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Helen P. Hazuda - One of the best experts on this subject based on the ideXlab platform.

  • The Hispanic Paradox and predictors of mortality in an aging biethnic cohort of Mexican Americans and European Americans: the san antonio longitudinal study of aging.
    Journal of the American Geriatrics Society, 2013
    Co-Authors: Sara E. Espinoza, Inkyung Jung, Helen P. Hazuda
    Abstract:

    Objectives: To examine predictors of mortality in aging Mexican Americans (MAs) and European Americans (EAs). Design: Longitudinal, observational cohort study. Setting: Socioeconomically diverse neighborhoods in San Antonio, Texas. Participants: Community-dwelling adults aged 65 and older (394 MA; 355 EA) who completed the baseline examination (1992�96) of the San Antonio Longitudinal Study of Aging (SALSA) and for whom vital status was ascertained over an average 8.2 years of follow-up. Measurements: Ethnic group was classified using a validated algorithm. Hazard ratios (HRs) for mortality were estimated using Cox proportional hazards models with age, sex, ethnic group, education, income, frailty, diabetes mellitus with and without complications, comorbidity, cognition, depressive symptoms, and body mass index included as predictors in sequential models. Results: At baseline, MAs had a higher prevalence of diabetes mellitus and frailty and lower socioeconomic status (SES) than EAs. The age- and sex-adjusted ethnic HR (MA vs EA) for mortality was 1.54 (95% confidence interval (CI) = 1.17�2.03). After adjusting for SES, the ethnic HR was no longer significant (HR = 1.16, 95% CI = 0.83�1.61). In the final model, comorbidity, diabetes mellitus with complications, depressive symptoms, and cognitive impairment were significant independent risk factors for mortality. Conclusion: Contrary to the Hispanic Paradox, MAs were at greater risk of mortality than EAs. SES differences largely explained this ethnic disparity. Significant independent predictors of mortality, regardless of ethnic group, were diabetes mellitus with complications, comorbidity, depressive symptoms, and cognitive impairment. Mortality reduction in older MAs requires attention to socioeconomic disparities and disease factors.

  • All-Cause and Cardiovascular Mortality among Mexican-American and Non-Hispanic White Older Participants in the San Antonio Heart Study— Evidence against the “Hispanic Paradox”
    American journal of epidemiology, 2003
    Co-Authors: Kelly J. Hunt, Ken Williams, Roy G. Resendez, Steve M. Haffner, Michael P. Stern, Helen P. Hazuda
    Abstract:

    The observation that Hispanics have lower all-cause and cardiovascular mortality rates despite increased rates of diabetes and obesity and lower socioeconomic status has been termed the "Hispanic Paradox." The authors therefore examined the relation between ethnicity and mortality in 1,438 Mexican-American and 921 non-Hispanic White San Antonio Heart Study participants, aged 45-64 years when they enrolled between 1979 and 1988. Over an average of 14.5 years, 466 deaths occurred: 238 attributed to cardiovascular disease (death certificate International Classification of Diseases, Ninth Revision, codes 401-414 or codes 420-447 with the exception of code 427.5) and 117 attributed to coronary heart disease (codes 410-414). Age- and gender-adjusted hazard ratios for all-cause, cardiovascular, and coronary heart disease mortality comparing Mexican Americans with non-Hispanic Whites were 1.50 (95% confidence interval (CI): 1.23, 1.81), 1.70 (95% CI: 1.30, 2.24), and 1.60 (95% CI: 1.09, 2.36), respectively. After adjusting for possible confounders, among diabetic individuals not using insulin, the authors found excess risk of all-cause, cardiovascular, and coronary heart disease mortality associated with being Mexican American; however, in nondiabetic individuals and insulin-using diabetic individuals, Mexican Americans and non-Hispanic Whites appeared to be at similar risk of mortality. Contrary to the prediction of the "Hispanic Paradox," in the San Antonio Heart Study, Mexican Americans were at greater risk of all-cause, cardiovascular, and coronary heart disease mortality than were non-Hispanic Whites.

