US migration history and depressive symptoms among older mexican adults.

OBJECTIVE: To explore the association between US migration, chronic conditions (diabetes, stroke, heart attack, cancer, and hypertension), and mental health (depressive symptoms, and depression). MATERIALS AND METHODS: We assessed average changes in depressive symptom scores as well as depression over time and their link with migration experience controlling for health and sociodemographic factors among older Mexican adults (50+) using 2012, 2015, and 2018 waves of the Mexican Health and Aging Study (MHAS). RESULTS: Non-migrants had higher average depressive symptom scores and prevalence of depression (5+ score) in 2012 and 2015, but there was no significant difference in either measure in 2018 or on changes over time. CONCLUSION: Although there were no significant differences in average depressive symptoms and depression over time by migration history, this study highlights some differences in 2012 and 2015. Comparing groups across migration histories allowed the researchers to examine how life course differences impact mental health outcomes.

The Impact of Education and Insurance Status on Past-Year Dental Visits Among Older Mexican Adults: Results From the 2001 and 2012 Mexican Health and Aging Study.

Objective: This study assessed past-year dental visits among older Mexican adults from the Mexican Health and Aging Study (MHAS). MHAS is a nationally representative cohort study of adults 50 years and older from Mexico. Methods: Baseline data from 2001 were compared with 2012 data. Binary logistic regression identified significant predictors of past-year dental visits. Decomposition techniques examined factors that contributed to changes in dental visits between 2001 and 2012. Results: Education and insurance status were positively associated with past-year dental visits, while decomposition results showed that population composition (more adults receiving insurance and higher education over time) contributed to the increased prevalence of dental visits between 2001 and 2012. Discussion: Education and insurance are critical factors that govern access to oral healthcare. After the provision of universal dental coverage by Mexico's Seguro Popular in 2003, our results may reflect promising effects of such programs, which can inform future policies in Mexico and other settings.

Injury-Related Emergency Medical Service Calls, Traffic Accidents, and Crime in Mexico City Before and During the COVID-19 Pandemic.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic had detrimental impacts across multiple sectors of the Mexican health care system. The prehospital care system, however, remains largely under-studied. The first objective of this study was to calculate the monthly per capita rates of injury-related 9-1-1 calls, traffic accidents, and crime at the state-level (Mexico City) during the early pandemic period (January 1 through June 30, 2020), while the second objective was to conduct these calculations at the borough-level for the same outcomes and time period. The third objective was to compare monthly per capita rates of injury-related 9-1-1 calls, traffic accidents, and crime at the state-level (Mexico City) during the pre-pandemic (January 1 through June 30, 2019), early pandemic (January 1 through June 30, 2020), and later pandemic periods (January 1 through June 30, 2021). METHODS: A retrospective analysis was conducted to examine injury-related 9-1-1 calls, traffic accidents, and crime at the state-level (Mexico City) and borough-levels. Monthly per capita rates were calculated using four datasets, including Mexico City's Public Release 9-1-1 Emergency Calls, National Institute of Statistics and Geography's (INEGI) Traffic Accidents Micro-Dataset, Mexico City's Attorney General's Office Crime Dataset, and Projections of the Population of the Municipalities of Mexico, 2015 to 2030. All statistical analyses were conducted using STATA 17.0. RESULTS: During the early pandemic period, injury-related 9-1-1 emergency calls, traffic accidents, and crime experienced similar trends in monthly per capita rates at the state-level and borough-levels. While the monthly per capita rates remained constant from January to March 2020, starting in March, there was a precipitous decrease across all three outcomes, although decline rates varied across boroughs. The monthly per capita rates across the three outcomes were higher during the pre-pandemic period compared to the early pandemic period. As the COVID-19 pandemic progressed, the monthly per capita rates during the later pandemic period increased across the three outcomes compared to the early pandemic period, although they did not reach pre-pandemic levels during the study period. CONCLUSION: The precipitous decline in injury-related 9-1-1 calls, traffic accidents, and crime in Mexico City occurred at the same time as the issuance of the first wave of public health orders in March 2020. The largest decrease across the three outcomes occurred one to two months post-issuance of the orders.

Heterogeneity in Excess Mortality and Its Impact on Loss of Life Expectancy due to COVID-19: Evidence from Mexico.

