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The School of Public Health of Mexico (ESPM, in Spanish), was founded on March 23, 1922, several years after the creation of the first schools of public health in the United States of America (USA), such as Johns Hopkins in 1916 and those of Harvard, Yale, and Columbia, among others. The Escuela de Salubridad, as the ESPM was initially called, was the first of its kind in Latin America and the fifth in the world; thus, it was responsible for providing the first public health degrees in Mexico to medical health officers and other higher education diplomas in the fields of hygiene and public health. Several years after its own founding, in 1987, the ESPM co-founded the National Institute of Public Health (INSP, in Spanish) which to date continues to be the organization in which the ESPM is housed. Since the ESPM merged with the INSP, research and human resources training have been considered necessary processes for initiating and strengthening structural change in the field of health at the national and regional levels. As part of its centennial, the ESPM is committed to the continued expansion of its future perspective through the restructuring of its academic programs; this is a process in which the instilling of values, a unified curriculum based on public health, a flexible educational model and social commitment are fundamental. Key words: Public Health, Public Health School of Mexico, social equity and education.

Public health training cannot be practiced in isolation, but rather within the framework of substantive conceptual visions, the organizational structure and teaching culture in a broad sense. The School of Public Health of Mexico (ESPM), in the mist of its 100th anniversary, is implementing an educational restructure with the guidance of conceptual and ethical principles. The restructure of the academic pro­grams will follow a constructivist pedagogical model, based on renewed institutional practices that integrates research, teaching and community outreach, making for truly transfor­mative learning. The new design of the whole structure of its academic programs has the objetive of making them flexible, less technical-based but more practical, and a within an uni­fied curricular system that articulates and allows continuity between master’s degrees and doctorates programs. In the new structure, the curriculum will have a common core for all the academic programs, emerging from the study of the essential bases of public health, human rights, including gender and social perspectives, principles of global health, ethics of public health practice, environmental and animal health inferences and community outreach in the form of social retribution. The Institute’s research groups will be the functional units for investigation and teaching, thus students will be integrated into these at an early stage, under the guidance of a tutor. In this context, the requirements for a comprehensive, unifying and at the same time flexible cur­riculum will support training of Public Health with a holistic approach. The current programs were analyzed including the review of their courses, regarding the pertinence of their contents and proposed competencies. We present herein a description of these observations, and propose a new com­mon core (conceptual-operative) with compulsory courses as the base for all programs. The participation of all academic bodies in reviewing the proposed new common core, as well as the syllabus and courses, identified those that are essential in each program’s study concentration area, is indicated.

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Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE:To estimate the burden of genital warts (GW)in Mexico. MATERIALS AND METHODS:We estimated the annual incidence of GW based on data reported by specialist physicians. We also assessed GW treatment practices, the average cost of treatment, and the psychosocial burden of GW among patients. RESULTS:The annual incidence of GW in Mexico was estimated to be 547 200 cases. Treatment procedures vary by specialist and patient gender. The estimated annual cost was $195 million USD. The psychosocial impact of GW was slightly greater in males than females. CONCLUSIONS:This is the first evaluation of the burden of GW in Mexico. Our data suggest that GW are common, with significant health-related costs and psychosocial impact.

Despite the efforts made by the coordinators and operators of Mexico's Universal Vaccination Program (PVU, in Spanish), at all levels, a complex and extensive program like this always encounters barriers that are a challenge to achieving and maintaining the expected success. Every PVU requires structural, functional and financial growth that guarantees the acquisition of enough vaccines and that they reach the target person, at the right time and with quality assurance. With the objective of identifying challenges of the PVU and propose improvement actions, the Undersecretary of Prevention and Health Promotion and the National Center for Child and Adolescent Health (Censia, in Spanish) requested the National Institute of Public Health (INSP, in Spanish) and the Pan American Health Organization/World Health Organization (PAHO/WHO), office of Representation in Mexico, to convene a group of independent national and international experts, to hold a dialogue and analysis with federal and state personnel who direct and operate the PVU. This manuscript describes a summary of the topics presented, relevant elements of the discussion and general recommendations. [ABSTRACT FROM AUTHOR]

Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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La alfabetización en salud es el proceso centrado en la obtención del conocimiento, la motivación y las competencias individuales para entender y acceder a información, expresar opiniones y tomar decisiones relacionadas con la promoción y el mantenimiento de la salud, lo que es aplicable en diferentes contextos, entornos y a lo largo de toda la vida. Esta perspectiva conceptual es muy necesaria ante la emergencia del virus SARS-CoV-2 que produce la enfermedad Covid-19, la cual ha producido una pandemia con efectos devastadores, no sólo desde el punto de vista de la salud, sino también, de manera muy importante, desde el económico, político y social. En este ensayo se tratan de establecer los elementos basados en la evidencia científica que orientan las políticas públicas de prevención y control, entre los que destacan: a) la inteligencia epidemiológica, la cual incluye no sólo la estrategia de vigilancia poblacional sino, ante la imposibilidad real de identificación de todos los casos positivos, la puesta en práctica de estrategias de vigilancia centinela y la vigilancia basada en eventos; b) las medidas de mitigación de la propagación de la epidemia, tales como distanciamiento social e higiene, lavado de manos, cuarentena, restricción de movimiento y utilización de cubrebocas, entre otras; c) medidas de supresión de la transmisión cuando el número de casos es muy elevado, como el endurecimiento de medidas drásticas de encierro en casa; d) fortalecimiento de la capacidad de atención médica en los sistemas de salud e incremento de la capacidad de prevención de la transmisión en los servicios de salud, incluyendo la utilidad de las pruebas diagnósticas; y e) el desarrollo de vacunas profilácticas contra Covid-19, así como la generación de agentes terapéuticos. Todas estas acciones no sólo deben implementarse rápidamente desde la perspectiva multidisciplinaria y multisectorial de la salud pública para contener, prevenir y controlar la epidemia, sino que necesitan obligatoriamente del concurso de la comunidad como responsabilidad compartida. Debido a todo esto, es necesaria la alfabetización en salud pública.

Objective. To determine the association of risky eating behaviors and the home with the percentage of body fat in adolescents, modified by gender. Materials and methods. We analyzed the information of a cohort of 2 388 adolescents from Morelos in Mexico, from 2004 to 2007. Descriptive techniques and multiple linear regression models of mixed effects were performed. Results. The change in body fat percentage (PGC) is -1.4 percentage points, in men -3.1, in women 0.2. The change of the PGC in relation to CAR’s and the household is different by sex. The multiple model shows that diet is associated with an increase in PGC (1.25 IC95% 0.68-1.83) in women, in men of 1.74 (95% CI 0.60-2.88). In relation with the family, women show a positive relationship with the increase in the percentage of body fat according to whether they feel that their family does not love them sometimes or never (value p of trend

Objective. To update information on the mortality trend due to lung cancer in Mexico from 1990 to 2016. Materials and methods. Age-adjusted rates were obtained using the direct method. The percentage of annual change in the mortality of lung cancer was obtained through joinpoint analysis at the national level, by region, sex and rural-urban stratum, and in the last two the age-cohort-period effect. Results. There was an annual decrease in mortality rates due to this neoplasm in the last 10 years, significantly higher in men (-3.5% CI95% -4.0,-2.9) than in women (-1.9% CI95% -2.1,-1.7), and a generational gap between men and women and urban-rural stratum with a decreasing trend in the risk of death. Conclusion. Mortality trends due to lung cancer from 1993 to 2016 show a decrease in different magnitudes and specific periods.

Objective. To determine external genital lesion (EGL) incidence –condyloma and penile intraepithelial neoplasia (PeIN)– and genital HPV-genotype progression to these EGLs. Materials and methods. Participants (healthy males 18- 74y from Cuernavaca, Mexico, recruited 2005-2009, n=954) underwent a questionnaire, anogenital examination, and sample collection every six months; including excision biopsy on suspicious EGL with histological confirmation. Linear array assay PCR characterized 37 high/low-risk HPV-DNA types. EGL incidence and cumulative incidence were calculated, the latter with Kaplan-Meier. Results. EGL incidence was 1.84 (95%CI=1.42-2.39) per 100-person-years (py); 2.9% (95%CI=1.9-4.2) 12-month cumulative EGL. Highest EGL inci­dence was found in men 18-30 years: 1.99 (95%CI=1.22-3.25) per 100py. Seven subjects had PeIN I-III (four with HPV16). HPV11 most commonly progresses to condyloma (6-month cumulative incidence=44.4%, 95%CI=14.3-137.8). Subjects with high-risk sexual behavior had higher EGL incidence. Conclusion. In Mexico, anogenital HPV infection in men is high and can cause condyloma. Estimation of EGL magnitude and associated healthcare costs is necessary to assess the need for male anti-HPV vaccination.

