Mexico
1Lt S. Erin Elarton, USAF, MSC
HCA 5312 Issues in International Health
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Agenda
Areas of responsibility
Peer nations
Topography
Climate
Water and natural resources
Natural disasters
Comparisons
Index of economic freedom
Wellbeing index
Transparency corruption index
Human development index
National demographics
Population pyramid
Aging
Muslim population
Poverty
Immigrants and refugees
Vaccinations
• Health status
• Morbidity & mortality
statistics
• HIV/AIDS
• Tuberculosis
• National health services
• Structure of health care
system
• Healthcare providers
• Costs/financing of health
care
• Pharmaceutical expenditures
• Health care reform
• External debt
• Politics and elections
• Telecommunications
• Utilization of technology
promoting health care
• Size of military/armed forces
History
• Ancient Civilizations
• 1521 Spain conquered Mexico
– Brought diseases, caused pandemic
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1821 Proclaimed Independence from Spain
1836 Texas Declared its Independence
1846-1848 Mexican-American War
1910 Mexican Revolution
1929 Mexican National Party (PNM) was created
2000 President Fox elected (PAN)
http://en.wikipedia.org/wiki/Mexico
Geography & Environment
• Terrain
– High, rugged mountains; low coastal plains; high plateaus; desert
• Land use
– arable land: 12%
permanent crops: 1%
permanent pastures: 39%
forests and woodlands: 26%
• Climate
– Varies from tropical to desert
• Natural resources
– petroleum, silver, copper, gold, lead, zinc, natural gas, timber
• Environmental issues
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Severe Air Pollution
Raw sewage polluting rivers
Deforestation
Widespread erosion
http://en.wikipedia.org/wiki/Geography_of_Mexico
http://www.countrywatch.com
Water Resources
• Population using improved drinking water
sources (1999)
– Total 86%, Rural 63%
• Population using adequate sanitation
– Total 73%, Rural 32%
• Prolonged regional drought along US border
– 1944 Treaty to share Rio Grande waters
– US-Mexico Water Treaty Dispute
http://www.prb.org/datafind/prjprbdata/wcprbdata.asp?DW=DR&SL
http://www.texaswater.org/press/us_mexico_dispute.pdf
Natural Disasters
Disaster
Earthquake
Flood
Volcano
Wind storm
Flood
Wind storm
Wind storm
Earthquake
Wind storm
Extreme
temp
Date
19-Sep-85
1959
1949
27-Oct-59
Oct-99
1-Oct-76
28-Sep-55
28-Aug-73
12-Nov-61
Killed
8,776
2,000
1,000
960
636
600
500
500
436
Disaster
Wind storm
Flood
Wind storm
Wind storm
Wind storm
Wind storm
Wind storm
Flood
Flood
Date
Affected
8-Oct-97
800,200
Oct-99
616,060
23-Sep-02
300,000
15-Jul-76
300,000
1-Oct-76
276,400
Aug-67
271,000
Dec-83
257,500
21-Sep-93
231,290
Aug-73
150,000
30-Apr-90
380
Earthquake
19-Sep-85
http://www.cred.be/emdat/profiles/natural/mexico.htm#top%20ten
130,204
Comparisons
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Human Development Index #55
Well-being Index #150
Transparency International Corruptions
Perceptions Index #64
World Health Systems Rankings
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Overall health system attainment #51
Overall health level #61
Migration #132 in world -2.84
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8% of U.S. population is from Mexican origin
http://www.who.int/whr2001/2001/archives/2000/en/statistics.htm
http://www.iucn.org/info_and_news/press/wonrank.doc
http://www.metropolis2003.at/en/WS9.1Sanchez.pdf
http://www.transparency.org/pressreleases_archive/2003/dnld/cpi2003.pressrelease.en.doc
http://www.undp.org/hdr2003/pdf/presskit/HDR03_PKE_HDI.pdf
http://www.photius.com/wfb1999/rankings/migration_rate_0.html
U.S. Department of State
Consular Information
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Crime
Drug penalties and prescription medications
Prison conditions
Kidnapping
Public Transportation
Insufficient safety standards
