A year and a half into the pandemic in Mexico: evidence of differences in COVID-19 mortality between Indigenous and non-Indigenous populations continues to accumulate.

Among the groups most vulnerable to COVID-19 are Indigenous populations around the world, and in particular, the Mexican Indigenous population. We used public data made available by the General Directorate of Epidemiology of the Mexican Ministry of Health to compare the risk of COVID-19 mortality among the Indigenous and non-Indigenous Mexican population one and a half years into the pandemic. The analytical sample comprises 3,545,952 Mexicans who were diagnosed as infected with severe acute respiratory syndrome coronavirus-2 between March 18, 2020, and September 16, 2021, of which 1.0% (36,195) are Indigenous. Based on parametric survival models, our results show that the risk of death among Indigenous individuals is 52% higher than that of their non-Indigenous counterparts, regardless of age, sex, area of residence, health service, number of chronic diseases, and obesity status. These results suggest that certain structural conditions of the Mexican Indigenous population increase their vulnerability to the pandemic.

Childhood disadvantages and the timing of the onset of natural menopause in Latin America and the Caribbean.

The aim of this study is to investigate the association of early life factors with the timing of the onset of natural menopause in Costa Rica and Puerto Rico. We use Cox proportional hazard models to estimate the risk of the onset of menopause. Our results suggest that socioeconomic disadvantages, as expressed by difficulties attending school due to economic hardships or parents never living together, increase the risk of the onset of natural menopause among Puerto Rican women. Among Costa Rican women, early life nutrition, estimated using anthropometric measures, is related to the timing of the onset of natural menopause.

Subjective Survival Expectations and Observed Survival: How Consistent Are They?

In this paper, we use new models to convert subjective expectations elicited from individual responses into conditional survival functions. We also estimate the effects of individual characteristics and assess the impact of health shocks on individual updates of subjective expectations. We use Health and Retirement Study (HRS) data from 1992 to 2006. By and large, our results confirm past empirical findings, but also identify patterns not documented in previous research. We show that the subjective probabilities are remarkably close to the results of actual life tables constructed from observed data, that whites underestimate their survival chances more than blacks, that women underestimate their survival chances more than men, and that the subjective underestimation of conditional survival increases with age in all population subgroups. We find significant differences in the survival outlooks of the original HRS cohort and a more recent HRS cohort (1992 versus 2004). These differences persist after introducing suitable controls. The observed mortality differentials between smokers and non-smokers, obese and non-obese individuals, and high-education and low-education groups are quite close to those of these subgroups' subjective survival expectations. Finally, we find large updating effects that result from recent health shocks on subjective expectations.

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.

The enduring effects of smoking in Latin America.

OBJECTIVES: We estimated smoking-attributable mortality, assessed the impact of past smoking on recent mortality, and computed expected future losses in life expectancy caused by past and current smoking behavior in Latin America and the Caribbean. METHODS: We used a regression-based procedure to estimate smoking-attributable mortality and information for 6 countries (Argentina, Brazil, Chile, Cuba, Mexico, and Uruguay) for the years 1980 through 2009 contained in the Latin American Mortality Database (LAMBdA). These countries jointly comprise more than two thirds of the adult population in Latin America and the Caribbean and have the region's highest rates of smoking prevalence. RESULTS: During the last 10 years, the impact of smoking was equivalent to losses in male (aged ≥ 50 years) life expectancy of about 2 to 6 years. These effects are likely to increase, particularly for females, both in the study countries and in those that joined the epidemic at later dates. CONCLUSIONS: Unless innovations in the detection and treatment of chronic diseases are introduced soon, continued gains in adult survival in Latin America and the Caribbean region may slow down considerably.

Adult obesity, disease and longevity in Mexico / Obesidad, enfermedad y longevidad en adultos mexicanos

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.

Objetivo. Estimar los efectos de sobrepeso y obesidad en edad adulta en la incidencia de diabetes tipo 2 y en la mortalidad. Material y métodos. Se emplearon tres paneles (2000, 2002, 2012) de la Encuesta Nacional de Salud y Envejecimiento en México (Enasem), junto a modelos de sobrevivencia y logísticos convencionales para estimar la mortalidad y la incidencia de diabetes, respectivamente. Resultados. El sobrepeso y la obesidad tienen un impacto poderoso en la incidencia de diabetes tipo 2, lo que en combinación con el incremento del riesgo de mortalidad asociado con la diabetes de tipo 2, se traduce en pérdidas de 2 a 3 años de vida a la edad de 50 años. Conclusiones. Si la tasa de crecimiento de la prevalencia de sobrepeso y obesidad en edad adulta mantiene el ritmo que ha tenido recientemente, las mejoras en sobrevivencia adulta se verán comprometidas y la incidencia de diabetes tipo 2 continuará en aumento.

Obesity and excess mortality among the elderly in the United States and Mexico.

Increasing levels of obesity could compromise future gains in life expectancy in low- and high-income countries. Although excess mortality associated with obesity and, more generally, higher levels of body mass index (BAI) have been investigated in the United States, there is little research about the impact of obesity on mortality in Latin American countries, where very the rapid rate of growth of prevalence of obesity and overweight occur jointly with poor socioeconomic conditions. The aim of this article is to assess the magnitude of excess mortality due to obesity and overweight in Mexico and the United States. For this purpose, we take advantage of two comparable data sets: the Health and Retirement Study 2000 and 2004 for the United States, and the Mexican Health and Aging Study 2001 and 2003 for Mexico. We find higher excess mortality risks among obese and overweight individuals aged 60 and older in Mexico than in the United States. Yet, when analyzing excess mortality among different socioeconomic strata, we observe greater gaps by education in the United States than in Mexico. We also find that although the probability of experiencing obesity-related chronic diseases among individuals with high BMI is larger for the U.S. elderly, the relative risk of dying conditional on experiencing these diseases is higher in Mexico.

Obesidad y Esperanza de Vida en México Obesity and life expectancy in Mexico.

The high and increasing prevalence of overweight and obesity in Latin American and the Caribbean and the increasing prevalence of some obesity-related chronic diseases could be changing the current mortality patterns and the improvements in life expectancy of this population. The main objective of this study is to measure the effect of overweight and obesity on mortality in Mexico among elderly people (60 years and older). We use the Mexican Health and Ageing Study (MHAS, 2001 and 2003) that is a panel nationally-representative study of the population 50 years and older in Mexico. Our results show that excess body weight (defined by the two highest quintiles of Body Mass Index-BMI-) increases the risk of mortality at 60 years and older in Mexico. As much as 11% of the deaths among elderly that occurred during the period 2001-2003 in Mexico would have been avoided if overweight and obese people (individuals belonging to the highest two quintiles of BMI) had had the "ideal" weight (defined by the middle quintile, or third quintile, of BMI). At individual level, we estimate that individuals 60 years old with excess body weight (fourth and fifth quintiles of BMI) survive four years less, in average, than individuals with normal body weight (third quintile of BMI).