The Health Status and Health Behaviors of Hispanics

Abstract

The rapid growth in the Hispanic population, and especially in the number of Hispanic youth, represents one of the most dramatic and important demographic trends affecting the U.S. Contemporary working-age Hispanic adults will age to become the first sizable wave of Hispanic seniors. More consequential, the large number of contemporary Hispanic children and adolescents will age to swell the ranks of Hispanic young and middle-aged adults within a decade or two. The health status and health behaviors of today’s Hispanic youth will play a central role in shaping the long-term health and health care needs not only of Hispanics in the U.S. but of all Americans. Yet efforts to provide a detailed and comprehensive description of the health and health behaviors of Hispanics are complicated by a variety of factors. Hispanics living in the U.S. represent an increasing diversity of national origin groups, and health status differs across national origin groups. Relatively new groups, such as Dominicans, Salvadorans, Guatemalans, and Colombians, have grown rapidly, adding their numbers to well-established populations of Mexican, Puerto Rican, and Cuban origin. Additionally, the health of U.S. Hispanics differs by generational status. On numerous dimensions, foreign-born Hispanics – i.e., immigrants to the U.S. – have better health indicators than their U.S.-born counterparts. Among the foreign-born, moreover, health status and health behaviors may differ by degree of acculturation to U.S. culture. In this context, the gaps in the available data on the health and health behavior of Hispanics impose serious limitations. One frequent and noteworthy problem is the lack of detailed data for subgroups of Hispanics defined by national origin and generation in the U.S. Most studies group Hispanics into a single category or focus on Hispanics of Mexican origin, who are by far the most numerous. Another problem is the relative lack of detailed epidemiologic data on the incidence and prevalence of common and important diseases, such as cardiovascular disease. Moreover, for many conditions data are unavailable to assess incidence or prevalence according to immigrant status or, among the foreign-born, by length of residence in the U.S. and degree of acculturation. Despite these limitations, researchers have learned a great deal about the health status and health behaviors of Hispanics over the last 25 years. The story that has emerged is a complex one, with some findings that warrant optimism and others that merit serious concern. The picture of both advantage and disadvantage that has surfaced must be appreciated and understood in order to develop interventions and design policies to improve Hispanic health. In this chapter, we provide an overview of the health status and health behaviors of Hispanics in the U.S. The chapter is divided into several sections: First we discuss mortality rates among Hispanics, compare them with rates for non-Hispanic whites and non-Hispanic blacks, and illustrate the variation in mortality across Hispanic national origin groups. The next three sections cover the health status and health behaviors of Hispanic adults, the health status and health behaviors of Hispanic children and adolescents, and birth outcomes. The fifth section discusses the so-called “epidemiological paradox,” one of the most fascinating findings regarding the health of Hispanics and a source of controversy since it was first described. Finally, we conclude with a summary of our findings and what they mean for the health and health care needs of future generations of Hispanics in the U.S.