Influence of indigenous status and community indigenous makeup on obesity and diabetes among Mexican adults

Purpose: We evaluated the hypothesis that indigenous adults have lower risk of obesity and diabetes than non-indigenous adults in Mexico, due to greater socioeconomic disadvantage. We further investigated whether all adults–regardless of indigenous status–are buffered against these conditions if they live in communities with a higher percentage of indigenous residents. We assessed whether this difference is due to lower community development in higher-indigenous communities. Methods: The sample included 19577 adults from the Mexican Family Life Survey (2002), a nationally representative survey of Mexican households and communities. Indigenous status was based on self-reports of indigenous group identification. Community percent indigenous was based on an aggregate of this variable. Communities ranged in size from rural areas to cities. We used multilevel models to estimate odds of obesity (based on anthropometric measures) and diagnosed diabetes. Results: Obesity (21% versus 28%) and diabetes (4% versus 7%) were less prevalent among indigenous than non-indigenous adults. This advantage remained after adjustment for socioeconomic status and other covariates (obesity: OR 0.71, 95% CI 0.61-0.82; diabetes: OR 0.55, 95% CI 0.42-0.72). For all residents, each 10% increase in community percent indigenous reduced odds of obesity (OR 0.94, 95% CI 0.90-0.98) and diabetes (OR 0.94, 95% CI 0.90-0.99), even after adjustment for community development indicators. Conclusion: An opportunity may still exist to prevent disparities in obesity and diabetes from developing among Mexican adults by indigenous status and community indigenous makeup. Identifying the sources of observed protective effects should be a priority, given global implications for prevention.