Spatio-temporal patterns of the mortality of diseases associated with malnutrition and their relationship with food establishments in Mexico

This study explores the spatio-temporal behavior of mortality due to multiple causes associated with several diseases and their relationship with the physical availability of food. We analyze data for the 2010-2020 period at the municipality level in Mexico. After collecting and standardizing national databases for each disease, we perform SATSCAN temporal and FleXScan spatial cluster analyses. We use the he Kruskal-Wallis test to analyze the differences between municipalities with high relative risk of mortality and their relationship with food retail units and food establishments. We found statistically significant relationships between clusters by disease and the physical availability of food per hundred thousand inhabitants. The main pattern is a higher average density of convenience stores, supermarkets, fast food chains and franchises, and Mexican snack restaurants in high-risk municipalities, while a higher density of grocery stores and inns, cheap kitchens, and menu restaurants exists in the municipalities with low risk. The density of convenience stores, fast food chains and franchises, and Mexican snack restaurants plays a very important role in mortality behavior, so measures must exist to regulate them and encourage and protect convenience stores, grocery stores, and local food preparation units.