University of Arizona, Mel and Enid Zuckerman College of Public Health, 1296 N. Martin, Tucson, AZ 85724, USA.
Instituto Nacional de Salud Pública, Centro de Investigación en Nutrición y Salud, 7a Cerrada de Fray Pedro de Gante 50, Tlalpan, Sección XVI, 14080 Ciudad de México, CDMX, Mexico.
Health Promot Int. 2020 Apr 1;35(2):409-421. doi: 10.1093/heapro/daz029.
Non-communicable diseases (NCD), such as diabetes and cardiovascular disease, have become a leading cause of the death in Mexico. The federal government has addressed this issue through developing NCD prevention plans, regulations and policies (PRPs) that seek to address social and environmental factors, which was led by the National Institute of Public Health and Ministry of Health in concert with various non-governmental organizations. This review aims to synthesize and summarize national NCD prevention PRPs addressing social and environmental factors passed from 2010 to 2016, and to assess the extent to which these efforts successfully addressed factors contributing to the epidemic. In total nine federal NCD prevention PRPs were identified from a scan that examined executive and legislative PRPs, which identified five documents. A scoping review was conducted for evaluation studies and reports corresponding to these PRPs. The majority of PRPs focused on nutrition, specifically the access and promotion of food. Studies and reports demonstrated that taxation on energy-dense low-nutrient foods and sugar-sweetened beverages were the most effective. Other PRPs had various issues with implementation, mostly related to adherence and resources available. Overall, there lacked evidence of evaluative work on several NCD prevention PRPs, specifically assessing implementation and effectiveness. Additionally, PRPs did not sufficiently address integration of clinical, social, environmental approaches and access to physical activity. While the Mexican federal government has taken the initial steps to address the multifactorial causes of NCD, firm political commitment and investment of significant resources are still needed.
非传染性疾病(NCD),如糖尿病和心血管疾病,已成为墨西哥的主要死亡原因。联邦政府通过制定 NCD 预防计划、法规和政策(PRPs)来解决这个问题,这些计划旨在解决社会和环境因素,由国家公共卫生研究所和卫生部与各种非政府组织共同领导。本综述旨在综合和总结 2010 年至 2016 年期间通过的针对社会和环境因素的国家 NCD 预防 PRPs,并评估这些努力在多大程度上成功解决了导致该流行病的因素。从对行政和立法 PRPs 的扫描中确定了 9 项联邦 NCD 预防 PRPs,其中确定了 5 份文件。对这些 PRPs 对应的评估研究和报告进行了范围综述。大多数 PRPs 侧重于营养,特别是获取和促进食物。研究和报告表明,对高能量、低营养食品和含糖饮料征税是最有效的。其他 PRPs 在实施方面存在各种问题,主要与遵守和可用资源有关。总体而言,缺乏对几项 NCD 预防 PRPs 的评估工作的证据,特别是对实施和效果的评估。此外,PRPs 没有充分解决临床、社会、环境方法的整合以及获得身体活动的问题。虽然墨西哥联邦政府已采取初步措施来解决 NCD 的多种因素,但仍需要坚定的政治承诺和大量资源的投入。