The Health in the Americas+ country profiles are based on the interagency indicators available as of the dates referenced. The sources are referenced in this table. In some cases, the values of the indicators may differ from the most recent data available in the country.
Environmental and social determinants of health
In 2000 the total population of Mexico was 97 873 442 inhabitants; by 2023 this figure had risen to 128 455 567, representing a 31.2% increase. Regarding the country’s demographic profile, in 2023 people over 65 years of age accounted for 8.6% of the total population, an increase of 3.6 percentage points compared to the year 2000. In 2023, there were 105.1 women per 100 men and 35.8 older people (65 years or older) per 100 children under 15 years of age, as can be seen in the country’s population pyramids, distributed by age group and sex (Figure 1). Considering the population between 15 and 64 years of age to be potentially active (i.e., potential participants in the labor force), this group represented 67.4% of the total population of the country in 2023 (86 569 424 people). When we add these figures to the potentially passive population (30 854 348 under 15 years of age and 11 031 795 over 65 years of age), the result is a dependency ratio of 48.4 potentially passive people per 100 potentially active people. This ratio was 64.6 in 2000.
Life expectancy at birth in 2023 was 75.0 years, lower than the average for the Region of the Americas and 1.5 years higher that in 2000.
Figure 1. Population pyramids of Mexico, years 2000 and 2023
Between 2000 and 2020, the average number of years of schooling in Mexico increased by 38.4%, reaching an average of 9.2 years in the latest year for which information is available. The unemployment rate in 2022 was 3.3%. Disaggregated by sex, the rate was 3.4% for women and 3.3% for men. The literacy rate was 99.1% in 2020. In men, this figure was 99.2%; in women, 99.0%. In addition, 43.9% of the population were below the national poverty line in 2020, a decrease from 41.9% in 2018. In 2020, 3.1% of the population was living in poverty, defined as the percentage of the population with an income of less than US$ 1.90 per day; this is below the regional average of 3%.
During the period 2000-2021, the country improved its score on the Human Development Index, with an increase of 6.9% (from a score of 0.709 to a score of 0.758); during the same period, the index rose 13.5% internationally and 9.4% in Latin America (Figure 2).
Figure 2. Human Development Index in the Region of the Americas, 2021
In 2020, public expenditure on health accounted for 3.3% of gross domestic product (GDP) (Figure 3) and 11.52% of total public expenditure, while out-of-pocket spending on health accounted for 38.77% of total health expenditure.
Figure 3. Domestic general government health expenditure as percentage of gross domestic product, 2020
In 2021, 75.6% of the population had an internet connection, representing a considerable increase from 2000, when 5.1% of the population had an internet connection.
Maternal and child health
Between 2000 and 2020, infant mortality in Mexico decreased from 22.6 to 12.1 deaths per 1000 live births, a decrease of 46.2% (Figure 4). The percentage of low-weight births (less than 2500 g) decreased from 9.7% to 6.7% between 2000 and 2021, while exclusive breastfeeding in the child population up to 6 months of age was 20.3% in 1998 and 30.1% in 2015 (latest available data).
Regarding the immunization strategy, measles vaccination coverage was 86.0% in 2022, a decrease of 10 percentage points from 2000.
The maternal mortality ratio for 2020 was estimated at 59.1 deaths per 100 000 live births, a reduction of 4.6% from the estimated value for 2000 (Figure 5). In relation to fertility, it is estimated that in 2023 women had an average of 1.8 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 27.8% decrease, from 73.7 live births per 1000 women aged 15 to 19 years in 2000 to 53.2 in 2023. In 2021, 97.1% of births were attended by skilled birth personnel. Between 2009 and 2020 the percentage of pregnant people who had four or more consultations for antenatal care increased from 83.9% to 87.8%.
Figure 4. Infant mortality per 1000 live births, 1995–2020
Figure 5. Maternal mortality per 100 000 live births, 2000–2020
In 2021, there were 17 new cases of tuberculosis per 100 000 population in Mexico. In 2019, the overall tuberculosis mortality rate (age-adjusted and per 100 000 population) was 1.6 (0.9 in women and 2.4 in men).
In 2020, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 6.9 per 100 000 population. The age-adjusted mortality rate for HIV was 3.2 per 100 000 population in 2019. It should be noted that during the 2000-2019 period this indicator decreased by 34.0%.
There were 1 reported cases of human rabies in the country in 2020.
Noncommunicable diseases and risk factors
In Mexico in 2023, the prevalence of tobacco use among people aged 15 and older was 11.9%. In the same age group, the prevalence of overweight and obesity was 64.9% in 2016.
Also in 2016, 28.9% of the population reported insufficient physical activity.
