Increased life expectancy and greater exposure to health risks associated with unhealthy habits have reshaped the leading causes of disease and death in Mexico. As in many middle-income countries, chronic non-communicable diseases (NCDs) now dominate the country’s epidemiological profile, placing enormous financial strain on households and the health system.
In 1960, two-thirds of deaths in Mexico were due to infectious diseases, maternal mortality, and malnutrition—commonly referred to as “lagging diseases”. Over the following decades, mortality from these causes declined significantly, and today they account for only 10% of deaths. In contrast, NCDs, which caused one-third of deaths in 1960, now account for approximately 90%.
The three leading causes of death in Mexico are heart disease, diabetes mellitus, and malignant tumors. Together, they accounted for half of all deaths in 2023—390,831 in total.
- Heart disease is the leading cause of death both in Mexico and globally. In 2023, it caused 189,000 deaths in Mexico, with more deaths among men (100,473) than women (88,802).
- Diabetes mellitus ranks second. With an adult prevalence of 18.3% (14.6 million people), Mexico far exceeds the averages for OECD countries (7.0%) and Latin America and the Caribbean (9.9%). In 2023, it was responsible for approximately 110,000 deaths, with a nearly equal distribution between men and women.
- Cancer is the third leading cause of death, with 91,000 deaths in 2023—slightly more among women. The most common cancers include respiratory tract cancers, strongly associated with smoking, and breast cancer, which caused 8,036 deaths that year.
Other major contributors to mortality include liver disease, cerebrovascular disease, chronic obstructive pulmonary disease, and kidney failure.
Beyond the suffering, disability, and death they cause, NCDs generate substantial indirect costs, such as lost productivity due to premature death, absenteeism, and reduced work performance—threatening both household financial stability and national economic growth. A study by the National Institute of Public Health estimated that between 2005 and 2021, productivity losses from NCDs totaled US$103 billion.
The high prevalence of NCDs is driven by prolonged exposure to environmental, behavioral, and metabolic risks—often acting in combination.
- Environmental risks include air pollution.
- Behavioral risks include smoking, alcohol consumption, physical inactivity, and diets low in fruits and vegetables.
- Metabolic risks include overweight and obesity, high blood pressure, hyperglycemia, and high cholesterol.
In Mexico, 75.2% of adults are overweight or obese—the second highest rate among OECD countries and one of the highest globally. Among children and adolescents, the figures are also alarming: 37.3% in school-age children and 51.1% in adolescents.
Some NCDs, while not leading causes of death, have a major impact on population health. These include musculoskeletal disorders (e.g., back and neck pain, osteoarthritis, and rheumatoid arthritis) and mental health conditions (e.g., depression, anxiety, schizophrenia, and bipolar disorder). Measured in disability-adjusted life years (DALYs)—which account for years lost to illness, disability, or premature death—back pain and related disorders account for 7.4% of DALYs lost annually, more than cirrhosis or cerebrovascular disease. Depression and anxiety contribute an additional 3.7%.
NCDs will remain the leading causes of death over the next 20 years, and their share of total mortality is projected to increase—from 74% in 2023 to 86% in 2043—while the share from communicable diseases and injuries will fall from 26% to 14%. The relative burden of specific NCDs will depend on how well their risk factors are managed. For example, controlling metabolic and behavioral risks could reduce deaths from heart disease, diabetes, chronic kidney disease, and stroke. However, if current trends persist, deaths from heart disease, diabetes, kidney disease, lung cancer, and colorectal cancer could increase by 30%, 35%, 88%, 71%, and 72%, respectively, over the same period.
This ongoing epidemiological transition has placed mounting financial pressure on the health system. NCDs are far more costly to manage than infectious or reproductive health conditions. This was a major factor behind the creation of the Social Protection System for Health in 2004, which aimed to increase investment in health, expand care coverage, and address emerging health challenges. Yet, despite increased spending, public investment in health remains insufficient. Mexico’s public health expenditure stands at just 2.9% of GDP—far below the 6% recommended by the World Health Organization and significantly less than that of peer countries in Latin America, such as Argentina (6.3%), Chile (4.9%), Colombia (5.7%), and Costa Rica (5.6%).
This chronic underinvestment has resulted in low-quality care for many NCDs. For example, fewer than 30% of diabetic patients in public facilities have adequate disease control. Consequently, complications are common—Mexico has the highest rate of hospital admissions for diabetes in Latin America (208 per 100,000 people), more than double the regional average of 92. In-hospital mortality for acute myocardial infarction is 27%—nearly four times the OECD average of 6.9%.
Facing limited access to quality public care—including frequent shortages of essential medicines—many patients turn to private providers. This has led to a surge in catastrophic and impoverishing health expenditures, affecting more than four million households in 2022.
To address the immense challenge of NCDs, four urgent actions are needed:
- Increase investment in health. Without greater public funding, the system cannot meet the needs of an ageing population living with complex, chronic conditions. Public health spending should reach 4% of GDP by 2030 and 6% by 2040. However, the current trend is moving in the opposite direction: the 2025 health budget has been cut by 11.6% in real terms, from 1.03 trillion constant pesos in 2024 to 908 billion.
- Control major risk factors. The most critical include overweight and obesity, tobacco and alcohol use, environmental pollution, and social isolation. While anti-smoking and anti-alcohol campaigns are important, an ambitious national strategy to tackle overweight and obesity is essential. This strategy must be multi-sectoral, well-funded, and include the promotion of physical activity and healthy diets, regulation of junk food and sugary drink advertising, and effective fiscal policies. Rigorous and transparent monitoring and evaluation mechanisms are also necessary.
- Improve early diagnosis and treatment. Early detection is vital to managing diseases like diabetes, hypertension, and cancer. Targeted interventions are needed to promote timely diagnosis and improve clinical management. This includes implementing standardized care protocols and quality improvement campaigns. Mental health, often neglected, must also receive adequate attention and resources.
- Expand access to medicines and technologies. Accurate diagnosis and effective treatment require access to essential medicines and modern technologies. Increasing the health budget would enable wider access to these resources. For example, access to advanced cancer treatments is not only critical for survival but also for protecting households from financial ruin.
A nation’s well-being depends largely on the health of its people—and today, the health of Mexicans depends on preventing and controlling NCDs. Good health reduces poverty, protects household assets, improves education outcomes, boosts productivity, and stimulates economic growth. In turn, economic growth generates resources that can be reinvested in health, creating a virtuous cycle. If we fail to control NCDs, we will miss this opportunity—and with it, the chance to make Mexico a more prosperous and equitable country.
Octavio Gómez Dantés and Edson Serván Mori
Researchers at the National Institute of Public Health
This article expresses the personal views of the authors and does not reflect the position of the institution where they work.
