Socioeconomic differences in mortality among U.S. adults: insights into the Hispanic paradox.
OBJECTIVE
This study examined socioeconomic differentials in mortality among Hispanics in the United States, focusing on the older ages. We address previous research suggesting that social disparities in health are smaller for Hispanics than for non-Hispanic Whites and examine whether these differentials in survival are related to the mortality advantage that characterizes the older Hispanic population (i.e., the Hispanic paradox).


METHODS
We used Poisson regression models based on data from the 1989 to 1994 waves of the National Health Interview Survey, with linked mortality through 1997, to estimate death rates for Hispanics and non-Hispanic Whites by age, gender, and socioeconomic status.


RESULTS
Deaths rates varied significantly (p <.05) by education and income for Whites and Hispanic subgroups defined by nativity (U.S. born and foreign born) and nationality (Mexican, Puerto Rican, and other Hispanic). However, with the exception of Puerto Ricans, the effects of education were significantly smaller for Hispanics than for Whites. The ethnic differences in mortality patterns by income were not statistically significant.


CONCLUSIONS
The findings reveal that the mortality advantage for Hispanics is concentrated at lower levels of socioeconomic status, with little or no advantage at higher levels. We propose several mechanisms related to immigration and assimilation patterns that may underlie these patterns of mortality.
Turra
Cassio M
CM
Department of Demography and Cedeplar, Universidade Federal de Minas Gerais, Brazil. turra@cedeplar.ufmg.br
Goldman
Noreen
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015982:Bias; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000706:statistics & numerical data; D004522:Educational Status; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D016012:Poisson Distribution; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014481:United States; D044465:White People / Q000706:statistics & numerical data*