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{{Short description|Epidemiological finding}}
[[File:Hispanic America (orthographic projection).svg|alt=Hispanic America (orthographic projection)|266x266px|thumb]]
[[File:Death rates for cancer and heart disease in Men.png|thumb|Death rates for cancer and heart disease among men aged 45–64, by race and ethnicity: United States, 1999–2017<ref name=
[[File:Death rates for cancer and heart disease in women.png|thumb|Death rates for cancer and heart disease among women aged 45–64, by race and ethnicity: United States, 1999–2017<ref name=
[[File:Life expectancy in USA by race -only overall.png|266x266px|thumb|Life expectancy in the USA by race<ref name="CDC_2020">{{cite journal|last1=Arias|first1=Elizabeth|last2=Xu|first2=Jiaquan|last3=M.D| first3=M.|title=United States Life Tables, 2020|url=https://www.cdc.gov/nchs/data/nvsr/nvsr71/nvsr71-01.pdf |date=8 August 2022 |journal=National Vital Statistics Reports|publisher=[[Centers for Disease Control and Prevention]] |volume=71|issue=1 |pages=51}} — Table 19</ref>]]
The '''Hispanic paradox''' is an [[Epidemiology|epidemiological]] finding that [[Hispanic Americans]] tend to have health outcomes that "[[paradox]]ically" are comparable to, or in some cases better than, those of their U.S. [[Non-Hispanic whites|non-Hispanic White]] counterparts, even though Hispanics have lower average income and education. Low [[Socioeconomic status|socioeconomic]] status is almost universally associated with worse population health and higher death rates everywhere in the world.<ref name=":0">{{cite journal |vauthors=Franzini L, Ribble JC, Keddie AM |title=Understanding the Hispanic paradox |journal=Ethn Dis |volume=11 |issue=3 |pages=496–518 |year=2001 |pmid=11572416}}</ref> The paradox usually refers in particular to low mortality among Hispanics in the [[United States]] relative to non-Hispanic Whites.<ref name="Abraido-Lanza, A. 1999">{{cite journal |doi=10.2105/AJPH.89.10.1543 |title=The Latino mortality paradox: A test of the "salmon bias" and healthy migrant hypotheses |year=1999 |last1=Abraído-Lanza |first1=Ana F |last2=Dohrenwend |first2=Bruce P |last3=Ng-Mak |first3=Daisy S |last4=Turner |first4=J Blake |journal=American Journal of Public Health |volume=89 |issue=10 |pages=1543–8 |pmid=10511837 |pmc=1508801}}</ref><ref name=":1">{{Cite journal|last1=Gallo|first1=Linda C.|last2=Penedo|first2=Frank J.|last3=Espinosa de los Monteros|first3=Karla|last4=Arguelles|first4=William|date=December 2009|title=Resiliency in the Face of Disadvantage: Do Hispanic Cultural Characteristics Protect Health Outcomes?|journal=Journal of Personality|volume=77|issue=6|pages=1707–1746|doi=10.1111/j.1467-6494.2009.00598.x|pmid=19796063|s2cid=21729536 |issn=0022-3506}}</ref><ref name=":7">{{Cite journal|last1=Abraído-Lanza|first1=Ana F.|last2=Chao|first2=Maria T.|last3=Flórez|first3=Karen R.|date=September 2005|title=Do healthy behaviors decline with greater acculturation?: Implications for the Latino mortality paradox|journal=Social Science & Medicine|volume=61|issue=6|pages=1243–1255|doi=10.1016/j.socscimed.2005.01.016|pmid=15970234|pmc=3587355|issn=0277-9536}}</ref><ref name=":2">{{Cite journal|last1=Abraído-Lanza|first1=A F|last2=Dohrenwend|first2=B P|last3=Ng-Mak|first3=D S|last4=Turner|first4=J B|date=October 1999|title=The Latino mortality paradox: a test of the "salmon bias" and healthy migrant hypotheses.|journal=American Journal of Public Health|volume=89|issue=10|pages=1543–1548|doi=10.2105/ajph.89.10.1543|pmid=10511837|pmc=1508801|issn=0090-0036}}</ref><ref name=":5">{{Cite journal|last1=Cagney|first1=Kathleen A.|last2=Browning|first2=Christopher R.|last3=Wallace|first3=Danielle M.|date=May 2007|title=The Latino Paradox in Neighborhood Context: The Case of Asthma and Other Respiratory Conditions|journal=American Journal of Public Health|volume=97|issue=5|pages=919–925|doi=10.2105/ajph.2005.071472|pmid=17395846|pmc=1854858|issn=0090-0036}}</ref><ref name=":3">{{Cite journal|last1=Ruiz|first1=John M.