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Since 2000, approximately 440,000 Mexicans have migrated to the United States every year. Tens of thousands have left children behind in Mexico to do so. For these parents, migration is a sacrifice. What do parents expect to accomplish by dividing their families across borders? How do families manage when they are living apart? More importantly, do parents' relocations yield the intended results? Probing the experiences of migrant parents, children in Mexico, and their caregivers, Joanna Dreby offers an up-close and personal account of the lives of families divided by borders. What she finds is that the difficulties endured by transnational families make it nearly impossible for parents' sacrifices to result in the benefits they expect. Yet, paradoxically, these hardships reinforce family members' commitments to each other. A story both of adversity and the intensity of family ties, Divided by Borders is an engaging and insightful investigation of the ways Mexican families struggle and ultimately persevere in a global economy.

In From Homemakers to Breadwinners to Community Leaders , Norma Fuentes-Mayorga compares the immigration and integration experiences of Dominican and Mexican women in New York City, a traditional destination for Dominicans but a relatively new one for Mexicans. Her book documents the significance of women-led migration within an increasingly racialized context and underscores the contributions women make to their communities of origin and of settlement. Fuentes-Mayorga’s research is timely, especially against the backdrop of policy debates about the future of family reunification laws and the unprecedented immigration of women and minors from Latin America, many of whom seek human rights protection or to reunite with families in the US. From Homemakers to Breadwinners to Community Leaders provides a compelling look at the suffering of migrant mothers and the mourning of family separation, but also at the agency and contributions that women make with their imported human capital and remittances to the receiving and sending community. Ultimately the book contributes further understanding to the heterogeneity of Latin American immigration and highlights the social mobility of Afro-Caribbean and indigenous migrant women in New York. 

Examining street vending as a global, urban, and informalized practice found both in the Global North and Global South, this volume presents contributions from international scholars working in cities as diverse as Berlin, Dhaka, New York City, Los Angeles, Calcutta, Rio de Janeiro, and Mexico City. The aim of this global approach is to repudiate the assumption that street vending is usually carried out in the Southern hemisphere and to reveal how it also represents an essential—and constantly growing—economic practice in urban centers of the Global North. Although street vending activities vary due to local specificities, this anthology illustrates how these urban practices can also reveal global ties and developments.

National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

Populations in Latin America, Asia and sub-Saharan Africa are rapidly ageing. The extent to which traditional systems of family support and security can manage the care of increased numbers of older people with chronic health problems is unclear. Our aim was to explore the social and economic effects of caring for an older dependent person, including insight into pathways to economic vulnerability. We carried out a series of household case studies across urban and rural sites in Peru, Mexico, China and Nigeria (n = 24), as part of a cross-sectional study, nested within the 10/66 Dementia Research Group cohort. Case studies consisted of in-depth narrative style interviews (n = 60) with multiple family members, including the older dependent person. Governments were largely uninvolved in the care and support of older dependent people, leaving families to negotiate a 'journey without maps'. Women were de facto caregivers but the traditional role of female relative as caregiver was beginning to be contested. Household composition was flexible and responsive to changing needs of multiple generations but family finances were stretched. Governments are lagging behind sociodemographic and social change. There is an urgent need for policy frameworks to support and supplement inputs from families. These should include community-based and residential care services, disability benefits and carers allowances. Further enhancement of health insurance schemes and scale-up of social pensions are an important component of bolstering the security of dependent older people and supporting their continued social and economic participation.

Several studies have identified multiple obesity-associated loci mainly in European populations. However, their contribution to obesity in other ethnicities such as Mexicans is largely unknown. The aim of this study was to examine 26 obesity-associated single-nucleotide polymorphisms (SNP) in a sample of Mexican mestizos. 9 SNPs in biological candidate genes showing replications (PPARG, ADRB3, ADRB2, LEPR, GNB3, UCP3, ADIPOQ, UCP2, and NR3C1), and 17 SNPs in or near genes associated with obesity in first, second and third wave GWAS (INSIG2, FTO, MC4R, TMEM18, FAIM2/BCDIN3, BDNF, SH2B1, GNPDA2, NEGR1, KCTD15, SEC16B/RASAL2, NPC1, SFRF10/ETV5, MAF, PRL, MTCH2, and PTER) were genotyped in 1,156 unrelated Mexican-Mestizos including 683 cases (441 obese class I/II and 242 obese class III) and 473 normal-weight controls. In a second stage we selected 12 of the SNPs showing nominal associations with obesity, to seek associations with quantitative obesity-related traits in 3 cohorts including 1,218 Mexican Mestizo children, 945 Mexican Mestizo adults, and 543 Indigenous Mexican adults. After adjusting for age, sex and admixture, significant associations with obesity were found for 6 genes in the case-control study (ADIPOQ, FTO, TMEM18, INSIG2, FAIM2/BCDIN3 and BDNF). In addition, SH2B1 was associated only with class I/II obesity and MC4R only with class III obesity. SNPs located at or near FAIM2/BCDIN3, TMEM18, INSIG2, GNPDA2 and SEC16B/RASAL2 were significantly associated with BMI and/or WC in the combined analysis of Mexican-mestizo children and adults, and FTO locus was significantly associated with increased BMI in Indigenous Mexican populations. Our findings replicate the association of 8 obesity-related SNPs with obesity risk in Mexican adults, and confirm the role of some of these SNPs in BMI in Mexican adults and children.

