392. [PMID: 31639186 DOI: 10.1093/gerona/glz238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many older adults become physically and cognitively impaired. However, it is unclear whether unimpaired older adults are more likely to become physically or cognitively impaired first and if this sequence impacts mortality risk. METHODS Data came from the Mexican Health and Aging Study. The sample included 1,283 participants aged ≥60 years who were physically and cognitively unimpaired in 2001. Multinomial logistic regression was used to estimate probabilities of being unimpaired, cognitively impaired only, physically impaired only, or cognitively-physically impaired in 2003. Proportional hazard models were used to estimate mortality risk through 2015 according to physical and cognitive status in 2003. RESULTS The probabilities for being unimpaired, physically impaired only, cognitively impaired only, and cognitively-physically impaired in 2003 were 0.45, 0.22, 0.19, and 0.13, respectively. Older age, female sex, and arthritis were associated with significantly greater probability of becoming physically impaired only than cognitively impaired only in 2003. Cognitive impairment only (hazard ratio [HR] = 1.42, 95% confidence interval [CI] = 1.09-1.85) in 2003 but not physical impairment only (HR = 1.22, 95% CI = 0.94-1.58) was associated with greater mortality than being unimpaired in 2003. Cognitively-physically impaired participants had higher mortality risk than participants who were physically (HR = 1.58, 95% CI = 1.18-2.12) or cognitively (HR = 1.36, 95% CI = 1.01-1.84) impaired only. DISCUSSION The likelihood of becoming only physically or cognitively impaired over 2 years varies by demographic and health characteristics. The mortality risk for unimpaired older adults who become cognitively impaired only is similar to those who become physically impaired only. Research should determine if the sequence of cognitive and physical impairments is associated with other outcomes.
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Affiliation(s)
- Brian Downer
- Division of Rehabilitation Sciences, School of Health Professions, Galveston.,Sealy Center on Aging, University of Texas Medical Branch, Galveston
| | - Sadaf Milani
- Sealy Center on Aging, University of Texas Medical Branch, Galveston
| | - Rebeca Wong
- Sealy Center on Aging, University of Texas Medical Branch, Galveston
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Mendez-Dominguez N, Alvarez-Baeza A, Carrillo G. Demographic and Health Indicators in Correlation to Interstate Variability of Incidence, Confirmation, Hospitalization, and Lethality in Mexico: Preliminary Analysis from Imported and Community Acquired Cases during COVID-19 Outbreak. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124281. [PMID: 32549337 PMCID: PMC7344596 DOI: 10.3390/ijerph17124281] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 12/20/2022]
Abstract
This study’s objective is to analyze the incidence, lethality, hospitalization, and confirmation of COVID-19 cases in Mexico. Sentinel surveillance for COVID-19 cases in Mexico began after the confirmation of the first patient with community transmission. Methods: This epidemiologic, cross-sectional study includes all clinically suspected, and laboratory-confirmed cases nationwide from the beginning of the outbreak to 21 April 2020. State-cluster demographic data and health indicators were analyzed in reference to epidemiologic measures, with logistic regressions for the dependent variables of incidence, confirmation, and lethality. Results: The national incidence was 13.89/100,000 inhabitants with a 6.52% overall lethality and a confirmed-case mortality of 11.1%. The incidence variation significantly correlated with migration, but not urbanization. Pediatric patients were less prone to be tested (OR = −3.92), while geriatric individuals were a priority. State lethality positively correlated with the proportion of the population assisted at public hospitals and correlated inversely to the number of hospitals and clinics in the state. Conclusions: Migration strongly correlated with incidence; elderly patients had lower odds of being hospitalized but were likely to die. Patients aged <15 were less prone to be laboratory-confirmed. Case confirmation was not performed in all hospitalized patients, but 72.15% of hospitalized patients had favorable outcomes to date.
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Affiliation(s)
- Nina Mendez-Dominguez
- Department of Health Sciences, School of Medicine, Universidad Marista, Periférico Norte Tablaje Catastral 13941, Merida 97300, Mexico; (N.M.-D.); (A.A.-B.)
| | - Alberto Alvarez-Baeza
- Department of Health Sciences, School of Medicine, Universidad Marista, Periférico Norte Tablaje Catastral 13941, Merida 97300, Mexico; (N.M.-D.); (A.A.-B.)
| | - Genny Carrillo
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, 212 Adriance Lab Road, College Station, TX 77843, USA
- Correspondence: ; Tel.: +1-979-436-0963
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