Alcalde-Rabanal J E, Orozco-Núñez E, Espinosa-Henao O E, Arredondo-López A, Alcayde-Barranco L
Center for Health System Research / National Institute of Public Health. Cuernavaca, México.
PLoS One. 2018 Jan 25;13(1):e0187028. doi: 10.1371/journal.pone.0187028. eCollection 2018.
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.
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.
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.
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.
在非传染性慢性病（NCCD）中，糖尿病和高血压是全球成年人死亡的主要原因。在经济合作与发展组织成员中，墨西哥的糖尿病患病率居首，肥胖率位居第二。为应对非传染性慢性病这一问题状况，卫生部发布了一项针对超重、肥胖和糖尿病的国家流行病学警报。本研究的目标是描述位于社会边缘化程度高的地区的初级卫生设施影响范围内成年人群的肥胖、糖尿病和高血压状况。
我们开展了一项横断面观察性研究，并使用了便利样本。对墨西哥四个州的四个初级卫生设施中18岁及以上的人群进行了调查。该调查探究了社会人口学特征、慢性病的存在情况、获得医疗服务的情况、风险因素和生活方式。我们还对20%的参与者应用了一份补充问卷，以探究过去一周的食物消费和身体活动情况（国际身体活动问卷）。我们的分析基于描述性统计和逻辑多元回归，以分析与糖尿病和高血压相关的因素。
73%（n = 7531，CI 0.72 - 0.74）的人群报告患有糖尿病、高血压和/或超重。他们中的大多数在公共卫生服务机构接受医疗保健。40岁以上的人患糖尿病的可能性是其他人的11倍，患高血压的可能性是其他人的8.7倍。这两种疾病主要影响女性，她们的主要活动是家庭主妇。在外面吃午餐和晚餐的人患糖尿病的可能性更大。进行剧烈身体活动的人患高血压的可能性较小。
根据自我报告，生活在社会边缘化程度高的地区的成年人群中，超过70%患有糖尿病、高血压和肥胖症。然而，患有这些慢性病但未意识到的人群比例尚不清楚。墨西哥卫生系统需要一种强调健康促进、及时发现非传染性疾病风险因素及其并发症预防的初级医疗保健。