The new coronavirus (COVID-19) is having a major impact on mortality and survival in most countries of the world, with Mexico being one of the countries most heavily impacted by the pandemic. In this paper, we study the impact of COVID-19 deaths on period life expectancy at birth in Mexico by sex and state. We focus on the loss of life expectancy at different ages as a geographically comparable measure of the pandemic's impact on the population in 2020. Results show that males have been affected more than women since they have lost more years of life expectancy at birth due to COVID-19, and they have also experienced a high variation of life expectancy loss across states. The biggest life expectancy loss concentrates in the Northeastern, Central, and Southeastern (Yucatan peninsula) states. Considering the likely undercount associated with COVID-19 deaths, sensitivity analysis suggests that the new coronavirus is having a much larger impact on life expectancy in Mexico than the official government data appears to indicate. Continuos assessment of the pandemic will help state governments quantify the effect of current and new public health measures.

La nouvelle maladie à coronavirus (COVID-19) a un impact majeur sur la mortalité et la survie dans la plupart des pays du monde, le Mexique étant parmi les pays les plus fortement touchés par la pandémie. Dans cet article, nous étudions l'impact des décès dus à la COVID-19 sur l'espérance de vie à la naissance comme mesure géographiquement comparable de l'impact de la pandémie sur la population en 2020. Les résultats montrent que les hommes ont été plus touchés que les femmes, ils ont perdu plus d'années d'espérance de vie à la naissance en raison de la COVID-19 et ont également connu une forte variation de la perte d'espérance de vie entre les États mexicains. La plus grande perte d'espérance de vie est concentrée dans les États du nord-est, du centre et du sud-est (péninsule du Yucatan). L'analyse de sensibilité tient compte du sous-dénombrement probable associé aux décès dus à la COVID-19 et suggère que la maladie a un impact beaucoup plus important sur l'espérance de vie au Mexique que les données officielles du gouvernement ne semblent l'indiquer. Une évaluation continue de la pandémie aidera les gouvernements des États à quantifier l'effet des mesures de santé publique actuelles et nouvelles à mesure que la pandémie se poursuit.

Impacts of the 1918 flu on survivors' nutritional status: A double quasi-natural experiment.

Robust empirical evidence supports the idea that embryonic and, more generally, intrauterine disruptions induced by the 1918-flu pandemic had long-term consequences on adult health status and other conditions. In this paper we assess the 1918-flu long-term effects not just of in utero exposure but also during infancy and early childhood. A unique set of events that took place in Puerto Rico during 1918-1919 generated conditions of a "double quasi-natural experiment". We exploit these conditions to empirically identify effects of exposure to the 1918 flu pandemic and those of the devastation left by an earthquake-tsunami that struck the island in 1918. Because the earthquake-tsunami affected mostly the Western coast of the island whereas early (in utero and postnatal) exposure to the flu was restricted to those born in the interval 1917-1920, we use geographic variation to identify the effects of the quake and timing of birth variation to identify those of the flu. We benefit from availability of information on markers of nutritional status in a nationally representative sample of individuals aged 75 and older in 2002. We make two contributions. First, unlike most fetal-origins research that singles out early nutritional status as a determinant of adult health, we hypothesize that the 1918 flu damaged the nutritional status of adult survivors who, at the time of the flu, were in utero or infants. Second, we target markers of nutritional status largely set when the adult survivors were infants and young children. Estimates of effects of the pandemic are quite large mostly among females and those who were exposed to the earthquake-tsunami. Impacts of the flu in areas less affected by the earthquake are smaller but do vary by area flu severity. These findings constitute empirical evidence supporting the conjecture that effects of the 1918 flu and/or the earthquake are associated not just with disruption experienced during the fetal period but also postnatally.

Antifungal and antioomycete activities and modes of action of isobenzofuranones isolated from the endophytic fungus Hypoxylon anthochroum strain Gseg1.

