Resiliency in the Face of Disadvantage: Do Hispanic Cultural Characteristics Protect Health Outcomes?

Abstract

Hispanics living in the United States may face substantial adversity, given stresses of immigration and acculturation, low incomes, poor educational and occupational opportunities, inadequate access to health care, and exposure to discrimination. Despite these disadvantages, the Hispanic population often shows equal or better health outcomes when compared to non-Hispanic Whites, a trend that has puzzled researchers and has been referred to as the "Hispanic Paradox." Hispanics with non-U.S. nativity also tend to show better health than those born in the United States, although this advantage dissipates with increasing time spent in the United States. The current article discusses the Reserve Capacity Model (L.C. Gallo & K. A. Matthews, 2003) as a potential framework for understanding how psychosocial risk and resilient factors may contribute to health disparities associated with broad sociocultural factors, such as low socioeconomic status or minority ethnicity. In addition, we examine theory concerning features of the Hispanic culture that may enhance resilience (e.g., social resources, familism, religiousness; G. Marin & B. V. Marin, 1991) in the face of adverse circumstances. We summarize some of our recent work that has empirically tested effects of risk and resilient factors in Hispanic health in the contexts of prostate cancer and cardiovascular disease. We conclude by discussing future directions and opportunities for researchers interested in culture-specific resiliency factors in relation to health outcomes.

Trends in Racial/Ethnic Disparities in Cardiovascular Health Among US Adults From 1999–2012

“…Indeed, the lower rates of CVD mortality among Hispanics as compared with NH whites—known as the Hispanic Paradox—are contrary to the generally higher risk factor burden and CVD incidence among Hispanics 3. It has been posited that cultural context may contribute to this particular CVH resiliency, despite disparate access to some health resources 23. However, US Hispanics are an aggregated ethnicity from multiple heritage backgrounds, and risk factor patterning may be different among Hispanic subgroups.…”

Duration of U.S. stay and body mass index among Latino and Asian immigrants: A test of theoretical pathways

“…Family cohesion, or feelings of solidarity and loyalty, is among the familism aspects considered to be health-protective, particularly for Latinos (Gallo et al, 2009). Cohesion may provide psycho-social benefits, such as social support for healthy behaviors such as exercise.…”

The Social Determinants of Health: It's Time to Consider the Causes of the Causes

“…92,95 Income and education have not predicted health as consistently among Latino immigrants in the U.S. as among other groups; hypothesized explanations have included protective factors such as social support or attitudes and norms that confer resilience. 122,123 Similarly, low income may have less impact on the health of individuals in settings in which basic needs-including food, housing, education, and/or medical care-are met by the state or family. 124 This may be due partly to access to needed goods and services through routes other than income, and also to an alleviation of insecurity about meeting basic needs.…”

“…The third pathway depicts health effects of education through psychobiological processes such as control beliefs, subjective social status, and social networks, again based on existing literature. 123 Figure 6 illustrates two of the most daunting challenges facing research on the socioeconomic and other upstream determinants of health: How could education affect health?…”