Macro-Regional Spatial Patterns of Ambient Air Pollution and Avoidable Hospitalizations for Community-Acquired Pneumonia in Mexico (2013–2020)

Abstract

Ambient air pollution significantly contributes to respiratory illnesses, yet little is known about how industrial emissions are linked to preventable hospitalizations across atmospheric basins in middle-income countries. This study develops a basin-based geo-matics framework to examine the spatial and temporal relationship between industrial pollutants and age- and sex-adjusted avoidable hospitalizations for community-acquired pneumonia (PQI 11) in Mexico from 2013 to 2020. Using state-level data grouped into eight macro-regions, we combine bivariate choropleth maps, Pearson correlations, linear regression, and longitudinal time-series analysis to identify spatial clusters of high risk and to estimate regional sensitivities to changes in PM2.5, SO2, NOx, and volatile organic compound emissions. The findings reveal notable regional differences: northern border states and the Mexico City metropolitan basin form persistent high–high clusters where elevated emissions coincide with high PQI 11 rates, while coastal and peninsular regions show lower hospitalization burdens despite medium emission levels. Although national industrial PM2.5 emissions decreased over the study period, several macro-regions—particularly CDMX_Edomex, Centro, and Centro Norte—experienced significant increases in avoidable hospitalizations and decoupled emission–health patterns. Correlation matrices and regression slopes suggest that the strength and even direction of links between pollutants and PQI 11 vary across macro-regions, with emission-responsive patterns in Centro Norte and weak or inverse relationships in Peninsula and Pacifico Sur. These findings demonstrate that national averages obscure critical spatial disparities and highlight the value of basin-based geomatics approaches for regional air-quality governance, spatial decision support, and primary-care planning aimed at reducing preventable respiratory hospitalizations.