Healthcare in Mexico
Healthcare in Mexico is provided by public institutions run by government departments, private hospitals and clinics, or private physicians. It is largely characterized by a special combination of coverage mainly based on the employment status of the people and secondarily, based on the capacity of affording external health insurance.
Government has been devoted to protecting the Mexican population, according to the Mexican Federal Constitution, which gives main responsibility to the state in providing national health to the population.  Given this, public healthcare is accomplished by an elaborate segmented provisioning and delivery system put in place by the federal government of Mexico around 70 years ago. This segmentation in the system allowed private organization and private offices run by physicians to offer a variety of healthcare options to people who can afford it and are willing to pay for it.
Hospitals were established in Mexico in the early 16th century, including ones exclusively for Indians. Some were established by the crown, others by private endowment, but most by the Catholic Church. Bishop Vasco de Quiroga established hospital complexes in Michoacan in the sixteenth century. In Mexico City, conqueror Hernán Cortés established the Hospital de Jesús Nazareno for Indians, which still functions as a hospital.
The Hospicio Cabañas in Guadalajara, Jalisco, Mexico, was founded in 1791. It is still functioning and is now a World Heritage Site. It is one of the oldest and largest hospital complexes in Latin America. The complex was founded by the Bishop of Guadalajara to combine the functions of a workhouse, hospital, orphanage, and almshouse.
The Mexican healthcare program, as we know it today, has its base on the creation of several health codes that ran during the first part of the 20th century. It was in 1943 when the Mexican Secretariat of Health and Assistance was established to merge the Department of Public Sanitation and the Secretariat of Public Assistance. Also, in that same year, the Instituto Mexicano del Seguro Social and the Mexican Children's Hospital were founded, during the presidency of Manuel Avila Camacho. After this, several and important changes came, aiming to provide better health for the population. In 1959, the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) was formed as a way of more effectively covering the health services of individuals employed in government institutions. Finally, the Seguro Popular, or Popular Health Insurance, was implemented countrywide in 2003 after the creation of the Social System for Health Protection (SPSS), during the presidency of Vicente Fox Quesada. This institution was charged with covering the country's most impoverished communities— those not covered under the IMSS or the ISSSTE. During the next few years, some other changes in health policies have been made by different presidents as a way of reaching universal healthcare. 
Compared with 1940 or even 1970, 1990s Mexico had mortality patterns that more closely approximated those of developed societies. By 2009, during the notorious swine flu pandemic, the World Health Organization director said that Mexico "gave the world a model of rapid and transparent reporting, aggressive control measures, and generous sharing of data and samples." The Centers for Disease Control and Prevention's flu director, Nancy Cox, added that Mexico's response "impressed the entire world." Additionally, in 2008, a study found that the mortality rate in Mexico had fallen more than eighty percent in comparison to the figures in the first half of the twentieth century— to approximately 4.9 deaths per 1000 inhabitants.
Private healthcare delivery
The services provided by private institutions and private physicians in their offices are afforded by a part of the population, either by contracting a private insurance or by paying directly for the services obtained. It is estimated that around 6.9% of the Mexican population has private insurance coverage, mainly paid as an out-of-pocket expenditure. Mexico has around 28.6 private facilities per 1 million inhabitants, which account for two thirds of all hospitals in Mexico, with 2,988 institutions.
Public healthcare delivery
Public care is fully or partially subsidized by the federal government, depending upon the person's employment status. All Mexican citizens are eligible for subsidized healthcare regardless of their work status via a system of health care facilities operating under the federal Secretariat of Health (formerly the Secretaría de Salubridad y Asistencia, or SSA) agency through the program called Seguro Popular, which offers coverage to Mexicans who do not have formal employment. The program currently protects over 57 million inhabitants and covers around 260 common diseases and 18 high-cost interventions.   This public insurance scheme, coupled with Social Security, represents 95% of the insured population in Mexico. Funding for Seguro Popular is derived from the federal government, the Secretariat of Health, and the individuals who form a part of this system. However, approximately 20% of individuals in this system, representing the poorest covered sector, are exempt from this.
Employed citizens and their dependents, however, can use the program administered and operated by the Instituto Mexicano del Seguro Social (IMSS) (English: Mexican Social Security Institute). The IMSS program is a tripartite system funded equally by the employee, the private employer, and the federal government. There are more than 65 million people covered through IMSS and its programs.Further, within IMSS there exists the IMSS-Oportunidades, a program established out of the Program to Combat Poverty, which is specifically targeted towards aiding the poorest individuals in the country in both the health and educational fields. This program is completely funded by the government.
The IMSS does not provide service to public employees, who instead are serviced by the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) (English: Institute for Social Security and Services for State Workers), which attends to the health and social care needs of government employees: local, state, and federal government employees. There are nearly 9 million people covered by ISSSTE.
The state governments of Mexico also provide health services independently of those that are provided by the federal government programs. In most states, the state government has established free or subsidized healthcare to all of its citizens.
