Latino Health Paradoxes: Empirical Evidence, Explanations, Future Research, and Implications

  • Dolores Acevedo-Garcia
  • Lisa M. Bates

In the last decades, the growth of the U.S. Latino population and the adaptation of Latino immigrants have increasingly been the subject of scholarly and policy attention. Some see the growth of the Latino population as a positive force that will redefine U.S. society and might strengthen diversity and democracy (Suarez-Orozco & Paez, 2002). On the other hand, some argue that Hispanic immigration constitutes a threat to the Anglo-Protestant values and practices that form the core of American culture (Huntington, 2004). In health research, the topic of Latino health paradoxes (defined below) is also becoming the subject of increased debate. For some, the health advantage that Latinos appear to have might be rooted in their “cultural orientation” and strong social networks. For others, the so-called paradoxes are the result of selection processes that bring to the United States Latino immigrants that are healthier than their nonimmigrant conationals. Hence, this school argues, “paradoxes” are, after all, not paradoxical. This chapter describes the empirical evidence on Latino health paradoxes and discusses possible explanations for and implications of such paradoxes. We argue that research on Latino health should be embedded in a complex understanding of the context of Latino immigration, including the Latin American sending countries and the process of immigrant adaptation. Thus, studying Latino health should involve an interdisciplinary dialogue between sociologists of immigrant adaptation and public health researchers. Large-scale Latino immigration is relatively recent and is rapidly evolving (e.g., the emergence of secondary destinations in addition to the traditional metro area gateways, the growth of non-Mexican Latin American immigration, and the resurgence of highly contentious immigration politics and policy debates). Because of this fluidity, understanding Latino immigration and Latino health often seems elusive. Therefore, the objective of this chapter is not to provide answers but to suggest research approaches that might enrich our inquiry into Latino health. Other chapters in this volume discuss in-depth important dimensions of the Latino experience in the United States, such as the demographics of the U.S. Latino population and immigrant adaptation. Here we discuss how these factors might influence Latino health and highlight some issues that are critical for understanding observed patterns of health in this population.


Latino Population Russell Sage Foundation Latino Immigrant Health Advantage Latin American Study 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Abraido-Lanza, A. F., Chao, M. T., & Florez, K. R. (2005). Do Healthy Behaviors Decline with Greater Acculturation? Implications for the Latino Mortality Paradox. Social Science and Medicine, 61(6), 1243–1255.CrossRefGoogle Scholar
  2. Acevedo-Garcia, D., Pan, J., Jun, H. J., Osypuk, T. L., & Emmons, K. M. (2005). The Effect of Immigrant Generation on Smoking. Social Science and Medicine, 61(6), 1223–1242.CrossRefGoogle Scholar
  3. Acevedo-Garcia, D., Soobader, M. J., & Berkman, L. F. (2005). The Differential Effect of Foreign-Born Status on Low-Birthweight by Race/Ethnicity and Education. Pediatrics, 115, e20–e30.Google Scholar
  4. Acevedo-Garcia, D., Soobader, M. J., & Berkman, L. F. (2006). Low Birthweight Among US Hispanic/Latino Subgroups: The Effect of Maternal Foreign-Born Status and Education. Social Science and Medicine, forthcoming. Manuscript submitted for publication.Google Scholar
  5. Alba, R. D., Abdel-Hady, D., Islam, T., & Marotz, K. (2006). Downward Assimilation and Mexican-Americans: An Examination of Intergenerational Advance and Stagnation in Educational Attainment. In Alba, R. and Waters, M. (Eds.), Proceedings from the Second Generation Conference.Google Scholar
  6. Alegria, M., Takeuchi, D., Canino, G., Duan, N., Shrout, P., Meng, X., Vega. W., Zane, N., Vila, D., Woo, M., Vera, M., Guarnaccia, P., Aguilar-Gaxiola, S., Sue, S., Escobar, J., Lin, K., & Gong, F. (2004). Considering Context, Place and Culture: the National Latino and Asian American Study. International Journal of Methods in Psychiatric Research, 13(4), 208–220.CrossRefGoogle Scholar
  7. Antecol, H., & Bedard, K. (2006). Unhealthy Assimilation: Why Do Immigrants Converge to American Health Status Levels? Demography, 43(2), 337–360.CrossRefGoogle Scholar
  8. Arcia, E., Skinner, M., Bailey, D., & Correa, V. (2001). Models of Acculturation and Health Behaviors Among Latino Immigrants to the US. Social Science and Medicine, 53(1), 41–53.CrossRefGoogle Scholar
