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.     

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.     

Selection,Language Heritage,and the Earnings Trajectories of Black Immigrants in the United States

Research suggests that immigrants from the English-speaking Caribbean surpass the earnings of U.S.-born blacks approximately one decade after arriving in the United States. Using data from the 1980–2000 U.S. censuses and the 2005–2007 American Community Surveys on U.S.-born black and non-Hispanic white men as well as black immigrant men from all the major sending regions of the world, I evaluate whether selective migration and language heritage of immigrants’ birth countries account for the documented earnings crossover. I validate the earnings pattern of black immigrants documented in previous studies, but I also find that the earnings of most arrival cohorts of immigrants from the English-speaking Caribbean, after residing in the United States for more than 20 years, are projected to converge with or slightly overtake those of U.S.-born black internal migrants. The findings also show three arrival cohorts of black immigrants from English-speaking African countries are projected to surpass the earnings of U.S.-born black internal migrants. No arrival cohort of black immigrants is projected to surpass the earnings of U.S.-born non-Hispanic whites. Birth-region analysis shows that black immigrants from English-speaking countries experience more rapid earnings growth than immigrants from non-English-speaking countries. The arrival-cohort and birth-region variation in earnings documented in this study suggest that selective migration and language heritage of black immigrants’ birth countries are important determinants of their initial earnings and earnings trajectories in the United States.     

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.     

Beliefs and expectations of family and nursing home care among Mexican-origin caregivers

This study examined perceptions of family care, nursing homes, and expectations of future care among 85 Mexican-origin women caregivers, some who lived in Mexico City and some who lived in East Los Angeles, California (East LA). Attitudes of Mexican-born women—living in Mexico City and in East LA—were more similar to each other than those of U.S.-born women. Most caregivers reported a preference for family care and had negative views of institutional care. In addition, despite the negative views about nursing homes, some caregivers expressed a willingness to seek nursing-home care for themselves so as to avoid burdening their children in the future. Findings lend support to the persistence of Mexican cultural values in this sample of Mexican-origin caregiving women, regardless of where they were born.     

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.     

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.     

Racial/Ethnic and Nativity Patterns of U.S. Adolescent and Young Adult Smoking

We document racial/ethnic and nativity differences in U.S. smoking patterns among adolescents and young adults using the 2006 Tobacco Use Supplement to the Current Population Survey (n = 44,202). Stratifying the sample by nativity status within five racial/ethnic groups (Asian American, Mexican–American, other Hispanic, non-Hispanic black, and non-Hispanic white), and further by sex and age, we compare self-reports of lifetime smoking across groups. U.S.-born non-Hispanic whites, particularly men, report smoking more than individuals in other racial/ethnic/nativity groups. Some groups of young women (e.g., foreign-born and U.S.-born Asian Americans, foreign-born and U.S.-born Mexican–Americans, and foreign-born blacks) report extremely low levels of smoking. Foreign-born females in all of the 25–34 year old racial/ethnic groups exhibit greater proportions of never smoking than their U.S.-born counterparts. Heavy/moderate and light/intermittent smoking is generally higher in the older age group among U.S.-born males and females, whereas smoking among the foreign-born of both sexes is low at younger ages and remains low at older ages. Taken together, these findings highlight the importance of considering both race/ethnicity and nativity in assessments of smoking patterns and in strategies to reduce overall U.S. smoking prevalence and smoking-attributable health disparities.     

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.     

Parental characteristics and the schooling progress of the children of immigrant and U.S.-born blacks

In this study, I examine disparities in schooling progress among children born to immigrant and U.S.-born blacks. I find that in one- and two-parent families, children born to black immigrants are less likely to fall behind in school than those born to U.S.-born blacks. In two-parent immigrant families, children born to two immigrant parents have a significant schooling advantage over children born to one immigrant parent. While children born to two immigrant parents in the wealthiest black immigrant families do better in the second generation than in the first, the reverse is observed among children in less wealthy families. These findings contribute in two ways to our understanding of the assimilation processes of children born to black immigrant parents. First, they show that there is a positive association between the number of immigrant parents in a family and children’s schooling performance. Second, they suggest that disparities in the assimilation patterns of the children of black immigrants are a likely product of the interaction between their parental characteristics and the socioeconomic circumstances of their families.     

