Social exclusion and health inequity in Mexico: A socio-spatial analysis

Objective: Determining the relationship between social exclusion and health inequity at state and municipal level in Mexico in recent years.  
Material and Methods: For 2005, adjusted mortality rates -related with transmissible illnesses in the childhood, the pregnancy and the childbirth as well as product of causes that could be considered potentially avoidable- were calculated; rates were calculated by states, for states grouped in quartiles according to marginalization level and for municipalities grouped according to marginalization grade. To measure the inequity, indicators as the rate ratio, the coefficient of Gini and the index of inequities in health (INIQUIS) were used. 
Results: An evident excess of mortality is observed in the states grouped in the Quartile IV (highest marginalization) in relationship with the Quartile I (lowest marginalization) and to the inverse one, the resources and health services in the Quartile I are evidently higher than the existent in the Quartile IV. The Coefficient of Gini reaches its higher value in the rate of mortality for nutritional anaemia (0,44). The excess of mortality is evident in the municipalities considered as of very high marginalization; the highest INIQUIS, so much when analyzing the mortality related to the childhood, pregnancy and childbirth like the potentially avoidable mortality, it is observed in the states located in the Quartile IV, mainly Chiapas, Oaxaca and Guerrero. 
Conclusions: A notorious health inequity exists in Mexico, associated to the high prevalent levels of social exclusion in different areas of the country; to modify this situation, deep structural changes are needed to promote the social development, and allow to reduce the unfair disadvantages to that important population groups are exposed.