Objective. To evaluate the effectiveness of a combined strategy of human papillomavirus virus (HPV) vaccination and high-risk HPV screening to reduce the occurrence of anogenital and oropharyngeal neoplasms among men who have sex with men, people with HIV, homeless people, transgender women, female sex workers and rape victims. Materials and methods. This mixed methods study evaluates the effectiveness of a combined vaccination-screening strategy to reduce HPV prevalence/incidence and occurrence of cervical intraepithelial neoplasms grade 2+ and/or anal intraepithelial neoplasms grade 2+, using Kaplan-Meier. The time-to-event method will evaluate time from positive results for specific anogenital HPV to incidence of anogenital lesions containing that HPV type. Results. People vaccinated against HPV and screened for HPV as a primary test will have lower prevalence and incidence of HPV infection and consequently lower fre­quency of HPV-related anogenital and oropharyngeal lesions. Conclusions. This study will generate scientific evidence on effectiveness of a combined vaccination-screening strategy to reduce the burden of HPV-associated neoplasms.

Objective. To estimate the burden of genital warts (GW) in Mexico. Materials and methods. We estimated the annual incidence of GW based on data reported by specialist physicians. We also assessed GW treatment practices, the average cost of treatment, and the psychosocial burden of GW among patients. Results. The annual incidence of GW in Mexico was estimated to be 547 200 cases. Treatment procedures vary by specialist and patient gender. The esti­mated annual cost was $195 million USD. The psychosocial impact of GW was slightly greater in males than females. Conclusions. This is the first evaluation of the burden of GW in Mexico. Our data suggest that GW are common, with significant health-related costs and psychosocial impact.

Materials and methods. A total of 1 329 men and women, with and without HIV, participated in one of three intervention studies, offering HPV vaccination, carried out in the states of Morelos, Tlaxcala and Mexico City; either the bivalent (Morelos n=103, Tlaxcala n=127) or quadrivalent HPV-vaccine (Mexico City n=1 099) was offered. Results. HPV vaccine was accepted by 80.3% of participants; acceptance was higher in people living with HIV than those without (84.4 vs. 78%, p=0.004). Women had greater HPV infection knowledge (p

Objective. To describe the methods of a study aimed at evaluating high risk-HPV (hrHPV)-based screening and cervical cytology as triage compared to conventional cervi­cal cytology as primary screening in the detection of grade 2+ cervical intraepithelial neoplasia in the National Cancer Screening Program (NCSP) of Mexico. Materials and methods. We will use information originated from the Womens Cancer Information System of Mexico regarding cervical cancer from 2008 to 2018. The database includes cytology results, diagnostic confirmation by histopathology and/or treatment colposcopy. We will then carry out statisti­cal analyses on approximately 15 million hrHPV. Results. We will evaluate the overall performance of hrHPV-based screening as part of the NCSP and compare hrHPV-based to cytology-based screening under real-life conditions. To guarantee an unbiased comparison between hrHPV with cy­tology triage and conventional cytology we will use propensity score matching. Conclusion. Decision makers may use our results to identify areas of opportunity for improvement in NCSP processes.

Objective. Describe the natural history of anal HPV among men. Materials and methods. Prospective study among men 18-70 years (n=665), from Cuernavaca, Mexico who completed questionnaires and provided specimens (HPV genotyped) at enrollment and 1+ follow-up visit. HPV preva­lence and incidence were estimated. Prevalence ratios were calculated with Poisson regression using robust variance esti­mation. Person-time for incident HPV infection was estimated using number of events modeled as Poisson variable for total person-months. Results. Anal infection prevalence: any HPV type=15%, high-risk=8.4%, HPV16=1.4%, tetravalent vaccine types (4vHPV)=4.4%, nonavalent vaccine types (9vHPV)=6.3%. Factors associated with prevalence: 50+ lifetime female sex partners (adjusted prevalence ratio, a PR=3.25, 95% CI:1.12- 9.47), 10+ lifetime male sex partners (aPR=3.06, 95%CI:1.4- 6.68), and 1+ recent male anal sex partners (aPR=2.28, 95%CI:1.15-4.5). Anal incidence rate: high-risk HPV=7.8/1000 person-months (95%CI:6.0-10.1), HPV16=1.8/1000 person-months (95%CI:1.1-2.9),4vHPV=3.4/1000 person-months (95%CI:2.3-4.9) and 9vHPV=5.5/1000 person-months (95%CI:4.1-7.5). Conclusions. Implementation of universal HPV vaccination programs, including men, is a public health priority.

