Closing the Cancer Divide: The case of women’s cancers and Mexico’s Seguro Popular

8/12/2019 Closing the Cancer Divide: The case of womens cancers and Mexicos Seguro Popular

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@jbikim Cmrij Dlmub, QhNHmrvmrn Ebfgmb Jqui ty I li timtivj, Ebfgmb msd @ frkj fl Jxpmlnjn Mkkjss tf

Kmlkjr Kmrj mln Kfltrfb i l BC IKs

^cmtjbf m Qjkhf M?K. Cxikf

Cjxikml Hjmbth @ fulnmtifl

Ufcjls Kfbbjej Wjsjmrkh Ilstitutj

^frfltf, Cmy 7;, 71=>

Kbfsile thj Kmlkjr Nivinj?

^hj kmsj f` wfcjls kmlkjrs mln

Cjxikfs [jeurf Qfpubmr


2/56

Jvinjlkj-gmsjnmnvfkmky

Mnvfkmky-ilspirjn jvinjlkj

Mktifl?

prfojkts, prfermcs, pfbikijs

Numbity?

jvinjlkj mln mnvfkmky


3/56

@rfc mljknftj

tf jvinjlkj


4/56

Omlumry, 7118

Oulj, 7115


5/56


6/56


7/56


8/56


9/56


10/56


11/56

tf jvinjlkj

@rfc mljknftj


12/56

Cijcgrfs

E^@.KKK


13/56

Ebfgmb ^msd @frkj fl

Jxpmlnjn Mkkjss tf

Kmlkjr Kmrj mln Kfltrfb

;> cjcgjrs?

Ebfgmb hjmbth + Kmlkjr kmrj ^jkhlikmb Mnvisfry Kfccittjj? 01+

Qrivmtj [jktfr Jlemejcjlt Erfup

Qrifrity mrjms mln Ufrdile erfups? Qjn Flk, Qmil & Qmbbimtifl, Ufcjls

kmlkjrs, [urvivfrship, Jkflfciks f` kmlkjr


14/56

Ebfgmb msd @frkj fl Jxpmlnjn

Mkkjss tf Kmlkjr Kmrj mln

Kfltrfb il Njvjbfpile Kfultrijs

3 ebfgmb hjmbth + kmlkjr kmrj


15/56

Mppbijs m nimeflmb

mpprfmkh tf mvfin

thj `mbsj nibjccmsgjtwjjl nisjmsj sibfs

-KN/LKN- thmtkfltiluj tf pbmeuj

ebfgmb hjmbth

Kbfsile thj Kmlkjr Nivinj?M GBZJQWIL^ ^F JXQMLN MKKJ[[ IL BCIKs


16/56

Kbfsile thj Kmlkjr Nivinj?Ml Jquity Icpjrmtivj

I? [hfubngj nflj

II? Kfubn gj nfljIII? Kml gj nflj

C=. Zlljkjssmry

C7. Zlm``frnmgbj

C;. Icpfssigbj

C>? Ilmpprfprimtj

Jxpmlnile mkkjss tf kmlkjr kmrj mln kfltrfb il BCIKs?

=? Illfvmtivj Njbivjry

7? Mkkjss? M``frnmgbj Cjns, Pmkkiljs & jkhs;? Illfvmtivj @ilmlkile? Nfcjstik mln Ebfgmb

>? Jvinjlkj `fr Njkisifl-Cmdile

:? [tjwmrnship mln Bjmnjrship


17/56


18/56

#7 kmusj f` njmth il wjmbthy kfultrijs

#; il uppjr cinnbj-ilkfcj#> il bfwjr cinnbj-ilkfcj

mln # 8 il bfw-ilkfcj kfultrijsCfrj thml 8:% f` pjnimtrik kmlkjr kmsjs mln 9:% f`

njmths fkkur il njvjbfpile kfultrijs.

@fr khibnrjl & mnfbjskjlts

:-=> kmlkjr is


19/56

Kmlkjr is m nisjmsj f` gfth rikh mln pffr4

yjt it is ilkrjmsileby thj pffr whf su``jr?

=. Jxpfsurj tf risd mktfrs

7. Qrjvjltmgbj kmlkjrs (il`jktifl)

;. Njmth mln nismgibity rfctrjmtmgbj kmlkjr

>. [tiecm mln niskricilmtifl

:. Mvfinmgbj pmil mln su``jrile

^hj Kmlkjr Nivinj?

