Around 26 million Mexican adults—one in three—face structural vulnerability, a condition associated with a higher likelihood of experiencing functional limitations. That is the finding of a study conducted by researchers at Tecnológico de Monterrey, who developed a new tool using data from the 2022 National Health and Nutrition Survey (ENSANUT).
The Structural Health Vulnerability Index (SHVI) combines three dimensions: educational deprivation, lack of social security coverage, and material poverty.
Parminder Kaur, the study’s lead author, researcher, and professor at the School of Humanities and Education, explains: “Previous studies have typically examined education, socioeconomic status, and access to social protection separately. In real life, however, people experience these challenges simultaneously.”
What Are Functional Limitations, and Why Does Understanding Them Matter?
Functional limitations are difficulties performing everyday activities independently because of physical, sensory, or cognitive impairments.
To assess functional limitations, the researchers used the Washington Group Short Set (WG-SS), a standardized questionnaire that measures difficulties with seeing, hearing, walking, remembering or concentrating, communicating, and self-care.
The team analyzed a sample of 11,805 Mexican adults from the 2022 ENSANUT, representing an estimated 84.73 million Mexicans aged 20 and older. Based on the SHVI, the researchers estimated that about 31% of this population—roughly 26 million people—experience two or three of the deprivations included in the index.
The study was a collaboration between Kaur, a professor at the School of Humanities and Education (EHE), Jatinder Jit Singh, a researcher at EGADE Business School, and José Mauricio Argüelles, a professor at the School of Social Sciences and Government.
“The government already measures who lives in poverty,” Kaur says, “but it does not measure how people experience poverty or what its consequences may be.”
Researchers Identify a Pattern Linking Rising Structural Deprivation to Functional Limitations
To develop the index, the research team drew on the Alkire-Foster counting methodology, which Mexico’s National Council for the Evaluation of Social Development Policy (CONEVAL) also uses to measure multidimensional poverty.
The method considers the accumulation of multiple social deprivations beyond income alone. The researchers adapted this approach to examine how the buildup of these disadvantages is associated with a greater risk of developing functional limitations.
The team identified a clear pattern: as structural deprivations increased, so did the likelihood of experiencing functional limitations. The share of people with these limitations rose from 6.3% among those with no deprivations to 17.7% among those experiencing all three.
Another key finding was that these effects do not appear equally across all age groups. Among younger adults, the health impacts of these deprivations are relatively subtle. They become more apparent during middle age—between 40 and 59 years old—and grow even stronger as people enter older adulthood.
“When we’re young, our bodies are resilient. Even when we face disadvantages, those problems often don’t show up,” Kaur explains. “But by middle age, if they haven’t been addressed, and people lack the resources, awareness, or support to deal with them, their health begins to decline.”
Middle Age: A Critical Window for Preventing Health Decline
Kaur says the findings highlight middle age as a crucial stage for prevention. She argues that this is the period when governments should focus their efforts on identifying vulnerable populations and implementing programs that reduce structural deprivations before they develop into serious health problems.
The study also found differences between men and women. Although the increase in risk associated with structural vulnerability was similar for both sexes, women started with a higher baseline prevalence of functional limitations.
Among the sample analyzed, 11.5% of women reported at least one functional limitation, compared with 8% of men.
“This clearly shows that women are more vulnerable, but that does not mean men are not vulnerable,” Kaur explains. “Women start from a higher baseline of vulnerability.”
According to the study, this disparity may be linked to gender-related factors such as unpaid domestic and caregiving work, reproductive health, and other inequalities that women face throughout their lives.
Educational Disadvantage Is the Strongest Predictor of Functional Limitations
Of the three dimensions analyzed, educational disadvantage was the strongest predictor of the risk of developing functional limitations. According to the researchers, higher levels of education improve access to formal employment and social security benefits, while also enhancing health literacy and encouraging timely use of medical care.
“Completing secondary school is not just an economic investment; it is also a strategy for preventing disability,” Kaur says.
Based on these findings, Kaur argues that programs such as those offered by Mexico’s National Institute for Adult Education (INEA) should also be viewed as public health and healthy aging initiatives.
She also proposes that institutions such as CONEVAL and the National Institute of Public Health link their databases to make it easier to identify people facing the greatest structural vulnerability and to evaluate how effectively social programs reduce the risk of functional limitations.
“If the government identifies this population using the tool we propose, it can provide them with the support they need,” Kaur says.
For Kaur, the SHVI’s greatest value lies in its ability to leverage data the government already collects to identify people facing the highest levels of structural vulnerability and to guide public policies and prevention programs before functional limitations emerge.
Did you find this story interesting? Would you like to publish it? Contact our content editor for more information: marianaleonm@tec.mx
