Among female and male workers who work in the formal sector, COVID-19 infections happen equally to those who earn less and those who earn more. The pandemic, it seems, has reached all kinds of homes in Mexico. But the outcome of the disease is not the same, those who receive the lowest wages have up to five times more likely to die than the highest paid staff in the country.
Knowing this helps the design and promotion of public policies, says in an interview Norma Gabriela López Castañeda, director of Incorporation and Collection of the Mexican Institute of Social Security (IMSS). The official participated in the study The effect of admission on mortality and hospitalization due to covid-19, along with the renowned economist Eva Arceo-Gómez; Gerardo Esquivel, deputy governor of Banco de México, and Raymundo Campos, researcher at El Colegio de México, among others, who was published in The Lancet magazine a few days ago.
The research started a bit with the hypothesis of a correlation between low income and infections. But after analyzing the data from more than 400,000 workers registered with the IMSS, they realized that the probability of transmission of the SARS-CoV-2 virus was “exactly the same”.
The analysis only included a population that works in the formal sector. “Our conclusions do not apply to the Mexican population in general: our data does not include workers registered in other health systems, workers in the informal sector, or unemployed people.” These conditions “may themselves imply different profiles and severity of comorbid diseases and different income levels.”
However, knowing the results, the institute will put more effort into two actions that it had already implemented, explains Norma Gabriela López: to affiliate people who until now had no possibility of having social security or who were very difficult to do so, domestic workers and independent workers.
“Having social security and access to health services does make a difference. Therefore, these affiliation schemes for domestic workers or people independent workers are of great importance. What interests us is that the groups that have been historically excluded have medical attention ”, as well as other benefits that only insurance grants.
Why are more poor workers dying?
Until now, the IMSS Director of Incorporation and Revenue says, the studies that had been done on income —or poverty— and covid-19 they used projections or aggregate data, but not hard information. “The institute has collaborated with authorities and with the academy in other projects and research,” the official details. From the IMSS, Eduardo Alcaraz, Planning and Evaluation coordinator, and Luis Alberto Martínez, Head of the Fiscal Policy Planning Division, also participated in the investigation.
From its database, the institute provided information on employees and patients tested for covid-19 and comorbidities such as asthma, cancer, chronic obstructive pulmonary disease, diabetes, HIV, hypertension, cardiovascular disease, obesity, kidney disease, smoking, and tuberculosis.
“We even locate his work history,” he adds. With all that information they managed to clear biases. They also learned if these people were hospitalized for covid-19 and how their disease evolved. That way, with figures, they knew that the number of infections Among the worst and best paid working people it was not the real problem, but the consequences for one group and another: people with less income die more.
The fact that they have had other illnesses when the covid-19 attacked them is not by itself the explanation of why those workers died, explains the official. Neither because of the lack of access to medical care, because precisely those who have social security were analyzed.
But “it could be due to disparities in obtaining timely and adequate care,” the study notes. “Another possible explanation is that low income people they wait longer for medical attention, so when they finally go to the hospital, their illness is already serious. “
“It is not true that the disease equals us: lower-income workers are much more likely to be hospitalized or die than higher-income workers. One more example of the disastrous effects of inequality“said Gerardo Esquivel when sharing the study on his Twitter account.
The preventive culture it is what could save lives, underlines Norma Gabriela López. However, the medical history, the way of reacting to illnesses and, above all, the possibilities to react of people who do not have social security are very different from those who do have a formal job and social security.
“The inclusion of workers who had been left out is fundamental,” he reiterates. Then, “as the director of the institute (Zoé Robledo) has mentioned many times, we must change the focus from curative to preventive medicine.”
Actions during the pandemic
“As of October 2021, there is the historical affiliation of more than 18 million permanent workers,” the IMSS reported this Friday. In the same period, 40,092 domestic workers were enrolled through the pilot program. Although this means 10 times more than those registered in the previous scheme (modality 34) in April 2019, the figure has not even reached 2% of the total of domestic employees.
“The IMSS has many challenges, and they are enormous, but this shows that the institute is one of the pillars of public policies to end inequality” and its deadly consequences. “The social Security it makes the social gaps to be shortened and they put a more even floor for everyone ”, points out Norma Gabriela López Castañeda.
It should be remembered, he points out, that the investigation focused on what happened between March and April 2020. “In that process, after identifying the most vulnerable population group, which was the third age, mechanisms were implemented to avoid contagion and worsening of the health condition ”.
For example, a program of medicine shipment at home for patients who receive controlled medications and who will not travel to the clinics. In addition, “the IMSS had the largest hospital counterclaim” of the entire health system.
The Social Security Respiratory Care Modules (MARSS) to detect covid-19 cases early, without going through a consultation and another procedure, he adds. “We were insistent on the ‘come to check’ messages, massive tests were carried out in the family medicine units.”
Care for covid-19 patients included those who were not affiliated with the IMSS. If all that had not been done, he says, “we would not have had the results that we had,” perhaps they would be worse.
Reference-www.eleconomista.com.mx