In Mexico, HOPE is working to reduce the impact and burden of noncommunicable diseases like diabetes, with a specific focus on reaching young people at risk.
About Mexico
Mexico is home to over 127 million people, making it the 10th-most populated country in the world. Mexico is classified as an upper-middle income country, with the world’s 14th-largest economy and the highest income per capita in the region. However, according to the Organisation for Economic Co-operation and Development, the country has the second-highest degree of economic disparity between the extremely poor and the extremely rich. Although only 2% of the population lives below the international poverty line, as of 2013, approximately 42% live below the national poverty line.
Young people play a significant role in shaping both the current and future health profile of the country. Children under 18 represent about 43% of the total population, and among OECD countries, Mexico has the second-highest share of youth age 15-19 who are unemployed or not receiving any form of education or training.
Mexico instituted universal health care in 2009, and most of the population relies on the public sector for health care, which is guaranteed by Article 4 of the Mexican Constitution. Health services are either partially or fully subsidized depending on an individual’s employment status. Mental health, however, is recognized as one of the main unresolved issues within the government’s national health policy agenda: Between 2008 and 2014, deaths related to mental health increased by 33%.
The Challenges
Rising obesity rates
Mexico has some of the highest overweight and obesity rates in the world: 65% of the overall population is overweight, and 30% of the population is obese — the second-highest rate in the world after the U.S. Children haven’t been spared — 1 in 3 are overweight or obese. Obesity rates have been gradually rising over the past four decades, putting tens of millions of Mexicans at a higher risk of developing chronic diseases like diabetes.
High rates of sugar consumption are a major factor for the rise. Like many developing countries, Mexico has gone through a drastic change in its consumption patterns, correlating with advances in agricultural technology in the 1970s and 1980s. This resulted in dramatic changes to diets high in carbohydrates and fats and low in proteins.
Mexico is especially notorious for its taste for sugary drinks: In 2012, the country consumed more sugar-filled drinks than anywhere else in the world. In 2014, Mexico introduced a soda tax in hopes of discouraging the unhealthy consumption habits, but the country was still the second-highest per capita consumer of soda in 2015, behind Chile.
Increasing risk of diabetes, a national emergency
Many noncommunicable diseases are linked with sugar consumption, unhealthy diets and sedentary lifestyles. It’s estimated that NCDs account for 80% of total deaths in Mexico. Cardiovascular disease is a major health challenge — approximately 1 in 4 adults has hypertension, 40% of whom are unaware — and diabetes claims more than 80,000 lives each year.
In 2017, Mexico declared the epidemic of diabetes a national emergency. The percent of Mexico’s population that has died from complications related to diabetes has tripled since 1990. More than 17 million adults in Mexico are currently living with the chronic disease — about 14% of the entire population.
The steadily increasing prevalence of diabetes imposes a tremendous financial strain on the health-care system, costing Mexico billions of dollars each year.
Prevalence of teenage pregnancy
Adolescent pregnancy is the leading cause of death for girls between 15 and 19 worldwide, and almost all of these deaths take place in developing countries, including Mexico.
Among OECD countries, Mexico has the highest teen pregnancy rate, with 66 out of every 1,000 pregnancies occurring in girls and adolescents. In 2017, 1 out of every 5 mothers who gave birth in Mexico was a teenager. Girls in the poorest settings are at greatest risk — teen pregnancy rates are over six times higher in low-income settings than in high-income groups.
Many of these pregnancies could be prevented with improved access to contraceptives and greater education and awareness around sexual and reproductive health.
Bringing HOPE to Mexico
Our history in Mexico
HOPE has been actively operating in Mexico since 1999.
Our work began with HIV/ AIDS programming, with a later focus on combating the increasing prevalence and burden of diabetes. Today, our activities are focused around training health workers, teaching people how to manage their health, and reaching high-risk populations including school children and women with gestational diabetes. We also work with local partner organizations to manage and reduce the growing threat of NCDs, with a particular focus on reaching young people with the knowledge and resources they need to lead healthy lives.
Helping diabetes patients manage their health and counsel others
In 2005, HOPE developed and introduced a comprehensive patient education program called “5 Steps to Self-Care” to provide diabetes patients with the knowledge, skills and social support they need to manage their condition and counsel others.
Delivered as a 12-part workshop series, the interactive program uses games and activities to teach diabetes and self-care behaviors and improve community health. The program has been so successful that we’ve since adapted it for use in Puerto Rico, South Africa and the United Arab Emirates.
In 2015, we launched community outreach and diabetes screening activities through the local organization SerBien (founded by Project HOPE). This work included placing testing kiosks in high-traffic areas like bus and train stations, as well as providing peer-to-peer education and referrals to nearby health centers.
Training health professionals, equipping low-resource facilities
In 2009, HOPE expanded its work to reach Mexico’s health professionals by providing diabetes training to doctors, nurses and other health professionals in several municipalities, including how to respond in communities with low-income diabetic patients.
The next year, HOPE developed a successful program to increase screening for gestational diabetes in pregnant women. The training program was specifically focused on providing a screening protocol for health professionals in low-resource, primary health-care facilities. We also leveraged SMS to send key educational text messages to women, promoting a greater understanding of risk factors, diabetes management and healthy lifestyle choices.
Promoting diabetes education and healthy lifestyles in schools
Between 2008 and 2012, HOPE implemented a school-based “diabesity” awareness program in the NEZA health district of Mexico City. The program raised awareness on the link between obesity, Type 2 diabetes and the associated health risks. We also promoted healthier eating habits and physical activity.
Empowering young people to protect themselves against NCDs
The period of adolescence is pivotal in reducing NCDs and maximizing health across all stages of life. Decisions are made, habits formed, and paths chosen that can have life-long repercussions. Evidence shows that unhealthy behavior patterns related to NCDs are often initiated during childhood and adolescence, and it’s estimated that over half of all NCD deaths are associated with behaviors that began or were reinforced during adolescence.
Today, through the AstraZeneca Young Health Program, we’re empowering young people (ages 10-24) with the knowledge they need to develop and practice healthier habits, while simultaneously strengthening the health services available to support them. We’re also strengthening the implementation of — and advocating for — policies and laws that help young people make healthier choices.
Our Impact
Our work to prevent and fight NCDs like diabetes has touched the lives of thousands of high-risk patients and health professionals. To date, nearly 2,400 people have graduated from our signature 5 Steps program, and thousands more have received prevention and care messages through peer counseling. Participants have also demonstrated improved health outcomes, including reductions in Hemoglobin A1c levels and Body Mass Index.
Through our work with SerBien, more than 2,200 people were screened and assisted over a 10-month period. Additionally, we’ve trained nearly 600 health professionals on diabetes and how to most effectively respond in communities with low-income patients, resulting in an average 25% increase in their knowledge of the disease.
As part of our efforts to reach higher-risk populations, screening for gestational diabetes has been implemented in 15 primary health-care clinics, effectively benefiting thousands of women in lower-resource settings. In schools, meanwhile, more than 11,000 children have participated in our “diabesity” awareness program. Most students registered improvements in healthy habits, including consumption of more water, fruits and vegetables, and taking more time to exercise.