Population Research and Policy Review

, Volume 35, Issue 1, pp 23–48 | Cite as

Erosion of Advantage: Decomposing Differences in Infant Mortality Rates Among Older Non-Hispanic White and Mexican-Origin Mothers



We build on findings from recent research showing an erosion of infant survival advantage in the Mexican-origin population relative to non-Hispanic whites at older maternal ages, with patterns that differ by nativity. This runs counter to the well-documented Hispanic infant mortality paradox and suggests that weathering and/or other negative health selection mechanisms may contribute to increasing disadvantage at older maternal ages. Using the National Center for Health Statistics (NCHS) cohort-linked birth and infant death files, we decompose the difference in Mexican-origin non-Hispanic white infant mortality at older maternal ages to better understand the contribution of selected medical and social risk factors to components of the difference. We find differences in the distribution and effects of risk factors across the three populations of interest. The infant mortality rate (IMR) gap between Mexican-origin women and non-Hispanic whites can be attributed to numerous offsetting factors, with inadequate prenatal care standing out as a major contributor to the IMR difference. Equalizing access to and utilization of prenatal care may provide one possible route to closing the IMR gap at older maternal ages.


Infant mortality Hispanic paradox Maternal age Multivariate decomposition 



The author gratefully acknowledges the support for this research provided by NICHD Grant NO. R01 HD049754 and National Institute for Health Center Grant R24 HD42849-9 and would like to thank Jiwon Jeon for helpful comments.


