Promoting healthy populations as a pandemic preparedness strategy: a simulation study from Mexico.

Publication date: Feb 01, 2024

The underlying health status of populations was a major determinant of the impact of the COVID-19 pandemic, particularly obesity prevalence. Mexico was one of the most severely affected countries during the COVID-19 pandemic and its obesity prevalence is among the highest in the world. It is unknown by how much the COVID-19 burden could have been reduced if systemic actions had been implemented to reduce excess weight in Mexico before the onset of the pandemic. Using a dynamic epidemic model based on nationwide data, we compare actual deaths with those under hypothetical scenarios assuming a lower body mass index in the Mexican population, as observed historically. We also model the number of deaths that would have been averted due to earlier implementation of front-of-pack warning labels or due to increases in taxes on sugar-sweetened beverages and non-essential high-energy foods in Mexico. We estimate that 52. 5% (95% prediction interval (PI) 43. 2, 61. 6%) of COVID-19 deaths were attributable to obesity for adults aged 20-64 and 23. 8% (95% PI 18. 7, 29. 1%) for those aged 65 and over. Had the population BMI distribution remained as it was in 2000, 2006, or 2012, COVID-19 deaths would have been reduced by an expected 20. 6% (95% PI 16. 9, 24. 6%), 9. 9% (95% PI 7. 3, 12. 9%), or 6. 9% (95% PI 4. 5, 9. 5%), respectively. If the food-labelling intervention introduced in 2020 had been introduced in 2018, an expected 6. 2% (95% PI 5. 2, 7. 3%) of COVID-19 deaths would have been averted. If taxes on sugar-sweetened beverages and high-energy foods had been doubled, trebled, or quadrupled in 2018, COVID-19 deaths would have been reduced by an expected 4. 1% (95% PI 2. 5, 5. 7%), 7. 9% (95% PI 4. 9, 11. 0%), or 11. 6% (95% PI 7. 3, 15. 8%), respectively. Public health interventions targeting underlying population health, including non-communicable chronic diseases, is a promising line of action for pandemic preparedness that should be included in all pandemic plans. This study received funding from Bloomberg Philanthropies, awarded to Juan A. Rivera from the National Institute of Public Health; Community Jameel, the UK Medical Research Council (MRC), Kenneth C Griffin, and the World Health Organization.

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Concepts Keywords
Mexican BMI
Obesity COVID-19
Sugar Epidemic response plan
Taxes Obesity
Pandemic preparedness
Population health


Type Source Name
disease MESH COVID-19 pandemic
disease MESH obesity
disease VO population
disease IDO intervention
disease MESH non-communicable chronic diseases
disease VO organization
disease MESH Emergency
disease MESH Infection
drug DRUGBANK Coenzyme M
disease VO vaccination
disease MESH overweight
disease MESH death
disease MESH critical illness
disease MESH Influenza
disease MESH infectious diseases
disease MESH chronic diseases
disease IDO country
disease MESH hypertension
disease VO Tax
disease VO Ssb
disease VO dose
drug DRUGBANK Platelet Activating Factor
disease VO frequency
disease VO vaccine
drug DRUGBANK Adenosine
disease MESH Uncertainty
disease VO report
disease VO time
disease MESH sequelae
disease MESH long COVID
disease VO Canada
disease VO effective
disease MESH emerging infectious disease
disease IDO susceptibility
disease MESH undernutrition
disease IDO blood
disease MESH Lifestyle
disease MESH inflammation
disease VO vaccine effectiveness

Original Article

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