  • All-cause and cardiovascular mortality among diabetic participants in the San Antonio Heart study. Evidence against the Hispanic Paradox
    Diabetes care, 2002
    Co-Authors: Kelly J. Hunt, Ken Williams, Roy G. Resendez, Helen P. Hazuda, Steve M. Haffner, Michael P. Stern
    Abstract:

    OBJECTIVE —The observation that Hispanics have lower all-cause and cardiovascular mortality, despite increased diabetes and obesity, lower socioeconomic status (SES), and barriers to health care, has been termed the “Hispanic Paradox.” We examined the relationship between ethnicity and all-cause and cardiovascular mortality in Mexican Americans (MAs) and non-Hispanic whites (NHWs) with diabetes. RESEARCH DESIGN AND METHODS —In the San Antonio Heart Study, a prospective cohort, we compared the mortality in 554 U.S.-born MAs, 95 Mexico-born MAs, and 178 NHW participants with diabetes aged 25–72 years. Over an average of 10.4 years, 188 deaths occurred: 115 from cardiovascular disease (CVD) [death certificate ICD-9 codes 401–414 or 420–447 (excluding 427.5)]. Because of potential differences between migrants and nonmigrants, hazard ratios (HRs) were calculated comparing U.S.-born MAs and Mexico-born MAs with NHWs. RESULTS —The age- and sex-adjusted HR for all-cause mortality comparing U.S.-born MAs with NHWs was 1.66 (95% CI 1.15–2.40), while comparing Mexico-born MAs with NHWs was 1.14 (95% CI 0.63–2.06). Cardiovascular mortality HRs were 1.66 (95% CI 1.04–2.65) and 0.89 (95% CI 0.40–2.01), respectively. After adjusting for possible confounders, such as fasting glucose and diabetes duration, the hazard of all-cause and cardiovascular mortality (although not statistically significant) appeared higher in U.S.-born MAs than in the other two groups. CONCLUSIONS —We found it important to differentiate MAs by birthplace. Among diabetic participants, contrary to the prediction of the “Hispanic Paradox,” compared with NHWs, U.S.-born MAs were at greater risk of all-cause and cardiovascular mortality, while Mexico-born MAs appeared to be at similar risk.

Haywood L. Brown - One of the best experts on this subject based on the ideXlab platform.

  • Hypertensive disease in pregnancy: An examination of ethnic differences and the Hispanic Paradox
    Journal of neonatal-perinatal medicine, 2013
    Co-Authors: Avis Carr, Trace Kershaw, Haywood L. Brown, Terrence K. Allen, Maria Small
    Abstract:

    OBJECTIVE The "Hispanic Paradox" refers to the epidemiological finding that Hispanics in the US have better health outcomes than the average population despite what their aggregate socioeconomic determinants would predict. The aim of this study was to evaluate obstetric outcomes for a multiethnic population with hypertensive diseases. METHODS We performed a retrospective review of parturients with hypertensive disease delivering at Duke University Medical Center. We analyzed maternal sociodemographic characteristics and ethnic differences in hypertensive disease types using Chi Square tests. RESULTS A total of 3,124 women delivered during a period of one year; 9% of them had hypertensive diseases in pregnancy. Gestational hypertension was more commonly diagnosed in Whites, whereas chronic hypertension and mild preeclampsia were more frequently encountered in Blacks and Hispanics respectively (Chi-square = 39.11, p < 0.001). The overall incidence of preeclampsia was less in Hispanics. However, severe preeclampsia rates were equal across groups. Hispanics were more likely to be uninsured and younger, enter prenatal care later, and least likely to complete high school. There was no significant difference in smoking or parity. Stratified analyses by ethnicity showed that the relationship between severe preeclampsia and comorbidities (intrauterine growth restriction, low birth weight, and need for admission to intensive care nursery) were least pronounced in Hispanics and strongest in Black women. CONCLUSION Despite similar rates of severe preeclampsia and adverse sociodemographic characteristics, Hispanic women with severe preeclampsia had better pregnancy outcomes than Black or White women with the disease.