  1. Abraido-Lanza, A. F., Dohrenwend, B. P., Ng-Mak, D. S., & Turner, J. B. (1999). The Latino mortality paradox: A test of the “salmon bias” and healthy migrant hypotheses. American Journal of Public Health, 89, 1543–1548.CrossRefGoogle Scholar
  2. Albrecht, S. L., Clarke, L. L., Miller, M. K., & Farmer, F. L. (1996). Predictors of differential birth outcomes among hispanic subgroups in the United States: The role of maternal risk characteristics and medical care. Social Science Quarterly, 77, 407–433.Google Scholar
  3. Angel, J. L., Wilson, K. J., & Brown H. S. (2013). How might immigration reform affect implementation of the Affordable Care Act?” PA Times Online, American Society of Public Administration. http://patimes.org/immigration-reform-affect-implementation-affordable-care-act/.
  4. Blinder, A. S. (1973). Wage discrimination: Reduced form and structural estimates. Journal of Human Resources, 8, 436–455.CrossRefGoogle Scholar
  5. Ceballos, M. (2011). Simulating the effects of acculturation and return migration on the maternal and infant health of Mexican immigrants in the United States: A research note. Demography, 48, 425–436.CrossRefGoogle Scholar
  6. Ceballos, M., & Palloni, A. (2010). Maternal and infant health of mexican immigrants in the USA: The effects of acculturation, duration, and selective return migration. Ethnicity & Health, 15, 377–396. doi: 10.1080/13557858.2010.481329.CrossRefGoogle Scholar
  7. Cho, Y. T., Frisbie, W. P., Hummer, R. A., & Rogers, R. G. (2004). Nativity, duration of residence and the health of Hispanic adults in the United States. International Migration Review, 38, 184–221.CrossRefGoogle Scholar
  8. Cobas, J. A., Balcazar, H., Benin, M. B., Keith, V. M., & Chong, Y. (1996). Acculturation and low-birthweight infants among Latino women: A reanalysis of HHANES data with structural equation models. American Journal of Public Health, 86, 394–396.CrossRefGoogle Scholar
  9. Cuellar, A., Simmons, A., & Finegold, K. (2012). The affordable care act and women. ASPE Issue Brief, Department of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation. http://aspe.hhs.gov.
  10. Elo, I. T., Mehta, N. K., & Huang, C. (2011). Disability among native born and foreign born blacks in the United States. Demography, 48, 241–265.CrossRefGoogle Scholar
  11. Elo, I. T., Turra, C. M., Kestenbaum, B., & Ferguson, B. R. (2004). Mortality among elderly Hispanics in the United States: Past evidence and new results. Demography, 41, 109–128.CrossRefGoogle Scholar
  12. Ennis, S.R., Rios-Vargas, M., & Albert, N. G. (2011). The Hispanic population: 2010. 2010 U.S. Census Brief, U.S. Department of Commerce Economics and Statistics Administration.Google Scholar
  13. Finch, B. K., Hummer, R. A., Kolody, B., & Vega, W. A. (2001). The role of discrimination and acculturative stress in physical health of Mexican-origin adults. Hispanic Journal of Behavioral Science, 23, 399–429.CrossRefGoogle Scholar
  14. Finch, B. K., & Vega, W. A. (2003). Acculturation stress, social support, and self-rated health among Latinos in California. Journal of Immigrant Health, 5, 109–115.CrossRefGoogle Scholar
  15. Franzini, L., Ribble, J. C., & Keddie, A. M. (2001). Understanding the Hispanic paradox. Ethnicity and Disease, 11, 496–518.Google Scholar
  16. Freide, A., Baldwin, W., Rhodes, P., et al. (1987). Young maternal ages and infant mortality: The role of low birth weight. Public Health Reports, 102, 192–199.Google Scholar
  17. Frisbie, W. P., Forbes, D., & Hummer, R. A. (1998). Hispanic pregnancy outcomes: Additional evidence. Social Science Quarterly, 79, 149–169.Google Scholar
  18. Frisbie, W. P., & Song, S. E. (2003). Hispanic pregnancy outcomes: Differences over time and current risks. Policy Studies Journal, 1, 237–252.CrossRefGoogle Scholar
  19. Geronimus, A. T. (1986). Effects of race, residence, and prenatal care on the relationship of maternal age to neonatal mortality. American Journal of Public Health, 76, 1416–1421.CrossRefGoogle Scholar
  20. Geronimus, A. T. (1992). The weathering hypothesis and the health of African-American women and infants: Evidence and speculations. Ethnicity and Disease, 2, 207–221.Google Scholar
  21. Geronimus, A. T. (1996). Black/white differences in the relationship of maternal age to birthweight: A population-based test of the weathering hypothesis. Social Science and Medicine, 42, 589–597.CrossRefGoogle Scholar
  22. Guendelman, S. (2000). Immigrants may hold clues to protecting health during pregnancy. In Jamner & D. Stokols (Eds.), Promoting human wellness: New frontiers for research, practice, and policy (pp. 222–257). Berkeley, CA: University of California Press.Google Scholar
  23. Hummer, R. A., Benjamins, M., & Rogers, R. G. (2004). Race/ethnic disparities in health and mortality among the elderly: A documentation and examination of social factors, chap. 3. In N. Anderson, R. Bulatao, & B. Cohen (Eds.), Critical perspectives on racial and ethnic differences in health in late life (pp. 53–94). Washington DC: National Research Council.Google Scholar
  24. Hummer, R. A., Biegler, M., DeTurk, P., Forbes, D., Frisbie, W. P., Hong, Y., & Pullum, S. G. (1999). Race/ethnicity, nativity, and infant mortality in the United States. Social Forces, 77, 1083–1118.CrossRefGoogle Scholar
  25. Hummer, R. A., Powers, D. A., Pullum, S. G., Gossman, G. L., & Frisbie, W. P. (2007). Paradox found (again): Infant mortality among the Mexican origin population in the United States. Demography, 44, 441–457.CrossRefGoogle Scholar
  26. Jasso, G., Massey, D. S., Rosenzweig, & Smith, J. P. (2004). Immigrant health: selectivity and acculturation, chap. 7. In N. B. Anderson, R. A. Bulatao, & B. Cohen (Eds.), Critical perspectives on racial and ethnic differences in health in late life (pp. 227–266). Washington DC: National Academies Press.Google Scholar
