Community size, perception of health, depression and diabetes mellitus in Mexican adults

Natalia Ramírez-Girón, Esther Gallegos-Cabriales, Jeyle Ortiz-Rodriguez


Introduction: Type 2 Diabetes Mellitus is a public health problem. Theoretical approaches that include factors of the individual, environmental factors and the synergy of these variables in the development of T2D are necessary, to achieve a better understanding of the phenomenon. The research question was: What individual and environmental factors explain the presence of diabetes in a representative sample of the adult population of Mexico?             

Method: Data from the Mexican Health and Aging Study were used. 13,186 observations were included corresponding to individuals over 50 years old living in Mexico. A linear hierarchical model with two levels (1. Individual, 2. Community) was performed.

Results: Individuals who have a better perception of their health condition and do more exercise are less likely to have diabetes. Meanwhile, depression, sleep problems, having hypertension, and parents with diabetes are positively related to the likelihood of having diabetes. Individuals who live on large-sized localities are more likely to have diabetes than people who live in small communities. The effect of community size is greater as individuals have a better perception of their health condition and the effect of depression levels on the likelihood of having diabetes increases as individuals live in large communities. The probabilities of risk and association of an exposure with an event such as diabetes are evaluated.

Discussion or Conclusion: Diabetes can be explained from individual factors and the size of the community where people reside, which interact with specific individual factors, which improves the understanding of the development of diabetes.


public health; diabetes mellitus; multilevel analyses; environment; depression; sleep problems; hypertension; heredity; social determinants of health; health services; diabetes epidemic

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