Ml Jquity Icpjrmtivj

@mk

jts


20/56

[furkj? Dlmub, Mrrjfbm, Cjlnjz. jsticmtjs gmsjn fl IMWK, Ebfgfkml, 71=1.

Khibnrjl

BFU

ILKFCJ

HIEH

ILKFCJ

@mkjt ;? ^hj Fppfrtulity tf [urvivj

(C/I) [hfubn Lft Gj Nj`iljn gy Ilkfcj

Il Kmlmnm, mbcfst 91% f` khibnrjl with bjudjcim survivj.

Il thj pffrjst kfultrijs flby =1% survivj.

Bjudmjcim

Mbb kmlkjrs

=11%

Cjxikf

Kmlmnm

BFU

ILKFCJ

HIEH

ILKFCJ

Grjmst Kjrvix

^jstis Qrfstmtj

Lfl-hfndils Hfndils

^yrfin

Cjxikf

Kmlmnm

[urvivmbiljqumbity

e

mp

Mnubts=11%

^h t i ini i o ti


21/56

^hj cfst ilsinifus iloustikj?

^hj pmil nivinj

757,111 ce

7,;11 ce

705,111 ce

0,011 ce

;5,111 ce

[furkj? Gmsjn fl nmtm `rfc? ^rjmt thj pmil

(http?//www.trjmtthjpmil.kfc)

Lfl-cjthmnflj, Cfrphilj

Jquivmbjlt fpifin kflsucptifl pjr

njmth `rfc HIP fr kmlkjr il pmil?

Qffrjst =1%? :> ce

Wikhjst =1%? 95,>11 ce

Z[/Kmlmnm? 751,111 ce

Ilnim
http://www.treatthepain.com/http://www.treatthepain.com/


22/56

Khmbbjlej mln nisprfvj thj

cyths mgfut kmlkjrC=. Zlljkjssmry LJKJ[[MWY

C7. Zlm``frnmgbj M@@FWNMGBJC;. Ilmpprfprimtj MQWFQWIM^J

C>? Icpfssigbj QF[[IGBJ

a:/81


23/56

a:/81 kmlkjr

nisjquibigriuc(Bmlkjt 71=1)

Mbcfst 81% f` thj NMBYs

(nismgibity-mnoustjn bi`j-yjmrs) bfstwfrbnwinj tf kmlkjr mrj il BCIKs,

yjt thjsj kfultrijs hmvj flby m vjry

scmbb shmrj f` ebfgmb rjsfurkjs `frkmlkjr ~ :% fr bjss.


24/56

^hj kfsts f` ilmktifl mrj huej?

Ilvjst I Lmktifl^fgmkkf is m huej jkflfcik risd? ;.0% bfwjr ENQ

^ftmb jkflfcik kfst f` kmlkjr, 71=1? 7->% f` ebfgmb ENQ

Qrjvjltifl mln trjmtcjlt f``jrs

pftjltimb wfrbn smviles f`

$ Z[ =;1-9>1 gibbifl

=/;-=/7 f` kmlkjr njmths mrj mvfinmgbj?7.>-;.5 cibbifl njmths,

f` whikh 81% mrj il BICKs


25/56

^hj kfsts tf kbfsj thj kmlkjr nivinj

mrj mln cmy gj bjss thml cmly `jmr?

Mbb gut ; f` 79 BCIK prifrity kmlkjr khjcf mlnhfrcflmb mejlts mrj f``-pmtjlt

Qmil cjnikmtifl is khjmp

Qrikjs nrfp? HjpG mln HQP vmkkiljs

Njbivjry & `ilmlkile illfvmtifls mrj

ulnjrutibizjn & ulnjvjbfpjn sf thmt purkhmsile

is `rmecjltjn mln prfkurjcjlt is ulstmgbj

QMHF 71=; [trmtjeik @uln `fr LKNs

ilkbunjs djy kmlkjr nrues


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C7. Zlm``frnmgbj M@@FWNMGBJC;. Ilmpprfprimtj MQWFQWIM^JC>? Icpfssigbj QF[[IGBJ


