Does the Hispanic Paradox in U.S. Adult Mortality Extend to Disability?

Studies consistently document a Hispanic paradox in U.S. adult mortality, whereby Hispanics have similar or lower mortality rates than non-Hispanic whites despite lower socioeconomic status. This study extends this line of inquiry to disability, especially among foreign-born Hispanics, since their advantaged mortality seemingly should be paired with health advantages more generally. We also assess whether the paradox extends to U.S.-born Hispanics to evaluate the effect of nativity. We calculate multistate life tables of life expectancy with disability to assess whether racial/ethnic and nativity differences in the length of disability-free life parallel differences in overall life expectancy. Our results document a Hispanic paradox in mortality for foreign-born and U.S.-born Hispanics. However, Hispanics’ low mortality rates are not matched by low disability rates. Their disability rates are substantially higher than those of non-Hispanic whites and generally similar to those of non-Hispanic blacks. The result is a protracted period of disabled life expectancy for Hispanics, both foreign- and U.S.-born.     

Neighborhood Concentrated Disadvantage and Adult Mortality: Insights for Racial and Ethnic Differences

While racial and ethnic differences in mortality are pervasive and well documented, less is known about how mortality risk varies by neighborhood socioeconomic status across racial and ethnic identity. We conducted a prospective analysis on a sample of adults living at or below 300% poverty with 8 years of the National Health Interview Survey (N = 159,400) linked to 11,600 deaths to examine the association between neighborhood disadvantage and mortality for non-Hispanic whites, non-Hispanic blacks, and U.S.- and foreign-born Hispanics. Using multilevel logistic regression, we find that the probability of death from any cause for lower-income adults is higher in more-disadvantaged neighborhoods, compared to less-disadvantaged neighborhoods, but only for whites. The adjusted likelihood of death for blacks and foreign-born Hispanics is not associated with neighborhood disadvantage, and the likelihood of death for U.S.-born Hispanics is lower in more-disadvantaged neighborhoods. While future research and policy should focus on improving health-promoting resources in all communities, care should be given to better understanding why race/ethnic groups have differential mortality returns with respect to area-specific socioeconomic conditions.     

Paradox Revisited: A Further Investigation of Racial/Ethnic Differences in Infant Mortality by Maternal Age

I reexamine the epidemiological paradox of lower overall infant mortality rates in the Mexican-origin population relative to U.S.-born non-Hispanic whites using the 1995–2002 U.S. NCHS linked cohort birth-infant death files. A comparison of infant mortality rates among U.S.-born non-Hispanic white and Mexican-origin mothers by maternal age reveals an infant survival advantage at younger maternal ages when compared with non-Hispanic whites, which is consistent with the Hispanic infant mortality paradox. However, this is accompanied by higher infant mortality at older ages for Mexican-origin women, which is consistent with the weathering framework. These patterns vary by nativity of the mother and do not change when rates are adjusted for risk factors. The relative infant survival disadvantage among Mexican-origin infants born to older mothers may be attributed to differences in the socioeconomic attributes of U.S.-born non-Hispanic white and Mexican-origin women.     

The residential segregation of mixed-nativity married couples

This article examines the ways in which mixed-nativity marriage is related to spatial assimilation in metropolitan areas of the United States. Specifically, we examine the residential patterns of households with a mixed-nativity—and, in some cases, interracial—marriage to determine whether they are less segregated from the native-born than entirely foreign-born households. Using restricted-use data from the 2000 census, we find that compared with couples in which both spouses are foreign-born, mixed-nativity couples tend to be less segregated from various native-born racial and ethnic groups. Further, among both foreign-born Asians and Hispanics, those with a native-born non-Hispanic white spouse are considerably less segregated from native-born white households than from other foreign-born Asian and Hispanic households. We also find that even though nativity status matters for black couples in a manner consistent with assimilation theory, foreign-born and mixed-nativity black households still each display very high levels of segregation from all other native-born racial/ethnic groups, reaffirming the power of race in determining residential patterns. Overall, our findings provide moderate support for spatial assimilation theory and suggest that cross-nativity marriages often facilitate the residential integration of the foreign-born.     