  9. Bates, L., Acevedo-Garcia, D., Alegria, M., & Krieger, N. (2006). Immigration and Generational Trends in Body Mass Index and Obesity in the United States: Results of the National Latino and Asian-American Survey (NLAAS), 2002–2003. American Journal of Public Health, forthcoming. Manuscript submitted for publication.Google Scholar
  10. Berkman, L., & Kawachi, I. (Eds.). (2000). Social Epidemiology. New York: Oxford University Press.Google Scholar
  11. Breslau, J., Aquilar-Gaxiola, S., Kendler, K., Su, M., Williams, D., & Kessler, R. (2006). Specifying Race-Ethnic Differences in Risks for Psychiatric Disorder in a USA National Sample. Psychological Medicine 36(1), 57–68.CrossRefGoogle Scholar
  12. Brown, E. R., & Yu, H. (2002). Latinos’B Access To Employment-Based Health Insurance. In M. M. Suarez-Orozco & M. Paez (Eds.), Latinos Remaking America (pp. 215–235). Berkeley: University of California Press; David Rockefeller Center for Latin American Studies.Google Scholar
  13. Finch, B., Kolody, B., & Vega, W. (2000). Perceived Discrimination and Depression Among Mexican-Origin Adults in California. Journal of Health and Social Behavior, 41(3), 295–313.CrossRefGoogle Scholar
  14. Fix, M., & Passel, J. (2002). Assessing Welfare Reform’s Immigrant Provisions. In A. Weil & K. Finegold (Eds.), Welfare Reform: The Next Act (pp. 179–202). Washington, DC: The Urban Institute.Google Scholar
  15. Franzini, L., Ribble, J. C., & Keddie, A. M. (2001). Understanding the Hispanic Paradox. Ethnicity and Disease, 11(3), 496–518.Google Scholar
  16. Goel, M. S., McCarthy, E., Phillips, R., & Wee, C. (2004). Obesity Among US Immigrant Subgroups by Duration of Residence. Journal of the American Medical Association, 292(23), 2860–2867.CrossRefGoogle Scholar
  17. Grant, B., Stinson, F., Hasin, D., Dawson, D., Chou, S., & Anderson, K. (2004). Immigration and Lifetime Prevalence of DSM-IV Psychiatric Disorders Among Mexican Americans and Non-Hispanic Whites in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61(12), 1226–1233.CrossRefGoogle Scholar
  18. Hajat, A., Lucas, J. B., & Kington, R. (2000). Health Outcomes Among Hispanic Subgroups: Data from the National Health Interview Survey, 1002–95. Advance Data, 310, 1–14.Google Scholar
  19. Hayes-Bautista, D. E. (2002). The Latino Health Research Agenda for the Twenty-first Century. In M. M. Suarez-Orozco & M. Paez (Eds.), Latinos Remaking America (pp. 215–235). Berkeley: University of California Press; David Rockefeller Center for Latin American Studies.Google Scholar
  20. Hunt, L. M., Schneider, S., & Corner, B. (2004). Should “Acculturation” Be a Variable in Health Research? A Critical Review of Research on US Hispanics. Social Science and Medicine, 59(2004), 973–986.Google Scholar
  21. Huntington, S. P. (2004). Who Are We? The Challenges to America’s National Identity. New York: Simon and Schuster.Google Scholar
  22. Jasso, G., Massey, D. S., Rosenzweig, M. R., & Smith, J. P. (2000). The New Immigrant Survey Pilot (NIS-P): Overview and New Findings about US Legal Immigrants at Admission. Demography, 37(1), 127–138.CrossRefGoogle Scholar
  23. Jasso, G., Massey, D. S., Rosenzweig, M. R., & Smith, J. P. (2004). Immigrant Health Selectivity and Acculturation. In N. B. Anderson, R. A. Bulatao, & B. Cohen, In Panel on Race Ethnicity and Health in Later Life and National Research Council (Eds.), Critical Perspectives on Racial and Ethnic Differences in Health in Late Life (pp. 227–266). Washington, DC: The National Academies Press.Google Scholar
  24. Lara, M., Akinbami, L., Flores, G., & Morgenstern, H. (2006). Heterogeneity of Childhood Asthma Among Hispanic Children: Puerto Rican Children Bear a disproportionate Burden. Pediatrics, 117(1), 43–53.CrossRefGoogle Scholar
  25. Lindstrom, D. P. (1996). Economic Opportunity in Mexico and Return Migration from the United States. Demography, 33(3), 367–374.CrossRefGoogle Scholar
  26. Massey, D. S., Durand, J., & Malone, N. J. (2002). Beyond Smoke and Mirrors: Mexican Immigration in an Era of Economic Integration. New York: Russell Sage Foundation.Google Scholar
  27. Mendoza, F. S., Ventura, S. J., Valdez, R. B., Castillo, R. O., Saldivar, L. E., Baisden, K., & Martorell, R. (1991). Selected Measures of Health Status for Mexican-American, Mainland Puerto Rican, and Cuban-American Children. Journal of the American Medical Association, 265(2), 227–232.CrossRefGoogle Scholar
  28. Menjivar, C. (2000). Fragmented Ties: Salvadoran Immigrant Networks in America. Berkeley: University of California Press.Google Scholar
  29. National Center for Health Statistics, Centers for Disease Control and Prevention, Department of Health and Human Services. (2002). A Demographic and Health Snapshot of the U.S. Hispanic/Latino Population. 2002 National Hispanic Health Leadership Summit, National Center for Health Statistics, Centers for Disease Control and Prevention, 2006. Retrieved July 17, 2006, from
