Oral health service utilization by elderly beneficiaries of the Mexican Institute of Social Security in México city

<p>Abstract</p> <p>Background</p> <p>The aging population poses a challenge to Mexican health services. The aim of this study is to describe recent oral health services utilization and its association with socio-demographic characteristics and co-morbidity in Mexican Social Security beneficiaries 60 years and older.</p> <p>Methods</p> <p>A sample of 700 individuals aged 60+ years was randomly chosen from the databases of the Mexican Institute of Social Security (IMSS). These participants resided in the southwest of Mexico City and made up the final sample of a cohort study for identifying risk factors for root caries in elderly patients. Sociodemographic variables, presence of cognitive decline, depression, morbidity, medication consumption, and utilization of as well as reasons for seeking oral health services within the past 12 months were collected through a questionnaire. Clinical oral assessments were carried out to determine coronal and root caries experience.</p> <p>Results</p> <p>The sample consisted of 698 individuals aged 71.6 years on average, of whom 68.3% were women. 374 participants (53.6%) had made use of oral health services within the past 12 months. 81% of those who used oral health services sought private medical care, 12.8% sought social security services, and 6.2% public health services. 99.7% had experienced coronal caries and 44.0% root caries. Female sex (OR = 2.0), 6 years' schooling or less (OR = 1.4), and caries experience in more than 22 teeth (OR = 0.6) are factors associated with the utilization of these services.</p> <p>Conclusion</p> <p>About half the elderly beneficiaries of social security have made use of oral health services within the past 12 months, and many of them have to use private services. Being a woman, having little schooling, and low caries experience are factors associated with the use of these services.</p

Gangs, urban violence, and security interventions in Central America

Urban violence is a major preoccupation of policymakers, planners and development practitioners in cities around the world. Public authorities routinely seek to contain such violence through repression, as well as through its exportation to and containment at the periphery of metropolitan centres. Yet, urban violence is a highly heterogeneous phenomenon and not amenable to reified diagnosis and coercive intervention. Muscular state-led responses tend to overlook and conceal the underlying factors shaping the emergence of urban violence, as well as the motivations and means of so-called violence entrepreneurs. This is very obviously the case of urban gangs in Central America, which are regularly labelled a ‘new urban insurgency’ threatening the integrity of governments and public order. This article considers both the shape and character of Central American gang violence and attempts to reduce it, highlighting the complex relationship between these two phenomena. We advance a threefold approach to measuring the effectiveness of interventions, focusing in turn on discursive, practical and outcome-based criteria. In this way, the article demonstrates how, contrary to their reported success in diminishing gang violence, repressive first-generation approaches have tended instead to radicalize gangs, potentially pushing them towards more organized forms of criminality. Moreover, although credited with some modest successes, more preventive second-generation interventions seem to have yielded more rhetorical advances than meaningful reductions in gang violence