Immigrant residential segregation in U.S. metropolitan areas, 1990–2000

This paper examines the extent of spatial assimilation among immigrants of different racial and ethnic origins. We use restricted data from the 1990 and 2000 censuses to calculate the levels of dissimilarity by race and Hispanic origin, nativity, and year of entry, and then run multivariate models to examine these relationships. The findings provide broad support for spatial assimilation theory. Foreign-born Hispanics, Asians, and blacks are more segregated from native-born non-Hispanic whites than are the U.S.-born of these groups. The patterns for Hispanics and Asians can be explained by the average characteristics of the foreign-born that are generally associated with higher levels of segregation, such as lower levels of income, English language ability, and home ownership. We also find that immigrants who have been in the United States for longer periods are generally less segregated than new arrivals, and once again, much of this difference can be attributed to the characteristics of immigrants. However, patterns also vary across groups. Levels of segregation are much higher for black immigrants than for Asian, Hispanic, and white immigrants. In addition, because black immigrants are, on average, of higher socioeconomic status than native-born blacks, such characteristics do not help explain their very high levels of segregation.     

Recent Trends in Coverage of the Mexican-Born Population of the United States: Results From Applying Multiple Methods Across Time

The accuracy of counts of U.S. racial/ethnic and immigrant groups depends on the coverage of the foreign-born in official data. Because Mexicans constitute by far the largest single national-origin group among the foreign-born in the United States, we compile new evidence about the coverage of the Mexican-born population in the 2000 census and 2001–2010 American Community Survey (ACS) using three techniques: a death registration, a birth registration, and a net migration method. For the late 1990s and first half of the 2000–2010 decade, results indicate that coverage error was somewhat higher than currently assumed but had substantially declined by the latter half of the 2000–2010 decade. Additionally, we find evidence that U.S. census and ACS data miss substantial numbers of children of Mexican immigrants, as well as people who are most likely to be unauthorized: namely, working-aged Mexican immigrants (ages 15–64), especially males. The findings highlight the heterogeneity of the Mexican foreign-born population and the ways in which migration dynamics may affect population coverage.     

Migration Selection, Protection, and Acculturation in Health: A Binational Perspective on Older Adults

In this article, we test for four potential explanations of the Hispanic Health Paradox (HHP): the “salmon bias,” emigration selection, and sociocultural protection originating in either destination or sending country. To reduce biases related to attrition by return migration typical of most U.S.-based surveys, we combine data from the Mexican Health and Aging Study in Mexico and the U.S. National Health Interview Survey to compare self-reported diabetes, hypertension, current smoking, obesity, and self-rated health among Mexican-born men ages 50 and older according to their previous U.S. migration experience, and U.S.-born Mexican Americans and non-Hispanic whites. We also use height, a measure of health during childhood, to bolster some of our tests. We find an immigrant advantage relative to non-Hispanic whites in hypertension and, to a lesser extent, obesity. We find evidence consistent with emigration selection and the salmon bias in height, hypertension, and self-rated health among immigrants with less than 15 years of experience in the United States; we do not find conclusive evidence consistent with sociocultural protection mechanisms. Finally, we illustrate that although ignoring return migrants when testing for the HHP and its mechanisms, as well as for the association between U.S. experience and health, exaggerates these associations, they are not fully driven by return migration-related attrition.     

Paradox found (again): Infant mortality among the Mexican-origin population in the united states

Recent research suggests that the favorable mortality outcomes for the Mexican immigrant population in the United States may largely be attributable to selective out-migration among Mexican immigrants, resulting in artificially low recorded death rates for the Mexican-origin population. In this paper we calculate detailed age-specific infant mortality rates by maternal race/ethnicity and nativity for two important reasons: (1) it is extremely unlikely that women of Mexican origin would migrate to Mexico with newborn babies, especially if the infants were only afew hours or afew days old; and (2) more than 50% of all infant deaths in the United States occur during the first week of life, when the chances of out-migration are very small. We use concatenated data from the U.S. linked birth and infant death cohort files from 1995 to 2000, which provides us with over 20 million births and more than 150,000 infant deaths to analyze. Our results clearly show that first-hour, first-day, and first-week mortality rates among infants born in the United States to Mexican immigrant women are about 10% lower than those experienced by infants of non-Hispanic, white U.S.-born women. It is extremely unlikely that such favorable rates are artificially caused by the out-migration of Mexican-origin women and infants, as we demonstrate with a simulation exercise. Further, infants born to U.S.-born Mexican American women exhibit rates of mortality that are statistically equal to those of non-Hispanic white women during the first weeks of life and fare considerably better than infants born to non-Hispanic black women, with whom they share similar socioeconomic profiles. These patterns are all consistent with the definition of the epidemiologic paradox as originally proposed by Markides and Coreil (1986).     

