Asociación entre inseguridad del agua y presencia de sintomatología depresiva en población mexicana de 20 años o más

OBJETIVO

Analizar la asociación entre la inseguridad del agua (IA) y la presencia de sintomatología depresiva (SD) en población mexicana de 20 años o más. Material y métodos. Se analizó información de 11 806 adultos participantes en la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022). La IA se evaluó con la escala de las experiencias de inseguridad del agua (HWISE) en los hogares y la SD con la Escala de Depresión del Centro de Estudios Epidemiológicos (CESD-7). Se realizaron modelos de regresión logística multinomial ajustando por variables confusoras.

RESULTADOS

La IA se asocia con la presencia de SD en los adultos mexicanos (razón de momios [RM]=1.5; p<0.001). La prevalencia ajustada de SD fue 6.1 puntos porcentuales mayor en personas con IA. Otros factores asociados a SD en presencia de la IA fueron: mujer (RM=2.0; p<0.001), separada(o) o divorciada(o) (RM=1.5; p=0.001), sin escolaridad (RM=2.9; p<0.001), tercil bajo de condiciones de bienestar (RM=1.3; p=0.005) y 60 años o más de edad (RM=3.5; p<0.001). Conclusión. Los problemas con el agua afectan la salud mental de la población. Es relevante su monitoreo en proyectos donde el agua tiene un papel clave como en disminución de la pobreza, desarrollo económico y mitigación del cambio climático.

Prevalencia de conductas alimentarias de riesgo en adolescentes mexicanos: Ensanut Continua 2022

OBJETIVO

Reportar prevalencias poblacionales actualizadas de conductas alimentarias de riesgo (CAR) con respecto a edad, sexo, condiciones de bienestar, tipo de localidad y región del país. Material y métodos. Se utilizaron los datos de adolescentes (n = 3 547) de la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022) obtenidos mediante el cuestionario breve de conductas alimentarias de riesgo (CBCAR) y datos sociodemográficos. Se obtuvieron prevalencias e intervalos de confianza.

RESULTADOS

El 1.6% (2.0% en mujeres y 1.2% en hombres) de los adolescentes tienen riesgo de un trastorno de la conducta alimentaria, en aquéllos entre 14 y 19 años, 2.3%, en zonas urbanas 2.1%, en la región centro 2.9% y por tercer quintil de bienestar, 3.1%. Conclusión. Los datos mostrados señalan la importancia de continuar monitoreando las CAR en encuestas representativas nacionales, a diferencia de los estudios realizados en muestras no probabilísticas; la Ensanut permite contar con datos que reflejan la diversidad de la población mexicana.

Respuesta a: ¿Es incorrecta la prevalencia de síntomas depresivos presentada en el informe de la Ensanut 2018-19?

No disponible.

Disordered eating behaviors and psychological correlates. Data from the Ensanut 2018-19

OBJECTIVE

To analyze the relationship between disordered eating behaviors (DEB) and depressive symptoms, suicide attempts, and alcohol and tobacco use in adolescents in a national survey in Mexico.

MATERIALS AND METHODS

Data from the Encuesta Nacional de Salud y Nutrición 2018-19 were used. Three levels of DEB were established: no risk (DEB-NR), moderate risk (DEB-MR), and high risk (DEB-HR). An ordinal logistic regression model was performed with level of DEB risk as a dependent variable.

RESULTS

National prevalence of DEB-MR was 6.0% (95%CI: 5.6, 6.5), while that of DEB-HR was 1.3% (95%CI: 1.1, 1.6). Suicide attempt (OR= 1.82, 95%CI: 1.02,3.25) and depressive symptoms (OR= 2.6, 95%CI: 1.40,4.98) were associated with being at a higher risk of DEB.

CONCLUSION

Since both depressive symptoms and suicide attempt are associated with DEB, prevention strategies should consider interventions that simultaneously address the various mental health problems present in adolescence.

