Original Research

Marginalization and health service coverage among Indigenous, rural, and urban populations: a public health problem in Mexico


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José Antonio Roldán1
Doctor in social sciences (Soc Sc Dr), Medical sciences researcher *

Marsela A. Álvarez 2 Master in Psychology, Medical sciences researcher

María Carrasco3 Master in Human Nutrition, Medical sciences researcher

Noé Guarneros4 PHD, Medical sciences researcher

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José Á Ledesma5
Master in Human Nutrition, Medical sciences researcher

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Mario Cuchillo-Hilario6
PHD, Medical sciences researcher

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Adolfo Chávez7
PhD, Medical sciences researcher


1, 2, 3, 4, 5, 6, 7 National Institute of Medical Science and Nutrition, Vasco de Quiroga 15, Tlalpan 14080; Mexico City.

ACCEPTED: 5 June 2017

early abstract:

Introduction: Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on indigenous, rural, and urban populations.
Objective: To understand Mexico's public health problem across three population areas, indigenous, rural, and urban, in relation to degree of marginalization and health service coverage.
Methods: The sampling universe of the study consisted of 107,458 geographic locations in the country. The study was retrospective, comparative, and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation, and correspondence analyses.
Results: Significant differences were identified between the indigenous, rural, and urban populations with respect to their level of marginalization and access to health services. The most affected area was indigenous, followed by rural areas. The sector that was least affected was urban.
Conclusion: Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the indigenous and rural populations throws the gravity of the public health problem into relief.