Kenya still experiences epidemiological and demographic challenges which affect the health of its population thus increasing mortality rates.

Global Burden of disease in Mexico

In the recent decades, Mexico has experienced an epidemiological transition, while common infections, in particular respiratory and intestinal tracts, are the most frequent causes of morbidity, chronic degenerative diseases such as diabetes and hypertension are reasons for seeking attention, especially in older ages.

Table 2 presents the first ten causes of disease in Mexico by age group in 2017, reported by the General Directorate of Epidemiology (DGE) agency of the Secretary of Health. The most frequent causes are acute respiratory infections, followed by intestinal infections, especially in the young population (>1-24 years of age) (DGE, 2018).

Table 2. Ten main causes of morbidity by age group. Mexico 2017.

Source: (Dirección General de Epidemiología & Secretaria de Salud, 2018).

(Notes: ICD-10: International Classification of Disease (https://icd.who.int/browse10/2010/en). Data show rates per 100 thousand inhabitants. Numbers in parenthesis in each cell indicate the place in which that specific disease is located within the ten main causes of disease in a specific age group).

In relation to mortality, diabetes, heart and cerebrovascular disease, cirrhosis, and cancer dominate the mortality picture, particularly among adults over the age of 40. In contrast, external injuries are the leading causes of death among young people aged 15-19, with homicides, traffic accidents and suicides being the most prominent (Secretaría de Salud, 2015b).

According to global burden of disease reports, in Mexico, the main causes of death have been remained unchanged between 2007-2017 (ischemic heart disease, chronic kidney disease, and diabetes), while interpersonal violence increased its relevance moving to the fourth cause of death. Relevance of neonatal disorders and road injuries decreased their relevance as main causes of Years of Life Lost (YLLs), while interpersonal violence, moved up and now represents the first cause of YLLs. Diabetes and headache disorders remain unchanged as causes of Years Lived with Disability (YLDs), while low back pain moved up to the third place.

In 2013, updated estimations of Burden of Disease in Mexico were generated by age groups, sex, regions of the country (North, Centre, and South), by major disease group (communicable, non-communicable, and injuries) (Lozano Asencio et al., 2013). Main results show a heterogeneous situation of the GBD in Mexico, divided into health risks and problems by different regions in the country. The Southern states, which lag in social development, show prevailing health problems related to transmissible diseases linked to nutrition, housing, and education disparities, whereas the Northern states of the country present an advanced epidemiological transition accompanied by much higher rates of violence. Table 3 shows the main causes of years of life lost due to premature death for all ages, by region, where it is observed that they are a combination of chronic diseases, infectious diseases, and injuries.

Taking mortality rates into account, regardless of the region of the country, non-communicable diseases predominate, accounting for 63% of health losses due to premature death. However, in relation to communicable diseases, nutrition and reproduction, there are important differences by region, as the risk of dying prematurely from these causes is 36% higher in the South than in the North of the country. In contrast, with intentional and accidental injuries, the risk of premature loss of life is 92% higher (almost double) for people living in the North compared to those living in the South.

Table 3 Main causes of years of life lost to premature death in Mexico by region.

Source: (Lozano Asencio et al., 2014, p. 33)

Mexico is therefore a heterogeneous country in relation to its health problems. Three important characteristics (Lozano Asencio et al., 2014) are identified as:

• A social gap in the South where communicable health problems remain as many are linked to basic deficiencies in housing, nutrition, education, and access to health services.
• A risk transition process, where non-communicable diseases predominate in any region of the country and in all age groups.
• A region living in situations of extreme violence, where the risk of intentional and accidental injuries is almost twofold among people living in the North, compared to those living in the South.

References:

Dirección General de Epidemiología, & Secretaria de Salud (DGE). (2018). Anuario de morbilidad 1984-2017.

Lozano Asencio, R., Gómez Dantés, H., Pelcastre Villafuerte, B. E., Montañez, J. C., Campuzano, J. C., Franco, F., & González Vilchis, J. J. (2013). Carga de la Enfermedad en México 1990-2010: Nuevos resultados y desafíos Contenido. 122.

Lozano Asencio, R., Gómez-Dantés, H., Pelcastre, B., Ruelas, M., Montañez, J., Campuzano, J., Franco, F., & González, J. (2014). Carga de la enfermedad en México 1990-2010. Nuevos resultados y desafíos (Vol. 91). Instituto Nacional de Salud Pública, Secretaría de Salud, 2014.

Secretaría de Salud. (2015b). Prontuario de la Salud. Informe sobre la salud de los Mexicanos 2015.