Social determinants of health in Mexico are factors that influence the status of
health
Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
among certain populations in
Mexico
Mexico (Spanish: México), officially the United Mexican States, is a country in the southern portion of North America. It is bordered to the north by the United States; to the south and west by the Pacific Ocean; to the southeast by Guatema ...
. These factors consist of circumstances in which people grow, live, work, and age, as well as the systems put in place to deal with illnesses.
In Mexico, the health inequality among the population is influenced by such social factors. In the past decade, Mexico has witnessed immense progress within their health care system that has allowed for greater access to health care and a decrease in mortality rate, yet there are still various health inequalities caused by social factors.
Definitions
Social determinants of health are useful when identifying risk factors that affect the health of an individual or group.
Health
Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
is defined as "the overall condition of someone's body or mind". As accessed by the World Health Organization, some major determinants of whether one is healthy or not include "the social and economic environment, the physical environment, and the person's individual characteristics and behaviours".
Social determinants of health, as described by the
World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
, include income and
social status
Social status is the level of social value a person is considered to possess. More specifically, it refers to the relative level of respect, honour, assumed competence, and deference accorded to people, groups, and organizations in a society. Stat ...
,
education
Education is a purposeful activity directed at achieving certain aims, such as transmitting knowledge or fostering skills and character traits. These aims may include the development of understanding, rationality, kindness, and honesty. Va ...
, social support networks,
health services,
gender
Gender is the range of characteristics pertaining to femininity and masculinity and differentiating between them. Depending on the context, this may include sex-based social structures (i.e. gender roles) and gender identity. Most cultures u ...
, employment status and conditions, and race and ethnicity.
[
]
Poverty
In Mexico, poverty is reported using the Multidimensional Poverty Index
Multidimensional Poverty Indices use a range of indicators to calculate a summary poverty figure for a given population, in which a larger figure indicates a higher level of poverty. This figure considers both the proportion of the population that ...
and the Human Development Index
The Human Development Index (HDI) is a statistic composite index of life expectancy, education (mean years of schooling completed and expected years of schooling upon entering the education system), and per capita income indicators, whi ...
. Together, these indicators suggest the overall poverty gradient of Mexico. The government’s social development agency reported a 0.6 percent drop of Mexico’s poverty rate from 2010 to 2012, but there are still 53.3 million people under the poverty line. A major effect of this poverty rate is the continuation of a huge wealth gap. Although there is a huge gap between the top ten percent and the bottom ten percent, Mexico has seen an increase in the percentage of Mexicans who are within the middle-class category.
The poverty within Mexico can be separated into two categories: moderate and extreme. Both categories total to about 45.5 percent of the total population of 117.3 million people. According to El Consejo Nacional de Evaluación de la Política de Desarrollo Social, also known as Coneval, there was a decrease in the percent of the Mexican population in extreme poverty, but an overall increase in the number of people that fall under the poverty line.[ The study showed that the extreme poverty rate fell from 11.3 percent to 9.8 percent, while the moderate poverty rate increased from 34.8 percent to 35.6 percent.
The correlation between poverty and health can be described as a negative relationship in which as poverty increases, health decreases.] With a low income, families do not have the desired access to nutrition, resources, and health care as well as a means to reach these necessities.
Gender
Gender
Gender is the range of characteristics pertaining to femininity and masculinity and differentiating between them. Depending on the context, this may include sex-based social structures (i.e. gender roles) and gender identity. Most cultures u ...
is a major factor that influences the health inequity among the Mexican population. There’s a certain gender bias within general health and specific diseases. Gender inequality
Gender inequality is the social phenomenon in which men and women are not treated equally. The treatment may arise from distinctions regarding biology, psychology, or cultural norms prevalent in the society. Some of these distinctions are empi ...
can be described as “the departure from parity in the representation of women and men in key dimensions of social life.” In Mexico, machismo
Machismo (; ; ; ) is the sense of being " manly" and self-reliant, a concept associated with "a strong sense of masculine pride: an exaggerated masculinity". Machismo is a term originating in the early 1930s and 1940s best defined as hav ...
still affects many parts of the country and the effect that it has on gender roles in a patriarchal society. According to the World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
, a major step towards improving the overall health of the population would be gender empowerment Gender empowerment is the empowerment of people of any gender. While conventionally, the aspect of it is mentioned for empowerment of women, the concept stresses the distinction between biological sex and gender as a role, also referring to other ...
.
