The Hispanic paradox is an epidemiological finding that Hispanic Americans tend to have health outcomes that paradoxically are comparable to, or in some cases better than, those of their U.S. non-Hispanic White counterparts, even though Hispanics have lower average income and education, higher rates of disability, as well as a higher incidence of various cardiovascular risk factors and metabolic diseases. Low socioeconomic status is almost universally associated with worse population health and higher death rates everywhere in the world. The paradox usually refers in particular to low mortality among Hispanics in the United States relative to non-Hispanic Whites. According to the Centers for Disease Control's 2015 Vital Signs report, Hispanics in the United States had a 24% lower risk of mortality, as well as lower risk for nine of the fifteen leading causes of death as compared to Whites. Researchers attribute the phenomenon to the cultural values, interpersonal context, and community context of the Hispanic population. Hispanics tend to be less stressed economically, since they tend to compare themselves to individuals in their country of origin. There is also strong social and communal support in Hispanic communities, especially for elders. Some health researchers attribute the Hispanic paradox to different eating habits, especially the relatively high intake of legumes such as beans and lentils. Statistical biases such as the "salmon bias", which suggests that Hispanics tend to return to their country of origin towards the end of their lives, or the "healthy migrant bias", which assumes that the healthiest and strongest members of a population are most likely to migrate, have been largely refuted by researchers. Since the 2010s, research has indicated that the Hispanic paradox is disappearing, as Latino mortality increases relative to white Americans, and cardiovascular risk factors are increasing in the Hispanic population. In 2023, a study found that the mortality advantage of Hispanics was largely erased during the COVID-19 pandemic, during which Hispanic death rates disproportionately increased.
History
First coined as the Hispanic Epidemiological Paradox in 1986 by Kyriakos Markides, the phenomenon is also known as the Latino Epidemiological Paradox. According to Markides, a professor of sociomedical sciences at the University of Texas Medical Branch in Galveston, this paradox was ignored by past generations, but is now "the leading theme in the health of the Hispanic population in the United States." The specific cause of the phenomenon is poorly understood, although the decisive factor appears to be place of birth. It appears that the Hispanic paradox cannot be explained by either the "salmon bias hypothesis" or the "healthy migrant effect", two theories that posit low mortality among immigrants due to, respectively, a possible tendency for sick immigrants to return to their home country before death and a possible tendency for new immigrants to be unusually healthy compared to the rest of their home-country population. Historical differences in smoking habits by ethnicity and place of birth may explain much of the paradox, at least at adult ages. Others have proposed that the lower mortality of Hispanics could reflect a slower biological aging rate of Hispanics. Some believe that there is no Hispanic paradox, and that inaccurate counting of Hispanic deaths in the United States leads to an underestimate of Hispanic mortality.
Statistical findings
Mortality Despite having lower socioeconomic status, higher rates of disability, obesity, cardiovascular disease and type 2 diabetes, most Hispanic groups, excepting Puerto Ricans, demonstrate lower or equal levels of mortality to their non-Hispanic White counterparts. The Centers for Disease Control reported in 2003 that Hispanic's mortality rate was 25 percent lower than non-Hispanic whites and 43 percent lower than African Americans. This mortality advantage most commonly found among middle-aged and elderly Hispanics. The death rates of Hispanics to non-Hispanic whites was found to exceed 1.00 in the twenties, decreases by age 45, then is severely reduced to 0.75–.90 by at age 65, persisting until death. When controlling for socioeconomic factors, the health advantage gap for Mexican Americans, the largest Hispanic population in the US, increases noticeably. Hispanics do not have a mortality advantage over non-Hispanic Whites in all mortality rates. In 1999, they had higher rates for mortality from liver disease, cervical cancer, AIDS, homicide (males), and diabetes.
Infant mortality Another important indicator of health is the infant mortality rate, which is also either equal to or lower than that of non-Hispanic Americans. A 2007 study by Hummer, et al. found that infants born to Mexican immigrant women in the United States have about a 10 percent lower mortality in the first hour, first day, and first week than that of infants born to non-Hispanic white, U.S.-born women. In 2003, the national Hispanic infant mortality rate was 5.7, nearly equal to that of non-Hispanic white Americans and 58 percent lower than that of African Americans. In 2014, the children of Mexican immigrant women had a lower infant mortality rate than that of U.S.-born Mexican-American women, even though the latter population usually has a higher income and education, and are much more likely to have health insurance.
Reasons for the paradox
Socio-economic factors According to Alder and Estrove (2006), the more socioeconomically advantaged individuals are, the better their health. Access to health insurance and preventative medical services are one of the main reasons for socioeconomic health disparities. Economic hardship within the household can cause distress and affect parenting, causing health problems among children leading to depression, substance abuse, and behavior problems. Low socioeconomic status is correlated with increased rates of morbidity and mortality. Mental health disorders are an important health problem for those of low socioeconomic status; they are two to five times more likely to develop a diagnosable disorder than those of high socioeconomic status, and are more likely to face barriers to getting treatment. This lack of treatment for mental disorders can affect educational and employment opportunities and achievement.
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