RESUMO
PIP: The authors discuss the recent mortality decline in Mexico, with a focus on causes of death at different ages by sex. They also describe the challenge of maintaining and improving health through preventive medicine and community participation.^ieng
Assuntos
Fatores Etários , Causas de Morte , Participação da Comunidade , Saúde , Mortalidade , Medicina Preventiva , Fatores Sexuais , América , Atenção à Saúde , Demografia , Países em Desenvolvimento , Serviços de Saúde , América Latina , Medicina , México , América do Norte , Organização e Administração , População , Características da População , Dinâmica PopulacionalRESUMO
PIP: Three significant recent trends in Mexican mortality are the decline in deaths due to large groups of causes, the increasing proportion of deaths due to nontransmissible causes, and the convergence of state mortality rates. The World Bank has proposed a classification of causes of death into three large groups according to the type of intervention required to reduce them: transmissible, maternal, and perinatal; nontransmissible; and accidents and injuries. The first group concentrates disorders susceptible to reduction with low cost and highly effective interventions such as vaccines and sanitary measures, generally available at the primary level of care. The nontransmissible disorders include chronic degenerative diseases requiring more expensive and prolonged treatment corresponding to the second and third levels of care and implying lifestyle changes. Injuries and accidents are potentially preventable through specific programs of the health system. The proportion of Mexican deaths due to nontransmissible causes increased from 53.4% in 1979 to 67.8% in 1992. Five of the ten main causes of death are nontransmissible: heart disease, malignant tumors, cerebrovascular diseases, cirrhosis, and diabetes mellitus. The increased proportion of deaths due to nontransmissible diseases is a consequence of the rapid decline in deaths from transmissible causes. Deaths due to transmissible causes declined by 47.5% between 1979 and 1992. Increased educational levels, potable water and sewage services, increased vaccination coverage and similar interventions contributed to mortality decline in the least developed regions. The greatest mortality gains were in the areas with the highest initial rates, which helped to homogenize state mortality rates. Among transmissible diseases, diarrhea and pneumonia and influenza dropped from first and second to tenth and eighth place, respectively. In 1992, only Chiapas and Oaxaca maintained mortality rates significantly higher than the rest of the country. The current trend in mortality rates by cause and population aging will increase future demands for health care for nontransmissible diseases. Modifications will be required in the Mexican health system.^ieng
Assuntos
Causas de Morte , Mortalidade , América , Demografia , Países em Desenvolvimento , América Latina , México , América do Norte , População , Dinâmica PopulacionalRESUMO
PIP: Some 6.4 million speakers of indigenous languages were enumerated in the 1990 Mexican census. The same census provided the basis for an indirect estimate of infant mortality using data on the numbers of live born and surviving children. Municipios with 40% or more of the population speaking an indigenous language were studied. The overall estimated infant mortality rate for indigenous municipios was 55.1/1000 live births, the equivalent of the Mexican infant mortality rate around 1982. Mexico's national infant mortality rate in 1990 was 34.8/1000. Great contrasts were found in indigenous infant mortality rates. Campeche, Quintana Roo, and Yucatan, the states of the Mayan region, had a low rate of 35.09/1000, very close to the national average. Infant mortality levels were relatively low in the indigenous populations of Hidalgo, the state of Mexico, and Michoacan, with rates of 44 to 48. Chiapas, Oaxaca, Puebla, Durango, Guerrero, and San Luis Potosi had rates of 55 to 65. The highest rates were in states with few indigenous municipios, including Chihuahua, Jalisco, and Nayarit. The Huichol of Jalisco had the highest rate at 100.01/1000. Infant mortality levels were found to be correlated in different degrees with socioeconomic indicators. The highest infant mortality rates were in the indigenous regions with the poorest socioeconomic conditions.^ieng