Erosion of Advantage: Decomposing Differences in Infant Mortality Rates Among Older Non-Hispanic White and Mexican-Origin Mothers

We build on findings from recent research showing an erosion of infant survival advantage in the Mexican-origin population relative to non-Hispanic whites at older maternal ages, with patterns that differ by nativity. This runs counter to the well-documented Hispanic infant mortality paradox and suggests that weathering and/or other negative health selection mechanisms may contribute to increasing disadvantage at older maternal ages. Using the National Center for Health Statistics (NCHS) cohort-linked birth and infant death files, we decompose the difference in Mexican-origin non-Hispanic white infant mortality at older maternal ages to better understand the contribution of selected medical and social risk factors to components of the difference. We find differences in the distribution and effects of risk factors across the three populations of interest. The infant mortality rate (IMR) gap between Mexican-origin women and non-Hispanic whites can be attributed to numerous offsetting factors, with inadequate prenatal care standing out as a major contributor to the IMR difference. Equalizing access to and utilization of prenatal care may provide one possible route to closing the IMR gap at older maternal ages.     

Moving Beyond Salmon Bias: Mexican Return Migration and Health Selection

Despite having lower levels of education and limited access to health care services, Mexican immigrants report better health outcomes than U.S.-born individuals. Research suggests that the Mexican health advantage may be partially attributable to selective return migration among less healthy migrants—often referred to as “salmon bias.” Our study takes advantage of a rare opportunity to observe the health status of Mexican-origin males as they cross the Mexican border. To assess whether unhealthy migrants are disproportionately represented among those who return, we use data from two California-based studies: the California Health Interview Survey; and the Migrante Study, a survey that samples Mexican migrants entering and leaving the United States through Tijuana. We pool these data sources to look for evidence of health-related return migration. Results provide mixed support for salmon bias. Although migrants who report health limitations and frequent stress are more likely to return, we find little evidence that chronic conditions and self-reported health are associated with higher probabilities of return. Results also provide some indication that limited health care access increases the likelihood of return among the least healthy. This study provides new theoretical considerations of return migration and further elucidates the relationship between health and migration decisions.     

An investigation of racial and ethnic disparities in birth weight in Chicago neighborhoods

We examine differences in the mean birth weights of infants born to non-Hispanic black, non-Hispanic white, and Mexican-origin Hispanic mothers (of any race) in Chicago in 1990 using linear regression models with neighborhood fixed effects. Our pooled models accounted for 64% of the black-white difference and 57% of the black/Mexican-origin Hispanic difference. Differences in the relationship between measured characteristics and birth weight accounted for around half the birth-weight gap between non-Hispanic black and other infants. Efforts to close this gap must go beyond programs that aim to reduce the level of risk factors among black women to address the causes of differences in the effects of risk factors.     

Familial Influences on Poverty Among Young Children in Black Immigrant,U.S.-born Black,and Nonblack Immigrant Families

This study examines how familial contexts affect poverty disparities between the children of immigrant and U.S.-born blacks, and among black and nonblack children of immigrants. Despite lower gross child poverty rates in immigrant than in U.S.-born black families, accounting for differences in family structure reveals that child poverty risks among blacks are highest in single-parent black immigrant families. In addition, within two-parent immigrant families, child poverty declines associated with increasing assimilation are greater than the respective declines in single-parent families. The heads of black immigrant households have more schooling than those of native-black households. However, increased schooling has a weaker negative association with child poverty among the former than among the latter. In terms of racial disparities among the children of immigrants, poverty rates are higher among black than nonblack children. This black disadvantage is, however, driven by the outcomes of first-generation children of African and Hispanic-black immigrants. The results also show that although children in refugee families face elevated poverty risks, these risks are higher among black than among nonblack children of refugees. In addition, the poverty-reducing impact associated with having an English-proficient household head is about three times lower among black children of immigrants than among non-Hispanic white children of immigrants.     

Simulating the Effects of Acculturation and Return Migration on the Maternal and Infant Health of Mexican Immigrants in the United States: A Research Note

A significant body of research on minority health shows that although Latino immigrants experience unexpectedly favorable outcomes in maternal and infant health, this advantage deteriorates with increased time of residence in the United States. This study evaluates the underlying assumptions of two competing hypotheses that explain this paradox. The first hypothesis attributes this deterioration to possible negative effects of acculturation and behavioral adjustments made by immigrants while living in the United States, and the second hypothesis attributes this deterioration to the mechanism of selective return migration. Hypothetical probabilistic models are simulated for assessing the relationship between duration and birth outcomes based on the assumptions of these two hypotheses. The results are compared with the empirical research on the maternal and infant health of first-generation, Mexican-origin immigrant women in the United States. The analysis provides evidence that a curvilinear pattern of duration and birth outcomes can be explained by the joint effects of both acculturation and selective return migration in which the former affects health status over the longer durations, and the latter affects health status at shorter durations.     