According to the 2012 National Survey of Health and Nutrition (ENSANUT), 38 percent of Mexican women aged 20–29 suffer abuses at home with more than 34.9 percent in public. With results like these, Mexico witnesses a huge gender bias that could explain major problems that emerge from within the household as well as those that partake in the work force. In the Mexican work force, women generally receive lower wages than men, even with educational levels taken into consideration. The median wage for female skilled technicians is 97.3 percent of what their male counterparts make, teachers with 97.6 percent, and female industrial supervisors make 68.4 percent of what males make in that same field.[ The gender inequity can be emphasized with the fact that there has not been "a female head of state and has had very few female cabinet members.”][ This explains the "26 percent of equality with men in the political sphere" and that of "42 percent within the economic and legal spheres."][ This gender inequality produces a gender bias that favors men. Women then lack the necessary access to resources such as medical care, transportation, and nutrition.][
]
Education
Level of educational attainment is a major determinant of health in Mexico. More education generally leads to increased income, better employment opportunities, and improved living conditions; these, in turn, lead to improved health.[ The educational system in Mexico has witnessed low enrollment as well as low student-achievement.] According to the United Nations Educational, Scientific, and Cultural Organization (UNESCO) Institute for Statistics, 99% of children are enrolled in pre-primary school. Furthermore, 96% of girls and 95% of boys are in primary school.[ Evaluating data on secondary schools across the nation, only 69% of girls and 66% of boys are enrolled in secondary education.][ The data also shows that 28% of the population of tertiary age are in tertiary education.][
The low enrollment can be correlated with the need for Mexican families to utilize all means to an income and having the whole family seek employment, even at a young age.][ A factor that can affect the low student-achievement is the matter of children lacking focus as a result of nutritional deprivation.][ Health indirectly influences education in the same way that education indirectly influences the health of an individual.
]
Location
Location affects overall health and "chances of leading flourishing lives".[ Location affects the daily living conditions that people endure which in turn affects ]health equity
Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequiti ...
. There are various differences between urban
Urban means "related to a city". In that sense, the term may refer to:
* Urban area, geographical area distinct from rural areas
* Urban culture, the culture of towns and cities
Urban may also refer to:
General
* Urban (name), a list of people ...
and rural
In general, a rural area or a countryside is a geographic area that is located outside towns and cities. Typical rural areas have a low population density and small settlements. Agricultural areas and areas with forestry typically are describ ...
living conditions.[ According to the 2011 Latin American Report on Poverty and Inequality, over the past decade, both national and urban inequality have decreased, yet rural inequality has increased.] World Bank
The World Bank is an international financial institution that provides loans and grants to the governments of low- and middle-income countries for the purpose of pursuing capital projects. The World Bank is the collective name for the Interna ...
data reports that about 61% of those living in rural areas live in extreme poverty.[ The major causes for such social and economic gaps between these two sectors come from "a manifestation of spatially-differentiated patterns of economic development".] A major factor to such disparity is the "absence of rural development policy planning", especially because the "highest public spending on rural development benefits the country’s richest states".[
]
Urban
Urban areas seem to be overpopulated with almost one-third of the population living in four major metropolitan areas-20 million people living in Mexico City
Mexico City ( es, link=no, Ciudad de México, ; abbr.: CDMX; Nahuatl: ''Altepetl Mexico'') is the capital and largest city of Mexico, and the most populous city in North America. One of the world's alpha cities, it is located in the Valley o ...
alone. This major urbanization represents the differences in living standards as well as access to health and social services.
The lack of adequate housing within urbanized cities represents a major problem.
According to research conducted by the Office of Population Research
The Office of Population Research (OPR) at Princeton University is the oldest population research center in the United States. Founded in 1936, the OPR is a leading demographic research and training center. Recent research activity has primarily f ...
at Princeton University, the main causes of mortality in rural areas are infectious diseases and malnutrition. Moreover, chronic disease and other health problems associated with industrialization dominate mortality within urban areas.[ A report from the World Health Organization states that about 32% of the total urban population in Latin America dwell in slums.][ ]Slum
A slum is a highly populated urban residential area consisting of densely packed housing units of weak build quality and often associated with poverty. The infrastructure in slums is often deteriorated or incomplete, and they are primarily inh ...
s do not provide the best access to sufficient living conditions. The same report details "the shift in population levels of weight towards obesity" due to nutrition transition that begins in cities.[
]
Rural
Rural regions in Mexico comprise more than 80% of the land and house around 37 million people (36% of the population). These statistics confirm that Mexico is the country with "the largest population hat livesin predominantly rural areas" within the Organisation for Economic Co-operation and Development
The Organisation for Economic Co-operation and Development (OECD; french: Organisation de coopération et de développement économiques, ''OCDE'') is an intergovernmental organization, intergovernmental organisation with 38 member countries ...
