Determinantes económicos en la incidencia de tuberculosis en México / Economic determinants in the incidence of tuberculosis in Mexico

Resumen Introducción La tuberculosis es la causa principal de muerte por un solo agente infeccioso en el mundo. Anualmente, ocurren 10 millones de casos nuevos y más del 95% en países en vías de desarrollo; este problema de salud se vincula a las condiciones sociales y económicas de la población. Objetivo Analizar la relación entre el gasto en salud y la pobreza con la incidencia de tuberculosis en México. Material y métodos Investigación no experimental en el que se analizan reportes económicos y epidemiológicos de tuberculosis de México, periodo 2009-2015. Resultados El producto interno bruto (PIB) de México creció 45% en 2014 con relación al año 2009. El porcentaje del PIB invertido en salud disminuyó desde 2009, pasando de 6.2 a 5.9% en 2015. La población en pobreza aumentó de 2010 a 2014, de 46.1 a 46.2%; la pobreza extrema disminuyó de 11.3 a 9.5%. En 2015, se diagnosticaron 20,561 casos nuevos de tuberculosis, con una incidencia de 17 casos por cada 100,000 habitantes, incrementando dos décimas con relación al año previo. Conclusión El incremento de la incidencia de tuberculosis en México se relaciona con las condiciones socioeconómicas de la población. Las políticas públicas deberán atender los determinantes sociales.

Abstract Introduction Tuberculosis, the main cause of death by a single infectious agent in the world. Annually there are 10 million new cases and more than 95% in developing countries; this health problem is linked to the social and economic conditions of the population. Objective To analyze the relationship between health spending and poverty with the incidence of tuberculosis in Mexico. Material and methods Non-experimental research, analyzing economic and epidemiological reports of tuberculosis in Mexico, period 2009-2015. Results Mexico's Gross Domestic Product (GDP) grew 45% in 2014 compared to 2009. The percentage of GDP invested in health decreased since 2009, from 6.2 to 5.9% in 2015. The population in poverty increased from 2010 to 2014, from 46.1 to 46.2%; extreme poverty decreased from 11.3 to 9.5%. In 2015, 20,561 new cases of tuberculosis were diagnosed, with an incidence of 17 cases per 100,000 inhabitants, increasing two tenths in relation to the previous year. Conclusion The increase in the incidence of tuberculosis in Mexico is related to the socioeconomic conditions of the population. Public policies must address social determinants.

Cancer mortality in the Mexican Social Security Institute, 1989-2013.

UNLABELLED: Objetive: To analyze cancer mortality in affiliates of the Mexican Social Security Institute (Instituto Mexicano del Seguro Social - IMSS) and time trends in the risk of death due to cancer from 1989 to 2013. MATERIALS AND METHODS: A descriptive analysis of cancer mortality trends in beneficiaries of the IMSS was performed. Age- and sex-adjusted mortality rates were obtained using direct standardization with the WHO population. Changes in the risk of death due to cancer over time were evaluated using Poisson regression. RESULTS: The absolute number of deaths due to cancer doubled from 1989 to 2013 due to increasing age of the affiliate population. The risk of death among affiliates decreased for the majority of cancers except for colon and rectal cancer. CONCLUSION: The risk of dying from cancer among IMSS affiliates showed a marked decrease, which may be due to an increase in detection and opportune treatment.

Cancer mortality in the Mexican Social Security Institute, 1989-2013 / Mortalidad por cáncer en el Instituto Mexicano del Seguro Social, 1989-2013

Abstract Objetive: To analyze cancer mortality in affiliates of the Mexican Social Security Institute (Instituto Mexicano del Seguro Social - IMSS) and time trends in the risk of death due to cancer from 1989 to 2013. Materials and Methods: A descriptive analysis of cancer mortality trends in beneficiaries of the IMSS was performed. Age- and sex-adjusted mortality rates were obtained using direct standardization with the WHO population. Changes in the risk of death due to cancer over time were evaluated using Poisson regression. Results: The absolute number of deaths due to cancer doubled from 1989 to 2013 due to increasing age of the affiliate population. The risk of death among affiliates decreased for the majority of cancers except for colon and rectal cancer. Conclusion: The risk of dying from cancer among IMSS affiliates showed a marked decrease, which may be due to an increase in detection and opportune treatment.

