Age-friendly initiatives: Mexico

Abstract

While the implementation of these initiatives varies globally and continues to face low uptake in the global south, it is crucial to underscore key ongoing efforts, particularly in developing nations. This allows us to have knowledge about progress and identify areas that require more effective strategies to advance the cause of global healthy aging.

The aim of this mini-review was to describe some of the key age-friendly initiatives made in Mexico through Governmental and Non-Governmental entities to promote healthy aging, at different levels of health and social institutions, covering the healthcare systems, community, and education.

The demographic shift towards an aging population carries profound implications for both societies and healthcare systems [1]. Notably, Latin America, primarily composed of low and middle-income countries, is projected to experience a significantly more rapid aging process compared to high-income countries [2]. Considering this demographic shift, promoting active and healthy aging while creating age-friendly communities and cities becomes crucial to ensure the well-being and independence of the older population [3]. These goals hinge on actively involving older adults in all aspects of community life while respecting their lifestyle choices. Additionally, institutions must proactively address the aging-related needs and preferences of this demographic group [4].

Numerous global initiatives aim to unite health and social care systems to promote healthy aging at the individual and community levels. A prominent example is the World Health Organization's (WHO) Decade of Healthy Aging (2020–2030), which seeks widespread implementation across all levels of health and social care to build healthier, more inclusive societies [4]. While the adoption of these initiatives varies globally and faces distinctive challenges in the global south [2], it's crucial to highlight ongoing national efforts to assess progress and identify areas requiring more effective strategies to promote global healthy aging.

This mini-review aims to describe some key age-friendly initiatives implemented in Mexico to promote healthy aging across various levels of health and social institutions, encompassing healthcare systems, communities, and education.

1. Health and social care systems

Older adults in Mexico access healthcare much like other age groups, but the system is fragmented among social security, government, and private insurance entities [5]. Efforts have been made to address this fragmentation with changes in national health policy and the creation of institutions such as the Institute of Health for Wellbeing (INSABI), which aims to provide health services, medicines, and related supplies free of charge to people without social security. However, there is still progress to be made, as 18.7% of older adults currently cannot access healthcare due to various reasons, including the impact of the COVID-19 pandemic [6].

In addition, specific healthcare programs tailored to the aging population have been launched to promote healthier and more active aging [7]. Nevertheless, significant gaps remain, particularly in areas like brain health and dementia care. There is a need for a national dementia action plan to enhance brain health and the care of individuals living with dementia [8]. The Ministry of Health has prioritized the creation of a new healthcare model tailored to older adults, with the establishment of the National Institute of Geriatrics (INGER) in 2012 and the implementation of healthy aging promotion programs through the production, dissemination, and use of scientific knowledge; the development and training of human resources; and the provision of health services directed to older people [9]. In addition, a national no-contributive pension program to enhance social protection of individuals ages 65 and over through financial support was implemented in 2001, as a state initiative, and later was expanded to nationwide coverage in 2020 [10].

2. Long term care

Mexico currently lacks a dedicated, formal, regulated long-term care (LTC) system for its older population, resulting in a staggering annual societal cost of $2.43 billion [11]. To address some of these gaps, the National Institute for Older Persons (INAPAM) and the National System for Integral Family Development (DIF) step in, offering social care resources to the older population. Although both institutions have daycare programs, only DIF provides access to long-term care services [12]. This lifeline of support has its limitations, and the burden of caring for older adults typically falls on family members, often placing the onus on women and underaged individuals [13]. Consequently, there arises an urgent need for the establishment of a formal LTC system, that can help mitigate the physical and mental health decline while relieving the economic strain on older adults, their families, and society at large [11].

3. Communities and housing

Mexico's involvement in the Age-Friendly Cities program, which has led to the transformation of 62 cities, represents a commendable step forward [2]. Nevertheless, implementation barriers persist as a challenge both nationally and internationally. Studies examining the hurdles in establishing age-friendly cities, including two conducted in Mexico, have shed light on the difficulties faced. These include the need to shift perceptions of aging, engage key stakeholders, cater to diverse needs, and improve program planning [14]. Despite Mexico's earnest endeavors, these challenges continue to hinder the pursuit of truly age-friendly cities. Furthermore, housing assistance programs in Mexico remain intrinsically tied to social security institutions, thereby limiting access primarily to those in formal employment [6,15].

4. Employment and civic participation

In Mexico, individuals over 65 represent 29.4% of the economically active population, with lower female participation [6]. However, recent findings show that 70% of this group works in the informal sector [15], which presents challenges as they may not be eligible for various social programs that primarily cover formal sector employees. Additionally, older adults have emerged as a significant voting bloc, and their social participation is increasing, with the potential for greater contributions to shaping public policy [16].

5. Education and research

There are currently 926 certified geriatricians in Mexico, with 43 specialization programs in Geriatric Medicine. Progress has also been made in developing subspecialties such as psychogeriatrics, cardio-geriatrics, neurogeriatrics, onco-geriatrics, and a geriatric nursing specialization program [17]. However, an important challenge that remains present is the primary care level where family physicians and general practitioners urgently need to acquire new capabilities for taking care of older persons.

Research on aging in Mexico has advanced, with the Mexican Health and Aging Study (MHAS) and international collaboration being notable examples. Nonetheless, there are still gaps in our understanding of aging within the Mexican population [9].

6. Conclusions and future perspectives

Mexico, like many Latin American countries, has implemented initiatives to prepare and adapt the society to the needs of an aging population. However, these efforts still fall short of adequately supporting the entire older population, and many interventions are needed to create more inclusive societies with better environments for older adults. To achieve this goal, it is essential to establish social, cultural, and environmental programs that promote fairer, more sustainable, and age-friendly societies [18]. The initiatives discussed in this article, along with new ones in the future, will hopefully become integral parts of public agendas with the active involvement of governmental and non-governmental institutions to achieve healthy aging for all Mexicans.

Declaration of interests

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:

Sara Solis reports administrative support was provided by Global Brain Health Institute. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.