  • OS028. Hypertensive disease in pregnancy: An examination of ethnic differences and the Hispanic Paradox
    Pregnancy hypertension, 2012
    Co-Authors: Maria Small, Avis Carr, Trace Kershaw, Haywood L. Brown
    Abstract:

    Introduction The "Hispanic Paradox" refers to the epidemiological finding that Hispanics in the US have better health outcomes than the average population despite what their aggregate socioeconomic determinants would predict. Objectives The aim of this study was to evaluate obstetric outcomes for a multiethnic population with hypertensive diseases. Methods We performed a retrospective review of parturients with hypertensive disease delivering at Duke University Medical Center in 2005–2007. We analyzed maternal sociodemographic characteristics and ethnic differences in hypertensive disease types using Chi Square. We assessed the role of race and ethnicity on maternal and neonatal outcomes through a series of logistic regression analyses. Results Nine thousand eight hundred and thirteen women delivered during the study period, and 9% had hypertensive diseases in pregnancy. There were significant racial and ethnic differences in presentation (Chi-square=39.11, p Conclusion Despite similar rates of severe preeclampsia and adverse sociodemographic characteristics, Hispanic women with severe preeclampsia had better pregnancy outcomes than African–American or White women with the disease.

  • the Hispanic Paradox an investigation of racial disparity in pregnancy outcomes at a tertiary care medical center
    American Journal of Obstetrics and Gynecology, 2007
    Co-Authors: Haywood L. Brown, Monique Chireau, Yhenneko Jallah, Daniel L Howard
    Abstract:

    Objective The purpose of this study was to examine racial disparities and the “Hispanic Paradox” in pregnancy outcomes at a tertiary-care medical center. Study Design A cross-sectional study of pregnancy events was performed with information from the Duke University birth database. The latter includes data on birth outcomes, cost, and health services factors. The final sample included 10,755 women with Medicaid insurance, who gave birth during calendar years 1994-2004. Pregnancy comorbidities and outcome measures were identified by International Classification of Diseases, 9th revision, and Current Procedural Terminology (CPT) codes. Univariate and multivariate analyses were performed to compare racial/ethnic groups. Results African-American women were younger and more likely to be employed, to have a medical comorbidity, to remain in the hospital for >4 days, and to have hospital charges of >$7500. African-American women had higher rates of preterm birth, small-for-gestational-age infants, preeclampsia, and stillbirths. There were no differences by race for gestational diabetes mellitus. With the use of white women as the reference group, Hispanic women had lower odds for preterm birth (odds ratio, 0.66; 95% CI, 0.54-0.80), and African-American women had greater odds for preeclampsia (odds ratio, 1.30; 95% CI, 1.07-1.58) and small-for-gestational-age infants (odds ratio, 1.74; 95% CI, 1.29-2.36). With the use of African-American women as the reference, Hispanic women were less likely than African-American women to experience any adverse pregnancy event, with the exception of gestational diabetes mellitus. Conclusion Poverty and insurance status does not explain differences in adverse pregnancy outcomes between African-American women and Hispanic women with Medicaid insurance.

  • The "Hispanic Paradox": an investigation of racial disparity in pregnancy outcomes at a tertiary care medical center.
    American journal of obstetrics and gynecology, 2007
    Co-Authors: Haywood L. Brown, Monique Chireau, Yhenneko Jallah, Daniel Howard
    Abstract:

    The purpose of this study was to examine racial disparities and the "Hispanic Paradox" in pregnancy outcomes at a tertiary-care medical center. A cross-sectional study of pregnancy events was performed with information from the Duke University birth database. The latter includes data on birth outcomes, cost, and health services factors. The final sample included 10,755 women with Medicaid insurance, who gave birth during calendar years 1994-2004. Pregnancy comorbidities and outcome measures were identified by International Classification of Diseases, 9th revision, and Current Procedural Terminology (CPT) codes. Univariate and multivariate analyses were performed to compare racial/ethnic groups. African-American women were younger and more likely to be employed, to have a medical comorbidity, to remain in the hospital for >4 days, and to have hospital charges of >$7500. African-American women had higher rates of preterm birth, small-for-gestational-age infants, preeclampsia, and stillbirths. There were no differences by race for gestational diabetes mellitus. With the use of white women as the reference group, Hispanic women had lower odds for preterm birth (odds ratio, 0.66; 95% CI, 0.54-0.80), and African-American women had greater odds for preeclampsia (odds ratio, 1.30; 95% CI, 1.07-1.58) and small-for-gestational-age infants (odds ratio, 1.74; 95% CI, 1.29-2.36). With the use of African-American women as the reference, Hispanic women were less likely than African-American women to experience any adverse pregnancy event, with the exception of gestational diabetes mellitus. Poverty and insurance status does not explain differences in adverse pregnancy outcomes between African-American women and Hispanic women with Medicaid insurance.