|last2=Campos|first2=Belinda|last3=Garcia|first3=James J.|date=May 2016|title=Special issue on Latino physical health: Disparities, paradoxes, and future directions.|journal=Journal of Latina/o Psychology|volume=4|issue=2|pages=61–66|doi=10.1037/lat0000065|issn=2163-0070}}</ref> According to the Center for Disease Control's 2015 ''Vital Signs'' report, Hispanics in the United States had a 24% lower risk of mortality, as well as lower risk for nine of the fifteen leading causes of death as compared to Whites.<ref>{{Cite journal|last=The Lancet|date=May 2015|title=The Hispanic paradox|journal=The Lancet|volume=385|issue=9981|pages=1918|doi=10.1016/s0140-6736(15)60945-x|pmid=26090624|issn=0140-6736|doi-access=free}}</ref>▼
The '''Hispanic paradox''' is an [[Epidemiology|epidemiological]] finding that [[Hispanic Americans]] tend to have health outcomes that "[[paradox]]ically" are comparable to, or in some cases better than, those of their U.S. [[Non-Hispanic whites|non-Hispanic White]] counterparts, even though Hispanics have lower average income and education, higher rates of disability, as well as a higher incidence of various cardiovascular risk factors and metabolic diseases.
▲
Other hypotheses around the Hispanic paradox maintain that the phenomenon is real, and is caused by sociocultural factors which characterize the Hispanic population. Many of these factors can be described under the more broad categories of cultural values, interpersonal context, and community context.<ref name=":6">{{Cite journal|last1=Abraído-Lanza|first1=Ana F.|last2=Echeverría|first2=Sandra E.|last3=Flórez|first3=Karen R.|date=2016-03-18|title=Latino Immigrants, Acculturation, and Health: Promising New Directions in Research|journal=Annual Review of Public Health|volume=37|issue=1|pages=219–236|doi=10.1146/annurev-publhealth-032315-021545|pmid=26735431|pmc=5337110|issn=0163-7525}}</ref> Some health researchers attribute the Hispanic paradox to different eating habits, especially the relatively high intake of [[legumes]] such as beans and lentils.<ref>{{Cite journal|pmid = 25445942|year = 2014|last1 = Young|first1 = R. P.|last2 = Hopkins|first2 = R. J.|title = A review of the Hispanic paradox: Time to spill the beans?|journal = European Respiratory Review |volume = 23|issue = 134|pages = 439–449|doi = 10.1183/09059180.00000814| pmc=9487402 |s2cid = 6843365|doi-access = free}}</ref>▼
▲
Statistical biases such as the "salmon bias", which suggests that Hispanics tend to return to their country of origin towards the end of their lives, or the "healthy migrant bias", which assumes that the healthiest and strongest members of a population are most likely to migrate, have been largely refuted by researchers.<ref name=Understanding/><ref name=salmon/><ref>{{Cite journal |last1=Ruiz |first1=John M. |last2=Steffen |first2=Patrick |last3=Smith |first3=Timothy B. |date=March 2013 |title=Hispanic Mortality Paradox: A Systematic Review and Meta-Analysis of the Longitudinal Literature |journal=American Journal of Public Health | volume=103 |issue=3 |pages=e52-60 |doi=10.2105/AJPH.2012.301103 |pmid=23327278|pmc=3673509 }}</ref>
Since the [[2010s]], research has indicated that the Hispanic paradox is disappearing, as Latino mortality increases relative to white Americans, and cardiovascular risk factors are increasing in the Hispanic population.<ref name=holdup/><ref name=Lost/> In 2023, a study found that the mortality advantage of Hispanics was largely erased during the [[COVID-19 pandemic]], during which Hispanic death rates disproportionately increased.<ref name="Nexus2023" />
==History==
