The aim of this study was to investigate the nationwide distribution of Parkinson’s disease  (PD) and its relationship with agriculture. 

We conducted an ecological, cross-sectional analysis of state-level data on PD cases and population from 2015 to 2024. Average annual cases were calculated for each state and standardized as prevalence per 100,000 inhabitants. States were grouped into two hypothesized hotspots (West: Colima, Michoacán, Jalisco; North: Sinaloa, Chihuahua, Durango) and compared with the rest of the country. Statistical comparisons included two-sample tests of proportions and Poisson regression models with population as offset.

Nationally, the mean PD prevalence was 5.3 per 100,000. The West hotspot showed higher prevalence (8.6 per 100,000) compared with other states (4.9 per 100,000; p<0.001). The North hotspot demonstrated the highest prevalence (13.8 per 100,000). In adjusted Poisson models, prevalence ratios were 1.54 (95% CI 1.44–1.63) for the West hotspot and 2.57 (95% CI 2.42–2.74) for the North hotspot, both highly significant. Our study identified two main regions in Mexico with higher PD prevalence: a western hotspot associated with intensive cultivation of Agave tequilana, Persea americana, and citrus crops, and a northern hotspot linked to large-scale production of Zea mays, Solanum lycopersicum, Phaseolus vulgaris, and Malus domestica. 

These patterns suggest that environmental exposures from intensive agriculture, alongside sociodemographic and genetic factors, may underlie regional disparities in Parkinson’s disease prevalence. They also emphasize the need to phase out pesticides such as paraquat, rotenone, and organophosphates. Mapping PD hotspots could inform targeted surveillance and health system planning in the region.