Factor-Inwentash Faculty of Social Work, University of Toronto 246 Bloor Street West, Toronto, ON M5S 1A1, Canada.
Int J Environ Res Public Health. 2013 May 3;10(5):1786-814. doi: 10.3390/ijerph10051786.
The "Hispanic Paradox" suggests that despite rates of poverty similar to African Americans, Hispanics have far better health and mortality outcomes, more comparable to non-Hispanic White Americans. Three prominent possible explanations for the Hispanic Paradox have emerged. The "Healthy Migrant Effect" suggests a health selection effect due to the demands of migration. The Hispanic lifestyle hypothesis focuses on Hispanics' strong social ties and better health behaviors. The reverse migration argument suggests that the morbidity profile in the USA is affected when many Hispanic immigrants return to their native countries after developing a serious illness. We analyzed data from respondents aged 55 and over from the nationally representative 2006 American Community Survey including Mexican Americans (13,167 U.S. born; 11,378 immigrants), Cuban Americans (314 U.S. born; 3,730 immigrants), and non-Hispanic White Americans (629,341 U.S. born; 31,164 immigrants). The healthy migrant effect was supported with SES-adjusted disability comparable between Mexican, Cuban and non-Hispanic Whites born in the USA and all immigrants having lower adjusted odds of functional limitations than U.S. born non-Hispanic Whites. The reverse migration hypothesis was partially supported, with citizenship and longer duration in the USA associated with higher rates of SES-adjusted disability for Mexican Americans. The Hispanic healthy life-style explanation had little support in this study. Our findings underline the importance of considering nativity when planning for health interventions to address the needs of the growing Hispanic American older adult population.
“西班牙裔悖论”表明，尽管西班牙裔的贫困率与非裔美国人相似，但他们的健康状况和死亡率却要好得多，与非西班牙裔的白人美国人更为接近。目前已经出现了三种解释“西班牙裔悖论”的突出可能性。“健康移民效应”表明，由于移民的需求，存在健康选择效应。西班牙裔生活方式假说侧重于西班牙裔人的强大社会关系和更好的健康行为。相反的移民论点表明，当许多西班牙裔移民在患上重病后返回原籍国时，美国的发病谱就会受到影响。我们分析了来自全国代表性的 2006 年美国社区调查中年龄在 55 岁及以上的受访者的数据，包括墨西哥裔美国人（13167 名美国出生；11378 名移民）、古巴裔美国人（314 名美国出生；3730 名移民）和非西班牙裔白人美国人（629341 名美国出生；31164 名移民）。在调整了社会经济地位（SES）的残疾数据后，健康移民效应得到了支持，表明在美国出生的墨西哥裔、古巴裔和非西班牙裔白人之间以及所有移民之间的残疾率相当，而调整后的功能障碍几率均低于在美国出生的非西班牙裔白人。部分支持了相反的移民假说，因为公民身份和在美国的居住时间较长与墨西哥裔美国人 SES 调整后的残疾率较高有关。在这项研究中，西班牙裔健康生活方式的解释几乎没有得到支持。我们的研究结果强调了在规划针对不断增长的西班牙裔美国老年人口的健康干预措施时，考虑原籍国的重要性。