Hypoxylon species are distributed worldwide and have been isolated from different habitats. The endophyte Hypoxylon anthochroum strain Gseg1 was isolated from healthy leaves of Gliricidia sepium. A chemical study of the culture medium and mycelium organic extracts of the endophytic fungus H. anthochroum Gseg1 led to the isolation of three known isobenzofuranones, 7-hydroxy-4,6-dimethyl-3H-isobenzofuran-1-one, 1, 7-methoxy-4,6-dimethyl-3H-isobenzofuran-1-one, 2, 6-formyl-4-methyl-7-methoxy-3H-isobenzofuran-1-one, 3, and one compound was isolated for the first time as a natural product, 7-methoxy-4-methyl-3H-isobenzofuran-1-one, 4. In addition, the chemical synthesis of 1 and 2, and a derivative, 7-methoxy-6-methyl-3H-isobenzofuran-1-one, 5, was performed. The isobenzofuranones showed antifungal and antioomycete activities. Compounds 1-5 inhibited the growth of Fusarium oxysporum, Alternaria alternata, Pythium aphanidermatum, and Phytophthora capsici, in addition, 1, 2 and 5 interrupted the respiration and caused electrolyte leakage due to cell membrane damage. Compound 2 was the most active, inhibiting the growth of the four microorganisms, affecting the respiration and increasing the relative conductivity due to electrolyte leakage. Compounds 1-4 also induce morphological changes in the plant pathogens' mycelia and hyphae. These compounds could be useful for the control of plant pathogenic fungi and oomycetes of agricultural relevance.

Aluminum complexes with new non-symmetric ferrocenyl amidine ligands and their application in CO2 transformation into cyclic carbonates.

A set of alkyl aluminum complexes supported by non-symmetric ferrocenyl amidine ligands were used as catalysts for the preparation of cyclic carbonates from epoxides and carbon dioxide using Bu4NI as a co-catalyst. A modified method for the synthesis of aminoferrocene allowed us to obtain this precursor in quantitative yield. Treatment of aminoferrocene with the corresponding acetimidoyl chloride afforded the desired ferrocenyl amidine ligands L1H, (E)-N-(2,6-diisopropylphenyl)-N'-(ferrocenyl)acetimidamide, and L2H, (E)-N-(2,6-dimethylphenyl)-N'-(ferrocenyl)acetimidamide. The reaction of these ligands with 1.0 or 0.5 equiv. of AlMe3 led to the synthesis of aminoferrocene based aluminum complexes ((L1)AlMe2 (1), (L2)AlMe2 (2), (L1)2AlMe (3), and (L2)2AlMe (4)) in excellent yields, which were characterized by spectroscopic and X-ray diffraction methods. In addition, we have studied their electrochemical properties and complex 1 was found to be the most active catalyst for the formation of cyclic carbonates 6a-j from their corresponding epoxides 5a-j and CO2.

Calloused hands, shorter life? Occupation and older-age survival in Mexico.

BACKGROUND: Inequalities in mortality are often attributed to socioeconomic differences in education level, income, and wealth. Low socioeconomic status (SES) is generally related to worse health and survival across the life course. Yet, disadvantaged people are also more likely to hold jobs requiring heavy physical labor, repetitive movement, ergonomic strain, and safety hazards. OBJECTIVE: We examine the link between primary lifetime occupation, together with education and net worth, on survival among older adults in Mexico. METHODS: We use data from four waves (2001, 2003, 2012, and 2015) of the Mexican Health and Aging Study (MHAS). We estimate age-specific mortality rates for ages 50 and over using a hazards model based on a two-parameter Gompertz function. RESULTS: Primary lifetime occupations have a stronger association with survival for women than men. Women with higher socioeconomic status have significantly lower mortality rates than lower status women, whether SES is assessed in terms of schooling, wealth, or occupation. Occupational categories are not jointly related to survival among men, even without controls for education and wealth. There are significant survival differences by wealth among men, but no disparities in mortality by education. CONCLUSIONS: Consistent with recent studies of the Mexican population, we fail to find the expected gradient in the association between some measures of SES and better survival among men. CONTRIBUTION: Our estimates extend this anomalous pattern among Mexican men to another dimension of SES, occupation. SES differentials in mortality are substantially larger for Mexican women, highlighting an important gender disparity.

Upsurge of Homicides and Its Impact on Life Expectancy and Life Span Inequality in Mexico, 2005-2015.