Resumen Objetivo: Analizar la frecuencia de las defunciones por cáncer en la población derechohabiente (DH) del Instituto Mexicano del Seguro Social, así como la tendencia temporal en el riesgo de muerte por esta causa de 1989 a 2013. Material y métodos: Se realizó análisis descriptivo del comportamiento de la mortalidad por cáncer en población derechohabiente del IMSS. Las tasas de mortalidad ajustadas por edad y sexo se obtuvieron con el método directo utilizando la población mundial estándar de la OMS. Los cambios en el riesgo de morir por cáncer a través del tiempo se evaluaron mediante regresión de Poisson. Resultados: El número absoluto de defunciones por cáncer se duplicó de1989 a 2013 debido a un aumento y al envejecimiento de la población derechohabiente. El riesgo de muerte en los DH disminuyó para la mayoría de los diferentes tipos de cáncer, excepto para el cáncer de colon y recto. Conclusión: El riesgo de morir por cáncer en DH del IMSS muestra una discreta disminución, posiblemente debido a la mejora en la detección y tratamiento oportuno.

[ENCOPREVENIMSS 2003, 2004 AND 2005. 3. Advances in Women, Men and Seniors' Health Programs]. / ENCOPREVENIMSS 2003, 2004 y 2005. 3. Avances en los Programas de Salud de la Mujer, del Hombre y del Adulto Mayor.

This paper presents the results of the National Survey of Coverage of Integrated Health Programs (ENCOPREVENIMSS) 2003, 2004 and 2005, with regard to the coverage of Women, Men and Seniors' Health Programs. ENCOPREVENIMSS are nationwide probabilistic population-based surveys with delegation (state) representativeness of insured population of the Mexican Institute of Social Security. The sampling frame was stratified, with several stages, and by clusters. The surveys gathered information of sociodemographic characteristics, use of health services and coverage of the main components of the Health Integrated Programs (PREVENIMSS), as well as other complementary variables. For the purpose of this article, the main variables studied were those related to health promotion, weight, height and waist measurement, as well as other related to early detection of certain diseases. The results show an increase in the coverage during the period 2003-2005 in the three groups; however, the lowest were found in the group of men from 20 to 59 years old and the highest, in the group of seniors older than 59, except for those related to the detection of cervical and breast cancer, which were higher in women from 20 to 59 years old. Coverage analysis is useful to ascertain the degree of imposition of the different preventive activities and it is also a good basis for planning.

[Analysis of the decrease in mortality due to cervical cancer at the Mexican Institute of Social Security, from 1991 to 2005]. / Análisis del descenso de la mortalidad por cáncer cervicouterino en el IMSS, 1991-2005.

OBJECTIVE: to analyze the decrease in mortality due to cervical cancer in insured population of the Mexican Institute of Social Security (IMSS) and its relation to changes in the organization of the Program for Prevention and Control of Cervical Cancer (PCCaCu). MATERIAL AND METHODS: a descriptive study in which the annual rates of national mortality due to cervical cancer was analyzed from 1991 to 2005 was carried out. Information of deaths due to cervical cancer was obtained from the IMSS Mortality System (SISMOR), a database that identifies deaths occurred in insured population user of IMSS. The tendency was compared in three periods: I. 1991-1995, reorganization of the original program, II. 1996-2000, transition, and III. 2001-2005, incorporation to PREVENIMSS strategy. RESULTS: between 1991 and 2005, the mortality rate due to cervical cancer by 100 thousand women older than 24 years, decreased from 16.2 to 8.9 (45.1%). Between 1991 and 1995, the mortality rate increased 4.9%; between 1996 and 2000, it decreased 27% and in the last period, 2001-2005, it decreased 29.4%. The only differences that were statistically significant were the ones between the transition and the consolidation periods. The greatest decrease was registered when the PCCaCu was incorporated to PREVENIMSS strategy. CONCLUSIONS: the acceleration in the decrease of mortality rate due to cervical cancer can be explained by the reorganization and expansion of PCCaCu to target population and its incorporation to PREVENIMSS.