Race/Ethnicity/Nativity Differentials and Changes in Cause-Specific Infant Deaths in the Context of Declining Infant Mortality in the U.S.: 1989–2001

Using data from the national linked birth/infant death cohort files, we examined race/ethnicity/nativity disparities and changes in infant mortality due to the five leading causes of infant death between 1989 and 2001. Our results indicate substantial decreases in infant mortality from three causes (congenital anomalies, sudden infant death syndrome, and respiratory distress syndrome) for which specific perinatal health innovations emerged or were expanded. However, for these three causes, the relative disparities in infant mortality between infants born to U.S.-born black women as compared to infants of U.S.-born white women increased following the introduction (or expansion) of beneficial interventions. Among infants of U.S.-born Mexican American mothers, the findings differed. In the static comparisons, our results show the often-reported similarity in the risk of death of these babies compared to those born to non-Hispanic white mothers. However, when changes over time were modeled, there was an erosion of the relatively favorable survival chances of Mexican American infants. Our models show little change in the relative risk of death for infants of immigrant women. Regarding the other two causes (disorders relating to short gestation and unspecified low birth weight and maternal complications) for which no efficacious innovations occurred, either little change or actual increases in risks were observed. Future studies and health policy efforts should be geared toward further understanding and aggressively working to close infant mortality gaps, especially for infants of U.S.-born black mothers—an effort that will be facilitated by research focused on cause-specific infant mortality.     

The demography of disability and the effects of immigrant history: Older Asians in the United States

Using data from the 2000 U.S. census, we compare the older Asian population with U.S.-born, non-Hispanic whites with respect to three indicators of disability. Insofar as any Asian "advantage" in health vis-a-vis whites exists among the population aged 65 and over, our evidence suggests that it occurs primarily among the U.S.-born segments of this population. We also investigate how differences in disability levels among Asian immigrant groups are influenced by country of birth and by the combined effects of duration of residence in the United States and life cycle stage at entry. These results highlight the diversity of the older Asian population with respect to the ways in which immigration and origin history are linked to disability outcomes. We conclude that in later life, immigrant status confers few disability advantages among the Asian population in the United States.     

U.S. Citizen Children De Facto Deported to Mexico

Between 2000 and 2015, the U.S. deported unprecedented numbers of Mexican immigrants. During the same period, the population of U.S.-born children living in Mexico doubled in size. This study estimates the number of U.S.-born children who emigrated to Mexico from the United States in order to accompany a deported parent: de facto deported children. The data come from the Mexican National Survey of Demographic Dynamics (ENADID), a national probability sample of households in Mexico collected in 2014 and 2018. About one in six U.S.-born children living in Mexico in 2014/2018, amounting to an estimated 80,000–100,000 U.S.-born children, were there because the U.S. government deported one or both of their parents. De facto deported U.S.-born children are socioeconomically disadvantaged in Mexico compared to U.S.-born children whose parents migrate to Mexico for other reasons. Women are overrepresented among deported people who bring their U.S.-born children to Mexico, and when deported mothers bring their children, they are far less likely to do so with a partner than are deported fathers. U.S. policy should consider the interests of U.S. citizen children forced to live abroad when redesigning immigration and child welfare policies.     

Diverging Demography: Hispanic and Non-Hispanic Contributions to U.S. Population Redistribution and Diversity

The substantial growth and geographic dispersion of Hispanics is among the most important demographic trends in recent U.S. demographic history. Our county-level study examines how widespread Hispanic natural increase and net migration has combined with the demographic change among non-Hispanics to produce an increasingly diverse population. This paper uses U.S. Census Bureau data and special tabulations of race/ethnic specific births and deaths from NCHS to highlight the demographic role of Hispanics as an engine of new county population growth and ethnoracial diversity across the U.S. landscape. It highlights key demographic processes—natural increase and net migration—that accounted for 1990–2010 changes in the absolute and relative sizes of the Hispanic and non-Hispanic populations. Hispanics accounted for the majority of all U.S. population growth between 2000 and 2010. Yet, Hispanics represented only 16 % of the U.S. population in 2010. Most previous research has focused on Hispanic immigration; here, we examine how natural increase and net migration among both the Hispanic and non-Hispanic population contribute to the nation’s growing diversity. Indeed, the demographic impact of rapid Hispanic growth has been reinforced by minimal white population growth due to low fertility, fewer women of reproductive age and growing mortality among the aging white population America’s burgeoning Hispanic population has left a large demographic footprint that is magnified by low and declining fertility and increasing mortality among America’s aging non-Hispanic population.     