Objective. To asses the non-inferiority between two differ­ent vaccination schedules one month after the administration of the third dose. Materials and methods. Evaluated the anti-HPV 16/18 antibody titers induced by quadrivalent HPV vaccine administered using two different schedules in girls 9 to 10-year-old girls: a traditional (0-2-6) and an alternative (0-6-50). Blood samples were collected at month 7, 21 and 51. Results. The antibody geometric mean titer ratios one month after the application of the third dose –month 51 for the alternative and month 7 for the traditional– were 1.55 for HPV16 (95%CI, 1.15-2.08) and 1.53 for HPV18 (95%CI, 1.12- 2.09). The seropositive rate was above 99% in both groups. Conclusions. The application of an alternative 3-dose schedule in 9 to 10-year-old girls induces a non-inferior im­mune response compared to the standard one month after the last dose. Further research is needed to understand the minimal number of doses and their timing to provide the best coverage for HPV infection.

Objectives. To report the prevalence of severe functional difficulties and disability (SFD) in a nationally representative sample of children ages 5 to 17 in Mexico, to identify factors associated with SFD, and population profiles predictive of SFD. Materials and methods. Using data from theNational Survey on Children and Women we estimated prevalence and 95% confidence intervals of SFD and risk factors. We fitted bivariate and multivariate logistic regression models. We then examined which combinations of the sociodemographic factors best predicted SFD. Results. The prevalence of SFD was 11.2%. The most prevalent SFD were on the socioemotional dimension (8.3%). The associated risk factors in the three dimensions were: living in a poor household, being a boy, having a mother with basic education or less, and non-indigenous background or living in an urban area. Conclusions. Identifying groups of the population at higher risk for SFD provides useful information for targeted intervention implementation.

Objective. Inborn errors of metabolism (IEM) are genetic conditions that are sometimes associated with intellectual developmental disorders (IDD). The aim of this study is to contribute to the metabolic characterization of IDD of unknown etiology in Mexico. Materials and methods. Metabolic screening using tandem mass spectrometry and fluorometry will be performed to rule out IEM. In addition,target metabolomic analysis will be done to characterize the metabolomic profile of patients with IDD. Conclusion. Identification of new metabolomic profiles associated withIDD of unknown etiology and comorbidities will contribute to the development of novel diagnostic and therapeutic schemes for the prevention and treatment of IDD in Mexico.

Objective. To describe the prevalence and factors associated with severe child functioning difficulties and disability (CFD) among two to four year old children in Mexico, and estimates the probability of presenting CFD based on specific population profiles. Materials and methods. The sample consists of 5 104 children who participated in the National Survey of Children and Women 2015 (ENIM). We used postestimation exploration by computing predicted values of CFD to interpret the logistic models for discrete combinations of the independent variables. Results. CFD prevalence is 2%,which means at least 130 000 two to four year-old children are at risk of experiencing severely limited participation in an unaccommodating environment. The probability of presenting CFD is dramatically higher in specific sub-groups of the population, in particular, male children of women with low education, who live in the poorest households. Conclusions. A significant proportion of Mexican children face important challenges due to functioning difficulties and disability. Public policies must be developed to accommodate the needs of these children and provide a proper environment for their development.

Objective. Report prevalence of functioning difficulties and disabilities among Mexican adolescent women 15-17 years old and identify differences in characteristics of those with and without a functioning difficulty or disability Materials and methods. Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used chi square tests for independence and logistic regression to explore associations between this condition and various characteristics. Results. Of Mexican adolescent women 15-17 years old, 11.1% had a functioning difficulty or disability. The group of domains of functioning difficulty and disability with by far the highest prevalence was socio-emotional and behavioral functioning difficulties or disability with 8.6%. Being employed, rural residence and self-reported depression symptoms were associated with having functioning difficulties or disability. Conclusions. This survey constitutes an important initial step in collecting data on functioning difficulty and disability in Mexico although larger samples should be studied.

Objective. To describe the characteristics of Mexican children and adolescents 5-17 years with severe functioning difficulties and disability and explore their participation in child labor. Materials and methods. Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used logistic regression to explore the association between this condition and child labor. Results. While 11.2% of Mexicans 5-17 years-old has severe functioning difficulties or disability, 13.4% work. The functioning difficulty and disability domains with the highest prevalence are experiencing anxiety (5.4%) and depression (1.5%) daily. Children and adolescents with severe functioning difficulties and disability are 70% more likely to do child labor [OR=1.7, 95%CI:1.2,2.4]. Educational lag doubles the likelihood of doing child labor [OR=2.2, 95%CI:1.5,3.3]. Conclusions. Guaranteeing educational opportunities and respect for the rights of children with severe functioning difficulties and disability is essential to achieve development of their full potential.

