Hispanic Paradox
Encyclopedia
The Hispanic Paradox, or Latino Paradox, also known as the "Epidemiologic Paradox," refers to the epidemiological
finding that Hispanic and Latino Americans
tend to have health outcomes that paradoxically
are comparable to, or in some cases better than, those of their U.S. white counterparts, even though Hispanics have lower average income and education. (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 Latinos in the United States relative to non-Hispanic whites. The specific cause of the phenomenon is poorly understood, although the decisive factor appears to be place of birth, raising the possibility that differing birthing and/or neonatal practices might be involved via a lack of breastfeeding combined with birth trauma imprinting (both common in American obstetrics) and consequent mental and physical illness, the latter compounded by the impact of psychological problems on the capacity for social networking. It appears that the Hispanic Paradox can not 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. Some believe that there is no Hispanic Paradox, however, and that inaccurate counting of Hispanic deaths in the United States leads to an underestimate of Hispanic or Latino mortality.
Also known as Hispanic Epidemiological Paradox and Latino Epidemiological Paradox.
groups, excepting Puerto Ricans, demonstrate lower or equal levels of mortality to their non-Hispanic White counterparts. The Center 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; they have higher rates for mortality from liver disease
, cervical cancer
, AIDS
, homicide
(males), and diabetes.
. Beginning in the 1970s, the low to moderate levels of income segregation in the United States began to degrade. As the rich became richer, so did their neighborhoods. This trend was inversely reflected in the poor, as their neighborhoods became poorer. As sociologist Douglas Massey explains, “As a result, poverty and affluence both became more concentrated geographically.” Professor of public administration and economics John Yinger writes that “one way for poor people to win the spatial competition for housing is to rent small or low-quality housing.” However, he continues, low quality housing often features serious health risks such as lead paint and animal pests. Though lead based paint was deemed illegal in 1978, it remains on the walls of older apartments and houses, posing a serious neurological risk to children. Asthma
, a possible serious health risk, also has a clear link to poverty. Moreover, asthma attacks have been associated with certain aspects of poor housing quality such as the presence of cockroaches, mice, dust, dust mites, mold, and mildew. The 1997 American Housing Survey
found that signs of rats and/or mice are almost twice as likely to be detected in poor households as in non-poor households.
in the United States is relative to his or her health. In general, Hispanics have a health advantage for lung, colon, breast, and prostate cancer and cardiovascular disease because they are less likely to drink alcohol and Hispanic women are less likely to smoke to non-Hispanic Whites. They are also less likely to do drugs and contract sexually transmitted diseases. However, unhealthy behaviors, such as smoking, have been found to increase with greater acculturation.
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...
finding that Hispanic and Latino Americans
Hispanic and Latino Americans
Hispanic or Latino Americans are Americans with origins in the Hispanic countries of Latin America or in Spain, and in general all persons in the United States who self-identify as Hispanic or Latino.1990 Census of Population and Housing: A self-designated classification for people whose origins...
tend to have health outcomes that paradoxically
Paradox
Similar to Circular reasoning, A paradox is a seemingly true statement or group of statements that lead to a contradiction or a situation which seems to defy logic or intuition...
are comparable to, or in some cases better than, those of their U.S. white counterparts, even though Hispanics have lower average income and education. (Low socioeconomic
Socioeconomic status
Socioeconomic status is an economic and sociological combined total measure of a person's work experience and of an individual's or family’s economic and social position in relation to others, based on income, education, and occupation...
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 Latinos in the United States relative to non-Hispanic whites. The specific cause of the phenomenon is poorly understood, although the decisive factor appears to be place of birth, raising the possibility that differing birthing and/or neonatal practices might be involved via a lack of breastfeeding combined with birth trauma imprinting (both common in American obstetrics) and consequent mental and physical illness, the latter compounded by the impact of psychological problems on the capacity for social networking. It appears that the Hispanic Paradox can not 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. Some believe that there is no Hispanic Paradox, however, and that inaccurate counting of Hispanic deaths in the United States leads to an underestimate of Hispanic or Latino mortality.
