Arias Elizabeth, Johnson Norman J, Vera Betzaida Tejada
Mortality Statistics Branch, Division of Vital Statistics, National Center for Health Statistics, 3311 Toledo Road, Hyattsville, 20782, MD, United States.
Mortality Research Branch, Center for Economic Studies, U.S. Census Bureau, 4600 Silver Hill Road, Room 5K127, Suitland, MD, 20746, United States.
SSM Popul Health. 2020 Apr 13;11:100583. doi: 10.1016/j.ssmph.2020.100583. eCollection 2020 Aug.
We addressed three research questions: (1) Are there racial mortality disparities in the adult Hispanic population that resemble those observed in the non-Hispanic population in the US? (2) Does nativity mediate the race-mortality relationship in the Hispanic population? and (3) What does the Hispanic mortality advantage relative to the non-Hispanic white population look like when Hispanic race is considered?
We estimated a series of parametric hazard models on eight years of mortality follow-up data and calculated life expectancy estimates using the Mortality Disparities in American Communities database.
Hispanic white adults experience lower mortality than their Hispanic black, American Indian and Alaska Native, Some Other Race, and multiple race counterparts. This Hispanic white advantage is found mostly among the US born. The Hispanic advantage relative to the non-Hispanic white population operates for most Hispanic race groups among the foreign born but either disappears or converts to a disadvantage for most of the non-white Hispanic groups among the US born.
Our study extends the literature on the Hispanic Mortality Paradox by revealing that the adult Hispanic population experiences racial mortality disparities that closely resemble those observed in the non-Hispanic population. The Hispanic mortality advantage is mediated not only by nativity but by race. These results indicate that race is a critical factor that should be considered in any study with the goal of understanding the health and mortality profiles of the Hispanic population in the US.
我们探讨了三个研究问题:(1)成年西班牙裔人群中是否存在与美国非西班牙裔人群中观察到的类似的种族死亡率差异?(2)出生地是否介导了西班牙裔人群中的种族-死亡率关系?以及(3)当考虑西班牙裔种族时,相对于非西班牙裔白人人群,西班牙裔的死亡率优势是怎样的?
我们基于八年的死亡率随访数据估计了一系列参数风险模型,并使用美国社区死亡率差异数据库计算了预期寿命估计值。
西班牙裔白人成年人的死亡率低于其西班牙裔黑人、美国印第安人和阿拉斯加原住民、其他种族以及多种族的同龄人。这种西班牙裔白人的优势主要在美国出生的人群中发现。相对于非西班牙裔白人人群,西班牙裔的优势在外国出生的大多数西班牙裔种族群体中存在,但在美国出生的大多数非白人西班牙裔群体中,这种优势要么消失,要么转变为劣势。
我们的研究扩展了关于西班牙裔死亡率悖论的文献,揭示了成年西班牙裔人群经历的种族死亡率差异与在非西班牙裔人群中观察到的差异非常相似。西班牙裔的死亡率优势不仅由出生地介导,还由种族介导。这些结果表明,在任何旨在了解美国西班牙裔人群健康和死亡率概况的研究中,种族都是一个应考虑的关键因素。