http://www.travel.state.gov/mexico.html
Pan American Health Organization
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Vector-borne diseases
Vaccine-preventable diseases
Intestinal infectious diseases
Communicable chronic diseases
Acute respiratory diseases
Human Rabies
STDs
AIDS
http://www.ops-oms.org/English/DD/AIS/cp_484.htm
Politics
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Representative and democratic republic
31 states and Federal District (Mexico City)
2,444 municipalities
2000 elections – new political party
Bicameral National Congress (Congreso de la
Union)
– Senate and Chamber of Deputies
– Women as percent of parliament 16% (US 14%)
http://en.wikipedia.org/wiki/Mexico#Politics
http://www.prb.org/datafind/prjprbdata/wcprbdata.asp?DW=DR&SL
The Pew Research Center
• Mexico’s view of U.S. slips
– From 1999 to 2002, slipped from 68% to 64%
• Personal concerns
– Economic problems as top personal concern (65%)
– Crime (17%)
– Personal satisfaction rated similar to Western Europe
• Satisfaction with State of the Country
– 79% dissatisfied
• Top 4 national problems
– Crime, AIDS & disease, corrupt political leaders,
terrorism
http://people-press.org/reports/pdf/165.pdf
Economy
• World’s ninth largest economy
• Index of Economic Freedom (2003)
– Ranked #63
• Labor Force
– 39.8M (2000)
• Exports $1.58B (2002)
– US 82.7%, Canada 5.4%, Japan 1.1% (2002)
– Commodities: manufactured goods, oil and oil
products, silver, fruits, vegetables, coffee, cotton
http://www.odci.gov/cia/publications/factbook/geos/mx.html
http://cf.heritage.org/index2004test/country2.cfm?id=Mexico
National Demographics
Population Total
Population Growth Rate (annual %)
0 – 14 Years (% of total)
15 – 64 Years (% of total)
65+ Years (% of total)
Total Fertility Rate
Adolescent Fertility Rate
(births per 1,000 women age 15-19)
Female Life Expectancy at Birth
Male Life Expectancy at Birth
Ethnicity: Mestizo 60.0%
Mexico
104,907,991
1.43%
32.3%
63.1%
4.6%
2.53
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75.49
69.26
United States
285,318,000
1.1%
20.9
66.7
12.4
2.07
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80.05
74.37
Religions: Roman Catholic 89.0%
Indigenous 30.0%
Protestant 6.0%
European descent 9.0%
Other 5.0%
Other 1.0%
Muslim 0.26%
http://devdata.worldbank.org/hnpstats/HnpAtaGlance.asp?sCtry=MEX,Mexico
http://www.odci.gov/cia/publications/factbook/geos/mx.html
http://www.islamicpopulation.com/america_general.html
Population Pyramid
http://www.census.gov/cgi-bin/ipc/idbpyrs.pl?cty=MX&out=s&ymax=250
Common Diseases According to
AFMIC & CDC
• Diseases carried by insects
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Dengue
Filariasis
Leishmaniasis – cutaneous
Malaria
Onchocerciasis
American trypanosomiasis
(Chagas disease)
– West Nile Virus
• Foodborne & waterborne
diseases
– Bacterial diarrhea
– Hepatitis A
– Typhoid / paratyphoid fever
• Water-contact diseases
– Leptospirosis
• Direct or indirect personal
contact
– Hemorrhagic Conjunctivitis
https://mic.afmic.detrick.army.mil/osis/search/sitesearch/filetest.php?query=mexico
http://www.cdc.gov/travel/camerica.htm
Socioeconomic Indicators
SOCIOECONOMIC
INDICATORS
GNI PPP Per Capita
Adult Female Literacy Rate
(% age 15+)
Adult Male Literacy Rate
(% age 15+)
GDP
GDP real growth rate
GDP per capita
External Debt
Inflation
Population below poverty
line
Unemployment
Rate
YEAR MEXICO YEAR
U.S
2001
2003
$8,240
90.50%
2001
1979
$34,280
97%
2003
94%
1979
97%
2002
2002
2002
2001
2002
2001
2001
$924B
0.70%
$8,920
$191B
6.40%
40%
3% urban
2002
2002
2002
2001
2002
2001
2002
$10.5T
2.40%
$36,300
$862B
1.60%
12.70%
6%
http://www.cia.gov/cia/publications/factbook/geos/mx.html
http://www.nationmaster.com/country/mx
http://www.prb.org/datafind/prjprbdata/wcprbdata.asp?DW=DR&SL
Morbidity & Mortality
HEALTH STATUS
INDICATORS
YEAR MEXICO YEAR
U.S.