Also known as Hispanic Epidemiological Paradox and Latino Epidemiological Paradox.
Mortality
Though they are often at lower socioeconomic standing, most HispanicHispanic
Hispanic is a term that originally denoted a relationship to Hispania, which is to say the Iberian Peninsula: Andorra, Gibraltar, Portugal and Spain. During the Modern Era, Hispanic sometimes takes on a more limited meaning, particularly in the United States, where the term means a person of ...
groups, excepting Puerto Ricans, demonstrate lower or equal levels of mortality to their non-Hispanic White counterparts. The Center for Disease Control reported in 2003 that Hispanic’s mortality rate
Mortality rate
Mortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...
was 25 percent lower than non-Hispanic Whites
Non-Hispanic Whites
Non-Hispanic Whites or White, Not Hispanic or Latino are people in the United States, as defined by the Census Bureau, who are of the White race and are not of Hispanic or Latino origin/ethnicity. Hence the designation is exclusive in the sense that it defines who is not included as opposed to who is...
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; they have higher rates for mortality from liver disease
Liver disease
Liver disease is a broad term describing any single number of diseases affecting the liver.-Diseases:* Hepatitis, inflammation of the liver, caused mainly by various viruses but also by some poisons , autoimmunity or hereditary conditions...
, cervical cancer
Cervical cancer
Cervical cancer is malignant neoplasm of the cervix uteri or cervical area. One of the most common symptoms is abnormal vaginal bleeding, but in some cases there may be no obvious symptoms until the cancer is in its advanced stages...
, AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
, homicide
Homicide
Homicide refers to the act of a human killing another human. Murder, for example, is a type of homicide. It can also describe a person who has committed such an act, though this use is rare in modern English...
(males), and diabetes.
Infant morality
Another important indicator of health is the infant mortality rate, which is also either equal or better in Hispanic Americans than in non-Hispanic Americans. In 2003, the national Hispanic infant mortality rate was found to be 5.7, nearly equal to that of non-Hispanic Americans and 58 percent lower than that of African Americans. Hispanic immigrants also have a 20% lower infant mortality rate than that of U.S.-born Hispanics, though the latter population usually has a higher income and education, and are much more likely to have health insurance.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 on of the main reasons for socioeconomic heath 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 suffer from a diagnosable disorder than those of high socioeconomic status, and are more likely to face barriers to getting treatment. Furthermore, this lack of treatment for mental disorders can affect educational and employment opportunities and achievement.Residential segregation
Important to the understanding of migrant community health is the increasingly stratified American society, manifested in Residential SegregationResidential Segregation
Residential segregation is the physical separation of cultural groups based on residence and housing, or a form of segregation that "sorts population groups into various neighborhood contexts and shapes the living environment at the neighborhood level."...
. Beginning in the 1970s, the low to moderate levels of income segregation in the United States began to degrade. As the rich became richer, so did their neighborhoods. This trend was inversely reflected in the poor, as their neighborhoods became poorer. As sociologist Douglas Massey explains, “As a result, poverty and affluence both became more concentrated geographically.” Professor of public administration and economics John Yinger writes that “one way for poor people to win the spatial competition for housing is to rent small or low-quality housing.” However, he continues, low quality housing often features serious health risks such as lead paint and animal pests. Though lead based paint was deemed illegal in 1978, it remains on the walls of older apartments and houses, posing a serious neurological risk to children. Asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
, a possible serious health risk, also has a clear link to poverty. Moreover, asthma attacks have been associated with certain aspects of poor housing quality such as the presence of cockroaches, mice, dust, dust mites, mold, and mildew. The 1997 American Housing Survey
American Housing Survey
The American Housing Survey is a statistical survey funded by the United States Department of Housing and Urban Development and conducted by the U.S. Census Bureau. It is the largest regular national housing sample survey in the United States and contains information on the number and...
found that signs of rats and/or mice are almost twice as likely to be detected in poor households as in non-poor households.