. Additionally, the standards of living in rural populations are much lower than its urban counterpart and the gap is larger than OECD standards. The major drawbacks are the lack of good shelter, adequate drainage, and access to electricity. Within dispersed rural areas, about 68% of the houses had a solid floor, 52% had drainage, yet 87% had electricity.
Malnutrition
In August 2020
2020 was heavily defined by the COVID-19 pandemic, which led to global Social impact of the COVID-19 pandemic, social and Economic impact of the COVID-19 pandemic, economic disruption, mass cancellations and postponements of events, COVID- ...
, Dr. Hugo López-Gatell
Hugo or HUGO may refer to:
Arts and entertainment
* ''Hugo'' (film), a 2011 film directed by Martin Scorsese
* Hugo Award, a science fiction and fantasy award named after Hugo Gernsback
* Hugo (franchise), a children's media franchise based on a ...
, Undersecretary of Health Prevention and Promotion, criticized the poor diet of many Mexicans, emphasizing the need to cut down on or leaving out soft drinks and junk food
"Junk food" is a term used to describe food that is high in calories from sugar and/or fat, and possibly also sodium, but with little dietary fiber, protein, vitamins, minerals, or other important forms of nutritional value. It is also known as ...
. He said that good health is more dependent upon good nutrition than on going to health clinics for medicine, and he called soft drinks "bottled poison."
Dr. Simón Barquera, director of Center for Research of Nutrition and Health of the '' Instituto Nacional de Salud Pública'' (National Public Health Institute, INSP) said that more sugary drinks are consumed than fruits and vegetables. He noted that 75.1% of Mexicans are overweight, and that obesity increases the severity of COVID-19 by 47%. ''“México se encuentra en medio de una sindemia de mala nutrición y COVID-19 que requiere acción inmediata”'' ("Mexico is in the midst of a poorly nutritioned syndemia and COVID-19 that requires immediate action"), he added.
Oaxaca
Oaxaca ( , also , , from nci, Huāxyacac ), officially the Free and Sovereign State of Oaxaca ( es, Estado Libre y Soberano de Oaxaca), is one of the 32 states that compose the political divisions of Mexico, Federative Entities of Mexico. It is ...
and Tabasco
Tabasco (), officially the Free and Sovereign State of Tabasco ( es, Estado Libre y Soberano de Tabasco), is one of the 32 Federal Entities of Mexico. It is divided into 17 municipalities and its capital city is Villahermosa.
It is located in ...
were the first two states to prohibit the sale of soft drinks and junk food to children and teens under 18.
Steps for improvement
In the mid-1990s, the ''Secretaría de Desarrollo Social
The Secretariat of Welfare ( Spanish: ''Secretaría de Bienestar'') is the government department in charge of social development efforts in Mexico. The Secretary of Welfare is a member of the Executive Cabinet, and is appointed at the discretion ...
'' introduced the ''Oportunidades
''Oportunidades'' (English: Opportunities; now rebranded as ''Prospera'') is a government social assistance program in Mexico founded in 2002, based on a previous program called ''Progresa'', created in 1997. '' program (formerly known as PROGRESA), which is a multi-sector policy that brought upon conditional cash transfers. ''Oportunidades'' dispenses money directly to poor households in return the families send their children to school, health services, and provide them with better nutrition by attending classes. Results from a study published in 2004 show that there have been improvements in overall health associated with better
outcomes in child health, growth, and development.
In 2003, Mexico's Congress enacted reforms to Mexico's health legislation that aimed at making health care available nationwide. Mexico's former Minister of Health, Julio Frenk
Julio José Frenk Mora (born December 20, 1953) is president of the University of Miami and has served in this role since 2015. He is the University of Miami's first Hispanic and native Spanish-speaking president. At the University of Miami, he ...
, as the original architect, implemented Seguro Popular which has insured 52.6 million previously-uninsured Mexicans.[
With the implementation of this universal health care, more Mexicans can now access the health services in their community.]
In 2008, the World Health Organization's Commission on Social Determinants of Health developed a plan of action to tackle the problems that social determinants of health have on health equity. The recommendations consist of "improving daily living conditions, tackle the inequitable distribution of power, money, and resources, and measure and understand the problem and assess the impact of action."[
]
See also
* Healthcare in Mexico
Healthcare in Mexico is provided by public institutions run by government departments, private hospitals and clinics, and private physicians. It is largely characterized by a special combination of coverage mainly based on the employment status ...
References
{{Mexico topics
Health in Mexico
Determinants of health
Social problems in medicine