Background/Objectives: Uric acid is a key metabolic byproduct of purine degradation and plays a dual role in human health. At physiological levels, it acts as an antioxidant, protecting against oxidative stress. However, excessive uric acid can lead to hyperuricemia, contributing to conditions like gout, kidney stones, and cardiovascular diseases. Emerging evidence also links elevated uric acid levels with metabolic disorders, including hypertension and insulin resistance. Understanding its regulation is crucial for preventing associated health complications. Methods: This study, part of the Tlalpan 2020 project, aimed to predict uric acid levels using advanced machine learning algorithms. The dataset included clinical, anthropometric, lifestyle, and nutritional characteristics from a cohort in Mexico City. We applied Boosted Decision Trees (Boosted DTR), eXtreme Gradient Boosting (XGBoost), Categorical Boosting (CatBoost), and Shapley Additive Explanations (SHAP) to identify the most relevant variables associated with hyperuricemia. Feature engineering techniques improved model performance, evaluated using Mean Squared Error (MSE), Root-Mean-Square Error (RMSE), and the coefficient of determination (R2). Results: Our study showed that XGBoost had the highest accuracy for anthropometric and clinical predictors, while CatBoost was the most effective at identifying nutritional risk factors. Distinct predictive profiles were observed between men and women. In men, uric acid levels were primarily influenced by renal function markers, lipid profiles, and hereditary predisposition to hyperuricemia, particularly paternal gout and diabetes. Diets rich in processed meats, high-fructose foods, and sugary drinks showed stronger associations with elevated uric acid levels. In women, metabolic and cardiovascular markers, family history of metabolic disorders, and lifestyle factors such as passive smoking and sleep quality were the main contributors. Additionally, while carbohydrate intake was more strongly associated with uric acid levels in women, fructose and sugary beverages had a greater impact in men. To enhance model robustness, a cross-feature selection approach was applied, integrating top features from multiple models, which further improved predictive accuracy, particularly in gender-specific analyses. Conclusions: These findings provide insights into the metabolic, nutritional characteristics, and lifestyle determinants of uric acid levels, supporting targeted public health strategies for hyperuricemia prevention.

Background Femicide—the gender-motivated killing of women—remains an urgent public health and human rights crisis in Latin America. In Mexico, legal reforms have established formal mechanisms for prevention and response, yet implementation remains fragmented, particularly in regions marked by structural violence and institutional distrust. This study examines how femicide is conceptualized and addressed by both formal institutions and grassroots organizations in two distinct contexts: Mexico City and rural Michoacán. Methods Drawing on 64 in-depth interviews and participant observations conducted between 2022 and 2024, this qualitative study employs a comparative case study design to explore how divergent organizational frameworks, political conditions, and cultural logics shape femicide response. Thematic analysis was used to identify patterns in discourse, action, and collaboration across formal and community-based actors. Results Findings reveal two fundamentally different logics of femicide response. Formal institutions emphasize legal harmonization, training protocols, and policy compliance metrics—reflecting a technocratic model of prevention aligned with bureaucratic governance. Grassroots actors, by contrast, center relational care, symbolic resistance, and immediate community mobilization. These differences are not merely operational, but epistemic: institutional actors often devalue lived experience and emotional labor, while grassroots actors articulate survivor-defined safety, cultural legitimacy, and trust as central to prevention. In rural and high-impunity regions, community-led responses often function as the only reliable form of protection and accountability. Conclusions Femicide prevention frameworks in Mexico must move beyond symbolic gestures of inclusion and begin to reckon with the structural exclusion of grassroots knowledge and labor. Meaningful response requires a shift in power and priorities—one that values community knowledge, centers survivor-defined metrics of safety and trust, and explores models of shared governance in contexts where institutional systems are distrusted or absent. In such settings, grassroots responses are not peripheral—they are essential.

Background Histoplasma is a fungal pathogen found in many parts of the world. In North America, its distribution is traditionally thought to be endemic to the Ohio and Mississippi River valleys. Development of histoplasmosis after Histoplasma exposure is related to degree of inoculum exposure and susceptibility, for example, immunocompromised status. Most exposed, healthy individuals are asymptomatic and few develop pulmonary symptoms. A limited number of infectious etiologies (that is, Histoplasma , Coccidioides , and Mycobacterium tuberculosis ) can cause miliary pattern on chest imaging, and thus, histoplasmosis should be considered whenever a patient presents with pulmonary symptoms and these unique radiographic findings. Case presentation A previously healthy 13-year-old Hispanic male presented as a transfer from an outside hospital with fever and hypoxia in the setting of a progressive, subacute gastrointestinal illness. Given hypoxia, the concern for sepsis, and unclear etiology of his illness, broad-spectrum antimicrobial therapy and noninvasive ventilation were started. Initial evaluation demonstrated miliary pulmonary infiltrates, and travel history raised suspicion for coccidioidomycosis or tuberculosis. After a complete evaluation, lab studies confirmed a diagnosis of histoplasmosis, and the patient made a full recovery after the initiation and completion of antifungal therapy. Conclusion Herein, we present a patient who acquired histoplasmosis from an area of Mexico not currently acknowledged as endemic and review recently published data emphasizing new areas of Histoplasma endemicity in North America, particularly the southwest USA and most states of Mexico. Though limited surveillance data exist, mounting case reports/series and local epidemiologic studies illustrate the expanding worldwide endemicity of Histoplasma and underscore histoplasmosis as a growing global health concern.