Trends and Compositional Changes in Fertility: California Circa 1970–1990

Since 1970 California has been the prime destination of the high numbers of both legal and illegal U.S. entrants. Fertility consequences have been dramatic. Births to U.S.-born women, after the decline in the 1970s and mild rebound in the 1980s, neared the 1970 level of 325,000. Yet total births rose from 360,000 to 600,000 in 1992. White non-Hispanic women bore nearly 70% of births in 1970 but 38% in 1992; Hispanic women, 20% in 1970 and 44% in 1992; others (primarily Asian ancestry), 3% and 10% respectively; and blacks, 9% and 7.5%. In the same period the proportion of births to U.S. natives fell from 89% to 56%; that to Mexican nationals rose from 7% to 27% (a six-fold increase absolutely); and that to women of all other birthplaces rose from 3% to 18%. Filipino women (the second largest category of foreign-born women) have borne 2% of all births since 1980. The increase in Mexican-born mothers was especially sharp after 1985, while the estimated Hispanic TFR rose 30% to 3.5 children per woman. In 1992 California's TFR was 2.42—18% above the U.S. average. In 1970 nearly 95% of teen mothers were U.S.-born, and 20% were Hispanic. In 1992, 61% of teen mothers were U.S. nationals; 60% were Hispanic, over half of them Mexican-born. The large increase in births in the 1980s, especially those to cultures supporting early childbearing, presages a sharp increase in births beginning in 2000. Meanwhile, the 5 years' median schooling of Mexican migrants has resulted in a parallel decline in parental education. Given the positive correlation of parental education and school achievement and attainment, California can expect a decline in the latter and hence lower labor productivity, incomes, and tax revenues by the young adults of the twenty-first century.     

Measuring Ethnicity with U.S. Census Data: Implications for Mexicans and Arabs

U.S. racial and ethnic populations can be defined by a number of census questions—race/ethnicity, ancestry, place of birth, and/or language—but little is known about how using alternative definitions of identity affect the size and characteristics of different groups. This article examines this question using combined data from the 1 % and 5 % Public Use Microdata Samples in census 2000, using Mexicans and Arabs as case studies. The analysis uses the standard method of classifying these groups (Hispanic origin and Arab ancestry) as a baseline to explore differences across the range of possible permutations of ethnic identity. In the Arab case, persons captured using alternative definitions of identity (Arabic language at home and/or born in an Arab country) are lesser educated, more likely to be in poverty, and more likely to identify as non-white or multi-racial than the Arab population as a whole. In contrast, persons in the Mexican alternative definition group (Mexican ancestry and/or born in Mexico) are more highly educated, less likely to be in poverty, and more likely to identify as white than the Mexican population as a whole. The article concludes with research and policy implications of these findings.     

Migrant Selection and the Health of U.S. Immigrants From the Former Soviet Union

Few prior studies have investigated the health of U.S. immigrants from the former Soviet Union (FSU). Utilizing data from the 2000 U.S. census and the 2000–2007 National Health Interview Survey (NIHS), we compare levels of disability of FSU immigrants with U.S.-born whites (ages 50–84). Our findings suggest an “epidemiologic paradox” in that FSU immigrants possess higher levels of education compared with U.S.-born whites, but report considerably higher disability with and without adjustment for education. Nonetheless, FSU immigrants report lower levels of smoking and heavy alcohol use compared with U.S.-born whites. We further investigate disability by period of arrival among FSU immigrants. Changes in Soviet emigration policies conceivably altered the level of health selectivity among émigrés. We find evidence that FSU immigrants who emigrated during a period when a permission to emigrate was hard to obtain (1970–1986) displayed less disability compared with those who emigrated when these restrictions were less stringent (1987–2000). Finally, we compare disability among Russian-born U.S. immigrants with that of those residing in Russia as a direct test of health selectivity. We find that Russian immigrants report lower levels of disability compared with Russians in Russia, suggesting that they are positively selected for health despite their poor health relative to U.S.-born whites.     

