Accidents and violence

In 2013, there was a reported rate of 13 deaths due to traffic accidents and 18.3 homicide deaths, both per 100 inhabitants. Types of vehicles studied in traffic accidents are bicycles, motorcycles, and motor vehicles. Also included are hit-and-run vehicles, which account for 41% of the load associated with all traffic accidents.

The risk of premature loss of life from intentional and accidental injury is 92% (almost double) higher for people living in the north than those living in the south (Soto-Estrada et al., 2016).

According to data reported by ENSANUT 2012, from a survey among adolescents (10-19 years) and young adults (20-29 years), 4% reported health damages or health issues due to interpersonal violence. This would represent approximately 1,712,485 cases at national level. The prevalence of interpersonal violence is higher among men (5.0%) than women (3.3%) and the most vulnerable age group is that of men aged 20 to 29 years. For women, the household is still the space where one of the highest proportions of violence is suffered, with one in four women (24.5%) reporting violent incidents in their own home (Valdez-Santiago et al., 2013).

Table 8. Prevalence of young people who suffered damage to their health due to interpersonal violence

Age group	Men % (95% CI)	Woman % (95% CI)	Total % (95% CI)
Adolescents (10-19 years)	4.4 (3.8-5.1)	3.4 (2.8-4.0)	3.9 (3.5-4.3)
Young adults (20-29 years)	5.7 (4.4-7.2)	3.1 (2.4-4.2)	4.4 (3.6-5.3)

Source: Own estimates from ENSANUT 2012 data

Disability and Disability-free life expectancy

Indicators of healthy life expectancy are useful to monitor effectively whether the years of life gained with the increase in life expectancy are spent in a good state of health or not. In Mexico there are a few sources of data in older adults: the 10/66 study, the Mexican Health, the Aging Survey (MHAS), and SAGE.

The healthy life expectancy is the estimate expected years of life in good health for persons at a given age. In 2010-2015 life expectancy was 74 years for men, but healthy life expectancy was 65 years, while for women was 78.9 and 69 respectively, which means that there are almost 10 years with disease. This may be related to two factors: the decrease in premature mortality, which has an important effect on improving life expectancy at birth, and the increase in people with disabling sequelae. In other words, there are fewer premature deaths but more disability.

The 10/66 study is a large cohort study, examining health, social, and biological characteristics of older adults living in eight countries (China, Cuba, Dominical Republic, India, Mexico, Peru, Puerto Rico, and Venezuela). In this study, disability was assessed using the more than 15 disability days in the past (assessed through WHODAS 2.0 (WHO, 2010)) month criteria, and dependence was assessed by needing some or much care (Prina et al., 2019). Table 9 reports the prevalence of disability and dependence in the total sample (n=2002), both increased with older age, and women had higher prevalence in the oldest age group.

 Table 9. Prevalence of disability and dependence, stratified by age group and sex.

	Disability		Dependence
Age group	Male	Female	Male	Female
65-69	8.1	7.1	3.7	5.0
70-74	5.9	5.9	7.7	6.9
75-79	9.8	15.2	8.4	11.2
80-84	14.9	15.9	11.6	14.9
85+	17.2	20.4	20.0	31.5

Source: (Prina et al., 2019)

Table 10 reports estimated disability-free life expectancy, which gradually declines with increasing age. Women tend to spend a longer period of time with disability and the proportion of remaining life spent disability-free is lower than among men. In the same way, dependence-free life expectancy, which is fundamental to achieve active life expectancy, also declined with increasing age, women had longer periods of dependence.

Table 10. Disability free life expectancy and proportion of remaining life spent in disability and dependence free, by age group and sex

	Disability free life expectancy				Dependence-free life expectancy
Age	Male	%	Female	%	Male	%	Female	%
65	15.4	89.9	16.5	88.1	15.6	91.0	16.4	87.5
70	12.3	89.1	13.1	86.4	12.3	89.0	12.8	84.9
75	9.3	86.6	9.8	83.0	9.4	87.3	9.6	81.2
80	6.8	84.0	7.3	81.8	6.8	84.3	6.8	76.4
85	5.0	83.1	5.4	79.8	4.9	80.3	4.6	68.6

Source: (Prina et al., 2019)

While in the 10/66 study, Mexico reports the highest disability free life expectancy at age 65 (compared with China, Cuba, the Dominican Republic, India, Peru, Puerto Rico, and Venezuela).

In 2018, Payne reported estimations of the rates of transitions between life without disability, life with disability, and death with data from longitudinal surveys of older adult populations in Costa Rica, Mexico, Puerto Rico, and the United States populations, and he reported that the growing older adult populations in Costa Rica, Puerto Rico, and Mexico are not experiencing a substantially higher burden of disability than the disability experienced by people of the same age in the United States (Payne, 2018).

For all these reasons, Mexico must direct its efforts to address the problems associated with the gap that still exists in relation to infectious diseases, the increase in chronic degenerative diseases and those related to injuries and violence, as well as disability and dependence that arise from all of them.

References:

Payne, C. F. (2018). Aging in the Americas: Disability-free Life Expectancy among Adults Aged 65 and Older in the United States, Costa Rica, Mexico, and Puerto Rico. Journals of Gerontology – Series B Psychological Sciences and Social Sciences, 73(2), 337–348. https://doi.org/10.1093/geronb/gbv076

Prina, A., Wu, Y., Kralj, C., Acosta, D., Acosta, I., Guerra, M., Huang, Y., Amuthavalli, T., Jimenez-Velazquez, I., Liu, Z., Llibre Rodriguez, J., Salas, A., Sosa, A., & Prince, M. (2019). Dependence- and Disability-Free Life Expectancy Across Eight Low- and Middle-Income Countries: A 10/66 Study. Journal of Aging and Health. https://doi.org/10.1093/geronb/gbv076

Soto-Estrada, G., Moreno-Altamirano, L., Pahua Díaz, D., Soto-Estrada, G., Moreno-Altamirano, L., & Pahua Díaz, D. (2016). Panorama epidemiológico de México, principales causas de morbilidad y mortalidad. Revista de La Facultad de Medicina (México), 59(6), 8–22. http://www.scielo.org.mx/pdf/facmed/v59n6/2448-4865-facmed-59-06-8.pdf

Valdez-Santiago, R., Hidalgo-Solórzano, E., Mojarro-íñiguez, M., Rivera-Rivera, L., & Ramos-Lira, L. (2013). Violencia interpersonal en jóvenes mexicanos y oportunidades de prevención. Salud Publica de Mexico, 55(SUPPL.2), 259–266. http://www.scielo.org.mx/pdf/spm/v55s2/v55s2a24.pdf

WHO. (2010). WHODAS 2.0 12-item version, interviewer-administered.