ESTHER CEPEDA: Latino immigrants arriving healthy, then declining

By Esther Cepeda

CHICAGO – When the Centers for Disease Control and Prevention this month released its first official compilation of life expectancy for U.S. Latinos, the headlines were dramatic: On average, Hispanics outlive whites by 2.5 years and blacks by 7.7 years.
The study recast a spotlight on the “Latino health paradox” – that Latinos in the U.S. tend to be healthier than the average population despite their generally low socioeconomic status and barriers to education. The CDC also released data showing that Hispanic males are three times more likely to have HIV than white males, and Hispanic females are a whopping five times likelier than white females, yet they inexplicably live longer than HIV-positive whites.
The breadth of the paradox has been disputed, but a 2007 study by the Tomas Rivera Policy Institute looked at mental health, obesity, diabetes, high blood pressure, heart disease, asthma and overall health. Among these, the Latino health paradox definitively existed for mental health issues, asthma and high blood pressure.
Many theories about the paradox abound. Some say the very Latino immigrants who chose to move to the U.S. are the heartiest – and the most likely to return to their native countries to die. Others point to the strong friend and family networks that are crucial to good health for anyone.
But here’s the important point: The paradox doesn’t last. The Tomas Rivera study also measured the effects of acculturation. It found that “Latinos are healthier … when they first arrive in the United States, however, they become less healthy after acculturation.”
This has been proved time and again. If you look at statistics on the frequency of alcohol and tobacco abuse, illegal drug use, obesity and obesity-related illnesses and teen pregnancy in the Latino community, U.S.-born Hispanics are worse off than the foreign born.
This is a five-alarm warning about the general state of American health. If you look at the CDC’s numbers, once you take out the Latino figures – skewed by the fact the Latino population in the country is becoming more and more U.S.-born – life expectancies declined.
The new life expectancy report – and its implications – comes as no surprise to Hector Castro, the director of the Beth Israel Latino Health Institute in New York and founding partner of Itzamna Medical Center, a Manhattan practice dedicated to eliminating racial and ethnic disparities in health care.
“We know that when Latinos come to America, diabetes and hypertension all increase,” Castro says. “People say Latinos have health challenges because they’re not educated, have lower incomes, poor access to health care, linguistic challenges, but their health issues are directly related to the adoption of the American lifestyle.”
More to the point, Castro says this is definitely not a minority/majority or an income-level issue. “The health care system is just not doing a great job in general, and this is just amplified in the minority community.” He touched on patients’ inability to access specialized care and navigate medical and health insurance systems, but then brought our conversation back to basics.
“I just read a study that found that of all the Americans getting annual checkups, only 60 percent got what they needed. Think about it – the last time you went to the doctor, did he look in your eyes? In your ears, your nose? At your skin? Did you get offered a pap smear? Doctors aren’t really examining patients thoroughly,” he said.
Castro also cited the 2007 Commonwealth Fund ranking of six affluent countries’ health care systems that found U.S. care ranks last or next-to-last in quality, access, efficiency, equity and healthy lives. On top of it all, the U.S. spends roughly double on health care per person and as a percentage of gross domestic product as does Australia, Canada, Germany, New Zealand or the United Kingdom.
While the “Latino paradox” is intriguing, it tells us more about mainstream America than about the fastest growing minority in the U.S. And it points to a raft of health care issues we all need to address so the entire country can enjoy longer, healthier lives.

Esther Cepeda writes for The Washington Post Writers Group. Her e-mail address is

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