Hispanic Paradox in Biological Risk Profiles

Abstract

Objectives. We examined biological risk profiles by race, ethnicity, and nativity to evaluate evidence for a Hispanic paradox in measured health indicators. Methods. We used data on adults aged 40 years and older (n = 4206) from the National Health and Nutrition Examination Surveys (1999–2002) to compare blood pressure, metabolic, and inflammatory risk profiles for Whites, Blacks, US-born and foreign-born Hispanics, and Hispanics of Mexican origin. We controlled for age, gender, and socioeconomic status. Results. Hispanics have more risk factors above clinical risk levels than do Whites but fewer than Blacks. Differences between Hispanics and Whites disappeared after we controlled for socioeconomic status, but results differed by nativity. After we controlled for socioeconomic status, the differences between foreign-born Hispanics and Whites were eliminated, but US-born Mexican Americans still had higher biological risk scores than did both Whites and foreign-born Mexican Americans. Conclusions. There is no Hispanic paradox in biological risk profiles. However, our finding that foreign-born Hispanics and Whites had similar biological risk profiles, but US-born Mexican Americans had higher risk, was consistent with hypothesized effects of migrant health selectivity (healthy people in-migrating and unhealthy people out-migrating) as well as some differences in health behaviors between US-born and foreign-born Hispanics.

Prevalence of Low Cardiovascular Risk Profile Among Diverse Hispanic/Latino Adults in the United States by Age, Sex, and Level of Acculturation: The Hispanic Community Health Study/Study of Latinos

“…Although some previous studies have suggested that foreign-born Mexican American adults may have more favorable risk status compared with those who were US born, 29,30 this finding has not been observed consistently. 31 Kershaw et al reported that foreign-born Mexican Americans adults had almost 3 times higher odds of being LR compared with US-born Mexican American adults.…”

Nativity Status and Cardiovascular Disease Mortality Among Hispanic Adults

“…First, we used a large national sample that included a heterogeneous population of Hispanic subgroups, a major limitation of prior work that has focused largely on Mexicans in 1 geographic region29 and on risk factors rather than mortality 30, 31, 32. US‐born Cubans and Puerto Ricans, in particular, had lower AMRs, suggesting a protective effect of generational status among these subgroups.…”

Social Determinants of Risk and Outcomes for Cardiovascular Disease

“…For Mexican Americans, unadjusted cardiovascular risk is intermediate between those of whites and blacks but is not significantly different from that of whites after controlling for income, education, and health insurance status. 291 However, the prevalence of risk factors rises with duration of residence in the United States and varies among cultural and ethnic subgroups within the larger group of US Latinos. 270 By income and by educational attainment, 292 disadvantage is associated with higher risk.…”