González-Salazar Constantino, Gasca-Gómez Kathia, Cordero-Saldierna Omar
ICAyCC-Instituto de Ciencias de la Atmósfera y Cambio Climático, UNAM-Universidad Nacional Autónoma de México, Mexico City 04510, Mexico.
C3-Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico.
Diseases. 2025 Aug 1;13(8):241. doi: 10.3390/diseases13080241.
Non-communicable diseases (NCDs) are a leading cause of mortality globally, contributing significantly to the burden on healthcare systems. Understanding the spatiotemporal patterns of NCD mortality is crucial for identifying vulnerable populations and regions at high risk.
Here, we evaluated the spatiotemporal patterns of NCD mortality in the Metropolitan Area of the Valley of Mexico (MAVM) from 2000 to 2019 for five International Classification of Diseases chapters (4, 5, 6, 9, and 10) at two spatial scales: the municipal level and metropolitan region.
Mortality rates were calculated for the total population and stratified by sex and age groups at both spatial scales. In addition, the relative risk (RR) of mortality was estimated to identify vulnerable population groups and regions with a high risk of mortality, using women and the 25-34 age group as reference categories for population-level analysis, and the overall MAVM mortality rate as the reference for municipal-level analysis.
Mortality trends showed that circulatory-system diseases (Chapter 9) are emerging as a concerning health issue, with 45 municipalities showing increasing mortality trends, especially among older adults. Respiratory-system diseases (Chapter 10), mental and behavioral disorders (Chapter 5) and nervous-system diseases (Chapter 6) predominantly did not exhibit a consistent general mortality trend. However, upon disaggregating by sex and age groups, specific negative or positive trends emerged at the municipal level for some of these chapters or subgroups. Endocrine, nutritional, and metabolic diseases (Chapter 4) showed a complex pattern, with some age groups presenting increasing mortality trends, and 52 municipalities showing increasing trends overall. The RR showed men and older age groups (≥35 years) exhibiting higher mortality risks. The temporal trend of RR allowed us to identify spatial mortality hotspots mainly in chapters related to circulatory, endocrine, and respiratory diseases, forming four geographical clusters in Mexico City that show persistent high risk of mortality.
The spatiotemporal analysis highlights municipalities and vulnerable populations with a consistently elevated mortality risk. These findings emphasize the need for monitoring NCD mortality patterns at both the municipal and metropolitan levels to address disparities and guide the implementation of health policies aimed at reducing mortality risk in vulnerable populations.
非传染性疾病（NCDs）是全球主要的死亡原因，对医疗保健系统的负担有重大影响。了解非传染性疾病死亡率的时空模式对于识别高危弱势群体和地区至关重要。
在此，我们评估了2000年至2019年墨西哥谷大都市区（MAVM）按五个国际疾病分类章节（4、5、6、9和10）划分的非传染性疾病死亡率的时空模式，空间尺度为两级：市级和大都市区。
计算了两个空间尺度上总人口的死亡率，并按性别和年龄组进行分层。此外，估计了死亡率的相对风险（RR），以识别高危弱势群体和地区，在人群水平分析中以女性和25-34岁年龄组作为参考类别，在市级分析中以MAVM总体死亡率作为参考。
死亡率趋势表明，循环系统疾病（第9章）正成为一个令人担忧的健康问题，45个市的死亡率呈上升趋势，尤其是在老年人中。呼吸系统疾病（第10章）、精神和行为障碍（第5章）以及神经系统疾病（第6章）主要未呈现出一致的总体死亡率趋势。然而，按性别和年龄组细分后，这些章节或亚组中的一些在市级层面出现了特定的负向或正向趋势。内分泌、营养和代谢疾病（第4章）呈现出复杂的模式，一些年龄组的死亡率呈上升趋势，52个市总体呈上升趋势。RR显示男性和年龄较大的年龄组（≥35岁）具有较高的死亡风险。RR的时间趋势使我们能够识别主要在与循环、内分泌和呼吸系统疾病相关章节中的空间死亡热点，在墨西哥城形成四个地理集群，显示出持续的高死亡风险。
时空分析突出了死亡率风险持续升高的市和弱势群体。这些发现强调需要在市级和大都市区层面监测非传染性疾病死亡率模式，以解决差异问题，并指导实施旨在降低弱势群体死亡风险的卫生政策。
