The Association Between Structural Birth Defects and Environmental Exposures in Mexico Through an Environmental Justice Lens
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Background: Birth defects significantly affect infant morbidity and mortality. They contribute to long-term disability, impacting individuals, families, healthcare systems and societies. Only 30% of birth defects can be attributed to a specific cause. Studies have shown that environmental exposures can increase the risk of birth defects, disproportionately affecting communities heavily exposed to environmental contaminants. This dissertation addresses birth defects, environmental justice, industrial pollution, as well as social and healthcare disparities. Objectives: This dissertation aims to assess the relationship between the density of polluting industries, and the incidence of genital and congenital heart defects, while seeking to evaluate how environmental justice and healthcare disparities play a role in the relationship. By identifying critical areas of vulnerability, the research provides evidence-based recommendations for policy interventions to protect public health and promote health equity Methods: This study utilized twelve years of nationwide official records on the incidence of genital birth defects across 2,446 Mexican municipalities. Data on contaminant-emitting industrial plants were integrated and information on socioeconomic status, access to healthcare, food, and household services was added to the final database. Both studies employed negative binomial regression models to analyze the relationships between industrial density, and birth defects, controlling for socioeconomic variables. The first study analyzed genital birth defects; and the second one analyzed congenital heart defects while including an interaction analysis to examine how healthcare disparities modify the effects of industrial pollution on congenital heart defects. Results: The first study found a significant association between the presence of polluting industries and increased rates of genital birth defects in Mexican municipalities. Municipalities with higher densities of chemical, petrochemical, and lead-emitting industries exhibited elevated incidence rates of genital birth defects. The second study revealed that municipalities with limited healthcare access and high industrial pollution had significantly higher incidence rates of congenital heart defects. The interaction analysis indicated that healthcare disparities exacerbated the adverse effects of industrial pollution on congenital heart defects. Conclusions: The findings highlight the critical need for addressing environmental health risks and healthcare disparities in Mexico. Industrial pollution significantly contributes to the incidence of congenital anomalies, and healthcare access plays an important role in mitigating these effects. Policy interventions targeting environmental justice and improving healthcare infrastructure are essential for protecting vulnerable populations and reducing the public health burden of congenital anomalies. This research highlights the importance of integrating environmental health and justice frameworks to promote health equity and sustainable development in industrialized regions.
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