Aging, chronic diseases, and illnesses leading to disability are key challenges to health systems because of their impact and high costs. Therefore, it is necessary to consolidate the right to health access for the entire population as well as to promote preventive programs that allow life expectancy to expand in optimal physical and mental conditions.
The Right to Health
In Mexico, the right to health was established in the social rights constitution after the Mexican Revolution but was linked to having formal work or the capacity to pay. As a result, more than 50 percent of the population lacked effective access to health care.
After 2003, Mexico took a more active role in terms of legal reforms, public policy, and increasing resources to guarantee all Mexicans their right to health without any distinction, as established by the human rights and psychosocial wellness approach and the World Health Organization. Consolidating this right while strengthening preventive actions and promoting timely healthy choices will allow Mexico to better deal with demographic and epidemiological challenges.
On January 2004, the General Health Law reform established a Social Protection System in Health, better known as Popular Insurance (Seguro Popular), an equitable financing scheme whereby the federal and local governments as well as beneficiaries contribute to provide a basic health care package to the whole population, especially covering certain interventions that tend to impoverish families.
Seguro Popular has been expanded and now covers 100 percent of basic primary care interventions, 95 percent of hospital interventions, and a growing number of specialty and catastrophic interventions that represent serious or very expensive treatments. Also included is a set of preventive interventions to reduce chronic disease prevalence and hospitalization, medicines, and analyses, as well as several types of cancer.
This voluntary affiliation insurance has already reached 45.8 million persons and involved around $4.9 billion1 in 2010. By 2012 universal coverage will be attained, meaning 51.3 million Mexicans will have access to health care while protecting their family incomes. Through this program, they will access not only medical attention but also health promotion services, a key element toward a healthier population.
To guarantee the population access to timely and quality health care services, a major federal and local investment has been made in infrastructure during the last four years, with over $5.3 billion spent to build, expand, or refurbish more than 2,750 medical units in the entire public health sector, including clinics, health centers, and community, general, and specialist hospitals.
More than 9,500 public and private health units providing 68 percent of the services to the Seguro Popular have been certified for their capacity, security, and quality. Starting in 2011, all hospitals providing services are required to be certified in order to receive any funding, thus establishing a quality standard and optimizing resources.
More than 96 million Mexicans—around 86 percent of the country’s population—are protected either by Seguro Popular or by social security institutions.
Preventive Actions and Chronic Diseases
Our country is currently going through an epidemiological transition, with the morbidity, disability, and mortality burdens changing. Chronic diseases such as diabetes mellitus, cardiovascular diseases, and cancer are taking over the first places as causes of mortality. While the challenge affects the entire population, older adults are especially vulnerable to health problems resulting from these conditions.
Many illnesses are directly related to unhealthy lifestyles and habits, such as sedentary behavior, alcohol and tobacco abuse, consumption of high-sodium processed food with low nutritional content, or psychosocial stress. Therefore, we are promoting, among many actions, physical activity to prevent obesity, control diabetes, and even prevent other diseases such as cancer.
In Mexico, more than 90 percent of the diabetes cases are related to being obese and overweight. Globally, Mexico is the second ranked country in terms of obesity: 70 percent of adults and two out of three children are overweight, which may lead to an average 14.5 years of sickness and a consequent reduction of 7 years in life expectancy.
National health policy emphasizes the promotion of health and prevention of diseases such as cancer, diabetes, and hypertension. Therefore, there is a need to build a new health culture involving public, social, and private sectors, which are already sensitive to the topic and becoming valuable allies to support the policy.
Recognizing the economic and social costs that these ailments represent for development will allow us to promote an overall higher quality of life for the population with interventions within and outside the health sector.
To face the obesity and weight challenge, the federal government has endorsed the National Agreement for Nutritional Health, A Strategy against Obesity and Overweight, which promotes access to healthier food and beverages while encouraging physical activity.
Another national program is Five Steps for Your Health, which communicates five easily understood elements: Move (physical activity); Drink water (promoting plain water over different beverages); Eat fruits and vegetables (healthier eating habits); Measure yourself (awareness of weight and food portions); and finally, Share your experience (with friends and family).
The nutritional content of more than 10 million school breakfasts has been improved, and since January 2010, foods and beverages sold at schools must comply with a new regulation: They cannot contain more than 40 percent fat as caloric intake, nor generate more than 140 calories per portion. Additionally, a self-regulation code to reduce unhealthy food television advertisements has been developed.
Specialized health units are being built to deal with chronic-progressive diseases through a demonstrative and multidisciplinary model to study and treat these diseases. By the end of 2010, 101 units were completed, each including a general physician, a social worker, a nutritionist, and an odontologist.
Through the program Healthy Communities and Environments, we are promoting self-care for the population and attending main needs together with municipal authorities, social sectors, and organized communities. Resources are allocated to municipal projects, communities are certified, and health procurement agents are trained.
Another essential element of our policy to respond to demographic change is the creation of the National Institute for Geriatrics, dedicated to research on a variety of topics related to aging, including the risks of certain diseases for older persons. Through this effort we have also enhanced the capacity of other institutes to respond to older persons, expanded the number of geriatric doctors, and trained more than 25 thousand health professionals in the topic.
Health is our country’s priority to improve quality of life and move toward a fairer, more equitable, and healthier Mexico.
1 The exchange rate considered was 12 pesos per dollar.
Dr. José Ángel Córdova Villalobos
Doctor José Ángel Córdova Villalobos is the Federal Health Secretary for the 2006-2012 term. He is a specialist in Internal Medicine and in General Surgery and Digestive Endoscopy, and he has a Master’s in Public Administration. He is the Chairman of the Congress of the Pan-American Health Organization.