Laura Moreno Altamirano

Area-level disadvantage and alcohol use disorder in northern Mexico

BACKGROUND In Mexico, the Northern States are highly impacted by alcohol consumption and associated problems. Little is known about the association between contextual social disadvantage and alcohol use disorder in this region. METHODS Information from 1265 current drinkers surveyed in the U.S.-Mexico Study on Alcohol and Related Conditions (UMSARC) was combined with official data on neighborhood disadvantage (index of urban marginalization, a composite of ten indicators of area-level social disadvantage) for 302 neighborhoods. Using statistical marginal models, we estimated the association of neighborhood disadvantage with alcohol use disorder (AUD; based on DSM-5 criteria), alone and with adjustment for individual and contextual covariates. We also tested for moderation of neighborhood disadvantage effects by sex, education, internal migration and border area. RESULTS There was a statistically significant increase in the odds of AUD of 59% (AOR=1.59; 95%CI=1.03, 2.46) for every one-point increase on the neighborhood disadvantage scale, after adjustment for covariates. A significant interaction between sex and neighborhood disadvantage was indicated by two measures of additive interaction (AP=0.55; p<0.001 and S=2.55; p<0.001), with higher neighborhood disadvantage related to higher prevalence of AUD for men but not for women. No moderation effects were observed for education, internal migration or border area. CONCLUSIONS Neighborhood disadvantage is a risk factor for AUD independent of other variables, specifically in men. Studies of contextual variables offer the possibility for understanding the role of collective circumstances on individuals in society. Future studies of alcohol use in this geographic area should consider effects of contextual determinants such as disadvantage.

Trends in frequency of type 2 diabetes in Mexico and its relationship to dietary patterns and contextual factors

OBJECTIVE To analyse the evolution of the frequency of type 2 diabetes (T2D) and its relationship to eating patterns in Mexico from 1961 to 2013, and the Gini coefficient, Human Development Index (HDI) and Gross Domestic Product (GDP). Mexico ranked sixth in world prevalence of diabetes in 2015 with an estimated 11.4 million Mexicans affected. METHOD Using data from the Balance Sheets Food published by the Food and Agriculture Organization of the United Nations (FAO), the means of apparent food consumption (kcal/person/day) were grouped by decades. Data for mortality rate for diabetes were obtained from 1990 until 2015. Spearmans correlation coefficient was calculated between the diabetes mellitus mortality rate and all food groups. Pearsons correlation explored the relationship between socio economic indicators and the prevalence of T2D diabetes. RESULTS The mortality rate for T2D has increased over the last decades. An increase of 647.9kcal/person/day in apparent food consumption was observed. Cereal and legume consumption decreased, while apparent sugar, animal food and animal fat and vegetable oil consumption increased substantially. HDI and GDP showed a directly proportional relationship to diabetes. Spearmans correlation coefficient was statistically significant only for sugar. The Gini coefficient suggests that in lower inequalities there is an increased frequency of diabetes. CONCLUSIONS The increase in the mortality rate of type 2 diabetes was constant during the study period, which coincides with the increase in energy density of Mexican eating patterns from 1961 to 2013. The higher the Gini coefficient, HDI and GDP, the higher the mortality observed for diabetes.