In the mid-1990s, many Mexicans lived inpoverty without adequate access to health and socialservices. Of a total population of 84 million, 25 percentwere considered poor and 16 percent, extremely poor. Urbanareas had health indicators similar to OECD countries, withan increasing burden of non-communicable diseases andinjuries, while many people in rural areas and the southernstates still suffered from common infectious diseases andmalnutrition. Life expectancy in rural areas was 55 versus71 in urban areas and 53 among the poor. The Mexicangovernment realized that inequitable access to basic healthcare for poor and indigenous people hampered economicdevelopment, jeopardized investments in basic education anddeprived citizens of their constitutional right to attaingood health. So it devised a strategy to reduce inequities,improve health care, and modernize the Federal HealthSecretariat (SSA). A 1994 presidential decree created aHealth Cabinet (Gabinete de Salud) headed by the Presidentwith representatives from social security, finance and othersocial sector entities, to guide the SSA restructuring,promote coordination among sectors, and oversee thedecentralization of health services.
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