OBJECTIVES: To quantify the effect of the upsurge of violence on life expectancy and life span inequality in Mexico after 2005. METHODS: We calculated age- and cause-specific contributions to changes in life expectancy and life span inequality conditional on surviving to age 15 years between 1995 and 2015. We analyzed homicides, medically amenable conditions, diabetes, ischemic heart diseases, and traffic accidents by state and sex. RESULTS: Male life expectancy at age 15 years increased by more than twice in 1995 to 2005 (1.17 years) than in 2005 to 2015 (0.55 years). Life span inequality decreased by more than half a year for males in 1995 to 2005, whereas in 2005 to 2015 the reduction was about 4 times smaller. Homicides for those aged between 15 and 49 years had the largest effect in slowing down male life expectancy and life span inequality. Between 2005 and 2015, three states in the north experienced life expectancy losses while 5 states experienced increased life span inequality. CONCLUSIONS: Ten years into the upsurge of violence, Mexico has not been able to reduce the homicide levels to those before 2005. Life expectancy and life span inequality stagnated since 2005 for young men at the national level. In some states, males live shorter lives than in 2005, on average, and experience higher uncertainty in their eventual death.

Links between Primary Occupation and Functional Limitations among Older Adults in Mexico.

Social inequalities in health and disability are often attributed to differences in childhood adversity, access to care, health behavior, residential environments, stress, and the psychosocial aspects of work environments. Yet, disadvantaged people are also more likely to hold jobs requiring heavy physical labor, repetitive movement, ergonomic strain, and safety hazards. We investigate the role of physical work conditions in contributing to social inequality in mobility among older adults in Mexico, using data from the Mexican Health and Aging Survey (MHAS) and an innovative statistical modeling approach. We use data on categories of primary adult occupation to serve as proxies for jobs with more or less demanding physical work requirements. Our results show that more physically demanding jobs are associated with mobility limitations at older ages, even when we control for age and sex. Inclusion of job categories attenuates the effects of education and wealth on mobility limitations, suggesting that physical work conditions account for at least part of the socioeconomic differentials in mobility limitations in Mexico.

Mexico's epidemic of violence and its public health significance on average length of life.

OBJECTIVES: A disproportionate number of homicides have caused Mexican life expectancy to stagnate during the new millennium. No efforts currently exist to quantify the harm of violent acts on the lives of the general population. We quantified the impact of perceived vulnerability on life expectancy. METHODS: Three Mexican national surveys on perceptions of public safety, life tables, and crime and vital statistics (2000-2014) were used. Prevalence rates of vulnerability/safety by age and sex were obtained from surveys at 2 different levels: federal state and home. The Sullivan method was used to estimate life expectancy lived with and without vulnerability for Mexican women and men. RESULTS: Overall life expectancy at age 20 stagnated between 2005 and 2014 for females and males; yet, there was an increase of 40% and 70% in average number of years lived with vulnerability at the state and home levels, respectively. In 2014, female life expectancy at age 20 was 59.5 years (95% CI 59.0 to 60.1); 71% of these years (42.3 years, 41.6 to 43.0) were spent with perceived vulnerability of violence taking place in the state and 26% at the home (15.3 years, 15 to 15.8). For males, life expectancy at age 20 was 54.5 years (53.7 to 55.1); 64% of these years (34.6 years, 34.0 to 35.4) were lived with perceived vulnerability of violence at the state and 20% at the home (11.1 years, 10.8 to 11.5). CONCLUSIONS: The number of years lived with perceived vulnerability among Mexicans has increased by 30.5 million person-years over the last 10 years. If perceived vulnerability remains at its 2014 level, the average Mexican adults would be expected to live a large fraction of his/her life with perceived vulnerability of violence. Acts of violence continue to rise in the country and they should be addressed as a major public health issue before they become endemic.

[Uncertainty of mortality estimators and hypothesis testing: the case of Latin America and the Caribbean, 1850-2010]. / Incertidumbre de los estimadores de mortalidad y pruebas de hipótesis: el caso de América Latina y el Caribe, 1850­2010.

We propose a simple procedure to address the uncertainty that arises when multiple estimators of adult mortality indicators are available in statistical analyses. We consider situations in which there are alternative estimators for the same population parameter, each one depending on a set of potentially overlapping assumptions, and some or all potentially characterizing the target parameter erroneously. Uncertainty arises because of the varying sensitivity of estimators to assumption violations or lack of information about how estimators have been calculated. The proposed procedure allows researchers to use all of the (plausible) estimators, instead of having to choose only one that, ex ante, is considered "the best or right one". This is achieved by assigning a precision score to each estimator depending on: (i) known errors attributable to violation of the assumptions on which the estimator is based, and (ii) (estimated) probability that the assumptions are violated in one particular case. The ensuing inferences on mortality determinants or trends can now be based on all estimators, leading to more robust and conservative hypotheses tests. Notwithstanding its use for mortality in this article, the methodology can be applied to any type of demographic parameter.

