Delivering Healthcare to the Mexican Megalopolis 

Mexico City is the world’s sixth most populated city when considering the metropolitan area in addition to the city proper. There are a staggering 5,920 inhabitants per km² and the city’s Ministry of Health faces great challenges, including demographics. Life expectancy for Mexicans has increased but many are getting sicker despite wanting a better quality of life. “We want to be fitter for a longer period of time, both physically and mentally

Sedentary routines, alcohol and tobacco consumption all affect Mexican lifestyles and contribute to bad health. Although infectious diseases are still an important cause of illness, Mexico’s main concerns are chronic diseases. Hyperglycemia and obesity are still ranked one and two but hypertension and glaucoma are rising through the ranks. In Mexico City, respiratory diseases are the first cause of illness, which is not a surprise when considering the frequently high levels of air pollution.

Rosales said the city is equipped to deal with this through 210 health centers integrated into its system, of which 100 are at a primary care level, 46 at the secondary and 64 tertiary centers. There are also 33 hospitals in the metropolitan area with a variety of specializations. There are 32,157 people working in the Mexico City health system.

The Médico en tu Casa program is responsible for visiting vulnerable groups in their homes. It has detected many pregnant women that had never been to the hospital for antenatal checkups, many of which are also children and adolescents. The program had visited 2.4 million homes in the populous Iztapalapa neighborhood alone by September 1, 2016.

“We are extremely interested in the participation of the public in looking after their own health,” the said. The Ministry is placing a bigger focus on prevention. It has 12 early detection clinics in Metro stations and two more in the Central de Abasto, the city’s main wholesale market. These provide free checkups for people going about their daily business, important as people are reluctant to go for checkups.

The city is campaigning for the reduction of salt in food and has also supported the sugar tax and the traffic light system on food packaging. Diabetes is the affliction that has increased the most since 1985. It is estimated that 76.6 percent of years of life lost in 2013 were caused by this condition.

Added to these issues, 56 percent of the metropolitan population does not have social security and even those who do still opt to pay for private services, according to Rosales. He explained that the city’s Ministry of Health strives to offer healthcare to those who do not have social security, most importantly those considered as the most vulnerable groups of society: children and adolescents, the disabled, mothers as sole breadwinners of families, indigenous populations, the imprisoned population, the elderly, the LGBT population and homeless people.

“Fifty percent of children between the ages of 10-14 do not perform any type of physical activity. 67 percent of them spend more than 2 hours a day watching television,” he said. This contributes to overweight and obese children. “We are approaching 40 percent obesity in adults between 20 and 50,” he added.

The Ministry is also working on the reduction of tobacco use and maintains programs like the weekly Ciclotón and is campaigning to keep children in school full time. It is creating urban gyms and has implemented the Ecobici program to encourage outdoor exercise.

“We are working on educating youngsters and adolescents on health instead of waiting for them to become ill,” Rosales said. For this the city’s Ministry of Health is distributing books and leaflets that teach good practices in nutrition and exercise, and providing sexual education to avoid pregnancies in children and adolescents. “To prevent and change lifestyles we need an informed population that has access to healthcare services, no matter through which means,” he concluded.