Infectious Intestinal Diseases and Residential Water Services in Mexico: a Spatial Analysis

Abstract

Infectious intestinal diseases (IID) represent a widespread public health problem in Mexico. The country also faces major challenges with respect to the provision of residential water services (piped water and sewer)—an essential input for hygiene and cleanliness in homes. This paper analyzes morbidity rates from several IID associated with unsanitary living conditions along with a series of residential water services indicators for Mexico’s 2,456 municipalities. With data obtained through a special request to the federal epidemiological authority as well as official census data for 2010, we find stark regional contrasts and identify interesting spatial structures for both IID morbidity and residential water services indicators. In particular, municipalities tend to present values similar to neighboring municipalities, forming clusters of relatively high-value (or low-value) municipalities. Moreover we find that municipalities with a relatively high level of access to residential water services tend to present relatively low IID morbidity rates. These results have multiple public policy implications. In order to reduce the incidence of IID effectively and efficiently, interventions should explicitly consider the spatial structure of morbidity and target problem spots—which typically spill over state, municipal and other administrative boundaries. Moreover, improvements in the quality of access to piped water (for example, increasing the frequency of supply) may be as important for reducing morbidity as the expansion of basic access to this service.