Time trends in adult chronic disease inequalities by education in Brazil: 1998-2013.

BACKGROUND: Socioeconomic differences in health in Brazil are largely driven by differences in educational attainment. In this paper, we assess whether educational gradients in chronic disease prevalence have narrowed in Brazil from 1998 to 2013, a period of a booming economy accompanied by major investments in public health in the country. METHODS: Individual-level data came from the 1998, 2003 and 2008 Brazilian National Household Survey and the 2013 National Health Survey. We first evaluate age-standardized prevalence rates of chronic disease by education and second, we predict the estimated prevalence rate between those in low vs. high education to assess if relative changes in chronic disease have narrowed over time. Third, we estimate the slope index of inequality (SII) that evaluates the absolute change in the predicted prevalence of a disease between those in low vs. high education. Finally, we tested for statistically significant time trends in adult chronic disease inequalities by education. RESULTS: Prevalence of diabetes and hypertension have increased over the period, whereas the prevalence of heart disease decreased. Brazilian adults with no education had higher levels of diabetes, hypertension and heart disease than those with some college or more. Adjusted prevalence for hypertension and heart disease indicate some progress in reducing educational disparities over time. However, for diabetes, adjusted results show a continuously increasing educational disparity from 1998 to 2013. By 2013, individuals with no education had about two times higher diabetes prevalence than those with higher education with larger disparity among women. CONCLUSIONS: Results confirm findings from previous work that educational inequalities in health are large in Brazil but also provide evidence suggesting some improvement in narrowing these differentials in recent times. Recent policies aiming at reducing the prevalence of obesity, smoking and alcohol consumption, and increasing physical activity and consumption of fruits and vegetables may increase the overall health and wellbeing of the Brazilian population. These programs are likely to be more effective if they target those with low socioeconomic status, as they appeared to be at a higher risk of developing chronic conditions, and promote educational opportunities.

SES Gradients Among Mexicans in the United States and in Mexico: A New Twist to the Hispanic Paradox?

Recent empirical findings have suggested the existence of a twist in the Hispanic paradox, in which Mexican and other Hispanic foreign-born migrants living in the United States experience shallower socioeconomic status (SES) health disparities than those in the U.S. POPULATION: In this article, we seek to replicate this finding and test conjectures that could explain this new observed phenomenon using objective indicators of adult health by educational attainment in several groups: (1) Mexican-born individuals living in Mexico and in the United States, (2) U.S.-born Mexican Americans, and (3) non-Hispanic American whites. Our analytical strategy improves upon previous research on three fronts. First, we derive four hypotheses from a general framework that has also been used to explain the standard Hispanic paradox. Second, we study biomarkers rather than self-reported health and related conditions. Third, we use a binational data platform that includes both Mexicans living in Mexico (Mexican National Health and Nutrition Survey 2006) and Mexican migrants to the United States (NHANES 1999-2010). We find steep education gradients among Mexicans living in Mexico's urban areas in five of six biomarkers of metabolic syndrome (MetS) and in the overall MetS score. Mexican migrants living in the United States experience similar patterns to Mexicans living in Mexico in glucose and obesity biomarkers. These results are inconsistent with previous findings, suggesting that Mexican migrants in the United States experience significantly attenuated health gradients relative to the non-Hispanic white U.S. POPULATION: Our empirical evidence also contradicts the idea that SES-health gradients in Mexico are shallower than those in the United States and could be invoked to explain shallower gradients among Mexicans living in the United States.

Homicides In Mexico Reversed Life Expectancy Gains For Men And Slowed Them For Women, 2000-10.

Life expectancy in Mexico increased for more than six decades but then stagnated in the period 2000-10. This decade was characterized by the enactment of a major health care reform-the implementation of the Seguro Popular de Salud (Popular Health Insurance), which was intended to provide coverage to the entire Mexican population-and by an unexpected increase in homicide mortality. We assessed the impact on life expectancy of conditions amenable to medical service-those sensitive to public health policies and changes in behaviors, homicide, and diabetes-by analyzing mortality trends at the state level. We found that life expectancy among males deteriorated from 2005 to 2010, compared to increases from 2000 to 2005. Females in most states experienced small gains in life expectancy between 2000 and 2010. The unprecedented rise in homicides after 2005 led to a reversal in life expectancy increases among males and a slowdown among females in most states in the first decade of the twenty-first century.