Objetivo. Describir la metodología y los resultados del levantamiento de la Encuesta Nacional de Niños, Niñas y Mujeres en México (ENIM 2015). Material y métodos. La ENIM 2015 es una encuesta probabilística con muestreo polietápico, estratificado y por conglomerados, con representatividad regional, por estratos rural y urbano, y para la población indígena. Se aplicaron cuestionarios para obtener información sobre el hogar, mujeres de 15 a 49 años, niños y niñas menores de cinco años y niños y niñas y adolescentes de 5 a 17 años. Resultados. La tasa de respuesta en hogares y en mujeres fue de 94%; se obtuvo información de 10 760 hogares y 12 110 mujeres; para los niños y niñas y adolescentes y niños y niñas menores de cinco años, estos valores fueron de 98%, 11 607 y 8 066, respectivamente. Conclusión. El diseño probabilístico de la ENIM 2015 permite generar indicadores que se pueden desagregar en cinco regiones, para los estratos rural y urbano y para la población indígena, así como una línea base para 15 indicadores de los ODS.

Objective. This study aims to generate evidence on intellectual development disorders (IDD) in Mexico. Materials and methods. IDD disease burden will be estimated with a probabilistic model, using population-based surveys. Direct and indirect costs of catastrophic expenses of families with a member with an IDD will be evaluated. Genomic characterization of IDD will include: sequencing participant exomes and performing bioinformatics analyses to identify de novo or inherited variants through trio analysis; identifying genetic variants associated with IDD, and validating randomly selected variants by polymerase chain reaction (PCR) and sequencing or real-time quantitative PCR (qPCR). Delphi surveys will be done on best practices for IDD diagnosis and management. An external evaluation will employ qualitative case studies of two social and labor inclusion programs for people with IDD. Conclusions. The results will constitute scientific evidence for the design, promotion and evaluation of public policies, which are currently absent on IDD.

Objective. To outline the design of a clinical trial to evalu- ate the impact of HPV vaccination as part of a hrHPV-based primary screening program to extend screening intervals. Materials and methods. A total of 18,000 women aged 25-45 years, attending the regular cervical cancer-screening program in primary health care services in Tlalpan, Mexico City, will be invited to the study. Eligible participants will be assigned to one of three comparison groups: 1) HPV16/18 vaccine and hrHPV-based screening; 2) HPV6/11/16/18 vaccine and hrHPV-based screening; 3) Control group who will receive only hrHPV-based screening. Strict surveillance of hrHPV persistent infection and occurrence of precancerous lesions will be conducted to estimate safety profiles at different screening intervals; participants will undergo diagnosis confirmation and treatment as necessary. Conclusion. The FASTER-Tlalpan Study will provide insights into new approaches of cervical cancer prevention programs. It will offer valuable information on potential benefits of combining HPV vaccination and hrHPV-based screening to safety extend screening intervals. DOI: http://dx.doi.org/10.21149/spm.v58i2.7790

Objective. To estimate the effect of care-delivery delays on survival among women with breast cancer. Materials and methods. A retrospective analysis of 854 women attending 11 hospitals from 2007-2009 was carried out. Kaplan-Meier estimators and a Cox proportional-risk model were employed. Results. A total of 10.5% of cases were diagnosed in stage I. 82% of sampled women delayed care for more than 67 days between noticing a symptom and initiating treatment. The median time from receipt of results of the mammography to biopsy was 31 days (IQR 14-56). Compared with those who were in quartile I (Q1), survival was lower among those in Q3 and Q4 (HR=1.68, 95%CI 0.94-3.00; HR=1.76, 95% CI 1.04-2.98, respectively). Conclusions. To increase survival, it is suggested that the time between receipt of the mammo- graphy results and diagnostic biopsy be reduced. DOI: http://dx.doi.org/10.21149/spm.v58i2.7793

