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# Contribution of socioeconomic factors and health care access to the awareness and treatment of diabetes and hypertension among older Mexican adults Translated title: Contribución de los factores socioeconómicos y de acceso a servicios médicos en el autorreporte y el tratamiento de diabetes e hipertensión en adultos mayores en México

Salud Pública de México

Instituto Nacional de Salud Pública

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### Abstract

Objective. To estimate changes in self-report and treatment of diabetes and hypertension between 2001 and 2012 among Mexican aged 50-80, assessing the contribution of education and health insurance coverage. Materials and methods. The Mexican Health and Aging Study was used to estimate associations of education and insurance on prevalence and treatment of diabetes and hypertension in 2001 and 2012. Multivariate decomposition was used to assess the contribution of changes in the composition of covariates vs. their "effects" on changes in prevalence and treatment over time. Results. Increases in the prevalence/diagnosis and treatment during the period are largely attributable to the expansion of health insurance. Its effects on diagnosis/prevalence and treatment have also increased over time. Conclusions. The expansion of Seguro Popular likely improved screening and treatment. More research is needed to assess if these have translated into better control and a lower burden of disease.

### Translated abstract

Objetivo. Estimar cambios en el autorreporte y en el tratamiento de diabetes e hipertensión en adultos de entre 50 y 80 años en México, en 2001 y 2012, y explicarlos en función de los sufridos en cuanto a composición educativa y de cobertura/derechohabiencia en servicios de salud. Material y métodos. Se utilizó la Encuesta Nacional de Salud y Envejecimiento en México y técnicas de descomposición multivariada. Resultados. El incremento en la prevalencia/ diagnóstico y tratamiento durante el periodo se debe en gran medida al aumento en la cobertura de servicios de salud. Los "efectos" de la cobertura también se incrementaron de forma importante. Conclusiones. La expansión del Seguro Popular probablemente tuvo un papel importante en la detección y tratamiento de la diabetes e hipertensión. Investigaciones futuras discernirán si dicha expansión se ha traducido en un mejor control y una menor carga de morbilidad.

### Most cited references41

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### The quest for universal health coverage: achieving social protection for all in Mexico.

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### Epidemiological and nutritional transition in Mexico: rapid increase of non-communicable chronic diseases and obesity.

(2002)
The objective of this paper is to characterise the epidemiological and nutritional transition and their determinants in Mexico. Age-adjusted standardised mortality rates (SMRs) due to acute myocardial infarction (AMI), diabetes mellitus and hypertension were calculated for 1980-1998. Changes in the prevalences of overweight and obesity in women and children and of dietary intake from 1988 to 1999 were also used in the analysis. Quantities of food groups purchased by adult equivalent (AE) and food expenditures away from home between 1984 and 1989 were used to assess trends. All information was analysed at the national and regional levels, and by urban and rural areas. SMR for diabetes, AMI and hypertension increased dramatically parallel to obesity at the national and regional levels. Fat intake in women and the purchase of refined carbohydrates, including soda, also increased. The results suggest that obesity is playing a role in the increased SMRs of diabetes, AMI and hypertension in Mexico. Total energy dietary intake and food purchase data could not explain the rise in the prevalence of obesity. The increases in fat intake and the purchase of refined carbohydrates may be risk factors for increased mortality. Information on physical activity was not available. SMRs due to diabetes, hypertension and AMI have increased dramatically in parallel with the prevalence of obesity; therefore actions should be taken for the prevention of obesity. Reliable information about food consumption and physical activity is required to assess their specific roles in the aetiology of obesity.
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### Diabetes in Mexico: cost and management of diabetes and its complications and challenges for health policy

Background Mexico has been experiencing some of the most rapid shifts ever recorded in dietary and physical activity patterns leading to obesity. Diabetes mellitus has played a crucial role causing nearly 14% of all deaths. We wanted to make a comprehensive study of the role of diabetes in terms of burden of disease, prevalence, cost of diabetes, cost of complications and health policy. Method We review the quantitative data that provides evidence of the extent to which the Mexican health economy is affected by the disease and its complications. We then discuss the current situation of diabetes in Mexico with experts in the field. Results There was a significant increase in the prevalence of diabetes from 1994 to 2006 with rising direct costs (2006: outpatient USD$717,764,787, inpatient USD$ 223,581,099) and indirect costs (2005: USD$177,220,390), and rising costs of complications (2010: Retinopathy USD$ 10,323,421; Cardiovascular disease USD$12,843,134; Nephropathy USD$ 81,814,501; Neuropathy USD$2,760,271; Peripheral vascular disease USD$ 2,042,601). The health policy focused on screening and the creation of self-support groups across the country. Conclusions The increasing diabetes mortality and lack of control among diagnosed patients make quality of treatment a major concern in Mexico. The growing prevalence of childhood and adult obesity and the metabolic syndrome suggest that the situation could be even worse in the coming years. The government has reacted strongly with national actions to address the growing burden posed by diabetes. However our research suggests that the prevalence and mortality of diabetes will continue to rise in the future.
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### Author and article information

###### Contributors
Role: ND
Role: ND
Role: ND
###### Journal
spm
Salud Pública de México
Salud pública Méx
Instituto Nacional de Salud Pública (Cuernavaca )
0036-3634
2015
: 57
: suppl 1
: s06-s14
###### Affiliations
[2 ] University of Illinois at Urbana-Champaign Estados Unidos de América
S0036-36342015000700003

###### Product
Product Information: SciELO Mexico
###### Categories
Health Policy & Services

Public health