Chiapas, Guerrero and Oaxaca: the trio of states with the most barriers to access health

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Chiapas and Oaxaca have 7 out of 10 inhabitants with lack of access to health; Guerrero 5 out of 10. These entities present low levels of affiliation to medical institutions, availability and accessibility in medical services and few state interventions focused on health.

The piece of land that comprises the states of Chiapas, Guerrero and Oaxaca is one of those that, historically, have been forgotten by the private and public initiative. Although in recent years many public interventions of federal order have been carried out, most of them are focused on infrastructure, connectivity, communications or work. The health field, in addition, has had almost no state interventions.

In these entities, located in the southeast of Mexico, the highest levels of poverty, labor informality and inequality are concentrated. Accessing health is significantly more difficult than in the rest of the country.

Chiapas and Oaxaca have 7 out of 10 inhabitants with lack of access to health; Guerrero 5 out of 10, according to figures from Coneval (National Council for the Evaluation of Social Development Policy).

Having a lack of access to health goes beyond having or not having social security, private medical insurance or being affiliated to a public institution. In these three entities, there are also fewer clinics and hospitals, less preventive health dissemination, fewer doctors and nurses, fewer medicines and equipment.

In its study on indicators of the right to health by federal entity, Coneval highlights that health is one of the areas with the least participation among social programs: only 11% of the total are focused on guaranteeing the right to health.

Informal work and its relationship with health One of the great obstacles to access health in entities such as Chiapas, Guerrero and Oaxaca is labor informality. In these states between 75 and 80% of the population works under informal schemes, and as a consequence, they are not necessarily affiliated to health institutions such as IMSS or ISSSTE.

In Chiapas and Oaxaca 9 out of 10 workers do not have direct access to health, for Guerrero the figure is 8 out of 10. For those who do not work (minors, the elderly or the population that does not find employment) the situation is not so different. In Chiapas and Oaxaca about 65% of this population also does not have direct access to health institutions.

Regional gaps are also reflected in the indicator that evaluates the extended gratuity of public health services. For example, in states such as Baja California or Nuevo Léon less than 10% of those who received care in public institutions had to spend more money.

On the other hand, in states such as Chiapas, Guerrero and Oaxaca, more than 40% of those who received care in public institutions had to spend more money, either to buy medicines, pay for transportation or other expenses.

The Coneval study also reveals that the states with the lowest percentage of the population with access to health services are Chiapas (30.6%), Oaxaca (32.4%), Guerrero (47.6%), Veracruz (53.8%) and Puebla (54.1%).

The states with the highest percentage of the population with access to health services are Nuevo León (88.9%), Coahuila (87.9%), Baja California (86.9%), Sonora (86.8%) and Chihuahua (86.6%).

The Coneval report concludes that the right to health in Mexico is still far from being guaranteed for all people, especially for those who live in conditions of poverty and marginalization. It also points out that the Covid-19 pandemic has exposed the weaknesses and challenges of the health system, and calls for strengthening public policies that ensure universal and quality health care.

Source: El Economista