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BackgroundMexico City prisons are characterized by overcrowded facilities and poor living conditions for housed prisoners. Chronic disease profile is characterized by low prevalence of self reported hypertension (2.5%) and diabetes (1.8%) compared to general population; 9.5% of male inmates were obese. There is limited evidence regarding on the exposure to prison environment over prisoner's health status; particularly, on cardiovascular disease risk factors. The objective of this study is to assess the relationship between length of incarceration and selected risk factors for non-communicable chronic diseases (NCDs).Methods and findingsWe performed a cross-sectional analysis using data from two large male prisons in Mexico City (n = 14,086). Using quantile regression models we assessed the relationship between length of incarceration and selected risk factors for NCDs; stratified analysis by age at admission to prison was performed. We found a significant negative trend in BMI and WC across incarceration length quintiles. BP had a significant positive trend with a percentage change increase around 5% mmHg. The greatest increase in systolic blood pressure was observed in the older age at admission group.ConclusionsThis analysis provides insight into the relationship between length of incarceration and four selected risk factors for NCDs; screening for high blood pressure should be guarantee in order to identify at risk individuals and linked to the prison's health facility. It is important to assess prison environment features to approach potential risk for developing NCDs in this context.

ObjectivesTo describe patterns of transmissible infections, chronic illnesses, socio-demographic characteristics and risk behaviors in Mexico City prisons, including in comparison to the general population, to identify those currently needing healthcare and inform policy.Materials and methodsA cross-sectional study among 17,000 prisoners at 4 Mexico City prisons (June to December 2010). Participation was voluntary, confidential and based on informed consent. Participants were tested for HIV, Hepatitis B & C, syphilis, hypertension, obesity, and, if at risk, glucose and cholesterol. A subset completed a questionnaire on socio-demographic characteristics and risk behaviors. Positive results were delivered with counseling and treatment or referral.Results76.8% (15,517/20,196) of men and 92.9% (1,779/1,914) of women participated. Complete data sets were available for 98.8%. The following prevalence data were established for transmissible infections: HIV 0.7%; syphilis: Anti-TP+/VDRL+ 2.0%; Hepatitis B: HBcAb 2.8%, HBsAg 0.15%; Anti-HCV 3.2%. Obesity: 9.5% men, 33.8% women. Compared with national age- and sex-matched data, the relative prevalence was greater for HIV and syphilis among women, HIV and Hepatitis C in men, and all infections in younger participants. Obesity prevalence was similar for women and lower among male participants. The prevalence of previously diagnosed diabetes and hypertension was lower. Questionnaire data (1,934 men, 520 women) demonstrated lower educational levels, increased smoking and substance use compared to national data. High levels of non-sterile tattooing, physical abuse and histories of sexual violence were found.ConclusionThe study identified that health screening is acceptable to Mexico City prisoners and feasible on a large-scale. It demonstrated higher prevalence of HIV and other infections compared to national data, though low rates compared to international data. Individual participants benefited from earlier diagnosis, treatment and support. The data collected will also enable the formulation of improved policy for this vulnerable group.

