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Public open spaces (POS) are "publicly owned spaces such as parks, green areas, squares, marketplaces, streets and highways which are of public access". Some attributes could increase or decrease participants' attendance. Thus, reliable and valid audit tools are needed in order to measure these attributes. This study aimed to develop and validate a tool to assess POS features within the Mexico City context. The Mexican Public Open Spaces Tool (MexPOS) was developed based on (1) two validated POS audit tools, (2) several visits to the POS, (3) pilot testing, and (4) multiple work sessions with a group of specialists. The original tool included 181 items divided into nine sections. Trained personnel visited and evaluated 944 POS in Mexico City. An exploratory factor analysis was performed to examine the construct validity of the items and the relationship between the subscales. The final model resulted in seven factors: (1) Food and Wellness Environment (α = 0.15), (2) Maintenance (α = 0.81), (3) Amenities (α = 0.72), (4) Legibility (α = 0.59), (5) Security (α = 0.48), (6) Perceived Environment (α = 0.65), and (7) Urban Environment (α = 0.58). Our study highlights the relevance of using a validated tool to measure POS characteristics related to participants' attendance to help assess infrastructure improvements and identify priority areas for changing socio-urban environments for physical activity.

Background: The World Health Organization stated a pandemic by severe acute respiratory syndrome coronavirus SARS-Cov2 (COVID-19) on March, 2020 with devastating implications for populations, healthcare systems, and economies globally., Objective: The present study explores the association between patients living in municipalities with crowding conditions and poverty and mortality from COVID-19 in Mexico; specifically evaluating the socioeconomic characteristics of the municipality in which the patients reside and some individual characteristics., Methods: In the present study, we examined public information collected from the National Epidemiological Surveillance System informing all persons tested for SARS-CoV-2 and published by the Ministry of Health. The present analysis was restricted to those with the date of registration to October 12, 2021. The association between the main exposures (overcrowded conditions and poverty) and the outcomes of interest (death by COVID-19) was explored using Cox proportional hazard regression models, including frailty penalties to accommodate multilevel data and random effects for the municipality of case occurrence., Results: A total of 9619917 subjects were included in the Epidemiological Surveillance System for viral respiratory disease platform. Of those for which results were available, 6141403 were negative for COVID-19 and 3478514 were positive for COVID-19; with a total of 273216 deaths in those who tested positive. Among those positive to COVID-19 mean age was 46.9. Patients living in municipalities with high rates of crowding conditions increased the risk of dying from COVID-19 by 8% (95% CI: 1.03, 1.14). Individuals living in municipalities with indigenous background was associated with an increased risk of dying from COVID-19 (HR = 1.10; 95% CI: 1.04, 1.17). Individuals living in municipalities with illiteracy (HR = 1.09; 95% CI: 1.03, 1.11), poverty (HR = 1.17; 95% CI: 1.14, 1.19), food insecurity (HR = 1.094; 95% CI 1.02, 1.06), limited access to social security (HR = 1.10; 95% CI: 1.08, 1.13) and health services (HR = 1.06; 95% CI: 1.04, 1.08) had a higher risk of mortality from COVID-19., Conclusion: Our data suggest that patients living in municipalities with higher rates of crowding conditions and higher rates of poverty had elevated risk of mortality from COVID-19. In Mexico, the COVID-19 pandemic is a systemic crisis linked to human development since we have seen that it affects less developed and more vulnerable municipalities. Policies to reduce vulnerabilities and develop strategies to deal with health crises like the current one needs to be considered., Competing Interests: The authors have declared that no competing interests exist.

Objective: To explore the perception of the use and comprehension of the nutrition labeling (GDA, NFT,NS) and claims in packaged foods among different socio economic-status (SES)., Materials and Methods: This was a qualitative study, 12 focus groups were performed in four cities of Mexico. Participants were recruited outside the supermarkets, which were selected according to SES using Basic Geostatistical Areas. The focus groups had a total of 78 participants., Results: Participants perceived several barriers to the use and understanding of the GDA; like technicalities of the terms used, and the format (small font size and percentages). Claims are mistrusted in general. Participants from the high SES believed that the claims are just a marketing strategy., Conclusions: This study shows the consumers' difficulties to understand the current nutrition labeling system regardless SES. These data might call attention in order to implement a simpler nutrition labeling system that is understood regardless of SES., Competing Interests: Declaration of conflict of interests. The authors declare that they have no conflict of interests.

Open streets programs are free and multisectoral programs in which streets are temporally closed allowing access to walkers, runners, rollerbladers, and cyclists. The Move on Bikes program (by its name in Spanish Muévete en Bici) (MEB) consists of 55 km of interconnected streets in middle-high income areas of Mexico City. There is scarce evidence on the evaluation of this program in Mexico. The purposes of this study were to estimate the participation, physical activity levels among the MEB participants, and the association of the frequency of participation with sociodemographic, physical, and program characteristics., Methods: From October 2017 to July 2018, six hundred seventy-nine MEB participants were surveyed using a questionnaire that contains sociodemographic, physical, and program characteristics. A wide-angle video camera was used to estimate the average speed of each activity per event per participant. Based on the information collected by the program authorities and survey interviews, we estimated the number of participants per event., Results: On a typical MEB program day, 21,812 people participated. MEB program users accumulated an average of 221 min of moderate-to-vigorous physical activity (MVPA) per typical Sunday and 88.4% accumulated at least 150 min of MVPA. In total, 29.6% of users attended the program every Sunday. Those who were more likely to attend the program frequently included: men, those aged 41 to 64 years old, users classified as very and sufficiently active, those that used active transportation to travel to the program, and participants that came alone., Conclusions: This study provides evidence that the MEB program adds an extra 71 min/week of MVPA to more than 20,000 users.

Background: Unhealthy environments and food advertisements are major determinants of childhood obesity. Recent regulation has banned unhealthy foods from schools in Mexico. However, currently there is no regulation limiting exposure to food marketing around schools. Thus, our objective was to analyze the characteristics of food advertising practices around 60 elementary schools in two cities and to evaluate compliance with the Pan American Health Organization (PAHO) recommendations and the local food industry self-regulatory marketing code., Methods: Data were collected during the period of October 2012 to March 2013. A random sample of elementary schools was selected from two Mexican cities. Using geographic information systems, we drew a 100-m-diameter buffer around each school. Trained personnel obtained photographs to assess the locations and types of food advertisements. Our results were stratified by school type and by indicators of compliance with the PAHO and industry recommendations. We developed a multivariate negative binomial regression model to determine factors predicting the number of advertisements around schools., Results: The number of advertisements was significantly higher around public schools than around private schools (6.5 ± 5.6 vs. 2.4 ± 3.5, p < 0.05). Printed posters were the most common type of marketing medium (97%), showing mostly sugar-sweetened beverages, sweet breads, candies, and bottled water. Promotions, such as special prices or gifts, were included on 30% of printed posters. Food advertising practices were often in compliance with industry recommendations (83%) but not with those from the PAHO (32%) (p < 0.001)., Conclusion: Our results support the importance of monitoring the obesogenic environment and identifying policy tools to protect children from food marketing not only inside schools but also around them, particularly in lower income communities.