title: Explaining low mortality among US immigrants relative to native-born Americans: the role of smoking.
abstract: BACKGROUND
  In many developed countries, immigrants live longer-that is, have lower death rates at most or all ages-than native-born residents. This article tests whether different levels of smoking-related mortality can explain part of the 'healthy immigrant effect' in the USA, as well as part of the related 'Hispanic paradox': the tendency for US Hispanics to outlive non-Hispanic Whites.
  
  
  METHODS
  With data from vital statistics and the national census, we calculate lung cancer death rates in 2000 for four US subpopulations: foreign-born, native-born, Hispanic and non-Hispanic White. We then use three different methods-the Peto-Lopez method, the Preston-Glei-Wilmoth method and a novel method developed in this article-to generate three alternative estimates of smoking-related mortality for each of the four subpopulations, extrapolating from lung cancer death rates. We then measure the contribution of smoking-related mortality to disparities in all-cause mortality.
  
  
  RESULTS
  Taking estimates from any of the three methods, we find that smoking explains >50% of the difference in life expectancy at 50 years between foreign- and native-born men, and >70% of the difference between foreign- and native-born women; smoking explains >75% of the difference in life expectancy at 50 years between US Hispanic and non-Hispanic White men, and close to 75% of the Hispanic advantage among women.
  
  
  CONCLUSIONS
  Low smoking-related mortality was the main reason for immigrants' and Hispanics' longevity advantage in the USA in 2000.
authors.affiliation: Office of Population Research, Princeton University, Princeton, NJ, USA. lblue@princeton.edu
authors.forename: Laura
authors.initials: L
authors.lastname: Blue
authors.forename: Andrew
authors.initials: A
authors.lastname: Fenelon
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008017:Life Expectancy / Q000208:ethnology*; D008175:Lung Neoplasms / Q000208:ethnology / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D044382:Population Groups / Q000706:statistics & numerical data; D018570:Risk Assessment; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology / Q000401:mortality*; D016019:Survival Analysis; D014481:United States; D044465:White People / Q000706:statistics & numerical data*