Explaining the Immigrant Health Advantage: Self-selection and Protection in Health-Related Factors Among Five Major National-Origin Immigrant Groups in the United States

Despite being newcomers, immigrants often exhibit better health relative to native-born populations in industrialized societies. We extend prior efforts to identify whether self-selection and/or protection explain this advantage. We examine migrant height and smoking levels just prior to immigration to test for self-selection; and we analyze smoking behavior since immigration, controlling for self-selection, to assess protection. We study individuals aged 20–49 from five major national origins: India, China, the Philippines, Mexico, and the Dominican Republic. To assess self-selection, we compare migrants, interviewed in the National Health and Interview Surveys (NHIS), with nonmigrant peers in sending nations, interviewed in the World Health Surveys. To test for protection, we contrast migrants’ changes in smoking since immigration with two counterfactuals: (1) rates that immigrants would have exhibited had they adopted the behavior of U.S.-born non-Hispanic whites in the NHIS (full “assimilation”); and (2) rates that migrants would have had if they had adopted the rates of nonmigrants in sending countries (no-migration scenario). We find statistically significant and substantial self-selection, particularly among men from both higher-skilled (Indians and Filipinos in height, Chinese in smoking) and lower-skilled (Mexican) undocumented pools. We also find significant and substantial protection in smoking among immigrant groups with stronger relative social capital (Mexicans and Dominicans).     

Crossing Boundaries: Nativity,Ethnicity, and Mate Selection

The influx of immigrants has increased diversity among ethnic minorities and indicates that they may take multiple integration paths in American society. Previous research on ethnic integration has often focused on panethnic differences, and few have explored ethnic diversity within a racial or panethnic context. Using 2000 U.S. census data for Puerto Rican–, Mexican-, Chinese-, and Filipino-origin individuals, we examine differences in marriage and cohabitation with whites, with other minorities, within a panethnic group, and within an ethnic group by nativity status. Ethnic endogamy is strong and, to a lesser extent, so is panethnic endogamy. Yet, marital or cohabiting unions with whites remain an important path of integration but differ significantly by ethnicity, nativity, age at arrival, and educational attainment. Meanwhile, ethnic differences in marriage and cohabitation with other racial or ethnic minorities are strong. Our analysis supports that unions with whites remain a major path of integration, but other paths of integration also become viable options for all ethnic groups.     

Racial and Ethnic Disparities in Health Insurance Coverage: Dynamics of Gaining and Losing Coverage Over the Life-Course

Health insurance coverage varies substantially between racial and ethnic groups in the United States. Compared to non-Hispanic whites, African Americans and people of Hispanic origin had persistently lower insurance coverage rates at all ages. This article describes age- and group-specific dynamics of insurance gain and loss that contribute to inequalities found in traditional cross-sectional studies. It uses the longitudinal 2008 Panel of the Survey of Income and Program Participation (N = 114,345) to describe age-specific patterns of disparity prior to the Affordable Care Act (ACA). A formal decomposition on increment–decrement life tables of insurance gain and loss shows that coverage disparities are predominately driven by minority groups’ greater propensity to lose the insurance that they already have. Uninsured African Americans were faster to gain insurance compared to non-Hispanic whites, but their high rates of insurance loss more than negated this advantage. Disparities from greater rates of loss among minority groups emerge rapidly at the end of childhood and persist throughout adulthood. This is especially true for African Americans and Hispanics, and their relative disadvantages again heighten in their 40s and 50s.     

Just Like in Their Home Country? A Multinational Perspective on Living Arrangements of Older Immigrants in the United States

Older immigrants are more likely to share residence with their adult children and other family members than are U.S.-born older adults. Because socioeconomic factors only partially explain these differences and direct measures of cultural preferences are seldom available, the persistently high rates of intergenerational coresidence among the older foreign-born are often interpreted as driven by cultural preferences and/or a lack of assimilation. To challenge this interpretation, this study investigates the extent to which older immigrants’ living arrangements deviate from those of older adults in their home countries. The analysis combines data on immigrants from the 2008–2012 American Community Survey (ACS) with census data from three major immigrant-sending countries: Mexico, the Dominican Republic, and Vietnam. Despite persistent differences from U.S.-born whites, coresidence in later life is significantly less common than in the sending countries among the older foreign-born who migrated as young adults, and especially among those who migrated as children. The older foreign-born who migrated after age 50, however, are more likely to coreside and less likely to live independently than the older adults in their home countries. The similarity of these patterns across the three immigrant subgroups suggests that the unusually high coresidence among late-life immigrants is driven by U.S. family reunification policy and not simply by cultural influences.