The Secretariat of Health is the largest public healthcare institution, operating 809 hospitals throughout the country. The IMSS grants hospital care and services to employed citizens and their dependents and had 279 hospitals affiliated to it. The ISSSTE grants hospital care and services to government employees and has 115 affiliated hospitals. The other 279 hospitals are affiliated with 9 government dependencies, including State Facilities, Secretariat of National Defense (Secretaria de Defensa Nacional), Mexican Navy (Secretaria de Marina), Petroleos Mexicanos (PEMEX), and the Red Cross (Cruz Roja). The health systems associated with SEDENA, SEMAR, and PEMEX cover over one million individuals combined.
In 2007, there were a total of 23,858 health units within the Mexican state. Approximately 27% of these were contained in the public sector.
Mexico has seen an overall improvement in almost every aspect of health trend. However, Mexico lags well behind other Organisation for Economic Co-operation and Development countries in health status and availability.
|Life expectancy at birth (years)||77.5*|
|Life expectancy at birth, male (years)||75.1*|
|Life expectancy at birth, female (years)||79.9*|
|Maternal mortality ratio
(reported, per 100,000)
|Mortality rate from [[communicable diseases (age-adjusted per 100,000)||52.1|
|Mortality rate from non-communicable diseases (age-adjusted per 100,000)||469.6|
|Mortality rate from external causes
(age-adjusted rates per 100,000)
|Mortality from breast cancer, female
(age-adjusted rates per 100,000)
|Mortality from lung cancer
(age-adjusted rates per 100,000)
|Mortality from ischemic heart diseases
(age-adjusted rates per 100,000)
|Mortality from cerebrovascular diseases
(age-adjusted rates per 100,000)
|Mortality from homicide
(age-adjusted rates per 100,000)
|Tobacco consumption among adults
(age adjusted, %)
|Alcohol consumption among adults
|Overweight and obesity, male
|Overweight and obesity, female
|Overweight and obesity in children aged < 5 years (%)||5.2**|
|Hospital births (%)||92.7|
|Antenatal care coverge by skilled birth attendants of 4+ visits (%)||89.5|
|Number of physicians
(per 10,000 population)
|Number of nurses (per 10,000 population)||29|
|Number of dentists (per 10,000 population)||1.9|
|*Data from 2018
**Data from 2012
|Diabetes and kidney diseases||102.15||18.18%|
|Self-harm and interpersonal violence||40.19||7.15%|
|Chronic respiratory diseases||27.11||4.82%|
|Respiratory infections and Tuberculosis||19.44||3.46%|
|Other non-communicable diseases||17.32||3.08%|
|Source: Institute for Health Metrics and Evaluation |
According to recent international statistics, Mexico has an estimated population of 130 millions of inhabitants, with a reported annual population growth rate of 1.2%. Since 1990 there was an increment of about 45 million people.
Total health expenditure represented around 5% of GDP in 1995, which went up to around 6.2% in 2012; however, in 2015 it declined to 5.6%. Historically, out-of-pocket expenditure has been a big portion of health expenditure, going from around 56% in 1995 to below 50% since 2008, with the most recent data being 40.6% in 2015.  
Demographic and epidemiological transitions have been notorious in the last 7 decades in Mexico. Life expectancy at birth (general) changed from being 45 years in 1950 to 71.5 years in 1990, and to actually reach 77.5 years, close to some high-income countries in America and the World.   Child mortality rate, as one the major health trends, have improved most notoriously after 1950, when an average of 252 children under-five years were dead per 1000 live births, decreasing to 44.5 in 1990 and reaching 14.6, in 2018.   Finally, after 1970, at least 20 years after the major changes in life expectancy and child mortality rate, there was a decrease in fertility rate. In 1950 it was estimated that for every woman, around 6.67 babies were born; in 1970, it increased to 6.8 and then, steadily decreased to 3.4 in 1990 to finally end in 2.1, which is below the world average.
In 1992, the New York Times reported that residents of the United States living near the Mexican border routinely crossed into Mexico for medical care. Popular specialties included dentistry and plastic surgery. In 2007, the Washington Post reported that Mexican dentists charged 20-25% of US prices, and other procedures typically cost a third of the US price. Additionally, Pagán et al. found that in 2006, over 30 million Mexicans in lower socioeconomic classes resorted to self-medication due to the high medical costs and low proportions of coverage in the country.
Universal health care
On December 1, 2006, the Mexican government created the Health Insurance for a New Generation (also called "Life Insurance for Babies"). It was followed by a February 16, 2009, announcement by President Felipe Calderon, who stated that at the current rate, Mexico would have universal health coverage by 2011, and a May 28, 2009 announcement of universal coverage for pregnant women. In August 2012 Mexico installed a universal healthcare system. 
Social determinants of health in Mexico are factors that influence the status of health among certain populations in Mexico. They are circumstances in which people grow, live, work, eat, and age and the systems put in place to deal with illnesses. In Mexico, health inequality in the population is influenced by such social factors. In the past decade, Mexico has witnessed immense progress within its health care system. This has allowed for greater access to health care and a decrease in mortality rate, but there are still various health inequalities caused by social factors.
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