Here’s a good article on the Hispanic Paradox—that Hispanics tend to live a long time relative to their income and education—from Stat:
The ‘Hispanic Paradox’ intrigues a new generation of researchers determined to unravel it
By Usha Lee McFarling
Sept. 14, 2023
For 40 years, researchers have unsuccessfully tried to explain—or debunk—the “Hispanic Paradox,” the finding that Hispanic Americans live several years longer than white Americans on average, despite having far less income and health care and higher rates of diabetes and obesity. Now, armed with more comprehensive data, powerful genomic tools, and a rich cultural awareness of the communities they study, a new generation of scientists is finally making headway.
… They’re finding that for Hispanics, living longer does not necessarily mean living healthier, and that lumping together people from places as varied as Brazil, Mexico, and Puerto Rico conceals important health risks for these individual populations, which may as a result go unnoticed by many American physicians. They’re also finding that healthy Hispanics who immigrate to the U.S. tend to get sicker the longer they stay—raising deeper questions about why our wealthy nation, which spends more than $4 trillion on health care, is far sicker than it should be.
“Part of the story about the Hispanic Paradox,” said Kyriakos S. Markides, a professor of aging at the University of Texas Medical Branch in Galveston, “is that the non-Hispanic white population is not doing as well as it should.”
… But researchers kept looking for reasons to overturn the paradox.
First, there was “the salmon bias,” which said many Hispanic immigrants weren’t included in U.S. mortality numbers because they return to their native countries to die. An analysis of Social Security data showed the salmon bias was too small to explain the paradox.
Then there was “the healthy migrant effect,” the idea that those able to emigrate voluntarily were unusually fit. That does seem to be true, but doesn’t fully explain the life expectancy gap, according to a detailed analysis conducted this year by a group of three Hispanic economists. They also debunked the idea that Hispanic deaths are fewer because the population is younger: When data are adjusted for age, the paradox still holds.
Other ideas, such as the role of diet—along with culturally insensitive paper titles such as “A review of the Hispanic paradox: time to spill the beans?”—have come and gone. While it’s true that legumes might fend off disease-causing inflammation, there hasn’t been conclusive evidence that food explains the longevity, and the diets of many immigrants worsen quickly after they reach the U.S.
Another explanation—that death certificates used in the original research were imprecise because Hispanic people were often erroneously classified as white—has been cast aside; the findings have held as the demographics of death reporting have become more precise.
The turning point for Markides came in 2010 when the National Center for Health Statistics released a report showing Hispanic Americans had a life expectancy more than two years longer than white Americans. A few years later, the Centers for Disease Control and Prevention weighed in with a lengthy report stating that mortality data for 2013 showed Hispanic Americans had lower death rates for most leading causes of death compared to white people. “The findings in this report are consistent with previous reports that use the term ‘Hispanic Paradox,’” it stated. …
Ruiz, now a professor of clinical health psychology at the University of Arizona, is doing just that, focusing on the tight-knit family and community networks that exist among many Hispanics and how they might improve health outcomes for a variety of diseases.
Nascent research in the area gives hints at what might be at play. One study suggested foreign-born Hispanic women with better birth outcomes than those in other groups had more “tenacity, agency and spirituality” that might underlie their resilience.
Latinas aren’t very feminist. Maybe that has something to do with it? American women’s life expectancy advantage over men narrowed due to more smoking among women.
Other research on what’s been termed the “Barrio Effect” shows people in high-density Hispanic neighborhoods have better health outcomes, despite sometimes higher levels of crime and poverty.
A variety of factors—from having someone home to help you if you fall or to remind you of a medical appointment, to living in a large group that together can manage unexpected bills—could contribute to better health, Ruiz said. …
And a paper published in 2020, Ruiz noted, showed the paradox was global and not tied solely to immigration; in addition to Hispanics living in the U.S., people living in countries such as Nicaragua, Colombia, Cuba, and Peru lived longer than whites in the U.S., possibly due to lower smoking rates and more cohesive social and family networks.
… Even as the paradox has gained acceptance, another recent paper delivered a different and more important message: Hispanics may live longer, but they tend to live sicker. And they may carry a disease burden that lasts for decades.
The research showed that Hispanic men in the U.S. had rates of heart disease higher than those in both white men and, in what was a surprise to many, Black men. And Hispanic women had more heart disease than white women.
But they die less from heart disease.
Lots more good stuff in this long article.