  27. Kaestner, R., Pearson, J. A., Keene, D., & Geronimus, A. T. (2009). Stress allostatic load, and the health of Mexican immigrants. Social Science Quarterly, 90, 1089–1111.CrossRefGoogle Scholar
  28. Kotelchuck, M. (1994). An evaluation of the Kessner adequacy of prenatal care index and a proposed adequacy of prenatal care utilization index. American Journal of Public Health, 84, 1414–1420.CrossRefGoogle Scholar
  29. Landale, N. S., Oropesa, R. S., & Gorman, B. K. (2000). Migration and infant death: Assimilation or selective migration among Puerto Ricans. American Sociological Review, 65, 888–909.CrossRefGoogle Scholar
  30. Leite, P., Angola, A., Castaneda, X., Felt, E., Scherker, M., & Ramirez, T. (2013). Health outcomes of Mexican immigrant women in the U.S. Migration Policy Institute, Migration Information Source ISSN 1946-4937. www.migrationpolicy.org.
  31. Liao, Y., Cooper, R., Cao, G., Durazo-Arvizu, R., Kaufman, J., Luke, A., & McGee, D. (1998). Mortality patterns among adult Hispanics: Findings from the NHIS, 1986–1990. American Journal of Public Health, 88, 227–232.CrossRefGoogle Scholar
  32. Livingston, G. & Cohn, D. (2010). The new demography of American motherhood. A Social & Demographic Trends Report, Pew Research Center Social and Demographic Trends Project.Google Scholar
  33. Markides, K. S., & Coreil, J. (1986). The health of Hispanics in the Southwestern United States: An epidemiologic paradox. Public Health Reports, 101, 253–265.Google Scholar
  34. Markides, K. S., & Eschbach, K. (2005). Aging, migration and mortality: Current status of research on the Hispanic paradox. Journals of Gerontology: Series B, 60B((special issue II)), 68–75.CrossRefGoogle Scholar
  35. Massey, D. S. (2001). Residential segregation and neighborhood conditions in US metropolitan areas. In N. J. Smelser, W. J. Wilson, & F. Michell (Eds.), America becoming: racial trends and their consequences. Washington DC: National Academy Press.Google Scholar
  36. Mathews, T. J., & MacDorman, M. F. (2008). Infant mortality statistics from the 2005 period linked birth/infant death data set. National Vital Statistics Reports; Vol. 57, no 2. Hyattsville, MD: National Center for Health Statistics.Google Scholar
  37. National Center for Health Statistics. (1995–2002). Birth cohort linked birth/infant death data set and documentation. NCHS CD-ROMs, Washington, DC: U.S. Department of Health and Human Services.Google Scholar
  38. Palloni, A., & Arias, E. (2004). Paradox lost: Explaining the Hispanic adult mortality advantage. Demography, 41(3), 385–415.CrossRefGoogle Scholar
  39. Palloni, A., & Morenoff, J. D. (2001). Interpreting the paradoxical in the Hispanic paradox. Annals of the New York Academy of Sciences, 954, 140–174.CrossRefGoogle Scholar
  40. Portes, A. (1995). Children of immigrants: segmented assimilation and its determinants. In A. Portes (Ed.), The economic sociology of immigration: Essays on networks, ethnicity, and entrepreneurship (pp. 248–279). New York: Russell Sage.Google Scholar
  41. Portes, A., & Zhou, M. (1993). The new second generation: Segmented assimilation and its variants among post-1965 immigrant youth. Annals of the American Academy of Political and Social Science, 530, 75–98.CrossRefGoogle Scholar
  42. Powers, D. A. (2013). Paradox revisited: A further investigation of race/ethnic differences in infant mortality by maternal age. Demography, 50, 495–520. doi: 10.1007/s13524-012-0152-6.CrossRefGoogle Scholar
  43. Powers, D. A., Yoshioka, H., & Yun, M.-S. (2011). mvdcmp: Multivariate decomposition for nonlinear response models. The Stata Journal, 11, 556–576.Google Scholar
  44. Rogers, R. G., Hummer, R. A., & Nam, C. B. (2002). Living and dying in the U.S.A.: Behavioral, health, and social differentials in adult mortality. San Diego, CA: Academic Press.Google Scholar
  45. Rosenbaum, E., & Friedman, S. (2001). Differences in the locational attainment of immigrant and native born households with children in New York City. Demography, 38, 337–348.CrossRefGoogle Scholar
  46. Saenz, R. (1997). Ethnic concentration and Chicano poverty: A comparative approach. Social Science Research, 26, 205–228.CrossRefGoogle Scholar
  47. Scribner, R., & Dwyer, J. H. (1989). Acculturation and low birthweight among Latinos in the Hispanic HANES. American Journal of Public Health, 79, 1263–1267.CrossRefGoogle Scholar
  48. Singh, G. K., & Siahpush, M. (2001). All-cause and cause-specific mortality of immigrants and native born in the United States. American Journal of Public Health, 91, 392–399.CrossRefGoogle Scholar
  49. Singh, G. K., & Siahpush, M. (2002). Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: An analysis of two national data bases. Human Biology, 74, 83–109.CrossRefGoogle Scholar
  50. Singh, G. K., & Yu, S. M. (1996). Adverse pregnancy outcomes: Differences between U.S.- and foreign-born women in major U.S. racial and ethnic groups. American Journal of Public Health, 86, 837–843.CrossRefGoogle Scholar
  51. Smith, D. P., & Bradshaw, B. S. (2006). Rethinking the Hispanic paradox: Death rates and life expectancy for US non-Hispanic White and Hispanic populations. American Journal of Public Health, 96, 1686–1692.CrossRefGoogle Scholar
  52. Turra, C. M., & Elo, I. T. (2008). The impact of Salmon bias on the hispanic mortality advantage: New evidence from social security data. Population Research and Policy Review, 27, 515–530.CrossRefGoogle Scholar
  53. White, K. D., Grossman, K., & Hopkins, J. E. Potter. (2012). Cutting family planning in Texas. New England Journal of Medicine, 367, 1179–1181. doi: 10.1056/NEJMp120792.CrossRefGoogle Scholar
  54. Wildsmith, E. M. (2002). Testing the weathering hypothesis among Mexican-origin women. Ethnicity and Disease, 12, 470–479.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  1. 1.Department of Sociology and Population Research CenterUniversity of Texas at AustinAustinUSA

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