Anticoncepción posevento obstétrico y embarazo subsecuente en adolescentes: perspectivas del personal de salud en México

Objetivo. Identificar cómo se implementa la estrategia de anticoncepción posevento obstétrico (APEO) y analizar las barreras, acciones y recomendaciones para prevenir embara­zos subsecuentes en adolescentes. Material y métodos. Estudio cualitativo a través de análisis de contenido de 21 en­trevistas semiestructuradas a personal de salud de instituciones de atención a población sin seguridad social de la Ciudad de México y Morelos. Resultados. La APEO se promueve du­rante el embarazo, parto, posaborto, puerperio y hasta 12 me­ses después del evento obstétrico. La consejería debe abordar, además de información técnica sobre métodos anticonceptivos, otras temáticas clave en relación con los derechos sexuales y reproductivos de los adolescentes. Se identifican barreras personales, institucionales y sociales para la implementación de la estrategia; el personal refiere acciones y recomendaciones específicas para su consolidación. Conclusión. La estrategia de APEO se debe fortalecer para garantizar la oferta de un servicio acorde con las necesidades de las mujeres menores de 20 años, así como diseñar intervenciones basadas en las buenas prácticas y recomendaciones de los prestadores de salud para superar las barreras y lograr periodos intergenésicos más allá de la adolescencia.

[Trends in vaccination coverage among children aged 12-23 and 24-35 months in Mexico. Ensanut 2012 and Ensanut 100]

OBJECTIVE

To evaluate and compare vaccination coverage among children aged 12-23 and 24-35 months living in localities with less than 100 000 inhabitants in Encuesta Nacional de Salud y Nutrición (Ensanut) 2012 and Ensanut 100k (2018).

MATERIALS AND METHODS

Estimate of coverage with both surveys.

RESULTS

Between 2012 and 2018, according to proof and self-report, the coverage of the basic scheme was maintained in children aged 12-23 (51.6 vs. 60.2%) and 24-35 months (51.4 vs. 50.0%). Similarly, only with proof (53.9 vs. 51.3% and 52.8 vs. 44.2%). In children aged 24-35 months, the coverage of the reinforced basic scheme reinforcements with probative document and self-report (30.9 vs. 34.0%) and only with reinforcements (30.2 vs. 27.8%) was maintained. Coverage with second and third doses of hepatitis B in both age groups decreased; additionally, first dose of measlesmumps-rubella vaccine (SRP, in Spanish) and third dose of Pentavalent in children aged 24-35 months.

CONCLUSIONS

Coverages were maintained by schemes, despite reductions in hepatitis B, pentavalent and SRP.

Effect of parental criticism on disordered eating behaviors in male and female university students in Mexico City

PURPOSE

The aim of this study was to analyze the effect of parental criticism of their offspring's bodies in the development of disordered eating behaviors (DEBs) in university students in Mexico City.

METHODS

A sample of 892 freshmen (502 women and 390 men) was included. The prevalence of the internalization of the aesthetic thin ideal, body dissatisfaction, self-esteem, depressive symptoms, and body mass index was estimated by sex. For each sex, the effect of parental criticism on DEBs, together with that of the other covariates, was measured through ordinal regression models.

RESULTS

It was found that women received more criticism from their mothers than men. Among the participants, the likelihood of DEBs is increased in the presence of criticism from both parents (OR = 2.5), criticism from the mother alone (OR = 2.0), overweight (OR = 1.7), obesity (OR = 2.1), wanting a slimmer body (OR = 8.3), and depressive symptoms (OR = 3.3). Among men, this risk is increased in the presence of criticism from both parents (OR = 2.7), being obese (OR = 2.4), wanting a slimmer body (OR = 3.4), and depressive symptoms (OR = 2.8).

CONCLUSIONS

It is essential to include issues linked to parental criticism of their bodies in interventions to prevent eating disorders in college students. Level of evidence V, cross-sectional descriptive study.

Contribution of Second and Higher-Order Births to Adolescent Fertility in Mexico

This study estimates the contribution of second and higher-order births to the adolescent fertility rate in Mexico from 2006 to 2014. We used data from nationally representative surveys for 2006, 2009, and 2014 to estimate the adolescent fertility rate, and the first, second, and higher-order birth components for the triennium prior to each survey at the national and state level. Our results showed that the second and higher-order component was 16.3 births per 1,000 women in 2003-05, 14.9 in 2006-08, and 16.9 in 2011-13. Second and higher-order births represented 25.9 percent of all teen births in 2003-05, 21.6 percent in 2006-08, and 21.9 percent in 2011-13. Second and higher-order births were heterogeneous across states. We found that second and higher-order births are highly prevalent and important contributors to the adolescent fertility rate. Postponing second and higher-order births would benefit both mothers and children. Monitoring them provides crucial information on the demand of targeted health system strategies that address the reproductive health needs of adolescent mothers. Interventions to prevent second and higher-order pregnancies must be developed and implemented.