Objective. This paper describes the study design and base- line characteristics of the study population, including the first 30 829 women who enrolled in the Forwarding Research for Improved Detection and Access for Cervical Cancer Screening and Triage (FRIDA Study). This is a large population based study that is evaluating the performance and cost-effective-ness of different triage strategies for high-risk HPV (hrHPV) positive women in Mexico. Materials and methods. The target population is more than 100 000 women aged 30 to 64 years who attend the Cervical Cancer Screening Program in 100 health centers in the state of Tlaxcala, Mexico. Since August 2013, all women in the region have been invited to enroll in the study. The study participants are evaluated to determine hrHPV infection using the Cobas 4800 HPV test. The HPV-16/18 genotyping and cytology triage strategies are performed as reflex tests in all hrHPV-positive participants. Women with a positive HPV-16/18 test and/or abnormal cytology (atypical squamous cells of undetermined significance or worse, ASCUS+) are referred for colposcopy evaluation, where a minimum of four biopsies and an endocervical sample are systematically collected. Histologic confirmation is performed by a standardized panel of pathologists. Results. Among the 30 829 women who have been screened, the overall prevalence of hrHPV is 11.0%. The overall prevalence of HPV16 and HPV18 are 1.5% and 0.7%, respectively. Cytological abnormalities (ASCUS+) were detected in 11.8% of the hrHPV-positive women. A total of 27.0% (920/3,401) of the hrHPV-positive women were referred to colposcopy because of a positive HPV16/18 test and/or abnormal reflex cytology, (31.6% had only ASCUS+, 53.6% were HPV16/18 positive with a normal cytology result, and 9.5% were positive to both triage tests). Conclusion. The results of this study will help policy makers and health service providers establish the best practices for triage in cervical cancer screening in Mexico and other countries. DOI: http://dx.doi.org/10.21149/spm.v58i2.7789

Objective.To assess prostate cancer (PC) mortality in Mexico from 1980 to 2013, according to the state marginalization level. Materials and methods. Using age-adjusted rates in men ≥ 40 years old, we estimated trends and agecohort-period effects of PC mortality from 1980-2013 according to state marginalization status by using a joinpoint regression model and a Poisson regression model proposed by Holford. Results. The PC mortality risk has increased nationwide at a constant rate (2% annually) during the past 13 years. The highest annual increase was observed among states with very high (4.4%) and high (7.7%) marginalization rates. In contrast, states with very low levels of marginaliza- tion showed a significant reduction of 1.5% per year. The main changes were observed in the 1945-1950 birth year cohorts. Conclusions. Differences in PC mortality across regions of Mexico may reflect differences in the timing of the diagnosis and treatment of PC. DOI: http://dx.doi.org/10.21149/spm.v58i2.7787

La salud mental es una prioridad en los sistemas de salud, no sólo porque tenemos conocimiento de la enorme carga que representa en el peso de la enfermedad, sino también porque se considera una condición primordial de calidad de vida. En términos epidemiológicos, la salud mental contribuye con la carga global de las enfermedades en alrededor de 12%, representa hasta 28% de los años vividos con discapacidad y constituye una de las tres principales causas de mortalidad entre las personas de 15 a 35 años, considerando el suicidio. La promoción de salud mental, particularmente desde una edad temprana, es un desafío para la población en su conjunto.

La revista Salud Pública de México, atenta a los fenómenos que inciden en la salud de la población, presenta un número monográfico titulado Terremotos, salud y sociedad: lecciones aprendidas. Esta iniciativa reúne, con pertinencia y oportunidad, la respuesta expedita de diversos grupos de investigación intersectorial en el ámbito nacional e internacional, para documentar la experiencia y describir las lecciones aprendidas, desde la perspectiva multidisciplinaria e intersectorial, de los terremotos ocurridos en México en septiembre de 2017.

La mayor carga de enfermedad a nivel global lo representan las enfermedades crónicas. Para el contexto de México, la mayor incidencia y mortalidad están representadas por la enfermedad cardiovascular,1 la diabetes mellitus2 y el cáncer. A pesar de estas evi­dencias, es hasta fecha reciente que en México se han propuesto registros de cáncer con base poblacional y posiblemente se implemente una política poblacional de prevención y control. En este contexto, el cáncer de pulmón representa un reto importante para la salud pública global al ser reconocido como primera causa de muerte por cáncer en México y en el mundo. Adi­cionalmente, la mayoría de los casos son considerados muertes prevenibles porque existe evidencia de que la mayor fracción atribuible es la exposición a humo de tabaco, por lo cual se debe enfatizar la gran necesidad de abordar esta problemática desde una visión integral que incluya ejes preventivos,3,4 así como de abordaje en pacientes que ya presentan la enfermedad. Esto consti­tuye la importancia del número especial de cáncer de pulmón en la revista Salud Pública de México.

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