Evidence suggests that social and economic factors are important determinants of health. Yet, despite higher porverty 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.

We studied 1% homeless and 194 housed poor families in Los Angeles, California to gain an understanding of events that precipitate family homelessness. Both homeless and housed poor mothers averaged 29 years old and were accompanied by two or three children.

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M e d o a , Laura E. S a l d i v a r , Robert 0 . Valdez, Ricardo 0 . C a s t i l l o , Reymldo M a r t o r e l l , C a t h e r i n e Baisden (Spon. by I r i s F. L i t t ) . Stanford U n i v e r s i t y -- Stanford Center f o r Chicano Research, S t a n f o r d , c a l i f The h e a l t h s t a t u s of Mexican-American c h i l d r e n (MAC) h a s been d i f f i c u l t t o a s s e s s because of t h e l a c k of d a t a about t h i s population. U t i l i z i n g t h eHispanic Health and N u t r i t i o n Examin a t i o n Survey, 3,710 MAC, a g e s 6 mos. -18 y r s . , were evaluated a s t o t h e prevalence of c h r o n i c medical c o n d i t i o n s , and perceived h e a l t h s t a t u s a s determined by t h e p h y s i c i a n , mother, and c h i l d . The r e s u l t s demonstrated t h a t 140 s u b j e c t s , o r 3.8%, of MAC bad a t least one c h r o n i c c o n d i t i o n . There were no d i f f e r e n c e s w i t h r e s p e c t t o poverty s t a t u s . P h y s i c i a n s r a t e d c h i l d r e n ( 6 mos. -11 ~r s . ) i n poor h e a l t h only 1% of t h e time, w h i l e mothers r a t e d them i n poor h e a l t h 15% of t h e time (P c.001). The n a t i o n a l p a r e n t a l norm i s 3%. Children 6 y e a r s t o 11 y e a r s and 12 y e a r s t o 18 y e a r s r e p o r t e d poor h e a l t h 11.3% and 19% of t h e time r e s p e c t i v e l y . I n c o n t r a s t , t h e p h y s i c i a n ' s r e p o r t was 1.2% and 0.7% r e s p e c t i v e l y . The p h y s i c i a n ' s p e r c e p t i o n of t h e c h i l d ' s h e a l t h s t a t u s was worse i f t h e c h i l d had a c h r o n i c c o n d i t i o n o r l i v e d i n poverty (Pc.025) w h i l e t h e mother's p e r c e p t i o n of her c h i l d ' s h e a l t h was most a f f e c t e d by poverty (P<.001). The c h i l d ' s p e r c e p t i o n (age 6-12 y r s . ) was n o t a s s o c i a t e d w i t h e i t h e r poverty o r c h r o n i c c o n d i t i o n . These r e s u l t s suggest t h a t MAC have prevalence r a t e s of c h r o n i c c o n d i t i o n s s i m i l a r t o t h e U.S. norms, b u t M A C a r e perceived t o be i n poorer h e a l t h by t h e i r mothers and themselves t h a n by p h y s i c i a n s . prematurity w i t h o t h e r r i s k f a c t o r s ( 2 ) . Death was a s s o c i a t e dw i t h non-use of monitors i n 5 i n s t a n c e s & q u e s t i o n a b l e u s e i n 3. However, 2 i n f a n t s d i d d i e d e s p i t e proper monitoring technique & family knowledge of CPR. Autopsies were done i n 9/10; a l l were c l a s s i f i e d a s SIDS. The p r o p o r t i o n of both ALTE & BPD i n f a n t s was g r e a t e r (P<.05, one t a i l ) than i n a c o n t r o l group of a l l 211 new p a t i e n t s s t a r t e d / c o n t i n u e d on M over a 6m p e r i o d . The demographics of t h e D a r e s i m i l a r t o t h o s e o f SIDS v i c t i m s i n g e n e r a l , b u t i n an exaggerated sense. For example, males gene r a l l y c o n s t i t u t e 60% of SIDS v i c t i m s , whereas they c o n s t i t u t e...

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