Infant Mortality Rate
(deaths per 1,000 live
births)
2003
25
2003
6.9
Mortality Rate – under 5
per 1,000 live births
2001
29
2001
8
Malnutrition prevalence
(% children under 5)
2001
7.5
1995
1.4
Adult Male Mortality
Rate
Adult Female Mortality
Rate
2000
180
2000
141
2000
101
2000
83
Maternal Deaths per
100,000 live births
2002
65
2002
12
Low-birth weight Babies
1995
9.2
2001
7
TB incidence
2000
38.1
2001
5.4
People Living with
2001
150,000
2001 900,000
HIV/AIDS
http://devdata.worldbank.org/hnpstats/HnpAtaGlance.asp?sCtry=MEX,Mexico
http://www.cia.gov/cia/publications/factbook/geos/mx.html
http://www.prb.org/datafind/prjprbdata/wcprbdata.asp?DW=DR&SL
Vaccinations
2002 Immunization
Profilles
Mexico
U.S.
BCG
DTP1
DTP3
HepB3
99
92
91
91
97
94
88
Hib3
MCV
Pol3
91
96
92
93
91
90
http://www.who.int/vaccines/globalsummary/immunization/CountryProfileResult.cfm
Mexico’s Health System
• Public Health Care
– Secretariat of Health and Assistance
– Institute of Social Security and Government
Workers
– Mexican Social Security Institute
• Less than 10% of the Mexican population
has private coverage
https://mic.afmic.detrick.army.mil/osis/search/sitesearch/filetest.php?query=mexico
http://open.imshealth.com/webshop2/IMSinclude/i_article_20040105.asp
Healthcare Costs & Finance
HEALTH CARE
FINANCE
YEAR MEXICO YEAR
U.S.
Total Health Expenditures
(% of GDP)
2001
5
2001
13.9
Health Care Expenditures
per capita ($US)
Public health expenditures
as % of total expenditures
Private health
expenditures as % of total
expenditures
Social Security
Expenditures as % of
health expenditures
Physicians per 1,000
people
Hospital Beds per 1,000
population
2000
$311
2000
$4,499
2001
44.3
2001
44.4
2001
55.7
2001
55.6
2001
66.5
2001
32.9
2000
1.8
2000
2.8
200
1.1
2000
4
http://www.who.int/country/mex/en/
http://devdata.worldbank.org/hnpstats/HnpAtaGlance.asp?sCtry=MEX,Mexico
Health Care Aid
• OECD – Aid from U.S.
– 1990-92 US$60M
– 1993-95 US$103.3M
– 1996-98 US$241.7M
• Inter-American Development Bank
– Summary of IDB Financing ($US)
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2002 Lending $1B
1961-2002 Lending $16B
2002 Disbursements $993B
1961-2002 Disbursements $13.2B
http://www.iadb.org/exr/country/eng/mexico/index.cfm
http://www.oecd.org/dataoecd/22/31/25503059.pdf
Telecommunications
• Telephones: main lines in use: 12.32M
(2000)
• Mobile cellular: 2.3M (1998)
• Radio broadcast stations: 1465 (2000)
• Television broadcast stations: 236 (1997)
• Internet Service Providers (ISPs): 51 (2000)
• Internet users: 3.5M (2002)
http://www.odci.gov/cia/publications/factbook/geos/mx.html
Military Forces
Armed Forces
Personnel
Strength
World
Ranking
Army
130,000
#18
Air Force
8,000
#33
Navy
37,000
#15
Military Spending
Military Expenditures per % GDP
(FY99, Mexico & US)
Military Expenditures Dollar Figure
(FY99, Mexico & US)
Mexico
1%
United States
3.2%
$4B
$276.7 B
http://www.nationmaster.com/country/mx/Military
Military Health Care
• Secretariats of National Defense and Navy
operate separate health care services
– Mexico City
• The Central Military Hospital
• Naval Medical Center
– Physicians are well trained and well regarded by
civilian authorities
– Training of nursing and paramedical personnel is
substandard compared to the U.S.
• Blood supply is safe
https://mic.afmic.detrick.army.mil/osis/search/sitesearch/filetest.php?query=mexico
Implications for Military Planners
• Viral or bacterial diarrhea could occur among
personnel consuming local food, water, or ice
• Water Resources
• Disease Prevalence
• Field conditions (including lack of hand
washing and primitive sanitation) may facilitate
person-to-person spread of epidemics