Cervantes Claudio Alberto Dávila, Baptista Emerson Augusto
Facultad Latinoamericana de Ciencias Sociales (FLACSO) Mexico, Mexico City, 14200, Mexico.
Center for Demographic, Urban and Environmental Studies, El Colegio de México, Mexico City, 14110, Mexico.
Arch Public Health. 2024 Oct 30;82(1):196. doi: 10.1186/s13690-024-01432-z.
One in six Mexican adults' lives with type 2 diabetes mellitus (T2DM), which is the third leading cause of death in the country. Analyzing the geographic distribution of T2DM mortality helps identify regions with higher mortality rates. This study aimed to examine the spatial patterns of mortality from type 2 diabetes mellitus (T2DM) across municipalities in Mexico and to analyze the main contextual factors linked to this cause of death in 2020.
We employed a spatial Bayesian hierarchical regression model to estimate the risk and probability of death from type 2 diabetes mellitus (T2DM) across Mexico's municipalities.
The SMR results revealed geographic and age-specific patterns. Central Mexico and the Yucatán Peninsula exhibited the highest excess mortality rates. For the population under 50 years of age, municipalities in Oaxaca had the highest T2DM mortality rates, whereas those aged 50 years old and older had the highest rates in Tlaxcala and Puebla. Socioeconomic factors such as low levels of educational attainment, lack of health services, dietary deficiency, and marginalization were positively associated with increased T2DM mortality risk. By contrast, GDP per capita showed a negative association. High-risk areas for T2DM mortality were prominent along the south of the Pacific Coast, the Bajío, Central Mexico, and southern Yucatán for those under 50, and along a central strip extending to the Yucatán Peninsula for the older population. Significant uncertainties in mortality risk were identified, with Central Mexico, Oaxaca, Chiapas, and Tabasco showing high probabilities of excess risk for those under 50 years of age and extended risk areas along the Gulf of Mexico for those 50 years old and older.
The assessment and identification of spatial distribution patterns associated with T2DM mortality, and its main contextual factors, are crucial for informing effective public health policies aimed at reducing the impact of this chronic disease in Mexico.
六分之一的墨西哥成年人患有2型糖尿病（T2DM），这是该国第三大死因。分析T2DM死亡率的地理分布有助于确定死亡率较高的地区。本研究旨在探讨墨西哥各市2型糖尿病（T2DM）死亡率的空间模式，并分析2020年与此死因相关的主要背景因素。
我们采用空间贝叶斯分层回归模型来估计墨西哥各市2型糖尿病（T2DM）的死亡风险和概率。
标准化死亡比（SMR）结果显示出地理和年龄特异性模式。墨西哥中部和尤卡坦半岛的超额死亡率最高。对于50岁以下人群，瓦哈卡州的市T2DM死亡率最高，而50岁及以上人群中，特拉斯卡拉州和普埃布拉州的死亡率最高。教育程度低、缺乏医疗服务、饮食不足和边缘化等社会经济因素与T2DM死亡风险增加呈正相关。相比之下，人均国内生产总值呈负相关。50岁以下人群中，T2DM死亡的高风险地区在太平洋沿岸南部、巴希奥地区、墨西哥中部和尤卡坦半岛南部较为突出，而老年人群的高风险地区则沿着延伸至尤卡坦半岛的中部地带。确定了死亡风险存在显著不确定性，墨西哥中部、瓦哈卡州、恰帕斯州和塔巴斯科州在50岁以下人群中显示出高风险概率，而50岁及以上人群在墨西哥湾沿岸存在扩大的风险区域。
评估和识别与T2DM死亡率相关的空间分布模式及其主要背景因素，对于制定有效的公共卫生政策以减少这种慢性病在墨西哥的影响至关重要。
