ArticleRevista brasileira de epidemiologia = Brazilian journal of epidemiology2026
Sociodemographic determinants of health care in heart failure mortality in Mexico, 019 and 2023.
Article in Revista brasileira de epidemiologia = Brazilian journal of epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo analyze sociodemographic determinants associated with medical care before death from heart failure (HF) in Mexico, comparing 2019 and 2023.
methodsA retrospective cross-sectional analytical study was conducted using national mortality records from the General Directorate of Epidemiology (DGE). HF deaths (ICD-10: I50.0-I50.9) from 2019 and 2023 were selected, representing pre- and post-pandemic (COVID-19) contexts. The variables included gender, age, education, marital status, health insurance coverage, area of residence, region, place of death, and year of occurrence. Multiple logistic regression was applied to estimate odds ratios (OR) with 95% confidence intervals (95% CI).
resultsIn the 2019-2023 period, 13,510 HF deaths were recorded (6,077 in 2019 and 7,433 in 2023). The probability of receiving medical care before death was 22% higher in 2023 compared to 2019 (OR 1.22; 95%CI 1.10-1.36). Medical care was more likely among individuals aged ≥80 years old, with higher educational levels, living in urban areas, and with health insurance coverage. Being male, lacking health coverage, and dying at home were associated with a lower probability of receiving medical care. The interaction between health insurance coverage and place of death revealed reduced access to medical care among individuals without social security who died at home.
conclusionsSubstantial gaps in access to medical care persist, associated with structural and social inequalities. The post-pandemic recovery of coverage indicates a partial strengthening of the health system. Strengthening primary health care, expanding effective universal coverage, and developing strategies targeting vulnerable groups are recommended.
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