RESUMO
BACKGROUND: Worldwide, Cervical Cancer (CC) is the fourth most common type of cancer and cause of death in women. It is a significant public health problem, especially in low and middle-income/Gross Domestic Product (GDP) countries. In the past decade, several studies of CC have been published, that identify the main modifiable and non-modifiable CC risk factors for Mexican women. However, there are no studies that attempt to explain the residual spatial variation in CC incidence In Mexico, i.e. spatial variation that cannot be ascribed to known, spatially varying risk factors. METHODS: This paper uses a spatial statistical methodology that takes into account spatial variation in socio-economic factors and accessibility to health services, whilst allowing for residual, unexplained spatial variation in risk. To describe residual spatial variations in CC risk, we used generalised linear mixed models (GLMM) with both spatially structured and unstructured random effects, using a Bayesian approach to inference. RESULTS: The highest risk is concentrated in the southeast, where the Matlapa and Aquismón municipalities register excessive risk, with posterior probabilities greater than 0.8. The lack of coverage of Cervical Cancer-Screening Programme (CCSP) (RR 1.17, 95 % CI 1.12-1.22), Marginalisation Index (RR 1.05, 95 % CI 1.03-1.08), and lack of accessibility to health services (RR 1.01, 95 % CI 1.00-1.03) were significant covariates. CONCLUSIONS: There are substantial differences between municipalities, with high-risk areas mainly in low-resource areas lacking accessibility to health services for CC. Our results clearly indicate the presence of spatial patterns, and the relevance of the spatial analysis for public health intervention. Ignoring the spatial variability means to continue a public policy that does not tackle deficiencies in its national CCSP and to keep disadvantaging and disempowering Mexican women in regard to their health care.
RESUMO
This article analyzes the relationship between the configuration and spatial reorganization of land-use and land-cover in the Pujal-Coy project area, Huasteca Potosina region, eastern San Luis Potosí, Mexico, as well as the relationship between these changes and the environmental conditions prevailing in the area. Land-use and land-cover changes were determined through the analysis and interpretation of satellite images from different dates. The changes identified in the different study periods were correlated with the prevailing physical factors. The results show that the spatial configuration of farming activities, initially induced by the implementation of a regional development project, is highly correlated to the presence of limiting factors such as soil type, slope, and climate. Particularly, the former represents the element that has led to the establishment of the current distribution pattern of farming activities.
Assuntos
Conservação dos Recursos Naturais , Ecossistema , Monitoramento Ambiental/métodos , Agricultura , Clima , Sistemas de Informação Geográfica , Geografia , México , SoloRESUMO
Large lowland river valleys include a variety of floodplain environments that represent opportunities and constraints for human activities. This study integrates extensive field observations and geomorphic data with analysis of satellite remote sensing data to examine spatial relations between land use/land cover (LULC) and floodplain environments in the lower Pánuco basin of eastern Mexico. The floodplain of the lower Pánuco basin was delineated by combining a digital elevation model with a satellite image of a large flood event. The LULC was classified by combining a hybrid classification strategy with image stratification, applied to 15-m-resolution ASTER data. A geomorphic classification of floodplain environments was performed using a dry-stage image (ASTER data) and a 1993 Landsat image acquired during a large flood event. Accuracy assessment was based on aerial photographs (1:38,000), global positioning satellite ground-truthing, and a Landsat 7ETM(+) image from 2000, which resulted in an overall accuracy of 82.9% and a KHAT of 79.8% for the LULC classification. The geomorphic classification yielded 83.5% overall accuracy, whereas the KHAT was 81.5%. LULC analysis was performed for the entire floodplain and individually within four valley segments. The analysis indicates that the study area is primarily utilized for grazing and farming. Agriculture is primarily associated with coarse-grained (sandy/silty) natural levee and point bar units close to the river channel, whereas cattle grazing occurs in distal and lower-lying reaches dominated by cohesive fine-grained (clayey) deposits, such as backswamps. In the Pánuco valley, wetlands and lakes occur within backswamp environments, whereas in the Moctezuma segments, wetlands and lakes are associated with relict channels. This study reveals considerable variation in LULC related to spatial differences in floodplain environments and illustrates the importance of considering older anthropogenic influences on the landscape. The research design should be applicable for other large lowland coastal plain river valleys where agriculture is a major component of the floodplain landscape.