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  • 1
    Online Resource
    Online Resource
    Respuesta a la carta al editor “El análisis de las desigualdades en salud”
    Instituto Nacional de Salud Publica ; 2018
    In:  Salud Pública de México Vol. 60, No. 5, sep-oct ( 2018-09-07), p. 496-
    Details
    In: Salud Pública de México, Instituto Nacional de Salud Publica, Vol. 60, No. 5, sep-oct ( 2018-09-07), p. 496-
    Abstract: [No disponible]
    Type of Medium: Online Resource
    ISSN: 1606-7916 , 0036-3634
    URL: Article
    DOI: 10.21149/9393
    Language: Unknown
    Publisher: Instituto Nacional de Salud Publica
    Publication Date: 2018
    detail.hit.zdb_id: 2060310-1
    SSG: 7,36
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  • 2
    Online Resource
    Online Resource
    Comprehensive Evaluation of the Impact of Sociodemographic Inequalities on Adverse Outcomes and Excess Mortality During the Coronavirus Disease 2019 (COVID-19) Pandemic in Mexico City
    Oxford University Press (OUP) ; 2022
    In:  Clinical Infectious Diseases Vol. 74, No. 5 ( 2022-03-09), p. 785-792
    Details
    In: Clinical Infectious Diseases, Oxford University Press (OUP), Vol. 74, No. 5 ( 2022-03-09), p. 785-792
    Abstract: The impact of the coronavirus disease 2019 (COVID-19) pandemic in Mexico City has been sharp, as several social inequalities at all levels coexist. Here we conducted an in-depth evaluation of the impact of individual and municipal-level social inequalities on the COVID-19 pandemic in Mexico City. Methods We analyzed suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases, from the Mexico City Epidemiological Surveillance System from 24 February 2020 to 31 March 2021. COVID-19 outcomes included rates of hospitalization, severe COVID-19, invasive mechanical ventilation, and mortality. We evaluated socioeconomic occupation as an individual risk, and social lag, which captures municipal-level social vulnerability, and urban population density as proxies of structural risk factors. Impact of reductions in vehicular mobility on COVID-19 rates and the influence of risk factors were also assessed. Finally, we assessed discrepancies in COVID-19 and non-COVID-19 excess mortality using death certificates from the general civil registry. Results We detected vulnerable groups who belonged to economically unfavored sectors and experienced increased risk of COVID-19 outcomes. Cases living in marginalized municipalities with high population density experienced greater risk for COVID-19 outcomes. Additionally, policies to reduce vehicular mobility had differential impacts modified by social lag and urban population density. Finally, we report an under-registry of COVID-19 deaths along with an excess mortality closely related to marginalized and densely populated communities in an ambulatory setting. This could be attributable to a negative impact of modified hospital admission criteria during the pandemic. Conclusions Socioeconomic occupation and municipality-wide factors played a significant role in shaping the course of the COVID-19 pandemic in Mexico City.