First coined as the ''Hispanic Epidemiological Paradox'' in 1986 by Kyriakos Markides,<!-- Incorrect or invalid reference. He used the term "epistemologic paradox" and referred to mental health. --> the phenomenon is also known as the ''Latino Epidemiological Paradox''.<ref name="Chung, Juliet 2006">{{cite news |last=Chung |first=Juliet |title=Hispanic Paradox: Income may be lower but health better than most |work=The Seattle Times |date=29 Aug 2006 |url=http://seattletimes.com/html/nationworld/2003233307_hispanichealth29.html |url-status=dead |archive-url=https://web.archive.org/web/20131105041813/http://seattletimes.com/html/nationworld/2003233307_hispanichealth29.html |archive-date=2013-11-05 }}</ref> According to Markides, a professor of sociomedical sciences at the [[University of Texas Medical Branch]] in Galveston, this paradox was ignored by past generations, but is now "the leading theme in the health of the Hispanic population in the United States."<ref name="Chung, Juliet 2006"/>
The specific cause of the phenomenon is poorly understood, although the decisive factor appears to be place of birth
Others have proposed that the lower mortality of Hispanics could reflect a slower biological aging rate of Hispanics.<ref name="Horvath2016Race"/> However, some believe that there is no Hispanic paradox, and that inaccurate counting of Hispanic deaths in the United States leads to an underestimate of Hispanic mortality.<ref name=pmid16380579>{{cite journal |vauthors=Smith DP, Bradshaw BS |title=Rethinking the Hispanic paradox: death rates and life expectancy for US non-Hispanic White and Hispanic populations |journal=Am J Public Health |volume=96 |issue=9 |pages=1686–92 |date=September 2006 |pmid=16380579 |pmc=1551967 |doi=10.2105/AJPH.2003.035378}}</ref>
==
===Mortality===
Despite having lower socioeconomic status, higher rates of [[disability]],<ref name="Hayward eg al 2013 pp. 81–96">{{cite journal | last=Hayward | first=Mark D. |author1-link=Mark D. Hayward | title=Does the Hispanic Paradox in U.S. Adult Mortality Extend to Disability? | journal=Population Research and Policy Review | publisher=[[Springer Science
Hispanics do not have a mortality advantage over non-Hispanic Whites in all mortality rates; they have higher rates for mortality from [[liver disease]], [[cervical cancer]], [[AIDS]], [[homicide]] (males), and [[diabetes]].<ref name="Abraido-Lanza, A. 1999"/>
===Infant mortality===
Another important indicator of health is the [[infant mortality rate]], which is also either equal to or
The children of Mexican immigrant women also have a lower infant mortality rate than that of U.S.-born Mexican-American women, even though the latter population usually has a higher income and education, and are much more likely to have health insurance.<ref name="DeCamp Choi Fuentes-Afflick Sastry 2014 pp. 1354–1363">{{cite journal | last1=DeCamp | first1=Lisa Ross | last2=Choi | first2=Hwajung | last3=Fuentes-Afflick | first3=Elena | last4=Sastry | first4=Narayan | title=Immigrant Latino Neighborhoods and Mortality Among Infants Born to Mexican-Origin Latina Women | journal=Maternal and Child Health Journal | publisher=[[Springer Science+Business Media]] | volume=19 | issue=6 | date=28 November 2014 | issn=1092-7875 | doi=10.1007/s10995-014-1640-7 | pages=1354–1363| pmid=25430802 | pmc=4447583 }}</ref>
== Reasons for the paradox ==▼
=== Socio-economic factors ===▼
According to Alder and Estrove (2006), the more socioeconomically advantaged individuals are, the better their health.<ref>{{cite journal |doi=10.1111/j.1749-6632.1999.tb08101.x |title=Socioeconomic Status and Health: What We Know and What We Don't |year=1999 |last1=Adler |first1=Nancy E. |last2=Ostrove |first2=Joan M. |journal=Annals of the New York Academy of Sciences |volume=896 |issue=1 |pages=3–15 |pmid=10681884|bibcode=1999NYASA.896....3A |s2cid=41676972 }}</ref> Access to health insurance and preventative medical services are one of the main reasons for socioeconomic health disparities. Economic hardship within the household can cause distress and affect parenting, causing health problems among children leading to depression, substance abuse, and behavior problems. Low socioeconomic status is correlated with increased rates of morbidity and mortality. Mental health disorders are an important health problem for those of low socioeconomic status; they are two to five times more likely to develop a diagnosable disorder than those of high socioeconomic status, and are more likely to face barriers to getting treatment. Furthermore, this lack of treatment for mental disorders can affect educational and employment opportunities and achievement.