Objective To analyse the effect of enrolment in the public health insurance scheme known as Seguro Popular [People's Insurance] on access to health resources, treatment and blood glucose control among poor adults with diabetes in Mexico. Methods We analysed cross-sectional data from the 2006 National Health and Nutrition Survey and compared health care access and biological health outcomes, specifically glycosylated haemoglobin (HbA1c) levels, among adults with diabetes who were enrolled in the Seguro Popular (treatment group) and those who had no health insurance (control group). Standard propensity score matching was used to create a highly comparable control group. Findings Adults with diabetes who were enrolled in the Seguro Popular had significantly more access than comparable uninsured adults to some type of blood glucose control test (by a difference of 9.5 percentage points; 95% confidence interval, CI: 2.4-16.6) and to insulin injections (3.13 more per week; 95% CI: 0.04-6.22). Those with insurance were also significantly more likely to have appropriately-controlled blood glucose levels (HbA1c [less than or equal to] 7%) than their uninsured counterparts (by a difference of 5.6 percentage points; 95% CI: 0.9-10.3). Very poor glucose control (HbA1c > 12%) was found in a significantly Smaller proportion of adults in the insured group than in the uninsured group (by a difference of 17.5 percentage points; 95% CI: 6.5-28.5). Conclusion The Seguro Popular appears to have improved access to health care and blood glucose control among poor adults with diabetes in Mexico, and it may have had a positive effect on the management of other chronic health conditions, but its long-term effects are yet to be demonstrated. Although the findings are most relevant to Mexico, they may also be applicable to other developing countries seeking to improve health-care coverage for the poor by expanding their public health insurance programmes. Objectif Analyser l'effet de la couverture par le schema d'assurance sante publique appele Seguro Popular (Assurance du peuple) sur racces aux ressources de sante, au traitement et au controle de la glycemie pour les adultes pauvres et diabetiques du Mexique. Methodes Nous avons analyse des donnees transversales provenant de l'Enquete nationale sur la sante et la nutrition de 2006 et compare l'acces aux soins de sante et les resultats biologiques, notamment les taux d'hemoglobine glyquee (HbA1c), chez des adultes diabetiques beneficiant de Seguro Popular (groupe traite) et chez des adultes diabetiques depourvus d'assurance sante (groupe temoin), On a fait appel a l'appariement par scores de propension standard pour constituer un groupe temoin hautement comparable. Resultats Les adultes diabetiques beneficiant de Seguro Popular disposaient d'un acces significativement plus important que les adultes comparables non assures a certains types de controles de la glycemie (difference de 9,5 points de pourcentage ; intervalle de confiance a 95 %, IC : 2,4-16,6) et aux injections d'insuline (3,13 de plus par semaine ;IC a 95 % : 0,04-6,22). Les individus assures avaient une probabilite significativement plus elevee de presenter une glycemie correctement controlee (HbA1c [less than or equal to] 7 %) que leurs homologues non assures (difference de 5,6 points de pourcentage ;IC a 95 % : 0,9-10,3). On a releve une proportion significativement plus faible d'adultes presentant un controle de la glycemie tres insatisfaisant (HbA1c > 12 %) dans le groupe assure que dans le groupe non assure (difference de 17,5 points de pourcentage ;IC a 95 % : 6,5-28,5). Conclusion l'assurance Seguro Popular semble avoir ameliore l'acces aux soins de sante et au controle de la glycemie pour les adultes pauvres et diabetiques du Mexique et pourrait avoir eu un effet positif sur la prise en charge d'autres maladies chroniques. Neanmoins, ses effets a long terme restent a demontrer. Si ces resultats concernent principalement le Mexique, ils peuvent aussi etre applicables a d'autres pays en developpement desireux d'ameliorer la couverture des plus demunis par les soins de sante a travers l'elargissement de leurs programmes d'assurance sante publique. Objetivo Analizar los efectos de la cobertura por el plan de seguro medico publico conocido como Seguro Popular en el acceso a los recursos de salud y el tratamiento y control de la glucemia entre los adultos pobres con diabetes en Mexico. Metodos Analizamos datos transversales de la Encuesta Nacional de Salud y Nutricion de 2006 a fin de comparar el acceso a la atencion de salud y el valor de variables biologicas, concretamente de los niveles de glucohemoglobina (HbA1c), en adultos con diabetes beneficiarios del Seguro Popular (grupo de tratamiento) y en una poblacion similar que carecia de seguro de enfermedad (grupo control). Se utilizo el metodo estandar de apareamiento segun propension para crear un grupo control altamente comparable. Resultados Los adultos con diabetes beneficiarios del Seguro Popular disfrutaron de un acceso significativamente mayor que los adultos no asegurados comparables a algun tipo de prueba de control de la glucemia (diferencia de 9,5 puntos porcentuales, con un intervalode confianza, IC, del 95% de 2,4-16,6) y a inyecciones e insulina (3,13 mas por semana; IC95%: 0,04-6,22). Los acogidos al seguro tenian tambien una mayor probabilidad de presentar una glucemia bien controlada (HbA1c [menor que o igual a] 7%) que sus homologos no asegurados (diferencia de 5,6 puntos porcentuales; IC95%: 0,9-10,3). En el grupo asegurado se observo que la proporcion de adultos con un control muy deficiente de la glucosa (HbA1c > 12%) era significativamente inferior a la hallada en el grupo no asegurado (diferencia de 17,5 puntos porcentuales; IC95%: 6,5-28,5). Conclusion El Seguro Popular parece haber mejorado el acceso a la atencion de salud y el control de la glucemia entre los adultos pobres con diabetes de Mexico, y puede haber tenido un efecto positivo en el tratamiento de otras dolencias cronicas, pero quedan por demostrar sus efectos a largo plazo. Aunque los resultados son de especial interes para Mexico, posiblemente pueden aplicarse tambien a otros paises en desarrollo que aspiran a mejorar la cobertura de atencion sanitaria de la poblacion pobre ampliando sus programas de seguro medico publico., Introduction Lack of health insurance can deprive the poor of access to services or put them at risk of financial hardship. To protect the poor against excessive health expenditures, many [...]

Objective: Hispanic populations typically show a high prevalence of dyslipidemias, especially of low high‐density lipoproteins (HDLs) or HDL cholesterol. Highly admixed populations are ideal groups to clarify the role of genetic ancestry on HDL concentrations, isolating it from that of other factors. The objective of this study was to estimate the association between Native American genetic ancestry and HDL‐cholesterol levels independent of socioeconomic factors in a representative sample of the Mexican population. Methods: We used data from the Mexican National Health Survey 2000, analyzing 1647 subjects from whom stored DNA samples and HDL measurements were available. To estimate proportional genetic ancestry (Native American, African, and European), we used a 107 genetic ancestry informative marker panel with the software STRUCTURE. To estimate the association between genetic ancestry and low HDL levels, we fitted logistic regression models with the percentage of Native American genetic ancestry, in quartiles, as the main predictor. Results: Mean HDL levels were 38.9 mg/dL, with 62% of subjects having levels below 40 mg/dL. Participants had on average 53.6% Native American, 39% European, and 7.3% African genetic ancestry. Those in the fourth quartile of Native American genetic ancestry had 35% higher odds of having low HDL‐cholesterol relative to those in the first quartile (odds ratio, 1.35; 95% confidence interval, 0.99‐1.81) after adjustment for socioeconomic level and other covariates, although the association is clearly nonlinear. Conclusion: Native American genetic ancestry seems to play a small but distinct role in the development of low HDL cholesterol levels. [ABSTRACT FROM AUTHOR]