    Type of Medium: Online Resource
    ISSN: 1058-4838 , 1537-6591
    URL: Article
    DOI: 10.1093/cid/ciab577
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2002229-3
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  • 3
    Online Resource
    Online Resource
    Socio-demographic inequalities and excess non-COVID-19 mortality during the COVID-19 pandemic: a data-driven analysis of 1 069 174 death certificates in Mexico
    Oxford University Press (OUP) ; 2022
    In:  International Journal of Epidemiology Vol. 51, No. 6 ( 2022-12-13), p. 1711-1721
    Details
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 51, No. 6 ( 2022-12-13), p. 1711-1721
    Abstract: In 2020, Mexico experienced one of the highest rates of excess mortality globally. However, the extent of non-COVID deaths on excess mortality, its regional distribution and the association between socio-demographic inequalities have not been characterized. Methods We conducted a retrospective municipal and individual-level study using 1 069 174 death certificates to analyse COVID-19 and non-COVID-19 deaths classified by ICD-10 codes. Excess mortality was estimated as the increase in cause-specific mortality in 2020 compared with the average of 2015–2019, disaggregated by primary cause of death, death setting (in-hospital and out-of-hospital) and geographical location. Correlates of individual and municipal non-COVID-19 mortality were assessed using mixed effects logistic regression and negative binomial regression models, respectively. Results We identified a 51% higher mortality rate (276.11 deaths per 100 000 inhabitants) compared with the 2015–2019 average period, largely attributable to COVID-19. Non-COVID-19 causes comprised one-fifth of excess deaths, with acute myocardial infarction and type 2 diabetes as the two leading non-COVID-19 causes of excess mortality. COVID-19 deaths occurred primarily in-hospital, whereas excess non-COVID-19 deaths occurred in out-of-hospital settings. Municipal-level predictors of non-COVID-19 excess mortality included levels of social security coverage, higher rates of COVID-19 hospitalization and social marginalization. At the individual level, lower educational attainment, blue-collar employment and lack of medical care assistance prior to death were associated with non-COVID-19 deaths. Conclusion Non-COVID-19 causes of death, largely chronic cardiometabolic conditions, comprised up to one-fifth of excess deaths in Mexico during 2020. Non-COVID-19 excess deaths occurred disproportionately out-of-hospital and were associated with both individual- and municipal-level socio-demographic inequalities.
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    URL: Article
    DOI: 10.1093/ije/dyac184
    RVK:
    XF 4100
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 1494592-7
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  • 4
    Online Resource
    Online Resource
    Desnutrición crónica en escolares: itinerarios de desatención nutricional y programas oficiales en comunidades indígenas de Guerrero, México
    Universidad Nacional de Lanus ; 2016
    In:  Salud Colectiva Vol. 12, No. 4 ( 2016-12-19), p. 551-
    Details
    In: Salud Colectiva, Universidad Nacional de Lanus, Vol. 12, No. 4 ( 2016-12-19), p. 551-
    Abstract: 〈 p 〉 En este texto se analizan diversos elementos de la dinámica nutricional de un municipio predominantemente indígena de Guerrero, México, con el propósito de explorar la pertinencia del concepto de 〈 em 〉 itinerarios de desatención nutricional 〈 /em 〉 para ampliar la comprensión del daño evitable a la salud. En el marco de un proceso de acompañamiento a la Comisión de Salud de la Coordinadora Regional de Autoridades Comunitarias - Policía Comunitaria, en el transcurso del año 2015, se aplicaron los siguientes recursos metodológicos: a) revisión de programas oficiales mediante consulta de documentos técnicos y entrevistas con personal sanitario; b) obtención de narrativas locales en familias de niños desnutridos, mediante entrevistas y observación participante; c) realización de somatometría en 151 menores en tres escuelas primarias de la región. Se resalta la inadecuación técnica y cultural de los programas oficiales de atención a la desnutrición y la existencia de distintas escalas (individual, familiar, comunitaria, estatal, estructural) y dimensiones (económica, ambiental, cultural, institucional, afectivo-emocional) de desatención, materializadas en altos índices de desnutrición crónica. 〈 /p 〉
    Type of Medium: Online Resource
