Social determination of obesity, diabetes and high blood pressure from the narratives of women from an indigenous community in the south of Morelos, Mexico

Objective: to understand the critical processes (CP) of social determination of obesity, diabetes and hypertension (ODH) in a Nahua community in Mexico.Methodology: qualitative study of records from a photovoice workshop, where participants photographed their environment and analyzed the causes and possible solutions to ODH. To analyze the CP of the ODH we use narrative research as a method and, as a theoretical reference, critical epidemiology. Results: ODH is reproduced socially and historically through destructive CP linked to global production and gender relations. These determine deteriorating lifestyles that limit health care, compromise mental health, produce pollution and differentiation in the use of spaces, and reduce opportunities for nutritious food and physical activity. All of this is expressed as ODH and mental health problems. The protective PCs against these expressions include state attention, work opportunities, and the promotion of cultural and community devices. Conclusions: our results contribute to the global discussion about how historical living conditions are part of the social determination of ODH. Understanding CP and its local expressions can guide us towards decolonizing the way of thinking and doing health promotion.