  30. Ogden, C., Carroll, M., Curtin, L., McDowell, M., Tabak, C., & Flegal, K. (2006). Prevalence of Overweight and Obesity in the United States, 1999–2004. Journal of the American Medical Association, 295(13), 1549–1555.CrossRefGoogle Scholar
  31. Ortega, A. N., Rosenheck, R., Alegria, M., & Desai, R. A. (2000). Acculturation and the Lifetime Risk of Psychiatric and substance Use Disorders Among Hispanics. Journal of Nervous and Mental Disease, 188(11), 728–735.CrossRefGoogle Scholar
  32. Palloni, A., & Arias, E. (2004). Paradox Lost: Explaining the Hispanic Adult Mortality Advantage. Demography, 41(3), 385–415.CrossRefGoogle Scholar
  33. Palloni, A., & Morenoff, J. D. (2001). Interpreting the Paradoxical in the Hispanic Paradox: Demographic and Epidemiologic Approaches. Annals of the New York Academy of Sciences, 954, 140–174.CrossRefGoogle Scholar
  34. Portes, A., & Rumbaut, R. G. (2001a). Legacies: The Story of the Immigrant Second Generation. Los Angeles: University of California Press, Russell Sage Foundation.Google Scholar
  35. Portes, A., & Rumbaut, R. G. (2001b). The New Americans. Los Angeles: University of California Press, Russell Sage Foundation.Google Scholar
  36. Ramirez, R. R., & De la Cruz, G. P. (2003). The Hispanic Population in the United States: March 2002 (U.S. Census Bureau No. 8). Washington, DC: Government Printing Office.Google Scholar
  37. Rose, D., Mannino, D., & Leaderer, B. (2006). Asthma Prevalence Among US Adults, 1998–2000: Role of Puerto Rican Ethnicity and Behavioral and Geographic Factors. American Journal of Public Health, 96(5), 880–888.CrossRefGoogle Scholar
  38. Rumbaut, R. G. (1999). Assimilation and Its Discontents: Ironies and Paradoxes. In C. Hirschman, J. Dewind, & P. Kasinitz, (Eds.), The Handbook of International Migration: The American Experience (pp. 172–195). New York: Russell Sage Foundation.Google Scholar
  39. Schmidley, A. D. (2003). The Foreign-Born Population in the United States: March 2002 (U.S. Census Bureau No. 70). Washington, DC: Government Printing Office. Retrieved July 17, 2006, from–539.pdf.
  40. 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(3), 392–399.CrossRefGoogle Scholar
  41. 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(1), 83–109.CrossRefGoogle Scholar
  42. Smith, J. P. (2003). Assimilation Across the Latino Generations. AEA Papers and Proceedings, 93(May), 315–319.Google Scholar
  43. Soldo, B., Wong, R., & Palloni, A. (2002). Migrant Health Selection: Evidence from Mexico and the US. Annual Meetings of the Population Association of America, Atlanta, GA, May 9–11.Google Scholar
  44. Suarez-Orozco, C., & Suarez-Orozco, M. M. (2001). Children of Immigration. Cambridge, MA: Harvard University Press.Google Scholar
  45. Suarez-Orozco, M. M., & Paez, M. (Eds.). (2002). Latinos Remaking America. Berkeley, CA: University of California Press, David Rockefeller Center for Latin American Studies.Google Scholar
  46. Suro, R., & Passel, J. S. (2003). The Rise of the Second Generation: Changing Patterns in Hispanic Population Growth. Washington, DC: Pew Hispanic Center.Google Scholar
  47. U.S. Census Bureau. (2003). Current Population Survey, March 2002. Washington, DC: U.S. Census Bureau.Google Scholar
  48. U.S. Census Bureau. (2004). Table 1a. Projected Population of the United States, by Race and Hispanic Origin: 2000 to 2050, U.S. Interim Projections by Age, Sex, Race, and Hispanic Origin, Washington, DC: US Census Bureau. Retrieved July 17, 2006, from
  49. Vega, W.A., Alderete, E., Kolody, B., & Aguilar-Gaxiola, S. (1998). Illicit drug use among Mexicans and Mexican Americans in California: The Effects of Gender and Acculturation. Addiction, 93(12), 1839–1850.CrossRefGoogle Scholar
  50. Villarejo, D. (2003). The Health of U.S. Hired Farm Workers. Annual Review of Public Health, 24, 175–193.CrossRefGoogle Scholar
  51. Weinberg, M., Hopkins, J., Farrington, L., Gresham, L., Ginsberg, M., & Bell, B. (2004). Hepatitis A in Hispanic Children Who Live Along the United States-Mexico Border: The Role of International Travel and Food-Borne Exposures. Pediatrics, 114(1), e68–e73.CrossRefGoogle Scholar
  52. Williams, D. R. (2001). Racial Variations in Adult Health Status: Patterns, Paradoxes, and Prospects. In N. J. Smelser, W. J. Wilson, F. Mitchell, & National Research Council (Eds.), America Becoming: Racial Trends and Their Consequences (pp. 371–410). Washington, DC: National Academy Press.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Dolores Acevedo-Garcia
  • Lisa M. Bates
    • 1
  1. 1.Department of EpidemiologyColumbia UniversityNew YorkUSA

Personalised recommendations