Sexual and reproductive health outcomes are positively associated with comprehensive sexual education exposure in Mexican high-school students

Objectives

To describe the comprehensive sex education (CSE) coverage and to evaluate a set of indicators related to knowledge, attitudes, and practices associated with the seven components of the CSE framework among Mexican high-school students.

Methods

We conducted a cross-sectional survey of a nationally representative sample of students in public and private high schools in Mexico. Questions about CSE coverage and about knowledge, attitudes, and practices related to sexual health were included. We present descriptive statistics for demographic characteristics, exposure to CSE, and sexual health outcomes. We fitted a series of multivariate logistic regression models to examine the association between each CSE component exposure and sexual health outcomes, adjusting for age and sex.

Results

There were significant associations between being exposed to each CSE components and the related sexual health outcomes. The strongest one was for identifying effective contraceptives among those exposed to the Sexual and Reproductive Health component (SRH) (OR 4.10; 95%CI[2.93,5.75]). Also, students exposed to the relationships component had 20% higher odds of affirming they could convince their partner to use condoms (OR 1.20; 95%CI[1.05,1.36]).

Conclusions

This paper provides evidence of the potential beneficial effects of CSE on attitudes, knowledge, and behaviors regarding sexual and reproductive health among adolescents. In addition, it identifies areas that should be strengthened to increase the positive impact of CSE.

Embarazo adolescente y rezago educativo: análisis de una encuesta nacional en México

Objetivo. Caracterizar a las adolescentes que han tenido algún embarazo y analizar la asociación de éste con el rezago educativo, a partir de una encuesta representativa en México. Material y métodos. Estudio transversal con información de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012, con datos sociodemográficos y reproductivos de 1 790 mujeres de 12 a 19 años de edad con inicio de vida sexual y antecedente de embarazo. Se ajustaron tres modelos estadísticos para observar la asociación entre variables. Resultados. El rezago educativo está presente en 74.9% de las adolescentes con antecedente de embarazo. Tener embarazo previo está asociado con cohabitar con la pareja (RM=8.4), rezago educativo (RM=2.4), nivel socioeconómico bajo (RM=2.0) y asistencia a la escuela (RM=0.5). El rezago educativo muestra una asociación con el antecedente de embarazo alguna vez en la vida (RM=2.4), no así con el primer embarazo al momento de la encuesta. Conclusión. Se requieren políticas y estrategias operativas eficientes para favorecer la permanencia escolar y reducir el rezago educativo en adolescentes con y sin hijos.

[Teen pregnancy and educational gaps: Analysis of a national survey in Mexico]

OBJECTIVE

To characterize female adolescents who have been pregnant, and to analyze the association between adolescent pregnancy and educational gaps.

MATERIALS AND METHODS

A cross-sectional study was conducted. Data come from the Encuesta Nacional de Salud y Nutrición (Ensanut 2012), a Mexican representative survey. The set of data used is related to sociodemographic and reproductive characteristics from 1 790 women from 12 to 19 years who had begun their sexual life and had a pregnancy record. Three statistical models were adjusted to observe the association between variables. The dependent variable of the first model was the condition of previous pregnancy, the second to be pregnant at the time of data collection, and the third, educational gap.

RESULTS

A 74.9% of the adolescents with history of pregnancy has educational gap. To have the condition of previous pregnancy is associated with living with sexual partner (OR=8.4), educational gap (OR=2.4), low socioeconomical level (OR=2.0) and school assistance (OR=0.5). To be pregnant at the time of data collection has related only to living with sexual partner (OR=9.4). The educational gap shows an association with having more than one pregnancy (OR=2.4), live with sexual partner (OR=1.6), low socioeconomical level (OR=1.8), and school assistance as protective factor (OR=0.3).

CONCLUSION

It is necessary to implement effective and efficient educational public politics in order to decrease educational gap. At the same time, to guarantee and improve sexual education in the school system to prevent adolescent pregnancy.