Kyriakos S. Markides - One of the best experts on this subject based on the ideXlab platform.

  • Aging and Health in Mexican Americans: Selected Findings from the Hispanic EPESE
    Race and Social Problems, 2014
    Co-Authors: Kyriakos S. Markides, Raphael Samper-ternent, Soham Al Snih Al Snih
    Abstract:

    The unprecedented growth in the number of adults over 65 in the United States is fueled by high rates of immigration from Latin American countries, especially Mexico. This growth rate has important implications for aging and health. The “Hispanic Paradox” has been described in terms of a longevity advantage of Mexican Americans compared to non-Hispanic Whites despite having a relatively low socioeconomic status. At the same time, the evidence suggests relatively poor health and high disability rates among older Mexican Americans. In this chapter we review recent literature on the Hispanic Paradox and present data from the Hispanic Established Population for the Epidemiological Study of the Elderly (Hispanic EPESE) on important health outcomes such as obesity, disability, depression, and frailty. We take advantage of the rich information available in the Hispanic EPESE to describe some health conditions using longitudinal analyses. We first analyze trends in diabetes and its effect on disability. We also investigate the effect of obesity on disability and mortality as well as the effect of depressive symptomatology on disability and mortality. We finalize by reviewing prevalence and correlates of frailty among older Mexican Americans. These important health conditions highlight the urgency of establishing public health programs that can target health outcomes among older Mexican Americans, a rapidly growing segment of the US population.

  • Socioeconomic deprivation as a determinant of cancer mortality and the Hispanic Paradox in Texas, USA.
    International journal for equity in health, 2013
    Co-Authors: Billy U Philips, Kyriakos S. Markides, Eric J. Belasco, Gordon Gong
    Abstract:

    We have recently reported that delayed cancer detection is associated with the Wellbeing Index (WI) for socioeconomic deprivation, lack of health insurance, physician shortage, and Hispanic ethnicity. The current study investigates whether these factors are determinants of cancer mortality in Texas, the United States of America (USA). Data for breast, colorectal, female genital system, lung, prostate, and all-type cancers are obtained from the Texas Cancer Registry. A weighted regression model for non-Hispanic whites, Hispanics, and African Americans is used with age-adjusted mortality (2004–2008 data combined) for each county as the dependent variable while independent variables include WI, percentage of the uninsured, and physician supply. Higher mortality for breast, female genital system, lung, and all-type cancers is associated with higher WI among non-Hispanic whites and/or African Americans but with lower WI in Hispanics after adjusting for physician supply and percentage of the uninsured. Mortality for all the cancers studied is in the following order from high to low: African Americans, non-Hispanic whites, and Hispanics. Lung cancer mortality is particularly low in Hispanics, which is only 35% of African Americans’ mortality and 40% of non-Hispanic whites’ mortality. Higher degree of socioeconomic deprivation is associated with higher mortality of several cancers among non-Hispanic whites and African Americans, but with lower mortality among Hispanics in Texas. Also, mortality rates of all these cancers studied are the lowest in Hispanics. Further investigations are needed to better understand the mechanisms of the Hispanic Paradox.

  • Hispanic Paradox in Adult Mortality in the United States
    International Handbook of Adult Mortality, 2011
    Co-Authors: Kyriakos S. Markides, Karl Eschbach
    Abstract:

    This chapter provides an update to our earlier review on the Hispanic Paradox in adult mortality (Markides and Eschbach 2005). We focus primarily on manuscripts published beginning in 2005. As in our earlier review, we concentrate on mortality at adult and older ages. When relevant, however, we will draw on recent literature examining other outcomes, such as disability, health behaviors, medical conditions, and mental health.