In 2015, the reported prevalence of arterial hypertension (high blood pressure) among people aged 18 years or older was 19.7%, a decrease of 4.1 percentage points compared to 2000 (23.8%). The prevalence of diabetes mellitus, which stood at 9.5% in 2000, increased to 11.2% in 2014.
En el 2019, la tasa ajustada de mortalidad prematura potencialmente evitable en México fue de 254,5 muertes por 100 000 habitantes, lo que equivale a una disminución de 9,4% en comparación con la tasa de 280,9 registrada en el 2000. En este sentido, el país presentó en el 2019 una tasa 12,3% mayor a la notificada para la Región de las Américas. De las muertes prematuras potencialmente evitables, la tasa por causas tratables ascendió a 117,4 por 100 000 habitantes, frente a un promedio regional de 89,6.
En cuanto a la tasa de mortalidad general ajustada por edad, en el 2019 fue de 5,8 por 1000 habitantes, lo cual implica un descenso de 7,6% con respecto al 2000 (6,2 muertes por cada 1000 habitantes).
Al categorizar las muertes en tres grupos principales, se observa que en el 2019 la tasa de mortalidad ajustada por edad por enfermedades transmisibles fue de 52,4 por 100 000 habitantes (62,4 por 100 000 en hombres y 43,7 por 100 000 en mujeres), mientras que la tasa de mortalidad ajustada por edad a causa de enfermedades no transmisibles ascendió a 468,7 por 100 000 habitantes (544,7 por 100 000 en hombres y 404,6 por 100 000 en mujeres). Por su parte, la tasa de mortalidad ajustada por edad por causas externas fue de 58,8 por 100 000 habitantes (99,3 por 100 000 en hombres y 21,3 por 100 000 en mujeres), en cuyo caso destacan los accidentes de transporte terrestre (12,9 por 100 000 habitantes), los homicidios (25,3 por 100 000 habitantes) y los suicidios (5,3 por 100 000 habitantes). En el 2000, la distribución porcentual de las causas fue de 70,2% para las enfermedades no transmisibles, 17,9% para las transmisibles y 11,9% para las causas externas, en tanto que para el 2019 los porcentajes fueron de 80,4%, 9,1%, y 10,5%, respectivamente (figura 6).
Figure 6. Proportional mortality in Mexico, 2000 and 2019
Regarding cancer mortality from tumors, in 2019, the adjusted mortality rate from prostate cancer was 14.1 per 100 000 men; lung cancer, 8.5 per 100 000; and colorectal cancer, 6.6 per 100 000. In women, these values were 11.2 deaths per 100 000 for breast cancer; 4.3 per 100 000 for lung cancer; and 4.9 per 100 000 for colorectal cancer.
The health situation and the COVID-19 pandemic
In Mexico in 2020, there were a total of 1 510 795 cases of COVID-19, representing 11 928.8 per million population. In 2021, there were 2 536 807 identified cases, equivalent to 20 016.5 per million population. In 2020, there were 148 659 deaths directly caused by COVID-19 in people diagnosed with the disease, or 1172 per million population; in 2021, 155 349 deaths were reported, or 1225.8 per million. In 2020, Mexico ranked second in the Region of the Americas in terms of the number of deaths from COVID-19, 17 in 2021 with a cumulative 2398 deaths per million population over the three years (Figure 7).
According to estimates by the World Health Organization, there were a total of 314 596 excess deaths in 2020, or 244 per 100 000 population. A total of 311 327 deaths were estimated in 2021, for an excess mortality rate of 239 per 100 000.
As of 31 December 2021, at least one dose of COVID-19 vaccine had been given to 66.5% of the country's population. As of 2 July 2022 (latest available data), 61% of the population had completed the vaccination schedule. The vaccination campaign began on 20 December 2020, and six types of COVID-19 vaccine have been used to date.
Figure 7. Cumulative COVID-19 deaths in the Region of the Americas, to July 29th, 2023
Measures to achieve universal health coverage
Mexico has a Strategic Health for Wellbeing Program (Programa Estratégico de Salud para el Bienestar ) that sets out the objectives, strategies and actions that define the actions of the coordinating agencies in this sector and the federal agencies that participate in the implementation of the strategy for the federalization of health services. The health sector agencies work in an articulated and collaborative manner, under a human rights approach, to guarantee the continuity of health services and the strengthening of priority plans and programs promoted by the federal government, as well as in the creation and maintenance of healthy and safe environments, and other public policies that may have an impact on the social determinants of health, which lead to inequalities.
Institutional restructuring, based on improved intersectoral coordination and the construction of the legal framework necessary for the consolidation of the National Health System, is intended to ensure that the federalization of health services for the population without social security - through the IMSS-BIENESTAR program, in the states that freely adopt this strategy - strengthens the steering role that the Ministry of Health must exercise over the health system. All this must be carried out with a public health approach that allows any person, regardless of his or her economic, social, or cultural condition, to be treated in a dignified manner and receive comprehensive and efficient care, so that health ceases to be a privilege and this right is guaranteed for all the inhabitants of the country.
