title: Trends in the Mexican infant mortality paradox over the past two decades.
abstract: OBJECTIVE
  Mexicans in the United States have lower rates of several important population health metrics than non-Hispanic whites, including infant mortality. This mortality advantage is particularly pronounced among infants born to foreign-born Mexican mothers. However, the literature to date has been relegated to point-in-time studies that preclude a dynamic understanding of ethnic and nativity differences in infant mortality among Mexicans and non-Hispanic whites.
  
  
  METHODS
  We assessed secular trends in the relation between Mexican ethnicity, maternal nativity, and infant mortality between 1989 and 2006 using a linked birth-death data set from one US state.
  
  
  RESULTS
  Congruent to previous research, we found a significant mortality advantage among infants of Mexican relative to non-Hispanic white mothers between 1989 and 1991 after adjustment for baseline demographic differences (relative risk = 0.78, 95% confidence interval, 0.62-0.98). However, because of an upward trend in infant mortality among infants of Mexican mothers, the risk of infant mortality was not significantly different from non-Hispanic white mothers in later periods.
  
  
  CONCLUSIONS
  Our findings suggest that the "Mexican paradox" with respect to infant mortality is resolving. Changing sociocultural norms among Mexican mothers and changes in immigrant selection and immigration processes may explain these observations, suggesting directions for future research.
authors.affiliation: Department of Epidemiology, Columbia University, New York, NY; College of Physicians and Surgeons, Columbia University, New York, NY. Electronic address: ame2145@columbia.edu.
authors.forename: Abdulrahman M
authors.initials: AM
authors.lastname: El-Sayed
authors.affiliation: Department of Epidemiology, Columbia University, New York, NY.
authors.forename: Magdalena M
authors.initials: MM
authors.lastname: Paczkowski
authors.affiliation: Department of Epidemiology, Columbia University, New York, NY.
authors.forename: Dana
authors.initials: D
authors.lastname: March
authors.affiliation: Department of Epidemiology, Columbia University, New York, NY.
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
mesh_terms: D000293:Adolescent; D000328:Adult; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000208:ethnology*; D017058:Mexican Americans / Q000706:statistics & numerical data*; D011295:Prenatal Care / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Disparities; Ethnicity; Infant mortality; Mexican paradox; Population health trends