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Abstract:
Evidence suggests that social and economic factors are important determinants of health. Yet, despite higher poverty rates, less education, and worse access to health care, health outcomes of many Hispanics living in the United States today are equal to, or better than, those of non-Hispanic whites. This paradox is described in the literature as the epidemiological paradox or Hispanic health paradox. In this paper, the authors selectively review data and research supporting the existence of the epidemiological paradox. They find substantial support for the existence of the epidemiological paradox, particularly among Mexican Americans. Census undercounts of Hispanics, misclassification of Hispanic deaths, and emigration of Hispanics do not fully account for the epidemiological paradox. Identifying protective factors underlying the epidemiological paradox, while improving access to care and the economic conditions among Hispanics, are important research and policy implications of this review.
Key words: Hispanic Americans, Hispanic health paradox, socioeconomic status, health status, review.
Ever-increasing evidence suggests that the health of a population is greatly determined by the social and economic circumstances of that population, as well as its access to health care services.1-6 Yet, for many Hispanics living in the United States today, health outcomes are equal to, or better than, those of non-Hispanic whites, despite higher poverty rates, less education, and worse access to health care. This paradox has been described in the literature as the epidemiological paradox or Hispanic health paradox.7-8 In this paper, we selectively review data and research supporting the existence of a Hispanic health paradox. The paper is broadly organized into three main sections: (1) a review of indicators of social, economic, and behavioral determinants of health for Hispanics in the United States, including a brief review of the demographics of Hispanics in the United States; (2) a review of indictors of health outcomes among Hispanics in the United States; and (3) a review of some potential alternative explanations to the existence of a Hispanic health paradox, focusing on potential biases in national data sets. The paper concludes with a discussion of policy implications derived from the information reviewed.
Demographics and socioeconomic status of Hispanics
Hispanics constitute one of the fastest-growing racial/ethnic groups in the United States. According to results from the 2000 census, the number of Hispanics in...