Migration status, socioeconomic status, and mortality rates in Mexican Americans and non-Hispanic whites: the San Antonio Heart Study.
It has been claimed that Mexican Americans have a favorable mortality experience despite their low socioeconomic status (SES). The present study compared all-cause mortality of non-Hispanic whites with that of United States-born and foreign-born (i.e., born in Mexico) Mexican Americans. Subjects were 3735 residents of San Antonio, TX, who were followed-up for 7-8 years. The sex-age adjusted death rates per 1000 person-years were higher for United States-born Mexican Americans (5.7) than for non-Hispanic whites (3.8) or for foreign-born Mexican Americans (3.6). Foreign-born Mexican Americans had the lowest socioeconomic status (SES), and non-Hispanic whites had the highest SES. After adjustment for SES, the mortality ratio for United States-born Mexican Americans compared with foreign-born Mexican Americans was 1.9 (95% confidence interval, 1.0-3.5), while the ratio for United States-born Mexican Americans compared with non-Hispanic whites was 1.0 (95% confidence interval, 0.7-1.6). Stratified analysis revealed that those in the lowest SES tertiles had threefold greater risk of death than those in the highest tertiles among both United States-born Mexican Americans and non-Hispanic whites (test for trend, P < 0.001). These data suggest that lower SES is strongly associated with increased mortality. After adjustment for SES, mortality rates were similar for United States-born Mexican Americans and non-Hispanic whites. Foreign-born Mexican Americans had the lowest mortality rates of the three groups.
Wei
M
M
Department of Medicine, University of Texas Health Science Center at San Antonio 78284-7873, USA.
Valdez
R A
RA
Mitchell
B D
BD
Haffner
S M
SM
Stern
M P
MP
Hazuda
H P
HP
D000328:Adult; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D012306:Risk; D012307:Risk Factors; D017678:Sex Distribution; D012923:Social Class; D013781:Texas / Q000453:epidemiology; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data*