The “Barrio Advantage”
The “barrio advantage” is the phenomenon that the sociocultural benefits conferred on Hispanic Americans living in high-density Hispanic-American neighborhoods outweigh the disadvantages caused by the high poverty rates of those neighborhoods. The results of a study done by Eschbach, et. al indicate that in older Hispanic Americans, the negative health effects of neighborhood poverty are less influential on health than the positive health effects due to the community of highly ethnically concentrated enclaves. Furthermore, health was shown to decline has the diversity of a neighborhood increases.Cultural factors
Cultural considerations are important to fully understand the Hispanic paradox. For any population, culture influences mortality outcomes because it affects lifestyle and health behaviors, social networks, and family structures. One’s diet, use of cigarettes, alcohol consumption, exercise habits, and use of medical care are all heavily influenced by their cultural practices.Acculturation
The extent of a Hispanic American’s acculturationAcculturation
Acculturation explains the process of cultural and psychological change that results following meeting between cultures. The effects of acculturation can be seen at multiple levels in both interacting cultures. At the group level, acculturation often results in changes to culture, customs, and...
in the United States is relative to his or her health. In general, Hispanics have a health advantage for lung, colon, breast, and prostate cancer and cardiovascular disease because they are less likely to drink alcohol and Hispanic women are less likely to smoke to non-Hispanic Whites. They are also less likely to do drugs and contract sexually transmitted diseases. However, unhealthy behaviors, such as smoking, have been found to increase with greater acculturation.
The “Healthy Migrant Effect”
The “Health Migrant Effect” hypothesizes that the selection of healthy Hispanic immigrants into the United States is reason for the paradox. International immigration statistics demonstrate that the mortality rate of immigrants is lower than in their country of origin. In the United States, foreign-born individuals have better self-reported health than American-born respondents. Furthermore, Hispanic immigrants have better health than those living in the US for a long amount of time. However, Abraido-Lanza, et. alThe “Salmon Bias” hypothesis
A second popular hypothesis, called the “Salmon Bias”, and attempts to factor in the occurrence of returning home to Mexico. This hypothesis purports that many Hispanic people return to Mexico after temporary employment, retirement, or severe illness, meaning that their deaths occur on Mexican soil and are not taken into account by mortality reports in the United States. This hypothesis considers those people as “statistically immortal” because they artificially lower the Hispanic mortality rate. Certain studies hint that it could be reasonable. These studies report that though return migration, both temporary and permanent, depend upon specific economic and social situations in communities, up to 75% of household in Mexican immigrant neighborhoods do some kind of return migration from the U.S. However, Abrafdo-Lanza, et. al found in 1999 that the “Salmon Hypothesis” cannot account for the lower mortality of Hispanics in the US.Comparison to other ethnicities
One of the most important aspects of this phenomenon is the comparison of Hispanic’s health to African American’s health. Both the current and historical poverty rates for Hispanic and African American populations in the United States are consistently starkly lower than that of non-Hispanic White and Asian Americans. Dr. Hector Flores explains that “You can predict in the African–American population, for example, a high infant-mortality rate, so we would think a [similar] poor minority would have the same health outcomes.” However, he said, the health poor outcomes are not present in the Hispanic population. For example, the age-adjusted mortality rate for Hispanics living in Los Angeles County was 52 percent less than the blacks living in the same county.Criticism
Some public health researchers have argued that the Hispanic paradox is not actually a national phenomenon in the United States. In 2006, Smith and Bradshaw argued that no Hispanic paradox exists. They maintain that life expectancies were nearly equal for non-Hispanic White and Hispanic females, but less close for non-Hispanic White and Hispanic Males.See also
- Ancestry and health
- HeterosisHeterosisHeterosis, or hybrid vigor, or outbreeding enhancement, is the improved or increased function of any biological quality in a hybrid offspring. The adjective derived from heterosis is heterotic....
- List of paradoxes
- Population groups in biomedicine