{"id":167820,"date":"2025-02-19T00:06:21","date_gmt":"2025-02-19T06:06:21","guid":{"rendered":"https:\/\/tecscience.tec.mx\/en\/?post_type=sciencecommunication&p=167820"},"modified":"2025-02-19T00:06:39","modified_gmt":"2025-02-19T06:06:39","slug":"socioeconomic-inequality-diabetes-prevalence","status":"publish","type":"sciencecommunication","link":"https:\/\/tecscience.tec.mx\/en\/science-communication\/socioeconomic-inequality-diabetes-prevalence\/","title":{"rendered":"Hidden Inequities in Diabetes and Hypertension Care in Mexico"},"content":{"rendered":"\n


By Linda Morales<\/a>, David Contreras Loya<\/a> and H\u00e9ctor Arreola Ornelas<\/a><\/p>\n\n\n\n

In Mexico, diabetes and hypertension represent significant public health challenges, magnified by socioeconomic inequalities. <\/p>\n\n\n\n

This article delves into the prevalence of these diseases across different socioeconomic groups, underscoring the need for a comprehensive approach to health policies.<\/p>\n\n\n\n

Diabetes mellitus and hypertension are two of the most pressing public health issues in contemporary Mexico. These conditions are deeply connected to social determinants of health, as evidenced by recent findings from the 2022 National Health and Nutrition Survey (ENSANUT) [1] and the 2019 Global Burden of Disease Study (GBD) [2].<\/p>\n\n\n\n

\r\n \r\n \"Percentage\r\n <\/picture>
Percentage Distribution of Type 2 Diabetes Diagnosis by Sociodemographic Characteristics and Health Conditions in the Mexican Population, ENSANUT 2022 <\/em><\/figcaption><\/figure>\n\n\n\n

Unaware condition<\/h2>\n\n\n\n

ENSANUT 2022 reveals alarming statistics: the national prevalence of diabetes reached 18.3%, with one-third of affected individuals unaware of their condition [3]<\/strong>. Self-reported hypertension stands at 15.9%, with 31.9% of cases undiagnosed.\u00a0<\/p>\n\n\n\n

Nearly half the Mexican population (47.8%) faces elevated blood pressure levels<\/strong>.<\/p>\n\n\n\n

\r\n \r\n \"\"\r\n <\/picture>
Percentage Distribution of Type 2 Diabetes Control (HbA1c* <7%) by Sociodemographic Characteristics and Health Conditions in the Mexican Population, ENSANUT 2022 (*HbA1c: Glycated Hemoglobin Test)<\/em><\/figcaption><\/figure>\n\n\n\n

The prevalence of diabetes and hypertension varies significantly with educational attainment and employment status. <\/p>\n\n\n\n

ENSANUT 2022 data shows diabetes affects 20.7% of individuals without formal education, compared to 9.3% of those with higher education<\/strong>. <\/p>\n\n\n\n

Similarly, hypertension is more prevalent among the less educated (31.3%) than their more educated counterparts (13.5%). These data highlight the link between education and chronic diseases.<\/strong><\/p>\n\n\n\n

Employment status also plays a critical role: hypertension impacts 24.1% of unemployed individuals versus 11% of the employed<\/strong>. Household income levels further highlight disparities, with hypertension affecting 24.9% of low-income households compared to 12.1% in higher-income households<\/strong>.<\/p>\n\n\n\n

Interestingly, individuals without social security report a lower prevalence of hypertension (13%) compared to those with coverage (18.2%), likely reflecting differences in diagnostic access. Alarmingly, the proportion of Mexicans without access to healthcare services surged from 16.2% in 2018 to 39.1% in 2022, representing an increase from 20.1 million to 50.4 million individuals. [5]<\/p>\n\n\n\n

\r\n \r\n \"\"\r\n <\/picture>
Percentage Distribution of Hypertension Diagnosis by Sociodemographic Characteristics and Health Conditions in the Mexican Population, ENSANUT 2022.<\/em><\/figcaption><\/figure>\n\n\n\n

Impact on Mortality and Morbidity<\/strong><\/h2>\n\n\n\n

Diabetes and hypertension not only diminish the quality of life but also significantly impact mortality and morbidity. In 2019, diabetes accounted for 59.1 deaths per 100,000 people, an 88.7% increase <\/strong>since 1990. <\/p>\n\n\n\n

Age-standardized mortality rates for diabetes were 65.41 per 100,000, with a slight 0.67% decline over 29 years. <\/p>\n\n\n\n

Diabetes is also the leading cause of age-standardized Years Lived with Disability (YLDs, by its English acronym), with 927.59 YLDs per 100,000 inhabitants. <\/strong>It also tops the list for Disability-Adjusted Life Years (DALYs), totaling 2,328.32 years lived with disability per 100,000 people [2].<\/p>\n\n\n\n

Hypertension’s toll is similarly grave, causing 118.4 deaths per 100,000 in 2019. It contributed to 2,200.88 Years of Life Lost (YLLs) per 100,000 nationally, <\/strong>underscoring its substantial mortality impact. <\/p>\n\n\n\n

Total DALYs due to hypertension reached 2,455.8 per 100,000, reflecting its critical public health burden [2].<\/p>\n\n\n\n

\r\n \r\n \"\"\r\n <\/picture>
Percentage Distribution of Hypertension Control by Sociodemographic Characteristics and Health Conditions in the Mexican Population, ENSANUT 2022.<\/em><\/figcaption><\/figure>\n\n\n\n

The Need for Targeted Interventions<\/strong><\/h2>\n\n\n\n

The high prevalence of undiagnosed and poorly controlled cases underscores the urgency of enhancing detection and treatment strategies. Although treatment rates for diabetes and hypertension are relatively high (86.7% and 82.3%, respectively), control rates remain alarmingly low at 36.1% and 33.7%.<\/p>\n\n\n\n