  • aging migration and mortality current status of research on the Hispanic Paradox
    Journals of Gerontology Series B-psychological Sciences and Social Sciences, 2005
    Co-Authors: Kyriakos S. Markides, Karl Eschbach
    Abstract:

    Objective. We reviewed recent evidence on the apparent Hispanic mortality Paradox. Methods. Recent studies using vital statistics, national community surveys linked to the National Death Index, Medicare data linked to application records for social security cards maintained in the Social Security Administration NUDIMENT file, and mortality follow-up by regional studies are reviewed critically. Results. Data based on vital statistics show the greatest mortality advantage compared with non-Hispanic Whites for all Hispanics combined. The advantage is greatest among older people. National Community Surveys linked to the National Death Index show a narrowing of the advantage, and one study suggests that the Mexican Origin mortality advantage can be attributed to selective return migration of less healthy immigrants to Mexico. The Medicare-NUDIMENT data that avoid problems of other data sets also show an advantage in mortality among Hispanic elders, although the advantage is considerably lower than is found using the vital statistics method. Discussion. Although some research has recently begun to question whether indeed all Hispanic groups enjoy a mortality advantage, the majority of the evidence continues to support a mortality advantage at a minimum among Mexican Americans and especially in old age, at least among men, which may provide partial, albeit indirect, support for a selective return migration or "salmon bias" effect. There is a need to further explore the existence of a selective return migration effect with expanded data bases that include more subjects from the various Hispanic origins. To date, the majority of the evidence continues to support the Hispanic Paradox at least among people of Mexican origin and calls for additional attention to this interesting and highly important phenomenon.

  • Aging, migration, and mortality: current status of research on the Hispanic Paradox.
    The journals of gerontology. Series B Psychological sciences and social sciences, 2005
    Co-Authors: Kyriakos S. Markides, Karl Eschbach
    Abstract:

    We reviewed recent evidence on the apparent Hispanic mortality Paradox. Recent studies using vital statistics, national community surveys linked to the National Death Index, Medicare data linked to application records for social security cards maintained in the Social Security Administration NUDIMENT file, and mortality follow-up by regional studies are reviewed critically. Data based on vital statistics show the greatest mortality advantage compared with non-Hispanic Whites for all Hispanics combined. The advantage is greatest among older people. National Community Surveys linked to the National Death Index show a narrowing of the advantage, and one study suggests that the Mexican Origin mortality advantage can be attributed to selective return migration of less healthy immigrants to Mexico. The Medicare-NUDIMENT data that avoid problems of other data sets also show an advantage in mortality among Hispanic elders, although the advantage is considerably lower than is found using the vital statistics method. Although some research has recently begun to question whether indeed all Hispanic groups enjoy a mortality advantage, the majority of the evidence continues to support a mortality advantage at a minimum among Mexican Americans and especially in old age, at least among men, which may provide partial, albeit indirect, support for a selective return migration or "salmon bias" effect. There is a need to further explore the existence of a selective return migration effect with expanded data bases that include more subjects from the various Hispanic origins. To date, the majority of the evidence continues to support the Hispanic Paradox at least among people of Mexican origin and calls for additional attention to this interesting and highly important phenomenon.

Robert A. Hummer - One of the best experts on this subject based on the ideXlab platform.

  • Longer-but Harder-Lives?: The Hispanic Health Paradox and the Social Determinants of Racial, Ethnic, and Immigrant-Native Health Disparities from Midlife through Late Life.
    Journal of health and social behavior, 2019
    Co-Authors: Courtney Boen, Robert A. Hummer
    Abstract:

    Though Hispanics live long lives, whether a "Hispanic Paradox" extends to older-age health remains unclear, as do the social processes underlying racial-ethnic and immigrant-native health disparities. Using data from the Health and Retirement Study (2004-2012; N = 6,581), we assess the health of U.S.- and foreign-born Hispanics relative to U.S.-born whites and blacks and examine the socioeconomic, stress, and behavioral pathways contributing to health disparities. Findings indicate higher disability, depressive, metabolic, and inflammatory risk for Hispanics relative to whites and similar health profiles among Hispanics and blacks. We find limited evidence of a healthy immigrant pattern among foreign-born Hispanics. While socioeconomic factors account for Hispanic-white gaps in inflammation, disparities in other outcomes persist after adjustment for socioeconomic status, due in part to group differences in stress exposure. Hispanics may live long lives, but their lives are characterized by more socioeconomic hardship, stress, and health risk than whites and similar health risks as blacks.

