Public Health Coverage and Ageing with Chronic Conditions in Mexico: Healthcare Utilization, Functional Autonomy, and Informal Caregiving Among Adults Aged 50 and Older

Population aging and chronic illness increase the need for healthcare and support to maintain functional ability. This study examines the association between public health coverage and healthcare utilization, functional autonomy, and informal caregiving among adults aged 50 and older with hypertension, diabetes, or arthritis in Mexico. We analyze seven waves of the Mexican Health and Aging Study (ENASEM/MHAS, 2001–2024). Propensity score matching estimates the average treatment effect on the treated (ATT); conventional and machine-learning estimators assess robustness. Public health coverage is positively and significantly associated with all four outcomes: outpatient healthcare utilization (ATT = 0.148), hospital and medical care utilization (ATT = 0.034), provision of informal care (ATT = 0.031), and functional autonomy (ATT = 0.017). Estimates show similar patterns across methods. The largest association is with outpatient healthcare use, and the smallest with functional autonomy. The positive association with informal caregiving indicates that adults managing chronic conditions may also provide care to family members; it does not necessarily indicate improved well-being, as caregiving may involve additional responsibilities. Findings suggest that health coverage relates to service use and broader dimensions of later life, supporting coordinated attention to coverage, functional support, and long-term care in Mexico.