Much obesity, scarce staff: the inequality of human resources in nutrition in Mexico (2019-2023).

Abstract

Objectives: To analyze the density and inequality of human resources in nutrition (HRN) in the Mexican public health system, as well as their evolution between 2019 and 2023.

Materials and methods: An ecological study was conducted with secondary information sources for 2019 and 2023. The density of HRN per 100,000 inhabitants was estimated, based on the total population, and its distribution was analyzed according to social security institution, level of care, and federative entity. In addition, the density of HRN for adults with overweight or obesity (OoO) was estimated for 2023. To estimate the inequality in the state distribution of HRN, the concentration index (CI) was used, and the marginalization index as a stratifier.

Results: In Mexico, the density of HRN increased from 5.9 in 2019 to 6.9 per 100,000 inhabitants in 2023; however, this increase was unequal among federative entities, institutions, and levels of care. In second and third-level care units, the density reached up to 22.41 HRN per 100,000 inhabitants, while in the first level it was 2.0. There is a higher concentration of HRN in entities with lower marginalization (CI=0.13 in 2019; CI=0.11 in 2023), units for the population with social security (CI=0.36 in 2019; CI=0.33 in 2023), and second and third levels (CI=0.20 in 2019; CI=0.18 in 2023).

Conclusions: In Mexico, between 2019 and 2023, the density of HRN increased, but state-level and by level of care inequalities persist. Strengthening its planning and distribution, particularly at the first level of care, is essential to respond to the nutritional and epidemiological needs of the country.