<ref>{{cite web |url=http://www.apa.org/about/gr/issues/socioeconomic/ses-health.pdf |archive-url=https://web.archive.org/web/20121021040636/http://www.apa.org/about/gr/issues/socioeconomic/ses-health.pdf |archive-date=October 21, 2012 |title=Socioeconomic Status and Health |publisher=APA Public Interest Government Relations Office}}</ref>▼
▲According to Alder and Estrove (2006), the more socioeconomically advantaged individuals are, the better their health.<ref>{{cite journal |doi=10.1111/j.1749-6632.1999.tb08101.x |title=Socioeconomic Status and Health: What We Know and What We Don't |year=1999 |last1=Adler |first1=Nancy E. |last2=Ostrove |first2=Joan M. |journal=Annals of the New York Academy of Sciences |volume=896 |issue=1 |pages=3–15 |pmid=10681884|bibcode=1999NYASA.896....3A |s2cid=41676972 }}</ref>
Important to the understanding of migrant community health is the increasingly stratified American society, manifested in [[residential segregation]]. Beginning in the 1970s, the low to moderate levels of income segregation in the United States began to degrade.<ref name="Massey, Douglas S 2004">{{cite book |last1=Massey |first1=Douglas S. |chapter=The New Geography of Inequality in Urban America |chapter-url=https://books.google.com/books?id=_DmN-Zq-WPIC&pg=PA173 |pages=173–87 |year=2004 |editor1-first=C. Michael |editor1-last=Henry |title=Race, Poverty, and Domestic Policy |location=New Haven |publisher=Yale University Press |isbn=978-0-300-12984-7}}</ref> As the rich became richer, so did their neighborhoods. This trend was inversely reflected in the poor, as their neighborhoods became poorer. As sociologist Douglas Massey explains, "As a result, poverty and affluence both became more concentrated geographically."<ref name="Massey, Douglas S 2004"/> Professor of public administration and economics John Yinger writes that "one way for poor people to win the spatial competition for housing is to rent small or low-quality housing." However, he continues, low-quality housing often features serious health risks such as lead paint and animal pests. Though lead-based paint was deemed illegal in 1978, it remains on the walls of older apartments and houses, posing a serious neurological risk to children. [[Asthma]], a possible serious health risk, also has a clear link to poverty. Moreover, asthma attacks have been associated with certain aspects of poor housing quality such as the presence of cockroaches, mice, dust, dust mites, mold, and mildew. The 1997 [[American Housing Survey]] found that signs of rats or mice are almost twice as likely to be detected in poor households as in non-poor households.<ref name=Yinger2009>{{cite book |last1=Yinger |first1=John |chapter=Housing Discrimination and Residential Segregation as Causes of Poverty |chapter-url=https://books.google.com/books?id=vuy6JGuLdi0C&pg=PA359 |pages=[https://archive.org/details/understandingpov0000unse/page/359 359–91] |editor1-first=Sheldon H. |editor1-last=Danziger |editor2-first=Robert H. |editor2-last=Haveman |year=2009 |title=Understanding Poverty |publisher=Harvard University Press |isbn=978-0-674-03017-6 |url=https://archive.org/details/understandingpov0000unse/page/359 }}</ref>▼
===Residential
▲Important to the understanding of migrant community health is the increasingly stratified American society, manifested in [[residential segregation]].