Contribution of socioeconomic factors and health care access to the awareness and treatment of diabetes and hypertension among older Mexican adults.

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.

Prospective study of the link between overweight/obesity and diabetes incidence among Mexican older adults: 2001-2012.

OBJECTIVE: To prospectively assess the relationship between overweight/obesity and incidence of type 2 diabetes mellitus (T2DM) among Mexicans aged 50+, assessing effects of age, genetic predisposition, education, physical activity, and place of residence. MATERIALS AND METHODS: The Mexican Health and Aging Study (MHAS) was used to prospectively follow respondents free of diabetes in 2001 who became diabetic by 2012. Multivariate random effects logistic regression was used to assess covariates effects on the incidence of T2DM. RESULTS: Obese or overweight individuals at baseline (2001) were about 3 and 2 times, respectively, significantly more likely to become diabetic by 2012. Genetic predisposition increases the risk of diabetes by about three times compared to those with no family history of diabetes. CONCLUSION: Overweight/obesity and genetic predisposition are the primary drivers of diabetes incidence among Mexican older adults. Reducing body weight and having access to health care may amel iorate the disease burden of T2DM.

Adult obesity, disease and longevity in Mexico.

OBJECTIVE: To obtain estimates of the effects of overweight and obesity on the incidence of type 2 diabetes (T2D) and adult mortality. MATERIALS AND METHODS: We use three waves (2000, 2002, 2012) of the Mexican Health and Aging Survey (MHAS).We employ parametric hazard models to estimate mortality and conventional logistic models to estimate incidence of T2D. RESULTS: Obesity and overweight have a strong effect on the incidence of T2D;this, combined with the large impact of diabetes on adult mortality, generates increases in mortality that translate into losses of 2 to 3 years of life expectancy at age 50. CONCLUSIONS: If increasing trends in obesity in Mexico continue as in the past, progress in adult survival may be slowed down considerably and the incidence of T2D will continue to increase.

Contribution of socioeconomic factors and health care access to the awareness and treatment of diabetes and hypertension among older Mexican adults / 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

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.

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.

Prospective study of the link between overweight/obesity and diabetes incidence among Mexican older adults: 2001-2012 / Estudio prospectivo de la asociación entre sobrepeso/obesidad e incidencia de diabetes en adultos mayores en México: 2001 -2012

Objective. To prospectively assess the relationship between overweight/obesity and incidence of type 2 diabetes mellitus (T2DM) among Mexicans aged 50+, assessing effects of age, genetic predisposition, education, physical activity, and place of residence. Materials and methods. The Mexican Health and Aging Study (MHAS) was used to prospectively follow respondents free of diabetes in 2001 who became diabetic by 2012. Multivariate random effects logistic regression was used to assess covariates effects on the incidence of T2DM. Results. Obese or overweight individuals at baseline (2001) were about 3 and 2 times, respectively, significantly more likely to become diabetic by 2012. Genetic predisposition increases the risk of diabetes by about three times compared to those with no family history of diabetes. Conclusion. Overweight/obesity and genetic predisposition are the primary drivers of diabetes incidence among Mexican older adults. Reducing body weight and having access to health care may amel iorate the disease burden of T2DM.

Objetivo. Cuantificar prospectivamente la relación entre sobrepeso/obesidad e incidencia de diabetes entre mexicanos mayores de 50 años mediante la medición de los efectos de la edad, predisposición genética, educación, actividad física y lugar de residencia. Material y métodos. Se utilizó el Estudio Nacional de Salud y Envejecimiento en México (Enasem) para seguir a adultos mayores sin diabetes en 2001 y que se convirtieron en diabéticos en 2012. Se utilizó el modelo de regresión logística de efectos aleatorios para cuantificar el efecto de covariables en la incidencia de diabetes. Resultados. Quienes tenían obesidad y sobrepeso en 2001 fueron 3 y 2 veces más propensos a adquirir diabetes en 2012, respectivamente. La predisposición genética aumentó tres veces el riesgo de padecer diabetes en comparación con aquéllos sin historia familiar de diabetes. Conclusiones. Sobrepeso, obesidad y predisposición genética son causantes de diabetes en adultos mayores mexicanos. Reducción de peso y acceso a atención de salud podrían reducir las consecuencias que tiene la diabetes.