Mexico's epidemic of violence and its public health significance on average length of life

Abstract

ObjectivesA disproportionate number of homicides have caused Mexican life expectancy to stagnate during the new millennium. No efforts currently exist to quantify the harm of violent acts on the lives of the general population. We quantified the impact of perceived vulnerability on life expectancy.MethodsThree Mexican national surveys on perceptions of public safety, life tables, and crime and vital statistics (2000–2014) were used. Prevalence rates of vulnerability/safety by age and sex were obtained from surveys at 2 different levels: federal state and home. The Sullivan method was used to estimate life expectancy lived with and without vulnerability for Mexican women and men.ResultsOverall life expectancy at age 20 stagnated between 2005 and 2014 for females and males; yet, there was an increase of 40% and 70% in average number of years lived with vulnerability at the state and home levels, respectively. In 2014, female life expectancy at age 20 was 59.5 years (95% CI 59.0 to 60.1); 71% of these years (42.3 years, 41.6 to 43.0) were spent with perceived vulnerability of violence taking place in the state and 26% at the home (15.3 years, 15 to 15.8). For males, life expectancy at age 20 was 54.5 years (53.7 to 55.1); 64% of these years (34.6 years, 34.0 to 35.4) were lived with perceived vulnerability of violence at the state and 20% at the home (11.1 years, 10.8 to 11.5).ConclusionsThe number of years lived with perceived vulnerability among Mexicans has increased by 30.5 million person-years over the last 10 years. If perceived vulnerability remains at its 2014 level, the average Mexican adults would be expected to live a large fraction of his/her life with perceived vulnerability of violence. Acts of violence continue to rise in the country and they should be addressed as a major public health issue before they become endemic.

The adult mortality profile by cause of death in 10 Latin American countries (2000–2016)

“…However, its relevance to adult mortality in Mexico is noteworthy, given that it is significantly larger than in other countries. This finding corroborates other studies that discuss the effect of diabetes on the evolution of life expectancy in Mexico (13,16).…”

“…On the other hand, the average number of years lived in adulthood decreased continuously for males and females in Mexico between 2007 and 2010. Part of the increase in adult mortality rates in Mexico can be explained by the rise in violence and the mortality from chronic diseases, such as heart disease and diabetes (12,13,16), which will be discussed later in this article. Since 2010, the average number of years lived in adulthood has risen again in Mexico, especially due to public policies aimed at the prevention and treatment of chronic diseases.…”

“…Another striking feature of the mortality pattern in Latin America, especially in Brazil, Colombia, Ecuador, and Mexico, has been the increasing number of deaths from violence and accidents since the 1980s. These levels are still high in many countries, and there is a concentration of these deaths among young adult males (3,11,(13)(14)(15)(16)(17)(18). Frenk et al (18) argue that the mortality from these causes in Latin American countries is independent of the epidemiological transition and is strongly associated with political instability, economic inequality, social segregation, and drug trafficking.…”

Changes in life expectancy due to avoidable and non-avoidable deaths in Argentina, Chile, Colombia and Mexico, 2000-2011

“…In 2011, the mortality rate from homicides was 23.2 and 36.1 (per 100,000 people) in Mexico and Colombia, respectively 9 . The excess mortality from homicides is an increasingly important phenomenon in Mexico that has been identified as the triggering cause of the stagnation in life expectancy in that country 10,38,39,40 . In Colombia, although the mortality rate from violence remains high, a gain of 1.13 years was recorded between 2000 and 2011 for men between 15 and 49 years of age 9 .…”

“…Even though external causes of death (such as homicides, suicides and traffic accidents) have an ample presence in the epidemiological profile of Latin America and the Caribbean 9,10,11,37,38,39,40,41,42 , they were not included in the avoidable causes of death classification. Given their complexity, they should be analyzed independently, considering that its approach should not only be restricted to the field of public health, but it also depends on wider public policies: social, economic, cultural, among others 42,43 .…”