Burden of non-communicable diseases and behavioural risk factors in Mexico: Trends and gender observational analysis

Background There is scarce gender-disaggregated evidence on the burden of disease (BD) worldwide and this is particularly prominent in low-and mid-dle-income countries. The objective of this study is to compare the BD caused by non-communicable diseases (NCDs) and related risk factors by gender in Mexican adults.Methods We retrieved disability-adjusted life years (DALYs) estimates for dia-betes, cancers and neoplasms, chronic cardiovascular diseases (CVDs), chronic respiratory diseases (CRDs), and chronic kidney disease (CKD) from the Glob-al Burden of Disease (GBD) Study from 1990-2019. Age-standardized death rates were calculated using official mortality microdata from 2000 to 2020. Then, we analysed national health surveys to depict tobacco and alcohol use and physical inactivity from 2000-2018. Women-to-men DALYs and mortality rates and prevalence ratios (WMR) were calculated as a measure of gender gap.Findings Regarding DALYs, WMR was >1 for diabetes, cancers, and CKD in 1990, indicating a higher burden in women. WMR decreased over time in all NCDs, except for CRDs, which increased to 0.78. However, WMR was <1 for all in 2019. The mortality-WMR was >1 for diabetes and cardiovascular dis-eases in 2000 and <1 for the rest of the conditions. The WMR decreased in all cases, except for CRDs, which was <1 in 2020. The WMR for tobacco and al-cohol use remained under 1. For physical inactivity, it was >1 and increasing.Conclusions The gender gap has changed for selected NCDs in favour of wom-en, except for CRDs. Women face a lower BD and are less affected by tobac-co and alcohol use but face a higher risk of physical inactivity. Policymakers should consider a gendered approach for designing effective policies to reduce the burden of NCDs and health inequities.