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The great public health challenge of the 21st century: chronic diseases

By Dr. Malaquías López – Professor of Public Health in the Faculty of Medicine at UNAM and Dr. Kenneth Thorpe, president of PFCD
En Español:
Just over three months after the first case of COVID-19 in Mexico, we are facing one of the biggest health challenges in the country’s history. Clinical reports have shown that people who suffer from chronic diseases run an increased risk that their symptoms and effects of COVID-19 will worsen. At the same time, its prevalence generates a substantial impact on public health sector expenses, as well as on the expenses of patients suffering from diseases such as diabetes, hypertension and morbid obesity. In Mexico, chronic diseases represent 7 of the 10 main causes of death[1], with diabetes and cardiovascular diseases being the most relevant.
Recently UNAM, with the support of PFCD[2], carried out a study entitled “Type 2 diabetes in Mexico: Mortality and the current situation,” which confirms that Mexico has the highest rate of Dt2 mortality in the world. To understand this assertion, it is important to observe patient diagnosis and treatment routes, which provide evidence of the condition’s severity. Although it is important to make visible the existence and seriousness of this disease, it is even more significant to raise awareness of the urgency of preventative, not corrective, actions.
In the country there is a direct correlation between the level of social and economic development and the behavior of mortality. In general, the most developed entities of the country are those that show a decrease in Dt2 afflictions, while the trends of sustained increase correspond with states with lower socio-economic levels. The data obtained in this study show this improvement; however, it is necessary to focus efforts in terms of prevention and detection, as 25% of diabetics are not diagnosed[3].
In the context of the current pandemic, diabetes doubles the risk of hospitalization and triples the risk of death. In Mexico, 17% of COVID-19 patients have diabetes, and 38% of the deceased also had this disease[4]. For this reason, it is more relevant than ever to provide patients with timely and detailed information. For example, in government announcements about COVID-19 symptoms, it is important to emphasize the risk for patients with chronic diseases, given that these people are at a greater risk of complications.
The pandemic is teaching us the need to update and refine protocols for providing care for people with chronic diseases and the comorbidities that they entail. Public health is at stake and its future is uncertain. This health emergency provides us with the opportunity to strengthen and establish new public policies and/or legislation; its review would benefit the appropriate clinical routes and treatments, and their influence on patient health, in addition to reducing the economic impact on the State and its citizens. Today is a great moment to face this challenge, a challenge that has placed chronic diseases as the cause of death for thousands of Mexicans each year.

[1] Webinar presented by UNAM and PFCD, “Early mortality from type 2 diabetes mellitus in CDMX and its risk factor for the Covid-19 pandemic”

[2] Partnership to Fight Chronic Disease, o La Asociación para la Lucha contra las Enfermedades Crónicas

[3] El creciente aumento de las enfermedades crónicas en México, PFCD

[4] Covid-19 México, Gobierno Federal