The increase in highly marginated areas may be partly explained by well-documented local registration of deaths. Further studies focusing on survival are required in order to better assess the effectiveness of cancer detection and medical treatment in our country.

Diabetes mellitus (DM) is currently one of the leading causes of mortality worldwide. However, the disease evolves differently across countries. This study intends to characterize the trends and assess the potential effects of marginalization on DM mortality between 1990 and 2019 in Mexico. We analyzed death certificates that listed DM as the underlying cause of death (N = 1,907,173), as well as the extent to which DM mortality changes were associated with marginalization through an age-period-cohort analysis. DM mortality increased in Mexico between 1990 and 2019; the change was faster in the first half and slowed down after 2004. The highest marginalization quintiles drove the changes in DM mortality trends during the study period, with a higher risk of dying in these quintiles as age increased. In recent cohorts, the highest marginalization quintiles doubled the risk of dying from DM as compared to the lowest. Renal complications was the main death driver among persons with DM, with a marked increase between 1999 and 2001. In conclusion, Mexico continues to have a substantially high DM mortality, but its pace slowed over time. Moreover, subnational differences in marginalization can partially explain such a trend.

The use of chronic kidney disease as a tracer of the technical capacity of the Mexican health care system is useful to understand the problems of primary care in the country's public settings.

Objective To determine the factors associated with anxiety, depression, and concern within the COVID-19 pandemic in a population with autoimmune diseases. Methods A telephonic survey was conducted during the early stages of the pandemic in a tertiary care center, which included patients with systemic autoimmune diseases. Mental health variables were assessed with Patient Health Questionnaire 2, General Anxiety Disorder 7 scores, and pandemic-related concern questions. Sociodemographic aspects were also evaluated. Results Of the total 334 participants, 291 (87.1%) were women, with a median age of 46 years; systemic lupus erythematosus (SLE) was the most frequent diagnosis (144, 43.2%); 44 patients (13.2%) showed depression and 32 (9.6%) anxiety. The variables associated with depression were all the pandemic concern items, body mass index, anxiety, and a higher COVID-19 symptom score. Anxiety was associated with depression, all pandemic concern items, and a higher COVID-19 symptom score. Women presented higher scores in all concern items. The SLE group presented higher scores in concern questions and difficulty finding medication. Conclusion During the COVID-19 outbreak, rheumatic patients are vulnerable to psychiatric conditions, which makes it imperative for physicians who treat these patients to pay careful attention in order to detect them promptly and to settle coping strategies.

Globally, diabetes mellitus (DM) is one of the leading causes of mortality. However, this behavior may differ over time for countries given their intrinsic factors. The objective of the study is to characterize the trend and assess the potential effect of marginalization on DM mortality during 1990-2019 in Mexico. We analyzed death certificates where DM was listed as the underlying cause of death (N=1,907,173) and the extent to which DM mortality changes, were associated with marginalization from an age-period-cohort analysis. DM mortality has increased for Mexico in the 1990-2019 period, this change was faster in the first half of our study and slowed after 2004. The highest marginalization quintiles drove the changes in DM mortality trends during 1990-2019 in Mexico, with higher risk of dying in these quintiles with aging than the lowest. In the most recent cohorts, the highest marginalization quintiles showed twice the risk of dying from DM than the lowest. Renal complications were the leading cause of death in persons with DM during 1990-2019, with a marked increase since 1999-2001. In conclusion, Mexico continues with a very high DM mortality, but this has slowed over time, and subnational differences in the marginalization can partially explain this trend.