Speculation of a sociocultural advantage stems from the idea that many traditional Hispanic cultural values are protective in health.<ref name=":3" /> One such value is that of ''simpatia'', a drive toward social harmony, which may serve to ameliorate social conflict and the negative stress-related health implications that come with it.<ref name=":1" /> ''Familismo'' (family-centeredness) and ''allocentrismo'' (valuing the group) are both values which emphasize the needs of the group in accordance to those of the individual.<ref name=":1" /> ''Respeto'' is another familial value in which family members are largely invested in care of their elders.<ref name=":3" /> Emphasis on family attachment in the [[Latino culture]] is believed to foster social cohesion and a sturdy social support network, which is protective of health during adverse circumstances.<ref name=":1" /><ref name=":3" /> Furthermore, familial support has been associated with higher likelihood of taking preventative health measures and of seeking medical attention when ill.<ref name=":1" /> Overall psychological and physical well-being has been found to be better in individuals who come from a supportive family than those who experience family conflict, which is why the family-centered culture of Hispanics may be advantageous in health.<ref name=":1" />▼
===Cultural values===
=== Interpersonal context ===▼
▲Speculation of a sociocultural advantage stems from the idea that many traditional Hispanic cultural values are protective in health.<ref name=
==== Social comparison theory ====▼
[[Social comparison theory]] proposes that individuals make comparisons with others, most often those of a similar group, in order to evaluate their own well-being and worth.<ref name=":4">{{Cite journal|last1=Campbell|first1=Kelly|last2=Garcia|first2=Donna M.|last3=Granillo|first3=Christina V.|last4=Chavez|first4=David V.|s2cid=56298042|date=2012-04-30|title=Exploring the Latino Paradox|journal=Hispanic Journal of Behavioral Sciences|volume=34|issue=2|pages=187–207|doi=10.1177/0739986312437552|issn=0739-9863}}</ref> The psychological implications that these comparisons present depend on the nature of the comparisons. Upward comparisons often result in negative psychological effects due to feelings of disadvantage when being compared to those higher in the hierarchy. Conversely, lateral and downward comparisons often result in satisfaction when one sees himself as better off than those lower in the hierarchy.<ref name=":4" /> Latino Americans and noncitizen Latinos are expected to make lateral or downward comparisons, either to other low-economic status Latinos and/or to relatives and friends in their home country. Such downward comparisons would result in boosted self-esteem and less psychological stress, resulting in better health.<ref name=":4" />▼
==== Social networks and support ====▼
Social capital is thought to be a significant moderator in the advantageous health outcomes of Latinos.<ref name=":1" /><ref name=":3" /> It has been found that the magnitude of the effect of social integration on mortality is greater than smoking fifteen cigarettes a day.<ref name=":3" /> Characteristic values of Latino culture such as ''familismo'' and ''allocentrismo'' contribute to greater social cohesion and social support networks.<ref name=":1" /> This tight social fabric is a mechanism which fosters resilience through social support.<ref name=":3" /> Resilience is the ability to adapt to a disadvantageous experience and high resilience is protective in health.<ref>{{Citation|last1=Smith|first1=Matthew Lee|title=Successful Aging and Resilience: Applications for Public Health, Health Care, and Policy|date=2018|work=Resilience in Aging|pages=17–33|publisher=Springer International Publishing|isbn=9783030045548|last2=Bergeron|first2=Caroline D.|last3=McCord|first3=Carly E.|last4=Hochhalter|first4=Angela K.|last5=Ory|first5=Marcia G.|doi=10.1007/978-3-030-04555-5_2}}</ref>▼