  • Smoking and Variation in the Hispanic Paradox: A Comparison of Low Birthweight Across 33 US States.
    Population research and policy review, 2018
    Co-Authors: Samuel H. Fishman, S. Philip Morgan, Robert A. Hummer
    Abstract:

    The Hispanic Paradox in birth outcomes is well documented for the US as a whole, but little work has considered geographic variation underlying the national pattern. This inquiry is important given the rapid growth of the Hispanic population and its geographic dispersion. Using birth records data from 2014 through 2016, we document state variation in birthweight differentials between US-born white women and the three Hispanic populations with the largest numbers of births: US-born Mexican women, foreign-born Mexican women, and foreign-born Central and South American women. Our analyses reveal substantial geographic variation in Hispanic immigrant–white low-birthweight disparities. For example, Hispanic immigrants in Southeastern states and in some states from other regions have reduced risk of low birthweight relative to whites, consistent with a “Hispanic Paradox.” A significant portion of Hispanic immigrants’ birthweight advantage in these states is explained by lower rates of smoking relative to whites. However, Hispanic immigrants have higher rates of low birthweight in California and several other Western states. The different state patterns are largely driven by geographic variation in smoking among whites, rather than geographic differences in Hispanic immigrants’ birthweights. In contrast, US-born Mexicans generally have similar or slightly higher odds of low birthweight than whites across the US. Overall, we show that the Hispanic Paradox in birthweight varies quite dramatically by state, driven by geographic variation in low birthweight among whites associated with white smoking disparities across states.

  • Hispanic-White Differences in Lifespan Variability in the United States
    Demography, 2015
    Co-Authors: Joseph T. Lariscy, Claudia Nau, Glenn Firebaugh, Robert A. Hummer
    Abstract:

    Abstract This study is the first to investigate whether and, if so, why Hispanics and non-Hispanic whites in the United States differ in the variability of their lifespans. Although Hispanics enjoy higher life expectancy than whites, very little is known about how lifespan variability—and thus uncertainty about length of life—differs by race/ethnicity. We use 2010 U.S. National Vital Statistics System data to calculate lifespan variance at ages 10+ for Hispanics and whites, and then decompose the Hispanic-white variance difference into cause-specific spread, allocation, and timing effects. In addition to their higher life expectancy relative to whites, Hispanics also exhibit 7 % lower lifespan variability, with a larger gap among women than men. Differences in cause-specific incidence (allocation effects) explain nearly two-thirds of Hispanics’ lower lifespan variability, mainly because of the higher mortality from suicide, accidental poisoning, and lung cancer among whites. Most of the remaining Hispanic-white variance difference is due to greater age dispersion (spread effects) in mortality from heart disease and residual causes among whites than Hispanics. Thus, the Hispanic Paradox—that a socioeconomically disadvantaged population (Hispanics) enjoys a mortality advantage over a socioeconomically advantaged population (whites)—pertains to lifespan variability as well as to life expectancy. Efforts to reduce U.S. lifespan variability and simultaneously increase life expectancy, especially for whites, should target premature, young adult causes of death—in particular, suicide, accidental poisoning, and homicide. We conclude by discussing how the analysis of Hispanic-white differences in lifespan variability contributes to our understanding of the Hispanic Paradox.

  • Hispanic Older Adult Mortality in the United States: New Estimates and an Assessment of Factors Shaping the Hispanic Paradox
    Demography, 2015
    Co-Authors: Joseph T. Lariscy, Robert A. Hummer, Mark D. Hayward
    Abstract:

    Hispanics make up a rapidly growing proportion of the U.S. older adult population, so a firm grasp of their mortality patterns is paramount for identifying racial/ethnic differences in life chances in the population as a whole. Documentation of Hispanic mortality is also essential for assessing whether the Hispanic Paradox—the similarity in death rates between Hispanics and non-Hispanic whites despite Hispanics’ socioeconomic disadvantage—characterizes all adult Hispanics or just some age, gender, nativity, or national-origin subgroups. We estimate age-/sex- and cause-specific mortality rate ratios and life expectancy for foreign-born and U.S.-born Hispanics, foreign-born and U.S.-born Mexican Americans, non-Hispanic blacks, and non-Hispanic whites ages 65 and older using the 1989–2006 National Health Interview Survey Linked Mortality Files. Results affirm that Hispanic mortality estimates are favorable relative to those of blacks and whites, but particularly so for foreign-born Hispanics and smoking-related causes. However, if not for Hispanics’ socioeconomic disadvantage, their mortality levels would be even more favorable.

