Growing Pains: The Epidemiological Transition In Mexico

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Article Date: 17 Jun 2008 - 0:00 PST

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The south of Mexico has the highest levels of infectious and nutritional disease, injuries, and non-communicable diseases, according to a study released on June 16, 2008 in the open access journal PLoS Medicine.

In this study, Gretchen Stevens of Harvard University, Boston, MA, USA, and the WHO, Geneva, Switzerland, and colleagues estimated the number of deaths and losses of healthy life caused by a number of various diseases and injuries in Mexico. These were calculated in cooperation with Mexico's National Institute of Public Health, and based on data from death registers, censuses, health examination surveys, and various epidemiological studies.

The loss of healthy life years was compared to actual deaths using a standard metric called the "disability-adjusted life year" or DALY. One DALY is equivalent to the loss of a single year of health life because of premature death or disability. DALYs were calculated, along with major risk factors for diseases and injuries across the country.

Nationally, 75% of all deaths and 68% of all DALYs are caused by non-communicable diseases, in particular heart disease, diabetes, stroke, and cirrhosis of the liver. 14% of deaths and 18% of DALYs were in turn caused by undernutrition, infectious diseases, and problems occurring in mothers and infants at the time of birth. The leading risk factors for disease were overweight status, high blood glucose, and alcohol consumption.

When comparing different regions of the country in an analysis called the "subnational burden of disease study," it was found that Mexico City had the lowest death rate in the country. In contrast, the largely undeveloped southern region of Mexico had the highest loss of life, especially in young children. For instance, Chiapas, the state of Mexico that is the furthest south, undernutrition and infectious, maternal, and perinatal diseases were responsible for almost one-third of all DALYs. The southern regions additionally had the highest noncommunicable disease and injury burden per capita.

The "epidemiological transition" is the shift in disease pattern as a poor country becomes richer, away from infectious diseases and malnutrition and toward noncommunicable diseases. In this study, it became clear that Mexico is a nation at an involved stage of this transition, as its improved economic status shifts the disease burden towards these diseases that are neither infectious nor related to undernutrition. However, liver cirrhosis and diabetes, with their corresponding alcohol use, overweight and obesity levels, and high blood glucose are extremely important in describing Mexico's health burden. In the poorest parts of the country, the population is lagging behind in the epidemiological transition.

Martin Tobias, from the New Zealand Ministry of Health, commented on this study's example as a basis for analysis of other countries: "Mexico has taken the lead in demonstrating how subnational burden of studies can be done and how their output can be used to inform policy. Other countries would benefit from adopting a similar approach."

About PLoS Medicine

PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit http://www.plosmedicine.org.

About the Public Library of Science

The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world's scientific and medical
literature a freely available public resource. For more information, visit http://www.plos.org.

Characterizing the epidemiological transition in Mexico: National and subnational burden of diseases, injuries, and risk factors.
Stevens G, Dias RH, Thomas KJA, Rivera JA, Carvalho N, et al.
PLoS Med 5(6): e125.
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Written by Anna Sophia McKenney
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