Interpreting the Paradoxical in the Hispanic Paradox

Abstract

A BSTRACT : This paper discusses problems that are common to both the epidemiologic risk-factor approach and the demographic variable-based approach to studying population health. We argue that there is a shared reluctance to move away from a narrow variable-based thinking that pervades both disciplines, and a tendency to reify the multivariate linear procedures employed in both disciplines. In particular, we concentrate on the difficulties generated by classical variable-based approaches that are especially striking when one neglects selection processes and the use of strategies to minimize its effects. We illustrate these difficulties in terms of the so-called "Hispanic Paradox", which refers to comparative health advantages that some Hispanic groups appear to have. We find that much of what is conceived by demographers and epidemiologists as a paradox may not be paradoxical at all. K EYWORDS : Hispanic paradox; demographic approach; epidemiologic approach

The Differential Effect of Foreign-Born Status on Low Birth Weight by Race/Ethnicity and Education

“…12,27,32,33 Another plausible explanation is that foreign-born women may be selected for being healthy. 25,26,29,34 Additional research is needed to examine these possible mechanisms.…”

“…5,7,9,16,[25][26][27][28][29] Epidemiologic paradoxes such as this one are sometimes defined in relation to the average SES of a population. In other cases, the term "paradox" is used to denote a residual protective effect of foreign-born status that cannot be accounted for by measured demographic, socioeconomic, behavioral, and/or medical risk factors.…”

The Impact of Salmon Bias on the Hispanic Mortality Advantage: New Evidence from Social Security Data

“…Khlat & Courbage 1996;Sharma, Michalowski & Verma 1990;Marmot, Adelstein & Bulusu 1984). Recent illustrations of its role in the mortality advantage of foreign-born Hispanics in the United States suggest that its effect is likely to be more important at younger ages than at older ages where the frailty composition of the foreign-born and US-born Hispanics becomes similar (Palloni & Ewbank 2004;Palloni & Morenoff 2001).…”

Test of the ‘healthy migrant hypothesis’: A longitudinal analysis of health selectivity of internal migration in Indonesia

“…Studies of this kind usually find that immigrants are generally healthier than the native-born populations as indicated by mortality rates, chronic conditions, mental health, etc., though the advantage enjoyed by immigrants tends to deteriorate over time (Anson, 2004;Cabral, Fried, Levenson, Amaro, & Zuckerman, 1990;Feranil, 2005;Marmot, Adelstein, & Bulusu, 1984a, 1984bPalloni & Morenoff, 2001;William, 1993). Such an observation is often referred to as the "epidemiological paradox", as immigrants usually face disadvantages in many socioeconomic aspects that have negative implications for health.…”

“…It 2 states that migrants represent a selectively healthy group that are not representative of all potential migrants from origin societies (Palloni & Morenoff, 2001). As a result, their health advantage stands out when they are compared with the general population at destination.…”