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^h Ni b M h


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^hj Nimeflmb Mpprfmkh tf

Hjmbth [ystjc [trjlethjlileWmthjr thml `fkusile fl jithjr nisjmsj-spjkiìk vjrtikmb frhfrizfltmb-systjcik prfermcs, hmrljss syljreijs thmt

prfvinj fppfrtulitijs tf tmkdbj nisjmsj-spjkiìk prifritijs

whibj mnnrjssile systjcik emps mln fpticizj mvmibmgbj

rjsfurkjs

Nimeflmb strmtjeijs cmofr gjljìts?X 3 < pmrts

Grinej nisjmsj nivinjs usile m bi`j kykbj rjspflsj

mvfins thj `mbsj nibjccms gjtwjjl nisjmsj sibfs -

KN/LKN- thmt kfltiluj tf pbmeuj ebfgmb hjmbth

Ejljrmtj pfsitivj jxtjrlmbitijs? j.e. wfcjls kmlkjr

prfermcs ìeht ejlnjr niskricilmtifl4 pmil kfltrfb >mbb


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Nimeflmb [trmtjeijs?

Qfsitivj Jxtjrlmbitijs

Qrfcftile prjvjltifl mln hjmbthy bi`jstybjs?

Wjnukj risd `fr kmlkjr mln fthjr nisjmsjs

Wjnukile stiecm `fr wfcjls kmlkjrs?

Kfltrigutjs tf rjnukile ejlnjr niskricilmtifl.

Ilvjstile il trjmtcjlt prfnukjs khmcpifls

Qmil kfltrfb mln pmbbimtifl

Wjnukile gmrrijrs tf mkkjss is jssjltimb `fr

kmlkjr, `fr fthjr nisjmsjs, mln `fr surejry.


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NimeflmbizileKmlkjr Kmrj?

@ilmlkile & Njbivjry=. @ilmlkile? Iltjermtj kmlkjr kmrj iltf

lmtiflmb ilsurmlkj mln sfkimb sjkurity

prfermcs7. Njbivjry? Hmrljss pbmt`frcs gy iltjermtile

grjmst mln kjrvikmb kmlkjr prjvjltifl,

skrjjlile mln survivfrship kmrj iltf CKH,[WH, HIP/MIN[, sfkimb wjb`mrj mln mlti-

pfvjrty prfermcs.


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C7. Zlm``frnmgbj M@@FWNMGBJC;. Ilmpprfprimtj MQWFQWIM^J

C>? Icpfssigbj QF[[IGBJ

Kh i


33/56

Khmcpifls?

Lfgjb Mcmrtym [jl,Kmlkjr survivfr nimelfsjn ilIlnim 01 yjmrs mef

Nrjw E. @mustQrjsinjlt f` Hmrvmrn

Zlivjrsity 77+ yjmr GK

survivfr

J b ` th ni


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Il njvjbfpile kfultrijs,

pjfpbj with cubtinrue-

rjsistmlt tugjrkubfsis usumbby

nij, gjkmusj j``jktivj trjmtcjltis f`tjl icpfssigbj il pffr

kfultrijs. UHF =990

Jxmcpbjs `rfc fthjr nisjmsjs?

CNW-^G trjmtcjlt, =990-99

[furkj? Qmub @mrcjr., 7119

CNW-^G is tff jxpjlsivj tf

trjmt il pffr kfultrijs4 it

njtrmkts mttjltifl mln rjsfurkjs

`rfc trjmtile nrue-suskjptigbj

nisjmsj. UHF =995

Nrue% Njkbilj il

prikj =995-9

Mcidmkil 91%

Jthiflmcinj 8>%

Kmprjfcykil 95%

F`bfxmkil 98%

with UHF?Wjnukjn pr ikjs f` sjkfln-

bilj G nrues


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Cjxikf? kjrvikmb kmlkjr.

[furkj? Dlmub jt mb., 7118. Wj rfnuktivj Hjmbth Cmttjrs, mln u nmtjn g Dlmub, Mrrjfbm-Frljbms mln Clnjz gmsjn fl UHF nmtm, UHF[I[ =9::-=958 , mln Cilistr f Hjmbth il Cjxikf =959-7110

1

>

8

=7

=0

=9::=90:

=95:

=98:

=99:

7118

[ukkjss il trjmtile sjvjrmb kmlkjrs.


