The complex scenario of obesity, diabetes and hypertension in the area of influence of primary healthcare facilities in Mexico.

INTRODUCTION: Among non-communicable chronic diseases (NCCD), diabetes and hypertension are the main cause of adult mortality worldwide. Among the members of the Organization for Economic Cooperation and Development, Mexico is first in prevalence of diabetes and second in obesity. To face this problematic situation of NCCDs the Ministry of Health declared a national epidemiological alert against the overweight, obesity and diabetes. The target of this study is to characterize the status of obesity, diabetes and hypertension in the adult population in the area of influence of primary health facilities located in high social marginality areas. METHODS: We conducted a cross-sectional observational study and used a convenience sample. A survey was conducted on a population of 18 years old and above in four primary health facilities in four Mexican States. The survey explored sociodemographic characteristics, the presence of chronic diseases, the access to healthcare services, risk factors and life styles. We also applied a complementary questionnaire to 20% of the participants, in order to explore food consumption during the last week and physical activity (International Physical Activity Questionnaire). We based our analysis on descriptive statistics and logistic multivariate regression to analyze factors associated with diabetes and hypertension. RESULTS: 73% (n = 7531, CI 0.72-0.74) percent of the population reported being diabetic, hypertensive and/or overweight. The majority of them receive healthcare in public health services. People over 40 years old, are 11 times more probable of living with diabetes and 8.7 times more probable of living with hypertension. Both conditions affect mostly women, whose main activity is to be a housewife. People who have lunch and dinner out of home are more likely to develop diabetes. People who perform intense physical activity are less likely to live with hypertension. CONCLUSION: According to the self-report, more than 70% of adult population living in areas with high social marginality suffer diabetes, hypertension and obesity. However, the percentage of people who live with these chronic conditions and are not aware of them, is unknown. The Mexican health system needs a primary healthcare that emphasizes on health promotion, timely detection of risk factors of Non Communicable Diseases and prevention of their complications.

[Practice of traditional medicine in Latin America and the Caribbean: the dilemma between regulation and tolerance]. / La práctica de la medicina tradicional en América Latina y el Caribe: el dilema entre regulación y tolerancia.

OBJECTIVE: This paper characterizes the current stage of traditional medicine in nine countries of Latin America and the Caribbean. MATERIAL AND METHODS: This qualitative study was conducted between March and December 1998. Data were collected on the components of traditional health systems in countries of Latin America and the Caribbean, by means of a network of individuals and institutions from different countries that acted as expert informants from different specialty areas. RESULTS: Findings from the analysis of traditional medicine regulation are presented in three groups: a) Countries with some developments in the area of legislation; b) Countries where legislation is underway; and, c) Countries with no legislation or incipient regulation. CONCLUSIONS: Several stages of traditional medical practice legislation are found in the region. This heterogeneity shows the complexity involved in regulating the practice of providers with low levels of formal training, with different therapeutic practices, and with customs that are frequently difficult to include within the standards of the official health system. These findings are important for designing and implementing healthcare policies to adequate traditional medical practices to the needs of populations that commonly use them.

[The use of anthropologic methods for studying the causes of lack of vaccination. The case of Nativitas, Xochimilco]. / Uso de métodos antropológicos para el estudio de las causas de no vacunación. El caso de Nativitas, Xochimilco.

The relationship between the socio-cultural characteristics of a population and their participation in immunization programs is described in this paper. An anthropological approach was utilized to study the reasons why certain population groups do not participate in the immunization programs or do so inadequately. The study was undertaken in a community south of Mexico City. The paper contains the description of the community's contextual elements, the organization of the medical care services and the participation of the population in the immunization programs. It was found that a wide millieu of socio-cultural factors are related with people's behavior toward vaccination, such as: lack of information about diseases and vaccines, lack of trust on modern health services, and the strong influence of traditional medicine. Clear implications can be derived from the analysis with regards to the need for revision and modification of strategies of the health education programs, in order to promote a wider participation in immunization programs.