Inicio de vida sexual, uso de anticonceptivos y planificación familiar en mujeres adolescentes y adultas en México

Objetivo. Ofrecer evidencia actualizada sobre inicio de vida sexual y uso de anticonceptivos en mujeres adolescentes y adultas en México por grupos de edad, lugar de residencia y estado civil. Material y métodos. Se analizaron datos de las ENSANUT 2006 y 2012, sobre conocimientos y uso de anticoncepción. Resultados. En 2012, 31.2% de las adolescentes (15-19 años) había iniciado vida sexual; el uso del condón aumentó de 31.8 a 47.8% entre 2006 y 2012. El 47.9% de 30 a 34 años y 53.2% de 35 a 49 años reportaron no haber usado anticonceptivo en su última relación sexual. En las áreas rurales se reporta menor uso de anticonceptivos en la última relación sexual. Un alto porcentaje no optó por anticonceptivo postevento obstétrico: 52% (15-19 años), 44.2% (20-29 años), 42.5% (30-34 años) y 39% (≥35 años). Conclusiones. Se requieren políticas equitativas que promuevan el uso de anticonceptivos, particularmente en el periodo postevento obstétrico.

[Use of contraception and family planning in adolescent and adult women in Mexico]

OBJECTIVE

To offer current evidence about age at sexual initiation and contraceptive use among adolescent and adult women of different age groups, places of residence, and marital status in Mexico.

MATERIALS AND METHODS

Data were analyzed from ENSANUT 2006 and 2012 surveys on knowledge and use of contraceptives.

RESULTS

In 2012 31.2% of 15-19 year old adolescent women had undergone sexual debut. Condom use increased from 31.8% in 2006 to 47.8% in 2012. Women in rural areas reported lower levels of contraceptive use at last sexual intercourse; 47.9% of 30-34 year-old and 53.2% of 35-49 year-old women reported not using any contraception at last sexual intercourse. A high percentage of women did not adopt contraception after the most recent obstetric event: 52% (15-19 years), 44.2% (20-29 years), 42.5% (30-34 years) and 39% (≥35 years)].

CONCLUSIONS

Equitable policies to promote contraception, particularly after a post-obstetric event, are needed.

Public opinion on abortion in Mexico City after the landmark reform

This article presents findings from three opinion surveys conducted among representative samples of Mexico City residents: the first one immediately prior to the groundbreaking legalization of first-trimester abortion in April 2007, and one and two years after the reform. Bivariate and multivariate analyses were performed to assess changes in opinion concerning abortion and correlates of favorable opinion following reform. In 2009 a clear majority (74 percent) of respondents were in support of the Mexico City law allowing for elective first-trimester abortion, compared with 63 percent in 2008 and 38 percent in 2007. A significant increase in support for extending the law to the rest of Mexico was found: from 51 percent in 2007 to 70 percent in 2008 and 83 percent in 2009. In 2008 the significant independent correlates of support for the Mexico City law were education, infrequent religious service attendance, sex (being male), and political party affiliation; in 2009 they were education beyond high school, infrequent religious service attendance, and ever having been married.

Association of socioeconomic status, problem behaviors, and disordered eating in Mexican adolescents: results of the Mexican National Health and Nutrition Survey 2006

PURPOSE

To explore the association of socioeconomic status (SES) with disordered eating behaviors (DEB) in Mexican adolescents, and the coexistence of DEB and other problem behaviors.

METHODS

Information about adolescents (10-19 years) was retrieved from the Mexican National Health and Nutrition Survey 2006 database. Associations were evaluated through ordinal regression.

RESULTS

Higher SES was associated with DEB (odds ratio [OR]: 2.05, 95% confidence interval [CI]: 1.52-2.75). Use of tobacco (OR: 2.10, 95% CI: 1.58-2.81), alcohol (OR: 2.03, 95% CI: 1.51-2.56), and suicide intent (OR: 5.13, 95% CI: 3.46-7.60) were associated with DEB.

CONCLUSION

DEB were more frequent among adolescents from higher SES households. The lack of association between SES and DEB reported by other studies might be because of the lack of variability in samples. The association of DEB and other problem behaviors highlights the importance of an integral approach to teenagers' mental health.