Assessing Environmental Justice in Mexico: How Polluting Industries and Healthcare Disparities Impact Congenital Heart Defects

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY

Birth Defects Research Pub Date : 2025-03-13 DOI:10.1002/bdr2.2463

Maria Jose Talayero, Carlos Santos-Burgoa, Jordan Kuiper, Robert Canales, Andrea Gropman

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引用次数: 0

Abstract

Background

Congenital heart defects (CHDs) are the most prevalent birth defects globally and the second leading cause of death in Mexican children under five. This study examines how industrial activity and social vulnerabilities independently and jointly influence CHD incidence across 2446 Mexican municipalities from 2008 to 2019.

Methods

Using negative binomial regression models, we evaluated associations between polluting industries, healthcare access, and CHD incidence. We analyzed these factors independently, jointly, and through interaction terms to assess potential effect modification by healthcare access. Incidence rate ratios (IRRs) and 95% confidence intervals were estimated across healthcare access strata.

Results

Municipalities without healthcare facilities were more likely to host polluting industries, highlighting structural inequities. The presence of polluting industries was associated with increased CHD incidence, even after adjusting for healthcare access. For instance, municipalities with poor healthcare access and two or more polluting industries exhibited a 42% higher CHD incidence (IRR = 1.42, 95% CI: 1.25–1.60) compared to a 26% increase in municipalities with better healthcare access (IRR = 1.26, 95% CI: 1.02–1.57).

Conclusions

These results show how environmental pollutant exposure and social vulnerabilities interact synergistically, disproportionately impacting socially vulnerable populations. Targeted policy interventions addressing both environmental pollution and healthcare inequities are crucial. Further research is also needed to clarify the mechanisms linking pollution to CHDs and to guide public health strategies aimed at reducing these disparities in Mexico.

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评估墨西哥的环境正义：污染工业和医疗保健差异如何影响先天性心脏缺陷

先天性心脏缺陷（CHDs）是全球最普遍的出生缺陷，也是墨西哥五岁以下儿童死亡的第二大原因。本研究考察了2008年至2019年墨西哥2446个城市的工业活动和社会脆弱性如何独立和共同影响冠心病发病率。方法采用负二项回归模型，评估污染行业、医疗服务可及性和冠心病发病率之间的关系。我们分别分析了这些因素，联合分析了这些因素，并通过相互作用来评估医疗保健可及性对潜在影响的影响。发病率比（IRRs）和95%置信区间估计在医疗保健访问层。结果没有医疗设施的城市更有可能成为污染行业的所在地，凸显了结构性不平等。污染工业的存在与冠心病发病率增加有关，即使在调整了医疗保健可及性之后也是如此。例如，医疗保健条件差和两个或两个以上污染行业的城市冠心病发病率高出42% (IRR = 1.42, 95% CI: 1.25-1.60)，而医疗保健条件较好的城市冠心病发病率增加26% （IRR = 1.26, 95% CI: 1.02-1.57）。这些结果表明，环境污染物暴露与社会脆弱性相互作用，对社会弱势群体的影响不成比例。针对环境污染和医疗不公平的有针对性的政策干预至关重要。还需要进一步研究，以澄清污染与冠心病之间的联系机制，并指导旨在减少墨西哥这些差异的公共卫生战略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.