Cardiometabolic Health in P'urépecha Migrant-Sending Communities in Michoacan, Mexico

Migration-health research frequently attributes cardiometabolic risk among migrants to post-migration dietary and lifestyle change, despite limited empirical evidence from migrant-sending communities. This assumption is particularly salient in studies of indigenous populations, where pre-migration contexts are often treated as culturally traditional and implicitly protective. Using a mixed-methods biocultural design, this study examines cardiometabolic risk among never-migrant P'urépecha adults living in migrant-sending communities in Michoacán, Mexico, to assess whether commonly used sociocultural indicators are associated with cardiometabolic outcomes and to situate origin-community health within broader population trends. We collected anthropometric measures, cardiometabolic biomarkers, and survey data from 193 adults and integrated these data with ethnographic observations of local food environments and comparisons to national surveillance benchmarks from ENSANUT. Cardiometabolic risk was widespread. Seventy-five percent of participants were overweight or obese, 59% were hypertensive, 34% exhibited dysglycemia (HbA1c ≥ 5.7% or medication use), and 77% met criteria for metabolic syndrome. In multivariable analyses, age and sex were consistently associated with cardiometabolic risk, while income, perceived stress, language proficiency, and cultural/ethnic identification were not independently associated with outcomes. Although bivariate differences by language group were observed, these associations disappeared after adjustment for age. When interpreted alongside ethnographic observations and population-level benchmarks, these findings reveal that cardiometabolic risk is already embedded within the everyday environments of indigenous migrant-sending communities. The lack of consistent associations between commonly used sociocultural indicators and health outcomes suggests that shared community-level exposures may be more important than individual measures of language or cultural identification in shaping cardiometabolic health. By integrating biomarker, survey, and ethnographic data, this study demonstrates the value of a biocultural approach for understanding health before migration and provides a critical point of comparison for future migration-health research.