Youth mortality, social marginalization and health inequity in Mexico

Abstract This study seeks to determine the differences in youth mortality in Mexico based on selected causes by sex and extreme levels of municipal marginalization in two triennia (2004-2006 and 2015-2017) and to establish a relationship between the differences found, the social environment and the availability of health resources. Using official data, years of life lost (YLL) between 0 and 85 years old and YLL for the 15-29-year-old age group were calculated for 15 of the main causes of death in Mexico in both triennia; the YLL was calculated for municipalities grouped into two categories: high and very high marginalization (HaVHMA) and low and very low marginalization (LaVLMA). Violent deaths (especially homicides) are the main causes of death in young women and men throughout Mexico, regardless of the level of marginalization, and increased from the first to second triennia studied. Men aged 15 to 29 years in HaVHMA municipalities had an excess YLL compared to those in LaVLMA municipalities in 13 of the 15 causes analyzed for 2004-2006 and in all causes for 2015-2017; for women, excess was observed for 13 of 15 causes in each triennium. These findings reflect the unfair disadvantages to which young people are exposed in HaVHMA municipalities.

摘要 本研究旨在探究2004-2006年与2015-2017年两个三年期内，墨西哥青少年死亡率基于选定死因、性别以及市级边缘化极端程度的差异，并厘清上述差异与社会环境、卫生资源可及性之间的关联。本研究利用官方统计数据，针对上述两个三年期内墨西哥15种主要死亡原因，分别计算了0至85岁人群以及15至29岁年龄组的减寿年数（Years of Life Lost, YLL）；同时将市级行政单位按边缘化程度划分为高/极高边缘化（High and Very High Marginalization, HaVHMA）与低/极低边缘化（Low and Very Low Marginalization, LaVLMA）两类，并分别测算两类地区的减寿年数。研究结果显示，无论边缘化程度如何，暴力死亡（尤其是他杀）均为墨西哥全体青年男女的首要死亡原因，且在本次研究的两个三年期内呈上升趋势。2004-2006年，在15种分析死因中，有13种死因对应的15至29岁男性在HaVHMA市级单位的超额减寿年数高于LaVLMA市级单位；2015-2017年，所有15种死因均呈现该特征。而女性群体在两个三年期内，均有13种死因表现出上述超额减寿年数差异。上述研究结果反映出，HaVHMA市级单位中的青年群体面临着不公平的生存劣势。