Dissonant health transition in the states of Mexico, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Summary Background Child and maternal health outcomes have notably improved in Mexico since 1990, whereas rising adult mortality rates defy traditional epidemiological transition models in which decreased death rates occur across all ages. These trends suggest Mexico is experiencing a more complex,...

Full description

Saved in:

Bibliographic Details
Published in:	The Lancet (British edition) 2016-11, Vol.388 (10058), p.2386-2402
Main Authors:	Gómez-Dantés, Héctor, MSc, Fullman, Nancy, MPH, Lamadrid-Figueroa, Héctor, PhD, Cahuana-Hurtado, Lucero, PhD, Darney, Blair, PhD, Avila-Burgos, Leticia, PhD, Correa-Rotter, Ricardo, MD, Rivera, Juan A, Prof, Barquera, Simon, Prof, González-Pier, Eduardo, PhD, Aburto-Soto, Tania, MSc, de Castro, Elga Filipa Amorin, PhD, Barrientos-Gutiérrez, Tonatiuh, PhD, Basto-Abreu, Ana C, MPH, Batis, Carolina, PhD, Borges, Guilherme, PhD, Campos-Nonato, Ismael, PhD, Campuzano-Rincón, Julio C, PhD, de Jesús Cantoral-Preciado, Alejandra, PhD, Contreras-Manzano, Alejandra G, MSc, Cuevas-Nasu, Lucia, MSc, de la Cruz-Gongora, Vanessa V, MSc, Diaz-Ortega, Jose L, MD, de Lourdes García-García, María, Prof, Garcia-Guerra, Armando, MSc, de Cossío, Teresita González, PhD, González-Castell, Luz D, MSc, Heredia-Pi, Ileana, PhD, Hijar-Medina, Marta C, PhD, Jauregui, Alejandra, MSc, Jimenez-Corona, Aida, PhD, Lopez-Olmedo, Nancy, MSc, Magis-Rodríguez, Carlos, MD, Medina-Garcia, Catalina, MS, Medina-Mora, Maria E, PhD, Mejia-Rodriguez, Fabiola, MD, Montañez, Julio C, MSc, Montero, Pablo, MS, Montoya, Alejandra, MS, Moreno-Banda, Grea L, PhD, Pedroza-Tobías, Andrea, MS, Pérez-Padilla, Rogelio, MD, Quezada, Amado D, MS, Richardson-López-Collada, Vesta L, MD, Riojas-Rodríguez, Horacio, PhD, Ríos Blancas, Maria J, MPH, Razo-Garcia, Christian, MSc, Mendoza, Martha P Romero, MD, Sánchez-Pimienta, Tania G, MSc, Sánchez-Romero, Luz M, PhD, Schilmann, Astrid, MSc, Servan-Mori, Edson, MSc, Shamah-Levy, Teresa, PhD, Téllez-Rojo, Martha M, Prof, Texcalac-Sangrador, José L, MSc, Wang, Haidong, PhD, Vos, Theo, Prof, Forouzanfar, Mohammad H, PhD, Naghavi, Mohsen, Prof, Lopez, Alan D, Prof, Murray, Christopher J L, Prof, Lozano, Rafael, Prof
Format:	Article
Language:	eng
Subjects:	Chronic Disease - epidemiology Communicable Diseases - epidemiology Disabled Persons Disease Epidemiology Female Global Burden of Disease - statistics & numerical data Global Health - statistics & numerical data Health Transition Humans Internal Medicine Life Expectancy - trends Male Mexico Mortality Public health Quality-Adjusted Life Years Risk Factors Socioeconomic Factors Studies
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Summary Background Child and maternal health outcomes have notably improved in Mexico since 1990, whereas rising adult mortality rates defy traditional epidemiological transition models in which decreased death rates occur across all ages. These trends suggest Mexico is experiencing a more complex, dissonant health transition than historically observed. Enduring inequalities between states further emphasise the need for more detailed health assessments over time. The Global Burden of Diseases, Injuries, and Risk Factors Study 2013 (GBD 2013) provides the comprehensive, comparable framework through which such national and subnational analyses can occur. This study offers a state-level quantification of disease burden and risk factor attribution in Mexico for the first time. Methods We extracted data from GBD 2013 to assess mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) in Mexico and its 32 states, along with eight comparator countries in the Americas. States were grouped by Marginalisation Index scores to compare subnational burden along a socioeconomic dimension. We split extracted data by state and applied GBD methods to generate estimates of burden, and attributable burden due to behavioural, metabolic, and environmental or occupational risks. We present results for 306 causes, 2337 sequelae, and 79 risk factors. Findings From 1990 to 2013, life expectancy from birth in Mexico increased by 3·4 years (95% uncertainty interval 3·1–3·8), from 72·1 years (71·8–72·3) to 75·5 years (75·3–75·7), and these gains were more pronounced in states with high marginalisation. Nationally, age-standardised death rates fell 13·3% (11·9–14·6%) since 1990, but state-level reductions for all-cause mortality varied and gaps between life expectancy and years lived in full health, as measured by HALE, widened in several states. Progress in women's life expectancy exceeded that of men, in whom negligible improvements were observed since 2000. For many states, this trend corresponded with rising YLL rates from interpersonal violence and chronic kidney disease. Nationally, age-standardised YLL rates for diarrhoeal diseases and protein-energy malnutrition markedly decreased, ranking Mexico well above comparator countries. However, amid Mexico's progress against communicable diseases, chronic kidney disease burden rapidly climbed, with age-standardised YLL and DALY
ISSN:	0140-6736 1474-547X