    ISSN: 1851-8265 , 1669-2381
    URL: Article
    DOI: 10.18294/sc.2016.917
    Language: Unknown
    Publisher: Universidad Nacional de Lanus
    Publication Date: 2016
    detail.hit.zdb_id: 2394313-0
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  • 5
    Online Resource
    Online Resource
    Assessing the Burden of Coronavirus Disease 2019 (COVID-19) Among Healthcare Workers in Mexico City: A Data-Driven Call to Action
    Oxford University Press (OUP) ; 2021
    In:  Clinical Infectious Diseases Vol. 73, No. 1 ( 2021-07-01), p. e191-e198
    Details
    In: Clinical Infectious Diseases, Oxford University Press (OUP), Vol. 73, No. 1 ( 2021-07-01), p. e191-e198
    Abstract: Healthcare workers (HCWs) could be at increased occupational risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections due to increased exposure. Information regarding the burden of coronavirus disease 2019 (COVID-19) epidemic in HCWs living in Mexico is scarce. Here, we aimed to explore the epidemiology, symptoms, and risk factors associated with adverse outcomes in HCWs in Mexico City. Methods We explored data collected by the National Epidemiological Surveillance System in Mexico City, in HCWs who underwent real-time reverse transcription polymerase chain reaction (RT-PCR) test. We explored COVID-19 outcomes in HCWs and the performance of symptoms to detect SARS-CoV-2 infection. Results As of 20 September 2020, 57 758 HCWs were tested for SARS-CoV-2 and 17 531 were confirmed (30.35%); 6610 were nurses (37.70%), 4910 physicians (28.0%), 267 dentists (1.52%), and 5744 laboratory personnel and other HCWs (32.76%). Overall, 2378 HCWs required hospitalization (4.12%), 2648 developed severe COVID-19 (4.58%), and 336 required mechanical-ventilatory support (.58%). Lethality was recorded in 472 (.82%) cases. We identified 635 asymptomatic SARS-CoV-2 infections (3.62%). Compared with general population, HCWs had higher incidence, testing, asymptomatic cases, and mortality rates. No individual symptom offers adequate performance to detect SARS-CoV2. Older HCWs with chronic noncommunicable diseases and severe respiratory symptoms were associated with higher risk for adverse outcome; physicians were at higher risk compared with nurses and other HCWs. Conclusions We report a high prevalence of SARS-CoV-2 infection in HCWs in Mexico City. Symptoms as a screening method are not efficient to discern those HCWs with a positive PCR-RT test. Particular attention should focus on HCWs with risk factors to prevent adverse outcomes.
    Type of Medium: Online Resource
    ISSN: 1058-4838 , 1537-6591
    URL: Article
    DOI: 10.1093/cid/ciaa1487
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2002229-3
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  • 6
    Online Resource
    Online Resource
    Inequidades en la mortalidad materna en México: un análisis de la desigualdad a escala subestatal
    Instituto Nacional de Salud Publica ; 2017
    In:  Salud Pública de México Vol. 59, No. 6, nov-dic ( 2017-10-23), p. 639-
    Details
    In: Salud Pública de México, Instituto Nacional de Salud Publica, Vol. 59, No. 6, nov-dic ( 2017-10-23), p. 639-
    Abstract: Objetivo. Estimar la razón de mortalidad materna (RMM) de las distintas regiones subestatales del país, para identificar aquellas con mayores índices, así como el grado de desigualdad interregional. Material y métodos. De bases de datos oficiales y públicamente disponibles, se tomaron los datosde muerte materna y de recién nacidos registrados, de 2005 a 2014. Se realizó una regionalización a partir de divisiones político-administrativas de cada estado y se calculó la RMM para las mismas, así como los coeficientes Gini. Resultados. La RMM por región subestatal varía de 16 (en Nuevo Leónno metropolitano) a 160 (en Sola de Vega, Oaxaca); asimismo, se identificaron 13 regiones de muy alta o extremadamente alta mortalidad materna. El coeficiente Gini nacional es de 0.175; destacan Chihuahua, Nayarit, Oaxaca y Guerrero como estados con una distribución muy desigual de la mortalidad materna. Conclusiones. Los promedios estatales de mortalidad materna ocultan importantes desigualdades al interior de los estados, reflejo de múltiples inequidades subyacentes.
    Type of Medium: Online Resource
    ISSN: 1606-7916 , 0036-3634
    URL: Article
    DOI: 10.21149/8788
    Language: Unknown
    Publisher: Instituto Nacional de Salud Publica
    Publication Date: 2017
    detail.hit.zdb_id: 2060310-1
    SSG: 7,36
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