▲[[Social comparison theory]] proposes that individuals make comparisons with others, most often those of a similar group, in order to evaluate their own well-being and worth.<ref name=
== Hypotheses ==▼
▲Social capital is thought to be a significant moderator in the advantageous health outcomes of Latinos.<ref name=
===Barrio advantage===
One hypothesis for the Hispanic paradox proposes that living in the same neighborhood as people with similar ethnic backgrounds confers significant advantages to one's health. In a study of elderly [[Mexican-Americans]], those living in areas with a higher percentage of Mexican-Americans had lower seven-year mortality as well as a decreased prevalence of medical conditions, including [[stroke]], [[cancer]], and [[hip fracture]].<ref name=Barrio>{{cite journal |doi=10.2105/AJPH.94.10.1807 |title=Neighborhood Context and Mortality Among Older Mexican Americans: Is There a Barrio Advantage? |year=2004 |last1=Eschbach |first1=Karl |last2=Ostir |first2=Glenn V. |last3=Patel |first3=Kushang V. |last4=Markides |first4=Kyriakos S. |last5=Goodwin |first5=James S. |journal=American Journal of Public Health |volume=94 |issue=10 |pages=1807–12 |pmid=15451754 |pmc=1448538}}</ref> Despite these neighborhoods' relatively high rates of poverty due to lack of formal education and a preponderance of low paying service sector jobs, residents do not have the same mortality and morbidity levels seen in similarly disadvantaged socioeconomic neighborhoods. These neighborhoods do have intact family structures, community institutions, and [[kinship]] structures that span households, all of which are thought to provide significant benefits to an individual's health.<ref name=Barrio /> These social network support structures are especially important to the health of the elderly population as they deal with declining physical function. Another reason for this phenomenon could be that those Hispanic-Americans that live among those of similar cultural and social backgrounds are shielded from some of the negative effects of assimilation to American culture.<ref name=Barrio />
Characteristics of the community in which one lives can also affect health.<ref name=
===Acculturation===
{{further|Americanization (immigration)|Minority stress#Health outcomes}}
[[Acculturation]], a phenomenon whereby individuals internalize habits and beliefs of a new culture upon being immersed in its social institutions, is also believed to influence the health of Latinos in the United States.<ref name=
The extent of a Hispanic American's [[acculturation]] in the United States, or their [[Cultural assimilation|assimilation]] to mainstream American culture, is relative to his or her health.<ref name="Abraido-Lanza, A. 1999"/> One of the main negative effects of acculturation on health has been on substance abuse. More assimilated Latinos have higher rates of [[illicit drug]] use, alcohol consumption, and smoking, especially among women.<ref name="acculturation and health">{{cite journal |doi=10.1146/annurev.publhealth.26.021304.144615 |title=Acculturation and Latino Health in the United States : A Review of the Literature and its Sociopolitical Context |year=2005 |last1=Lara |first1=Marielena |last2=Gamboa |first2=Cristina |last3=Kahramanian |first3=M. Iya |last4=Morales |first4=Leo S. |last5=Hayes Bautista |first5=David E. |journal=Annual Review of Public Health |volume=26 |pages=367–97 |pmid=15760294|pmc=5920562 }}</ref> Another negative effect of acculturation is changes in diet and [[nutrition]]. More acculturated Latinos eat fewer/less fruits, vegetables, vitamins, fiber and protein and consume more fat than their less acculturated counterparts.<ref name="acculturation and health" /> One of the most significant impacts of acculturation on Latino health is birth outcomes. Studies have found that more acculturated Latinas have higher rates of low [[birthweight]], [[premature births]], [[teenage pregnancy]] and undesirable [[prenatal]] and [[postnatal]] behaviors such as smoking or drinking during pregnancy, and lower rates of breastfeeding.