The Spatial and Environmental Predictors of Adult Mortality in the Northern Mexico Border Region.

Validity Study;Spatial Distribution of Mortality;Mexico;Public Health;Health Sciences;Epidemiological Science

Freire de Carvalho, Mary HofmeisterMorgenstern, Lewis B. ;

University of Michigan

关键词: Validity Study;    Spatial Distribution of Mortality;    Mexico;    Public Health;    Health Sciences;    Epidemiological Science;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/62350/hofmeist_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

The Northern Mexico Border Region, bolstered by the growth of export processing factories (maquiladoras) and cross-border travel and migration, has experienced rapid population expansion and urbanization in the past 50 years. While, early research on the impact of maquiladoras identified important direct and indirect health effects of employment in the industry, little research has been conducted on the overall impact of the region’s trade-driven development on population health.This dissertation, through a series of cross-sectional studies set in the desert ecosystem of the capital city of the Northwestern Border State of Sonora, measures the association between diverse aspects of the urban environment and the spatial and temporal distribution of adult mortality. Adult mortality data from the vital registry of the state of Sonora is a valuable, yet underutilized tool for epidemiologic research in the region.The first stage of this project examined the reliability of the underlying cause of death (uCOD) provided by the vital registry system.This study found moderate to good agreement between the original and an expert uCOD at the International Classification of Disease (ICD-10) chapter level. In the second stage of the project, Geographic Information Systems and spatial analysis were used to identify vulnerable populations within the urban environment. Clusters of high adult mortality for all-cause and circulatory deaths were identified in high marginality census tracts. In the final study, generalized additive models were used to demonstrate a significant negative association between daily maximum temperature and mortality, with the strongest temperature effects occurring in the elderly and for circulatory and respiratory deaths. The Northern Mexico Border region has experienced rapid demographic and epidemiologic shifts, with limited research on the impact of these shifts on population health.Consistent with previous research on infant mortality, this study found vulnerable populations, both spatially and demographically defined, which experience higher adult mortality rates than other populations within the urban environment, suggesting future directions for both research and policy initiatives in the region.