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mbb Bmtil Mcjrikml lmtifls, cukh f`

jmstjrl Jurfpj mln kjltrmb Msim, Khilm,

Ilnim, cmly fthjr pmrts f` sfuth Msim,

mln jvjl kfultrijs il M`rikm, mrj `mkile m

pmil`ub nfugbj gurnjl f` nisjmsjlft

flby thj pjrsistjlkj f` il`jktifus thrjmts,

khibn mln cmtjrlmb cfrtmbity, mlnulnjrlutritifl, gut mbsf thj jcjrejlkj f`

ljw nmlejrs, lftmgby nimgjtjs, fgjsity,

kmrnifvmskubmr nisjmsj, strfdj, kmlkjr,

cjltmb ibb-hjmbth, mln ilourijs.

OZBIF @WJLD & WIKHMWN HFW^FL

HJMB^H WJ@FWC IL CJXIKF [JWIJ[

^HJ BMLKJ^, 7110


37/56

Huej stjps il thj trmlsitifl thru rj`frc tfwmrn

Zlivjrsmb Hjmbth Kfvjrmej il cmly kfultrijs

Jxmcpbjs?

Grmzib

Khilm

Kfbfcgim

Khibj

JJZZ(M``frnmgbj Kmrj Mkt)

Jb [mbvmnfr

Qjru [futh M` r ikm

^miwml Cjxikf? [jeurf Qfpubmr nj [mbun

Yjtf`tjl il thjkfltjxt f` rmpin,

prf`fuln,

pfbmrizjn mlnkfcpbjx

jpinjcifbfeikmbtrmlsitifl fr

gmttbile`rmecjltjn hjmbth

systjcs


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NimeflmbizileKmlkjr Kmrj?

@ilmlkile & Njbivjry

=. @ilmlkile? Iltjermtj kmlkjr kmrj iltf

lmtiflmb ilsurmlkj mln sfkimb sjkurity

prfermcs

7. Njbivjry? Hmrljss pbmt`frcs gy iltjermtile

grjmst mln kjrvikmb kmlkjr prjvjltifl,

skrjjlile mln survivfrship kmrj iltf CKH,[WH, HIP/MIN[, sfkimb wjb`mrj mln mlti-

pfvjrty prfermcs.


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Nfcjstik @ilmlkile

IllfvmtiflsIltjermtj KKK iltf lmtiflmb ilsurmlkj mln

sfkimb sjkurity prfermcs tfgjeillile with

kmlkjrs f` wfcjl mln khibnrjl?

Cjxikf, Kfbfcgim, Nfcilikml

Wjpugbik, QjruKhilm, Ilnim, ^miwml

Wwmlnm, Djlym


40/56

Cjxikfs 711;? cmofr hjmbth rj`frc

krjmtjn [jeurf Qfpubmr

Hfrizfltmb Kfvjrmej?

Gjljìkimrijs

PjrtikmbKfvjrmej

Nisjmsjsm

lnIltjrvjltifls?

Gjlj`

itsQmkdmej

M`ìbimtifl? 711>? 0.: c

71=7? :>.0 c

Gjljìt pmkdmej? 711>? ==;

71=7? 78>+:5

Jvfbutifl f` vjrtikmb kfvjrmej? kucubmtivj #


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Jvfbutifl f` vjrtikmb kfvjrmej? kucubmtivj #

f` kfvjrjn iltjrvjltifls, 711>-71=7

Lftjs?

[Q 3 [jeurf Qfpubmr

CILE 3 Cjnikmb Ilsurmlkj `fr m Ljw Ejljrmtifl (Khibnrjl gfrl m`tjr Njkjcgjr =, 7110 mln ultib thjy mrj : yjmrs f` mej)

@QKHJ 3 @ule fr Qrftjktifl memilst Kmtmstrfphik Hjmbth Jxpjlniturj

JQH[ 3Jssjltimb Qjrsflmb Hjmbth [jrvikjsJQI 3 Jxpmlnjn Qrfermccj f` Icculismtifls

KGQ3 Kfcculity-gmsjn pmkdmej

1

:1

=11

=:1

711

7:1

;11

;:1

>11

>:1

:11

711> 711: 7110 7115 7118 7119 71=1 71== 71=7

0; 0: 0: 0: 0: 0: 0: 0: 0:

