Epidemiologic Transitions and Preventive Frameworks in Latin America: Structural Determinants, Internal Medicine and Population Health Challenges in the 21st Century

Population health in the 21st century is shaped by the convergence of chronic disease burdens, emergent infectious threats, environmental pressures and widening social inequities. This review analyzes epidemiologic dynamics in Mexico, Colombia and Ecuador within the broader global context, integrating findings from mortality patterns, behavioral and metabolic risk profiles, structural determinants and health-system capacities. Results indicate that the three countries share an advanced epidemiologic transition dominated by noncommunicable diseases, while still experiencing persistent communicable threats and injury-related mortality. Elevated levels of obesity, hypertension and physical inactivity contribute to an intensified risk environment compared with global averages, reflecting rapid lifestyle and urban transitions. Social determinants—including inequality, urbanization and variable access to primary care—further differentiate population vulnerabilities. Additionally, substantial variation in preventive capacity and epidemiologic intelligence underscores systemic disparities in preparedness and response. The findings highlight the need for integrated, multilevel preventive strategies that address metabolic risks, strengthen primary care, reduce inequities and modernize surveillance systems. This study contributes to a nuanced understanding of how diverse structural and epidemiologic forces shape population health trajectories in the 21st century.