Registration completeness and international comparisons of infant mortality

The physical development of the live born infant is the single most important variable governing its survival: infant mortality among those weighing 2,500 grams (5 1/2 pounds) or less at birth is 17 times the mortality among those weighing more than 2,500 grams at birth. The variation in mortality according to birth weight (or gestation) is greater than for subclasses of color, sex, maternal age, or birth order. Infant mortality in the United States is significantly higher than in a number of other countries e.g., Sweden, Netherlands, Norway. The difference is thought, by some, to be due to underregistration of low birth weight infants in other countries. In this paper, distributions of live births by birth weight for Denmark, England and Wales, New Zealand, and the United States, and infant mortality data for Denmark and the United States are examined. The data do not support a hypothesis of gross underregistration of live born infants in other countries. The results indicate that some index of physical development (birth weight, gestation, or a combination of both) should be included in any appraisal of infant mortality.     

Wealth Inequality Among Immigrants: Consistent Racial/Ethnic Inequality in the United States

Wealth is a strong indicator of immigrant integration in U.S. society. Drawing on new assimilation theory, we highlight the importance of racial/ethnic group boundaries and propose different paths of wealth integration among U.S. immigrants. Using data from the Survey of Income and Program Participation and quantile regression, we show that race/ethnicity shapes immigrant wealth inequality across the entire distribution of net worth, along with immigrants’ U.S. experience, such as immigrant status, U.S. education, English language proficiency, and time spent in the United States. Our results document consistent racial/ethnic inequality among immigrants, also evidenced among the U.S. born, revealing that even when accounting for key aspects of U.S. experience, wealth inequality with whites for Latino and black immigrants is strong.     

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.     

One Size May Not Fit All: How Obesity Among Mexican-Origin Youth Varies by Generation,Gender, and Age

Immigrants’ health (dis)advantages are increasingly recognized as not being uniform, leading to calls for studies investigating whether immigrant health outcomes are dependent on factors that exacerbate health risks. We answer this call, considering an outcome with competing evidence about immigrants’ vulnerability versus risk: childhood obesity. More specifically, we investigate obesity among three generations of Mexican-origin youth relative to one another and to U.S.-born whites. We posit that risk is dependent on the intersection of generational status, gender, and age, which all influence exposure to U.S. society and weight concerns. Analyses of National Health and Nutrition Examination Studies (NHANES) data suggest that accounting for ethnicity and generation alone misses considerable gender and age heterogeneity in childhood obesity among Mexican-origin and white youth. For example, second-generation boys are vulnerable to obesity, but the odds of obesity for first-generation girls are low and on par with those of white girls. Findings also indicate that age moderates ethnic/generational differences in obesity among boys but not among girls. Overall, ethnic/generational patterns of childhood obesity do not conform to a “one size fits all” theory of immigrant health (dis)advantage, leading us to join calls for more research considering how immigrants’ characteristics and contexts differentially shape vulnerability to disease and death.     

Immigration and living arrangements: Moving beyond economic need versus acculturation

Prior research seeking to explain variation in extended family coresidence focused heavily on the potentially competing roles of cultural preferences and socioeconomic and demographic structural constraints. We focus on challenges associated with international immigration as an additional factor driving variation across groups. Using 2000 census data from Mexico and the United States, we compare the prevalence and age patterns of various types of extended family and non-kin living arrangements among Mexican-origin immigrants and nonimmigrants on both sides of the U.S.-Mexico border. Additionally, we use the Survey of Income and Program Participation to examine the stability of extended family living arrangements among Mexican-origin immigrants and natives in the United States. We find that newly arrived immigrants to the United States display unique patterns in the composition and stability of their households relative to nonimmigrants in both Mexico and the United States. Recent immigrants are more likely to reside in an extended family or non-kin household, and among those living with relatives, recent immigrants are more likely to live with extended family from a similar generation (such as siblings and cousins). Further, these households experience high levels of turnover. The results suggest that the high levels of coresidence observed among recently arrived Mexican immigrants represent a departure from “traditional” household/family structures in Mexico and are related to the challenges associated with international migration.