0 0 8 0 =7 =7=7 =7 =;

77

8;

=50 =8>=89 =89 =98 =98

710

0

0

=571

>9 >9

>9 :5:5

==1

=18 ==0=78

=78=;=

CILE

JQH[

JQI

KGQ

@QKHJ

Lucgjrf`iltjrvjltifls

[jeurf Qfpubmr

78> iltjrvjltifls

CILE + [Q

@QKHJ

:5iltjrvjltifls

KMZ[J[ 9=

@QKHJ 0

KMZ[J[ 78>

@QKHJ :5

D t ` [je rf Qfp bmr


42/56

Mkkjbjrmtjn, ulivjrsmb, vjrtikmb kfvjrmej gy nisjmsj

with ml j``jktivj pmkdmej f` iltjrvjltifls

711>/0? HIP/MIN[, kjrvikmb kmlkjr, MBB il

khibnrjl

7115? Mbb pjnimtrik kmlkjrs4 Grjmst kmlkjr

71==? ^jstikubmr mln Qrfstmtj kmlkjr mln LHB

71=7? Fvmriml (kfbfrjktmb) kmlkjr

Djy mspjkt f` [jeurf Qfpubmr?

nimeflmb, `ilmlkimb prftjktifl `fr

kmtmstrfphik ibbljss

[ Q b n


43/56

[jeurf Qfpubmr mln kmlkjr?

Jvinjlkj f` icpmkt

Grjmst kmlkjr mnhjrjlkj tf trjmtcjlt?

711:? 711/011

71=1? =1/911

[ilkj thj ilkfrpfrmtifl f` khibnhffn

kmlkjrs iltf thj [jeurf Qfpubmr;1-cflth survivmb? ;1% tf mbcfst 51%

mnhjrjlkj tf trjmtcjlt? 51% tf 9:%.

^hj hucml `mkjs f`


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^hj hucml `mkjs f`

[jeurf Qfpubmr?

Euibbjrcilm Mvibm

&Mgish Wfcjrf

Njbivjry mln `ilmlkimb prftjktifl khmbbjlejs?


45/56

Gjljìts?kfvjrjnil

tjrvjltifls

Njbivjry mln ìlmlkimb prftjktifl khmbbjlejs?

[jeurf Qfpubmr il Cjxikf

MKKJBJWM^JN PJWÎKMB KFPJWMEJ `fr Kmtmstrfphik

Ibbljssjs ilkbunjn il thj @uln? grjmst kmlkjr, MIN[

Kfcculity mln Qugbik Hjmbth [jrvikjs

Qffr Wikh

KHIBNWJL? Hjmbth ilsurmlkj `fr m Ljw Ejljrmtifl / XXI Kjltury Cjn Ils.

Qmkdmej f` jssjltimb pjrsflmb

sjrvikjs

Gjljìkimrijs


46/56

Hjmbth [ystjc

@ulktifls

[tmej f` thj Khrflik Nisjmsj Bi`j Kykbj KfltiluucQricmry

Qrjvjltifl

[jkflnmry

prjvjltiflNimelfsis ^rjmtcjlt

[urvivfrship/

Wjhmgibitmtifl

Qmbbimtifl/

Jln-f`-bi`j kmrj

[tjwmrnship

@ilmlkile

Njbivjry

Wjsfurkj

Ejljrmtifl

Wjspflnile tf thj Khmbbjlej f` Khrflikity?

Hjmbth [ystjc @ulktifls gy Kmrj Kfltiluuc

J``jktivj `ilmlkimb kfvjrmej f` m


47/56

J``jktivj `ilmlkimb kfvjrmej f` m

khrflik nisjmsj? grjmst kmlkjr

Cjxikf? Bmrej mln jxjcpbmry ilvjstcjlt il `ilmlkimbprftjktifl `fr grjmst kmlkjr prjvjltifl mln trjmtcjlt,

yjt..m bfw survivmb rmtj.

