The Hispanic Paradox and older adults' disabilities: is there a healthy migrant effect?

Esme Fuller Thomson,Meredith Minkler,Ferrah Raza,Dawn Richardson,Amani Nuru-Jeter

doi:10.3390/ijerph10051786

Abstract

The “Hispanic Paradox” suggests that despite rates of poverty similar to African Americans, Hispanics have far better health and mortality outcomes, more comparable to non-Hispanic White Americans. Three prominent possible explanations for the Hispanic Paradox have emerged. The “Healthy Migrant Effect” suggests a health selection effect due to the demands of migration. The Hispanic lifestyle hypothesis focuses on Hispanics’ strong social ties and better health behaviors. The reverse migration argument suggests that the morbidity profile in the USA is affected when many Hispanic immigrants return to their native countries after developing a serious illness. We analyzed data from respondents aged 55 and over from the nationally representative 2006 American Community Survey including Mexican Americans (13,167 U.S. born; 11,378 immigrants), Cuban Americans (314 U.S. born; 3,730 immigrants), and non-Hispanic White Americans (629,341 U.S. born; 31,164 immigrants). The healthy migrant effect was supported with SES-adjusted disability comparable between Mexican, Cuban and non-Hispanic Whites born in the USA and all immigrants having lower adjusted odds of functional limitations than U.S. born non-Hispanic Whites. The reverse migration hypothesis was partially supported, with citizenship and longer duration in the USA associated with higher rates of SES-adjusted disability for Mexican Americans. The Hispanic healthy life-style explanation had little support in this study. Our findings underline the importance of considering nativity when planning for health interventions to address the needs of the growing Hispanic American older adult population.

Highlights

Over the past two decades a growing body of research has suggested that there is an “HispanicParadox” in the United States
Ethnicity 2 included information on ethnicity and nativity resulting in 6 categories: Non-Hispanic White Americans born in U.S, Non-Hispanic White immigrants, Mexican Americans born in the U.S, Mexican Americans immigrants, Cuban Americans born in the U.S, Cuban American immigrants
Mexican Americans and Cuban Americans, both those born in the U.S and immigrants, were more likely to be in the youngest age cohort (55 to 64) than were Non-Hispanic Whites

Summary

Introduction

Over the past two decades a growing body of research has suggested that there is an “HispanicParadox” in the United States. Despite disadvantaged social position (including education and income), Hispanics have better than expected health outcomes in such key areas as life expectancy and infant mortality [2] the Hispanic paradox has not been shown with all diseases [3] or ages [4,5]. Despite lower than average income and educational levels [7]. Some of this likely reflected data discrepancies and the fact that the term Hispanic was not always clearly defined [6,8], the findings overall were suggestive of the paradox effect. In the United States, Hispanics’ life expectancy at birth is 2.5 years longer than that of non-Hispanic Whites and 7.7 years longer than Blacks (80.6 years, 78.1 years and 72.9 years, respectively) [9]. Additional studies have found that among adults ages 45–64 and 65-plus, foreign-born Mexican Americans have lower mortality rates than native-born non-Hispanic Whites [7,9,10,11,12]

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