ArticleFrontiers in public health2026
The compounding burden of disability in Mexico: social protection gaps, chronic disease excess, and prospective mortality from national open data sources.
Article in Frontiers in public health, 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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10 authors.
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Abstract
Background: Persons with disabilities (PWD) face disproportionate barriers to social protection and healthcare worldwide, yet comprehensive multi-source evidence linking social security coverage, morbidity, and mortality outcomes remains scarce in Latin America. Methods: We conducted a cross-sectional, multi-source population-based study with a prospective cohort component, integrating nine nationally representative Mexican data sources (2017-2023) encompassing over 125 million persons. Disability was operationalized using source-specific measures, including Washington Group-based instruments where available. We examined social security coverage disparities, catastrophic health expenditure, chronic disease prevalence, intersectional exclusion, prospective three-year mortality, and geographic overlap with healthcare infrastructure deficits. Survey-weighted logistic regression with progressive adjustment, Benjamini-Hochberg correction for multiple comparisons, and unweighted binomial models for prospective mortality were employed. Results: Among 6.8 million PWD in the 2020 Census, apparent social security coverage advantages reflected a structural shift to non-contributory programs driven by older age structure; after demographic adjustment the advantage disappeared (OR = 0.99, Conclusions: The apparent social security advantage of PWD is an artifact of older age structure and a shift toward non-contributory programs that confer nominal affiliation without a detectable mortality benefit in this older-adult cohort, with disadvantage intensifying for indigenous women with disability. Expanding enrollment alone is likely insufficient: closing this gap requires disability-inclusive coverage that translates affiliation into effective protection.
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