Background

Rates of diseases and injuries and the effects of their risk factors can have substantial subnational heterogeneity, especially in middle-income countries like Mexico. Subnational analysis of the burden of diseases, injuries, and risk factors can improve characterization of the epidemiological transition and identify policy priorities.

Methods and Findings

We estimated deaths and loss of healthy life years (measured in disability-adjusted life years [DALYs]) in 2004 from a comprehensive list of diseases and injuries, and 16 major risk factors, by sex and age for Mexico and its states. Data sources included the vital statistics, national censuses, health examination surveys, and published epidemiological studies. Mortality statistics were adjusted for underreporting, misreporting of age at death, and for misclassification and incomparability of cause-of-death assignment. Nationally, noncommunicable diseases caused 75% of total deaths and 68% of total DALYs, with another 14% of deaths and 18% of DALYs caused by undernutrition and communicable, maternal, and perinatal diseases. The leading causes of death were ischemic heart disease, diabetes mellitus, cerebrovascular disease, liver cirrhosis, and road traffic injuries. High body mass index, high blood glucose, and alcohol use were the leading risk factors for disease burden, causing 5.1%, 5.0%, and 7.3% of total burden of disease, respectively. Mexico City had the lowest mortality rates (4.2 per 1,000) and the Southern region the highest (5.0 per 1,000); under-five mortality in the Southern region was nearly twice that of Mexico City. In the Southern region undernutrition and communicable, maternal, and perinatal diseases caused 23% of DALYs; in Chiapas, they caused 29% of DALYs. At the same time, the absolute rates of noncommunicable disease and injury burdens were highest in the Southern region (105 DALYs per 1,000 population versus 97 nationally for noncommunicable diseases; 22 versus 19 for injuries).

Conclusions

Mexico is at an advanced stage in the epidemiologic transition, with the majority of the disease and injury burden from noncommunicable diseases. A unique characteristic of the epidemiological transition in Mexico is that overweight and obesity, high blood glucose, and alcohol use are responsible for larger burden of disease than other noncommunicable disease risks such as tobacco smoking. The Southern region is least advanced in the epidemiological transition and suffers from the largest burden of ill health in all disease and injury groups.

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Does Gender Matter?
A Commentary by Ben A. Barres, NAture Vol 442, pg 133, 13th July 2006

Prof. Barres should be commended for a frank, honest and, at times, personal reflection on the notion that women are not advancing in science because of innate inability. The sentiment that women make bad scientists because of a lack of aptitude has been publicized several times lately most famously by Harvard University president Larry Summers, in an essay by Peter Lawrence and the work of Simon Baron-Cohen.
Men are allegedly better equipped to do science because of their abilities to systematize, analyze and be more forgetful of others. Women empathise and are communicative and caring by comparison. This view is disputed in this article, and an alternative set of hypotheses proposed.
Barres proposes that women are not advancing in science because of discrimination. This discrimination is intrinsic within society and occurs at every level for women. It includes girls being told that competitive sports make them too masculine, that girls don’t do science, and also involves women’s achievements being less recognized than men’s. For example, one study found that women applying for research grants needed to be 2.5 times more productive than men in order to be considered equally competent. It is also noted (and rightfully so) that women are as guilty of discriminating against other women as men are.
Lets take action then, and start ending this discrimination. Barres suggests a series of steps:-
1. Make academic and scientific institutions have more diverse leadership.
2. Run fair job searches, based on merit on an even playing field.
3. Speak out. End discrimination by speaking out against prejudice and being responsible for your own actions. Support those who do speak out.
4. Enhance fairness in any competitive scenarios. Awards, grant competitions, promotion competitions must be conducted fairly and by a diverse committee.
5. Teach young scientists the skills they need to thrive – self confidence, a strong sense of fairness, being a presence in a room, giving great presentations and dealing with academics.
Science may be a ‘popularity contest’ but if we all get together we can do something about it.

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