Socio-spatial vulnerability index of type 2 diabetes mellitus in Mexico in 2020

This study aimed to estimate a socio-spatial vulnerability index for type 2 diabetes mellitus (T2DM) at the municipal level in Mexico for 2020. It incorporated factors such as poverty, social backwardness, marginalization index, and human development index. This retrospective ecological study analyzed 317,011 incident cases of T2DM in 2020. Utilizing multi-criteria decision analysis, weighted values were assigned to each vulnerability criterion. A multiple linear regression model was developed, complemented by cluster and outlier analyses using Moran I's and the high-low clustering method. A clustered spatial autocorrelation of high values was found across 17.65% of Mexico, which was statistically significant (p < 0.001). Conversely, 37.78% of the territory showed a pattern of low values without significant evidence of groupings. The analysis revealed 117 nodes of very high vulnerability forming six focal areas, 172 nodes with high vulnerability across five areas, 168 nodes with medium vulnerability in two areas, 112 nodes with low vulnerability across 16 areas, and 152 nodes with very low vulnerability in 24 focal areas. This method proves to be robust and offers a technical-scientific basis for guiding T2DM prevention strategies and actions using a spatial/epidemiological approach. It is recommended that future strategies take into account factors such as poverty, social backwardness, marginalization index, and human development index to be effective.