Diabetes, life course and childhood socioeconomic conditions: an empirical assessment for Mexico

Social Determinants of Health. Retrieved from https://​www.​who.​int/​health-topics/​social-determinants-of-health#tab=​tab_​1. Accessed on January 22, 2024.

Given the survey design, people responding the childhood questionnaire are new participants.

A Body Mass Index (BMI) was constructed considering the variables of height and weight reported in the MHAS 2018 survey (C6: “What is your current weight in kilograms?”, C67: “What is your height without shoes in meters?”). For adults, the World Health Organization (WHO) defines overweight as a BMI of 25 or higher, and obesity as a BMI of 30 or higher. BMI was calculated by dividing a person’s weight in kilograms by the square of their height in meters (kilograms/m²).This information is available at: https://​www.​who.​int/​es/​news-room/​fact-sheets/​detail/​obesity-and-overweight, accessed on January 10, 2024.

In this context, the term “proxy”, was employed to describe variables that serve as stand-ins for factors that are not directly observable within our dataset. As noted by [48].

Numerous variables that could reflect household income were tested, but since they were self-reported and not part of the survey’s core, there is a large number of missing values.

We thank one referee for her suggestions regarding education years.

This question is found in section J.18 of the basic questionnaire and corresponds to the question “Does this home have ... internet?” If the person answers “yes”, that means that they have internet service and were assigned a value of 1, and 0 if the person does not have this service.

There is an interesting possibility of comparing the linear marginal effects with direct estimations from a Logit model (risk differences), [52]. We thank a referee for pointing this out.

This is consistent with what was stated in Aging in Mexico: The Most Vulnerable Adults of the MHAS Newsletter: May 20-2, 2020, which indicates that women are more likely to report diabetes than men. Retrieved from http://​www.​enasem.​org/​images/​ENASEM-20-2-Aging_​In_​Mexico_​AdutosMasVulnera​bles_​2020.​pdf. Accessed on February 10, 2024.

Furthermore, Danish researchers found a connection between the Body Mass Index of one spouse and the other spouse’s risk of developing type 2 diabetes. According to this study, spouses tend to be similar in terms of body weight, as people often tend to marry someone similar to themselves and share dietary and exercise habits when living together [55].

It has long been known that type 2 diabetes is, in part, hereditary. Family studies have revealed that first-degree relatives of people with type 2 diabetes are approximately 3 times more likely to develop the disease than people without a positive family history of the disease [59‐61]. Likewise, in a study for Mexico, [62] point out that obesity and a history of type 2 diabetes in parents and genes play an important role in the development of type 2 diabetes. Furthermore, [63], points out that the frequency of diabetes mellitus also varies between different races and ethnicities.

This is consistent with the research by [64] who find that the conditions in which the person lived at the age of 10 affect health in old age.

According to [67] in a regional analysis on the degree of social mobility in Mexico, it indicates that social mobility is higher than the national average in the North and Central North regions, similar to the national average in the Central region, and lower than the average in the South region. In particular, it notes that children of poor parents made above-average progress if they grew up in the northern region, and less than average progress if they grew up in the southern region.

The country’s food environment has been transformed; it is becoming easier to access unhealthy products. In this sense, for the last 40 years, important changes have been observed in the Mexican diet, mainly from fresh and unprocessed foods to processed and ultra-processed products with a high content of sugar, salt, and fat. Marrón-Ponce et al. [68], point out that in 2016 around 23.1% of the energy in the Mexican population’s diet came from ultra-processed products, even though the WHO recommendations suggest that at most, this percentage should present between 5 and 10% of total energy per day. In addition, Mexico is the worldwide largest consumer of sugary beverages; its consumption represents approximately 10% of the total daily energy intake in adults and children and constitutes 70% of the total added sugar in the diet [69].

The study incorporates biomarkers to evaluate health conditions related to diabetes and obesity. Glycosylated hemoglobin results are employed as an indicator of diabetes [71], with a value equal to or exceeding 6.5% signifying a positive diagnosis (coded as “1”), while values below this threshold are coded as “0”, indicating the absence of the condition. Concurrently, Body Mass Index (BMI) is calculated from weight and height measurements to determine obesity, with a BMI of 30 or more classified as obese. These biomarkers provide quantifiable and reliable means of assessing the presence of these two critical health issues within the study’s population.