title: Latina Birth Outcomes in California: Not so Paradoxical.
abstract: Objectives To investigate Latina-White differences in birth outcomes in California from 2003 to 2010, looking for evidence of the often-cited "Latina paradox" and assessing the possible role of socioeconomic factors in observed differences. MethodsUsing statewide-representative data from the California Maternal and Infant Health Assessment, an annual population-based postpartum survey, we compared rates of preterm birth (PTB) and low birth weight (LBW) in five groups: U.S.-born non-Latina Whites ("Whites"), U.S.-born Mexican-Americans, U.S.-born non-Mexican Latinas, Mexican immigrants, and non-Mexican Latina immigrants. Logistic regression models examined the relative likelihood of PTB and LBW for women in each Latina subgroup compared with Whites, before and after adjustment for socioeconomic and other covariates. Results In unadjusted analyses, women in each Latina subgroup appeared more likely than White women to have PTB and LBW, although the increased likelihood of LBW among Mexican immigrants was statistically non-significant. After adjustment for less favorable socioeconomic characteristics among Latinas compared with Whites, observed differences in the estimated likelihoods of PTB or LBW for Latina subgroups relative to Whites were attenuated and (with the exception of PTB among U.S.-born Mexican Americans) no longer statistically significant. Conclusions We found no evidence of a "Latina paradox" in birth outcomes, which some have cited as evidence that social disadvantage is not always health-damaging. As observed in several previous studies, our findings were non-paradoxical: consistent with their socioeconomic disadvantage, Latinas had worse birth outcomes than non-Latina White women. Policy-makers should not rely on a "Latina paradox" to ensure good birth outcomes among socioeconomically disadvantaged Latina women.
authors.affiliation: Department of Health Education, San Francisco State University, 1600 Holloway Ave., San Francisco, CA, 94132, USA. emmav@sfsu.edu.|Center on Social Disparities in Health, University of California San Francisco, San Francisco, CA, USA. emmav@sfsu.edu.
authors.forename: Emma V
authors.initials: EV
authors.lastname: Sanchez-Vaznaugh
authors.affiliation: Center on Social Disparities in Health, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Paula A
authors.initials: PA
authors.lastname: Braveman
authors.affiliation: Center on Social Disparities in Health, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Egerter
authors.affiliation: Center on Social Disparities in Health, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Kristen S
authors.initials: KS
authors.lastname: Marchi
authors.affiliation: Center on Social Disparities in Health, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Heck
authors.affiliation: Surveillance, Assessment and Program Development Section, Epidemiology, Assessment and Program Development Branch, Maternal, Child and Adolescent Health Program, California Department of Public Health, Sacramento, CA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Curtis
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D047928:Premature Birth / Q000208:ethnology*; D011295:Prenatal Care / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Disparities in preterm birth; Latina paradox; Low birth weight; Socioeconomic factors