  • Does the Hispanic Paradox in U.S. Adult Mortality Extend to Disability
    Population research and policy review, 2013
    Co-Authors: Mark D. Hayward, Robert A. Hummer, Chi-tsun Chiu, César González-gonzález, Rebeca Wong
    Abstract:

    Studies consistently document a Hispanic Paradox in U.S. adult mortality, whereby Hispanics have similar or lower mortality rates than non-Hispanic whites despite lower socioeconomic status. This study extends this line of inquiry to disability, especially among foreign-born Hispanics, since their advantaged mortality seemingly should be paired with health advantages more generally. We also assess whether the Paradox extends to U.S.-born Hispanics to evaluate the effect of nativity. We calculate multistate life tables of life expectancy with disability to assess whether racial/ethnic and nativity differences in the length of disability-free life parallel differences in overall life expectancy. Our results document a Hispanic Paradox in mortality for foreign-born and U.S.-born Hispanics. However, Hispanics’ low mortality rates are not matched by low disability rates. Their disability rates are substantially higher than those of non-Hispanic whites and generally similar to those of non-Hispanic blacks. The result is a protracted period of disabled life expectancy for Hispanics, both foreign- and U.S.-born.

Heather A. Wakelee - One of the best experts on this subject based on the ideXlab platform.

  • how do social factors explain outcomes in non small cell lung cancer among Hispanics in california explaining the Hispanic Paradox
    Journal of Clinical Oncology, 2013
    Co-Authors: Manali I. Patel, Clayton W. Schupp, Scarlett Lin Gomez, Ellen T. Chang, Heather A. Wakelee
    Abstract:

    Purpose Hispanics in the United States have lower age-adjusted mortality resulting from non–small-cell lung cancer (NSCLC) compared with non-Hispanic whites (NHWs). The purpose of this study was to evaluate individual, clinical, and neighborhood factors in survival among Hispanics with NSCLC. Patients and Methods We performed a retrospective analysis of NHWs and Hispanics with NSCLC between 1998 and 2007 in the California Cancer Registry (follow-up to December 2009). Kaplan-Meier curves depict survival by nativity for Hispanics with NSCLC. Cox proportional hazards models estimated hazard of mortality by race with adjustment for individual (age, sex, marital status), clinical (histologic grade, surgery, irradiation, chemotherapy), and neighborhood factors (neighborhood socioeconomic status, ethnic enclave). Results We included 14,280 Hispanic patients with NSCLC. Foreign-born Hispanics had 15% decreased risk of disease-specific mortality resulting from NSCLC compared with NHWs (hazard ratio [HR], 0.85; 95%...

  • How Do Social Factors Explain Outcomes in Non–Small-Cell Lung Cancer Among Hispanics in California? Explaining the Hispanic Paradox
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013
    Co-Authors: Manali I. Patel, Clayton W. Schupp, Scarlett Lin Gomez, Ellen T. Chang, Heather A. Wakelee
    Abstract:

    Purpose Hispanics in the United States have lower age-adjusted mortality resulting from non–small-cell lung cancer (NSCLC) compared with non-Hispanic whites (NHWs). The purpose of this study was to evaluate individual, clinical, and neighborhood factors in survival among Hispanics with NSCLC. Patients and Methods We performed a retrospective analysis of NHWs and Hispanics with NSCLC between 1998 and 2007 in the California Cancer Registry (follow-up to December 2009). Kaplan-Meier curves depict survival by nativity for Hispanics with NSCLC. Cox proportional hazards models estimated hazard of mortality by race with adjustment for individual (age, sex, marital status), clinical (histologic grade, surgery, irradiation, chemotherapy), and neighborhood factors (neighborhood socioeconomic status, ethnic enclave). Results We included 14,280 Hispanic patients with NSCLC. Foreign-born Hispanics had 15% decreased risk of disease-specific mortality resulting from NSCLC compared with NHWs (hazard ratio [HR], 0.85; 95%...