<ref name="acculturation and health" /> Acculturation and greater time in the United States has also been associated with negative [[mental health]] impacts. US-born Latinos or long-term residents of the United States had higher rates of mental illness than recent Latino immigrants.<ref name="Mental health facts">{{cite web|title=Latino Community Mental Health Fact Sheet|url=http://www.nami.org/Content/NavigationMenu/Find_Support/Multicultural_Support/Annual_Minority_Mental_Healthcare_Symposia/Latino_MH06.pdf|publisher=Nami Multicultural Action Center|url-status=dead|archive-url=https://web.archive.org/web/20120324011410/http://www.nami.org/Content/NavigationMenu/Find_Support/Multicultural_Support/Annual_Minority_Mental_Healthcare_Symposia/Latino_MH06.pdf|archive-date=2012-03-24}}</ref> In addition, foreign-born Mexican Americans are at significantly lower risk of [[suicide]] and [[Depression (mood)|depression]] than those born in the United States.<ref name="Mental health facts" /> The increased rates of mental illness is thought to be due to increased distress associated with alienation, discrimination and Mexican Americans attempting to advance themselves economically and socially stripping themselves of traditional resources and ethnically based social support.<ref>{{cite journal |doi=10.1016/0277-9536(90)90070-9 |title=Adverse effects of acculturation: Psychological distress among Mexican American young adults |year=1990 |last1=Kaplan |first1=Mark S. |last2=Marks |first2=Gary |journal=Social Science & Medicine |volume=31 |issue=12 |pages=1313–19 |pmid=2287960}}</ref>
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===Salmon Bias===
A second popular hypothesis, called the "Salmon Bias", attempts to factor in the occurrence of returning home.<ref name="Abraido-Lanza, A. 1999"/> This hypothesis purports that many Hispanic people return home after temporary employment, retirement, or severe illness, meaning that their deaths occur in their native land and are not taken into account by mortality reports in the United States. This hypothesis considers those people as "statistically immortal" because they artificially lower the Hispanic mortality rate.<ref name="Abraido-Lanza, A. 1999" /> Certain studies hint that it could be reasonable. These studies report that though return migration, both temporary and permanent, depend upon specific economic and social situations in communities, up to 75 percent of households in immigrant neighborhoods do some kind of return migration from the U.S. However, [[Ana Abraido-Lanza|Abraido-Lanza]], ''et al.'' found in 1999 that the "Salmon Hypothesis" cannot account for the
===Slow biological aging===
Horvath et al. (2013) have proposed that the lower mortality of Hispanics could reflect a slower biological aging rate of Hispanics.<ref name="Horvath2016Race">{{Cite journal| title
==Comparison with other ethnicities==
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===Comparison to non-Hispanic white Americans===
Although Hispanic Americans are twice more likely to be living under the poverty line and three times more likely to not have health insurance than non-Hispanic white Americans, they have a longer life span than them by 3 years. More Hispanics, than any other racial group, are uninsured and are in general less likely to use medical care. The median life span of Hispanic Americans is an average of 81.8 years and non-Hispanic white Americans have an average of 78.8 years.<ref name=
It is also found that Hispanics, when first migrating to the US, have lower smoking rates, better diet and general health. Hispanic infant mortality is also less than NHWs with an average of 5.8 per 1000 births and 9.1 per 1000 births for non-Hispanic whites.
