Advances and challenges on the path toward the SDGs: subnational inequalities in Mexico, 1990–2017
Background The sustainable development goals (SDGs) have generated momentum for global health, aligning efforts from governments and international organisations toward a set of goals that are expected to reflect improvements in life conditions across the globe. Mexico has huge social inequalities th...
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| Format: | Article |
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BMJ Publishing Group
2020-10-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/5/10/e002382.full |
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| author | Rafael Lozano Marcela Agudelo-Botero María Cecilia González-Robledo Claudio Alberto Dávila-Cervantes Gabriel Martinez Nancy Fullman Juan Pablo Gutierrez Sebastian Garcia-Saiso Carolina Zepeda-Tena Christian Razo Bernardo Hernández-Prado Simón Barquera |
| author_facet | Rafael Lozano Marcela Agudelo-Botero María Cecilia González-Robledo Claudio Alberto Dávila-Cervantes Gabriel Martinez Nancy Fullman Juan Pablo Gutierrez Sebastian Garcia-Saiso Carolina Zepeda-Tena Christian Razo Bernardo Hernández-Prado Simón Barquera |
| author_sort | Rafael Lozano |
| collection | DOAJ |
| description | Background The sustainable development goals (SDGs) have generated momentum for global health, aligning efforts from governments and international organisations toward a set of goals that are expected to reflect improvements in life conditions across the globe. Mexico has huge social inequalities that can affect access to quality care and health outcomes. The objective of this study is to analyse inequalities among Mexico’s 32 states on the health-related SDG indicators (HRSDGIs) from 1990 to 2017.Methods These analyses rely on the estimation of HRSDGIs as part of the Global Burden of Disease study 2017. We estimated the concentration index for 40+3 HRSDGI stratified by Socio-demographic Index and marginalisation index, and then for indicators where inequalities were identified, we ran decomposition analyses using structural variables such as gross domestic product per capita, poverty and health expenditure.Findings Mexico has made progress on most HRSDGIs, but current trends in improvement do not appear to fast enough to meet 2030 targets. Out of 43 HRSDGIs, we identified evidence of inequality between Mexico’s states for 30 indicators; of those, 23 HRSDGIs were unequal distributed affecting states with lower development and seven affecting states with higher development. The decomposition analysis indicates that social determinants of health are major drivers of HRSDGI inequalities in Mexico.Interpretation Modifying current trends for HRSDGIs will require subnational-level and national-level policy action, of which should be informed by the latest available data and monitoring on the health-related SDGs. The SDGs’ overarching objective of leaving no-one behind should be prioritised not only for individuals but also for communities and other subnational levels. |
| format | Article |
| id | doaj-art-373c1bf93e9b413089f216416b0bd3a2 |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-373c1bf93e9b413089f216416b0bd3a22024-12-11T17:20:09ZengBMJ Publishing GroupBMJ Global Health2059-79082020-10-0151010.1136/bmjgh-2020-002382Advances and challenges on the path toward the SDGs: subnational inequalities in Mexico, 1990–2017Rafael Lozano0Marcela Agudelo-Botero1María Cecilia González-Robledo2Claudio Alberto Dávila-Cervantes3Gabriel Martinez4Nancy Fullman5Juan Pablo Gutierrez6Sebastian Garcia-Saiso7Carolina Zepeda-Tena8Christian Razo9Bernardo Hernández-Prado10Simón Barquera11Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USACenter for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, Mexico4 Center for Research in Health Systems, National Institute of Public Health, Cuernavaca, Morelos, MexicoFacultad Latinoamericana de Ciencias Sociales Mexico, Mexico DF, DF, MexicoDepartamento Académico de Economía, ITAM, Alvaro Obregon, MexicoDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USACenter for Policy, Population and Health Research, School of Medicine, National Autonomous University of Mexico, CDMX, MexicoCenter for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, MexicoCenter for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, Mexico4 Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USAInstitute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USAdirectorBackground The sustainable development goals (SDGs) have generated momentum for global health, aligning efforts from governments and international organisations toward a set of goals that are expected to reflect improvements in life conditions across the globe. Mexico has huge social inequalities that can affect access to quality care and health outcomes. The objective of this study is to analyse inequalities among Mexico’s 32 states on the health-related SDG indicators (HRSDGIs) from 1990 to 2017.Methods These analyses rely on the estimation of HRSDGIs as part of the Global Burden of Disease study 2017. We estimated the concentration index for 40+3 HRSDGI stratified by Socio-demographic Index and marginalisation index, and then for indicators where inequalities were identified, we ran decomposition analyses using structural variables such as gross domestic product per capita, poverty and health expenditure.Findings Mexico has made progress on most HRSDGIs, but current trends in improvement do not appear to fast enough to meet 2030 targets. Out of 43 HRSDGIs, we identified evidence of inequality between Mexico’s states for 30 indicators; of those, 23 HRSDGIs were unequal distributed affecting states with lower development and seven affecting states with higher development. The decomposition analysis indicates that social determinants of health are major drivers of HRSDGI inequalities in Mexico.Interpretation Modifying current trends for HRSDGIs will require subnational-level and national-level policy action, of which should be informed by the latest available data and monitoring on the health-related SDGs. The SDGs’ overarching objective of leaving no-one behind should be prioritised not only for individuals but also for communities and other subnational levels.https://gh.bmj.com/content/5/10/e002382.full |
| spellingShingle | Rafael Lozano Marcela Agudelo-Botero María Cecilia González-Robledo Claudio Alberto Dávila-Cervantes Gabriel Martinez Nancy Fullman Juan Pablo Gutierrez Sebastian Garcia-Saiso Carolina Zepeda-Tena Christian Razo Bernardo Hernández-Prado Simón Barquera Advances and challenges on the path toward the SDGs: subnational inequalities in Mexico, 1990–2017 BMJ Global Health |
| title | Advances and challenges on the path toward the SDGs: subnational inequalities in Mexico, 1990–2017 |
| title_full | Advances and challenges on the path toward the SDGs: subnational inequalities in Mexico, 1990–2017 |
| title_fullStr | Advances and challenges on the path toward the SDGs: subnational inequalities in Mexico, 1990–2017 |
| title_full_unstemmed | Advances and challenges on the path toward the SDGs: subnational inequalities in Mexico, 1990–2017 |
| title_short | Advances and challenges on the path toward the SDGs: subnational inequalities in Mexico, 1990–2017 |
| title_sort | advances and challenges on the path toward the sdgs subnational inequalities in mexico 1990 2017 |
| url | https://gh.bmj.com/content/5/10/e002382.full |
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