Challenges related to population health
Currently, the main health challenge facing the country is the effective coordination of medical care and public health. To improve the effectiveness and equity of medical care, as mentioned above, efforts are continuing to increase access to health services for the population without social security (through the IMSS-BIENESTAR program). To strengthen public health, we are working to reorganize the areas under the Undersecretariat for Prevention and Health Promotion into national centers capable of implementing the actions of their respective programs more effectively and in greater coordination with health care providers.
This institutional redesign seeks to renew the steering and coordinating role of the Ministry of Health and provide it with the necessary tools to solve various problems, such as bottlenecks, inefficiencies and the segmentation of outpatient and inpatient medical care, which have grown because of the administrative decentralization of the Ministry's health care services, which took place in the 1990s.
In addition, work is being done on a new public health performance evaluation system that will make it possible to analyze not only the results of the actions of each program, but also the transversality and subsidiarity between the different components. This new evaluation system has been designed as a kind of prism to focus on the scales of values corresponding to the social determinants of health and the life course of people, from the local to the national level.
COVID-19 pandemic response
To strengthen the capacity to respond to emergency situations such as the pandemic, Mexico is carrying out performance evaluation programs and initiatives, on its own and in collaboration with the Pan American Health Organization, aimed at redesigning the epidemiological surveillance of communicable diseases; improve inter-institutional coordination in epidemiological surveillance reporting; promote the operation of a negative hospital network and the monitoring of the conversion and reconversion capacity of health services; and promote the redesign of useful indicators for risk communication (epidemiological monitoring system).
However, despite the progress made, there is still a need to diagnose problems and plan solutions for issues such as the supply of medicines and other supplies needed for emergencies, and equipment for hospital units, as well as to make the investments needed to improve infrastructure and processes for the collection, processing and analysis of epidemiological and health surveillance information in a timely manner (at the state and federal levels), in order to support decision-making in public health.
Actions to address health inequalities
The current health policy is based on the principles of the enforcement of rights, gender equality and non-discrimination. In addition, it adopts health perspectives centered on the person and his or her health.
The government authorities' agenda for gender equality in the health sector is aimed at eliminating all forms of discrimination against women, which is a priority policy for the Mexican Ministry of Health.
In addition, the National Center for Gender Equity and Reproductive Health (Centro Nacional de Equidad de Género y Salud Reproductiva) has implemented programs to improve access to - and the quality of - preventive sexual and reproductive health care for the most vulnerable population groups; universalize access to safe abortion services and contraceptive and family planning services, and implement enabling environments and labor, delivery and recovery rooms, with the incorporation of nursing and midwifery professionals for the care of low-risk labor and delivery, as well as of the newborn, and the implementation of cost-effective strategies based on scientific evidence, respect for sexual and reproductive rights, and person-centered health care.
Another priority action has been to improve the quality of information on and about health care seekers throughout the country, to identify their social vulnerability attributes and the way in which the latter affect the patterns of demand for care and widen the gap in the supply of services. The analysis of this information leads to specific actions for health promotion, epidemiological surveillance, and disease control, to address the most urgent needs of the population with greater vulnerabilities and less effective access to health services.
National strategy for addressing health inequalities
The national health strategy seeks to reduce inequality gaps in terms of effective access to health care. In this regard, there are historical differences in access between people who have coverage under the social security system and those who do not. For this reason, with the reforms to the General Health Law, a Strategic Health Program for Well-Being (Programa Estratégico de Salud para el Bienestar ) was created, which includes two major subcomponents or models of care, which are presented below.
Health Care Model for Wellness in Medical Care (Modelo de Atención a la Salud para el Bienestar)
This model is based on primary health care according to the life course and is centered on individuals, families, and communities. Its actions and guidelines are aimed at health promotion, disease prevention, early detection, comprehensive medical care, rehabilitation and palliative care, and its focus is on community participation and social determinants. The purpose of the model is to protect the wellbeing of the country's population, those without social security coverage.
Health Care Model for Wellness in Collective Care (Modelo de Atención a la Salud para el Bienestar)
The transition process of health care services should be understood as an opportunity for the health secretariats of the different states, in coordination with the Ministry of Health, to strengthen their capacity for steering and governance of the entire health sector at the local level, through priority health care and public health plans and programs, promoted by the Ministry of Health itself, and public policies aimed at the social determinants of health. This is to ensure the sustainability of healthy and safe environments with a comprehensive and human rights perspective, especially in the most vulnerable populations.
The implementation of this new collective health model, from a public health perspective, will make it possible to articulate population health and medical care services in integrated health service networks, favoring the institutional arrangements necessary to ensure the equity, effectiveness, and efficiency of health services at the individual and population levels.