In 2012, new cancer cases of all sites among Hispanic men and Non-Hispanic men had a ratio of 0.7, Hispanic men having 362.2 and Non-Hispanic men having 489.9.<ref>{{Cite web| url=https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=61|title=Cancer – The Office of Minority Health| website=minorityhealth.hhs.gov}}</ref> In comparison to non-Hispanic Whites, Hispanic men are 10 percent less likely to be diagnosed with [[prostate cancer]]. Hispanic women, compared to NHW, were found to be 30 percent less likely to be diagnosed with [[breast cancer]].▼
==21st century waning of the paradox==
▲Although Hispanic Americans are twice more likely to be living under the poverty line and three times more likely to not have health insurance than non-Hispanic white Americans, they have a longer life span than them by 3 years. More Hispanics, than any other racial group, are uninsured and are in general less likely to use medical care. The median life span of Hispanic Americans is an average of 81.8 years and non-Hispanic white Americans have an average of 78.8 years.<ref name="auto">{{Cite web|url=https://www.weforum.org/agenda/2016/11/the-hispanic-paradox-scientists-finally-find-out-why-latinos-age-more-slowly/|title=The Hispanic paradox: scientists finally find out why Latinos age more slowly|website=World Economic Forum}}</ref> This could be explained from scientist taking DNA samples from multiple ethnic groups, the blood from Latino aged more slowly than any other group.<ref name="auto"/>
Since the 21st century, a number of studies have published results which contradict the Hispanic paradox, suggesting that the health status of Hispanic Americans is declining. These findings include a higher incidence of [[cardiovascular disease]] risk factors among Hispanics,<ref name=holdup/> higher rates or obesity,<ref name=holdup/> increasing deaths from stroke even as white deaths remain stable,<ref name=holdup/> and a larger increase in deaths from heart failure.<ref name=holdup>{{cite web | title=The 'Hispanic paradox': Does a decades-old finding still hold up? | website=www.heart.org | date=2023-05-10 | url=https://www.heart.org/en/news/2023/05/10/the-hispanic-paradox-does-a-decades-old-finding-still-hold-up | access-date=2023-08-31}}</ref> Other researchers have predicted that the paradox will disappear as obesity rates rise rapidly among Hispanic males, in particular.<ref name=Lost>{{cite journal | last=Nicole | first=Wendee | title=Paradox Lost? The Waning Health Advantage among the U.S. Hispanic Population | journal=Environmental Health Perspectives | volume=131 | issue=1 | year=2023 | issn=0091-6765 | doi=10.1289/ehp11618 | page=12001| pmid=36607287 | doi-access=free | pmc=9819285 }}</ref> A 2023 study published found that the Hispanic mortality advantage had been erased by the [[COVID-19 pandemic]]. Hispanic death rates increased at a much higher rate than [[White Americans]] death rates, during this period.<ref name="Nexus2023">{{cite web | title=Missing Americans: Early death in the United States—1933–2021 | url=https://academic.oup.com/pnasnexus/article/2/6/pgad173/7185600 | first1=Jacob | last1=Bor| first2=Andrew C | last2=Stokes | first3=Julia | last3=Raifman | first4=Atheendar | last4=Venkataramani | first5=Mary T | last5=Bassett | first6=David | last6=Himmelstein | first7=Steffie | last7=Woolhandler | publisher=[[Oxford University Press]] | work=[[Proceedings of the National Academy of Sciences of the United States of America]] | date=29 May 2023}}</ref>
▲It is also found that Hispanics, when first migrating to the US, have lower smoking rates, better diet and general health. Hispanic infant mortality is also less than NHWs with an average of 5.8 per 1000 births and 9.1 per 1000 births for non-Hispanic whites.
▲In 2012, new cancer cases of all sites among Hispanic men and Non-Hispanic men had a ratio of 0.7, Hispanic men having 362.2 and Non-Hispanic men having 489.9.<ref>{{Cite web|url=https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=61|title=Cancer – The Office of Minority Health|website=minorityhealth.hhs.gov}}</ref> In comparison to non-Hispanic Whites, Hispanic men are 10 percent less likely to be diagnosed with [[prostate cancer]]. Hispanic women, compared to NHW, were found to be 30 percent less likely to be diagnosed with [[breast cancer]].
==Criticism==
Some public health researchers have argued that the Hispanic paradox is not actually a national phenomenon in the United States. In 2006, Smith and Bradshaw argued that no Hispanic paradox exists. They maintain that [[life expectancy
Although it may not mean progress for all Hispanics,
==See also==
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* [[Ancestry and health]]
* [[Immigrant paradox]]
* [[List of paradoxes]]
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[[Category:Health paradoxes]]
[[Category:Race and health in the United States]]
[[Category:Hispanic and Latino American society]]
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