[trjlethjl jmrby njtjktifl, survivfrship mln pmbbimtifl?

nimeflmbizj njbivjry

Kmlkjr Kfltrfb-Kmrj kfltiluuc

Qricmry

Qrjvjltifl

Jmrby

Njtjktifl Nimelfsis ^rjmtcjlt [urvivfrship Qmbbimtifl

Gmrrijrs tf Mkkjss Qmbbimtivj Kmrj


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Gmrrijrs tf Mkkjss Qmbbimtivj Kmrj

gy Hjmbth [ystjc @ulktifl? Cjxikf

[furkj? Mnmptjn `rfc Dlmub, @. C., Ermbfw, O. W., Mtul, W., & Ghmnjbim, M. (Jns.). Kbfsile thj Kmlkjr Nivinj. Hmrvmrn Zlivjrsity Qrjss, 71=7.

Hjmbth[ystjc

@ulktifl

Kfcpfljlts f` thj Hjmbth Kmrj Kfltiluuc

Qrjvjltifl

[urvivmbQmbbimtivj Kmrj, Qmil Kfltrfb mln Jln f` Bi`j Kmrj

Wjeubmtifl

Cissile? Lmtiflmb Qbml / Qrfermc

Ujmd, pffrby nj`iljn mln rjstriktivj rjeubmtfry `rmcjwfrds

Mgsjlkj jvmbumtifl mln cflitfrile

@ilmlkile

LF jxpbikit kfvjrmej f` iltjrvjltifls il jithjr thj Kfcprjhjlsivj

Qmkdmej `fr Jssjltimb [jrvikjs fr thj @uln `fr Qrftjktifl Memilst

Kmtmstrfphik Jxpjlniturj

-[fkimb [jkurity thjrj is ml jvjrythile mln lfthile

NjbivjryBmkdile ulits mln bjvjbs fr njbivjry

[uppby khmil mln nistrigutifl is spfrmnik mln spftty

Wjsfurkj

Ejljrmtifl mln

Wjsjmrkh

Bmkd f` trmiljn pjrsflljb

@jmr f` prjskriptifl

^fpik lft mvmibmgbj il cjnikmb skhffb kurrikubuc

Lf pugbishjn rjsjmrkh rjbmtjn tf hjmbth systjc


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50/56

% nimelfsjn il [tmej > gy stmtj# 7 dibbjr f`

wfcjl ;1-:>

:-=1% njtjktjnil [tmej 1-=

Qffr

culikipmbitjs?:1% [tmej >4 :x

thj rmtj fr r ikh

Grjmst Kmlkjr? Njbivjry `miburj

Qffr

Wikh

O it


51/56

Oumlitm?Mnvmlkjn cjtmstmtik grjmst

kmlkjr is thj rjsubt f` m sjrijs

f` cissjn fppfrtulitijs

Nimeflmbizile Njbivjry =?


52/56

Nimeflmbizile Njbivjry =?

Iltjermtifl f` kjrvikmb & grjmst kmlkjr

jnukmtifl iltf mlti-pfvjrty prfermcs,

Fpfrtulinmnjs

Ilkbunj il`frcmtifl il

cmlumbjs `frkfcculity wfrdjrs

=.: cibbifl prfcftjrs

< 91% f` pffr

Cjxikml hfusjhfbns?

:.8 cibbifl `mcibijs

Nimeflmbizile Njbivjry 7?


53/56

Nimeflmbizile Njbivjry 7?^rmilile pricmry kmrj prfvinjrs

il jmrby njtjktifl f` grjmst kmlkjrQrfcftjrs (+>111), Lursjs & CNs (+=>11)

cjnikmb stunjlts (+5:1)

Lujvf Bjfl, Ombiskf, Cfrjbfs, Qujgbm & Cjxikml Ilstitutj

f` [fkimb [jkurity (;7,111 CNs)

[ieli`ikmlt ilkrjmsj il dlfwbjnej, jspjkimbby il KGJ


54/56

Flefile rjsjmrkh mln ilitimtivjs

Kbfsile thj Qmil Nivinj

[urvivfrshipGrmzib mln Cjxikf Jkflfciks f` Hfpj

@ilmlkile Qbmt`frcsQMHF Qjn

Flk


55/56

Gj mlfpticist

fpticmbist

Jxpmlnile mkkjss tf kmlkjr kmrj mln kfltrfb il

BCIKs? [hfubn, Kfubn, mln Kml gj nflj


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