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SES Gradients Among Mexicans in the United States and in Mexico: A New Twist to the Hispanic Paradox?

ABSTRACT: Recent empirical findings have suggested the existence of a twist in the Hispanic paradox, in which Mexican and other Hispanic foreign-born migrants living in the United States experience shallower socioeconomic status (SES) health disparities than those in the U.S. POPULATION:In this article, we seek to replicate this finding and test conjectures that could explain this new observed phenomenon using objective indicators of adult health by educational attainment in several groups: (1) Mexican-born individuals living in Mexico and in the United States, (2) U.S.-born Mexican Americans, and (3) non-Hispanic American whites. Our analytical strategy improves upon previous research on three fronts. First, we derive four hypotheses from a general framework that has also been used to explain the standard Hispanic paradox. Second, we study biomarkers rather than self-reported health and related conditions. Third, we use a binational data platform that includes both Mexicans living in Mexico (Mexican National Health and Nutrition Survey 2006) and Mexican migrants to the United States (NHANES 1999-2010). We find steep education gradients among Mexicans living in Mexico's urban areas in five of six biomarkers of metabolic syndrome (MetS) and in the overall MetS score. Mexican migrants living in the United States experience similar patterns to Mexicans living in Mexico in glucose and obesity biomarkers. These results are inconsistent with previous findings, suggesting that Mexican migrants in the United States experience significantly attenuated health gradients relative to the non-Hispanic white U.S. POPULATION:Our empirical evidence also contradicts the idea that SES-health gradients in Mexico are shallower than those in the United States and could be invoked to explain shallower gradients among Mexicans living in the United States.

SUBMITTER: Beltran-Sanchez H

PROVIDER: S-EPMC5161411 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

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SES Gradients Among Mexicans in the United States and in Mexico: A New Twist to the Hispanic Paradox?

Beltrán-Sánchez Hiram H Palloni Alberto A Riosmena Fernando F Wong Rebeca R

Demography 20161001 5

Recent empirical findings have suggested the existence of a twist in the Hispanic paradox, in which Mexican and other Hispanic foreign-born migrants living in the United States experience shallower socioeconomic status (SES) health disparities than those in the U.S.<h4>Population</h4>In this article, we seek to replicate this finding and test conjectures that could explain this new observed phenomenon using objective indicators of adult health by educational attainment in several groups: (1) Mex ...[more]

PMID: 27655408

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Project description:The incidence of systemic lupus erythematosus (SLE) is disproportionately high in nonwhite patients compared with white patients. However, variation in mortality according to race/ethnicity has not been well studied. The aim of this study was to examine all-cause mortality according to race/ethnicity among SLE patients enrolled in Medicaid.We used Medicaid Analytic eXtract data, with billing claims from 47 US states and Washington, DC, to identify individuals ages 18-65 years who were enrolled in Medicaid for ?3 months in 2000-2006. Individuals were classified as having SLE if they had ?3 visits ?30 days apart with an International Classification of Diseases, Ninth Revision (ICD-9) code for SLE (710.0). Among the individuals with SLE, those with lupus nephritis (LN) were identified by the presence of ?2 ICD-9 claims for glomerulonephritis, proteinuria, or renal failure. We calculated mortality rates per 1,000 person-years, with 95% confidence intervals (95% CIs), according to race/ethnicity. Multivariable Cox proportional hazards regression models were used to estimate mortality risks, adjusting for age, sex, demographics, and comorbidities.Among 42,221 prevalent cases of SLE, 8,191 prevalent cases of LN were identified. Blacks represented 40.1%, whites 38.4%, and Hispanics 15.3%. Overall SLE mortality rates per 1,000 person-years were highest among Native American (27.52), white (20.17), and black (24.13) patients and were lower among Hispanic (7.12) or Asian (5.18) patients. After multivariable adjustment, Hispanic and Asian patients had lower mortality risks (hazard ratio [HR] 0.48 [95% CI 0.40-0.59] and 0.59 [95% CI 0.40-0.86], respectively) compared with whites. Conversely, the risk of death was significantly higher among Native American (HR 1.40 [95% CI 1.04-1.90]) and black (HR 1.21 [95% CI 1.10-1.33]) patients compared with white patients. Among patients with LN, mortality risks were lower in Hispanic and Asian patients compared with white patients.After accounting for demographic and clinical factors, mortality among Asian and Hispanic Medicaid patients with SLE was lower than that among black, white, or Native American patients.

Dataset Information

SES Gradients Among Mexicans in the United States and in Mexico: A New Twist to the Hispanic Paradox?

Publications

SES Gradients Among Mexicans in the United States and in Mexico: A New Twist to the Hispanic Paradox?

Similar Datasets

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