Since the early 1990s, Mexico entered a transitional stage in the health of its population and some indicators such as mortality patterns are identical to those found in highly developed countries like Germany or Japan. Mexico's medical infrastructure is highly rated for the most part and is usually excellent in major cities, but rural communities still lack equipment for advanced medical procedures, forcing patients in those locations to travel to the closest urban areas to get specialized medical care. Social determinants of health can be used to evaluate the state of health in Mexico.