An integrated approach addressing the social and economic determinants of health is crucial. <\/p>\n\n\n\n

This includes socioeconomic interventions, educational campaigns, and improved access to medical care. Policymaking that tackles these disparities can enhance the detection, prevention, and management of diabetes and hypertension nationwide.<\/p>\n\n\n\n

Equity in Healthcare<\/strong><\/h2>\n\n\n\n

The data analyzed highlights the pressing need to reassess Mexico\u2019s healthcare model for managing diabetes and hypertension. A holistic, equitable approach is essential to reduce socioeconomic disparities and improve public health services.<\/p>\n\n\n\n

Recent initiatives leveraging recommended systems and artificial intelligence in primary care to improve diagnosis and treatment are promising steps. However, barriers to large-scale adoption must be addressed.<\/p>\n\n\n\n

Mexico\u2019s health policies must prioritize equity in healthcare access and strengthen primary care. Achieving this requires robust early detection programs, expanded health insurance coverage, and community interventions targeting social and economic determinants of health. <\/p>\n\n\n\n

Additionally, establishing monitoring and evaluation mechanisms is critical to timely and effective adjustments, ensuring better control of diabetes and hypertension in the country.<\/p>\n\n\n\n

References<\/strong><\/p>\n\n\n\n

1. Lazcano-Ponce EC, Shamah-Levy T. Encuesta Nacional de Salud y Nutrici\u00f3n Continua 2022: recomendaciones de pol\u00edtica p\u00fablica<\/a>. Salud P\u00fablica de M\u00e9xico<\/em>. 2023;65:s268-s274.<\/p>\n\n\n\n

2. Institute for Health Metrics and Evaluation. GBD Compare Data Visualization.<\/a> Seattle, WA: IHME, University of Washington<\/em>. <\/p>\n\n\n\n

3. Escamilla-N\u00fa\u00f1ez MC, Castro-Porras L, Romero-Mart\u00ednez M, Z\u00e1rate-Rojas E, Rojas-Mart\u00ednez R. Detecci\u00f3n, diagn\u00f3stico previo y tratamiento de enfermedades cr\u00f3nicas no transmisibles en adultos mexicanos.<\/a> Ensanut 2022. Salud P\u00fablica de M\u00e9xico<\/em>. Published online 2023:1-10.<\/p>\n\n\n\n

4. Campos-Nonato I, Oviedo-Sol\u00eds C, Vargas-Meza J, et al. Prevalencia, tratamiento y control de la hipertensi\u00f3n arterial en adultos mexicanos: resultados de la Ensanut 2022<\/a>. Salud P\u00fablica de M\u00e9xico<\/em>. 2023;65:1-12.<\/p>\n\n\n\n

5. Consejo Nacional de Evaluaci\u00f3n de la Pol\u00edtica de Desarrollo Social (CONEVAL). EL CONEVAL PRESENTA LAS ESTIMACIONES DE POBREZA MULTIDIMENSIONAL 2022 [COMUNICADO No. 7].<\/em><\/a> CONEVAL.<\/em>; 2023.<\/p>\n\n\n\n

6. Basto-Abreu A, L\u00f3pez-Olmedo N, Rojas-Mart\u00ednez R, et al. Prevalencia de prediabetes y diabetes en M\u00e9xico: Ensanut 2022<\/a>. Salud P\u00fablica de M\u00e9xico<\/em>. Published online 2023:1-6.<\/p>\n\n\n\n

7. Knaul FM, Bhadelia A, Atun R, Frenk J. Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses. <\/a>Health Affairs<\/em>. 2015;34(9):1514-1522. <\/p>\n\n\n\n

8. Mackenzie SC, Sainsbury CAR, Wake DJ. Diabetes and artificial intelligence beyond the closed loop: a review of the landscape, promise and challenges.<\/a> Diabetologia<\/em>. 2024;67(2):223-235. <\/p>\n\n\n\n


Autors<\/strong><\/p>\n\n\n\n

Linda Morales<\/strong>. A medical doctor from Universidad Veracruzana with a master\u2019s and Ph.D. in Epidemiological Sciences from the National Institute of Health. Since 2017, she has collaborated with the Global Burden of Disease and is a member of the Regional Network for Establishing Health Priorities in the 21st Century. She is currently a postdoctoral researcher at the Public Policy Unit of the\u00a0Institute for Obesity Research<\/a>\u00a0at Tecnol\u00f3gico de Monterrey.<\/p>\n\n\n\n

David Contreras Loya<\/strong>. Professor and researcher at the School of Government and Public Transformation at Tecnol\u00f3gico de Monterrey<\/a>, affiliated with the Institute for Obesity Research. His work focuses on management, productivity, and skill transfer in health and education in low- and middle-income countries. He has researched topics such as diabetes, hypertension, obesity, and HIV in Mexico. Currently, he leads a pilot study on healthy environments in elementary schools in Mexico and teaches quantitative methods and health economics at the graduate level.<\/p>\n\n\n\n

H\u00e9ctor Arreola Ornelas<\/strong>. Economist from Instituto Tecnol\u00f3gico Aut\u00f3nomo de M\u00e9xico. He holds an MBA in Health Economics from the Center for Research and Teaching in Economics and the National Institute of Public Health. He is a research professor at the Public Policy Unit of the Institute for Obesity Research<\/a> and the School of Government and Public Transformation at Tecnol\u00f3gico de Monterrey<\/a>. He is also a visiting professor at the Institute for Advanced Studies of the Americas at the University of Miami and the Executive Director of T\u00f3matelo a Pecho A.C.<\/p>\n\n\n\n

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