News Column

Hispanic Paradox: A Fountain of Youth Scientists Can't Explain

Dec. 3, 2012

Tom Kisken

Latinos in Ventura County, Calif., are four times less likely to have health insurance than white non-Hispanics. Their median income -- $21,693 -- is less than half that of white non-Hispanics. Their poverty rate is more than three times higher. They're more than 10 times less likely to earn the high school degree that can bring income, insurance and access to doctors, according to three-year census estimates from 2008 to 2010. Their rates of diabetes and obesity hover at epidemic levels.

But they live longer. Research suggests their life expectancy swells even more if they immigrated from another country, although that journey brings more poverty and even less access to health care.

It's a fountain of youth that doctors and demographers flatly admit they can't explain. They call it the Hispanic paradox.

"We keep seeing the same trends for 30 years. We can't explain it away. We can't adjust it away," said Dr. David Hayes-Bautista, director of the Center for the Study of Latino Health and Culture at UCLA. "If everyone in the U.S. had the epidemiological profile as Latinos for heart disease, cancer and stroke, we would save about 300,000 lives a year. I think that's worth understanding."

Some observers question the way ethnicity is tracked at death, along with the inability to track immigrants who return to their homeland late in life. But few researchers question that the paradox is real. They point to a litany of statistics.

According to California Department of Finance estimates culled from 2008 to 2010, Latino men in Ventura County had an average life expectancy of slightly more than 80 years, about two years longer than non-Hispanic whites. Latino women lived about 85 years, compared with 82 for white women.

Across the nation, Latinos can expect to live an average of 81.2 years. That's more than two years longer than white non-Hispanics and nearly seven years longer than African-Americans, according to 2009 data from the National Center for Health Statistics.

The national numbers also show Latinos have a 33 percent lower mortality rate from heart disease than white non-Hispanics. Their rate of cancer deaths is 36 percent lower.

Data from the California Department of Health Services and the U.S. Census Bureau show Latinos across California have a life expectancy of nearly 81 years, longer than any major ethnic or racial group except for one. Asians have a life expectancy of 83 years, according to the 2004 report from the Public Policy Institute of California.

It's not the longevity alone that grabs the attention of Hans Johnson, a demographer with the Public Policy Institute who has studied mortality rates on and off for 20 years. He focuses on the high rate of uninsurance, the overwhelming poverty and pressures that push people away from high school and college degrees.

The socioeconomic factors have always been used to measure well-being, cited in explanations of why African-Americans live shorter lives and Asian-Americans live longer.

It's more than a theory, Johnson said. Researchers know poverty and lack of insurance increase the risk of illness and disease. But even with the barriers, Latinos live longer.

"It flies in the face of common sense," he said. "It flies in the face of the relationship we know exists between health access and health outcome."

Johnson's research goes further. The 2004 Public Policy Institute study that he co-authored shows Latinos who immigrate to the United States, often for backbreaking jobs, low wages and no chance at insurance, live an average of nearly three years longer than Latinos born here and 10 years longer than African-Americans.

They're worse off than second- and third-generation immigrants in almost every way -- except their health.

Part of the explanation may come from Tony Rodriguez, a 58-year-old construction carpenter from Oxnard. He grew up in Guadalajara, Mexico. His father was a bracero who worked in Napa Valley farm fields.

When he was 21, Rodriguez crossed the border, too. He wanted a job that paid more than the 20 pesos a week he earned in an auto shop.

If he hadn't been healthy, able to endure the journey and able to find a job in Long Beach putting hubcaps on imported cars, he wouldn't have come.

"If you're not healthy, no one's going to tell you, 'Hey, come on over. I'm going to give you a hand,' " he said.

The perils of the journey and the hard labor at the end of it mean people with asthma or heart problems often don't come from Latin America, Johnson said. He contends people who cross the border live longer because they come here in better shape.

"What we're seeing in U.S. immigrants is the healthiest of the healthiest," said Helen Lee, an Oakland sociologist with the research organization MDRC.

She worries, however, that the rise of obesity and diabetes in Latino children could mean the longer life expectancies won't last.

"One question is if the paradox is going to last," she said. "We don't yet know how that plays out."

When Dr. Miguel Cervantes, medical director of the Las Islas Family Medical Group in Oxnard, sees first-generation immigrants, they're physically fit. They suffer more often from anemia -- possibly because they can't afford red meat -- than diabetes.

But the longer they live here, the more their diets, exercise and fitness change. And their children and grandchildren suffer from the same problems that dominate a Las Islas clinic aimed at the uninsured and underserved: diabetes, high blood pressure, heart problems and weight issues.

"I think the lifestyle here is easy access to cheap fast food and processed food," Cervantes said.

Immigration patterns, assimilation and rising diabetes rates, however, don't explain why Latinos born in the United States live longer than non-Hispanic whites, Hayes-Bautista said. He offers ideas that range from the emphasis on greens and fruits in traditional Latino diets to a reliance of family that may bring more support. Other theories revolve around the reliance of Latinos on religion and a cultural emphasis on breast-feeding babies.

Hayes-Bautista pointed to social vices. A California Department of Public Health report in 2010 suggested about 7 percent of Latino women smoke, almost half the rate of non-Hispanic white women. Latinos are also more likely to abstain from alcohol, according to the National Institutes of Health.

But even the statistics that seem to explain the paradox have a twist.

"In all the other populations, smoking is inversely related to education and income. With Latinos, it's opposite," said Hayes-Bautista, claiming the smoking rate increases for Latinos born in the United States compared with new immigrants. "What is it that immigrants bring here that gets weakened in the U.S.?"

In Honduras, where Maria Ortega de Velasquez lived until her 30s, people walk everywhere because many of them don't have cars. Meals revolve around rice, beans, fruits and vegetables and are always home-cooked.A night at a restaurant, even a fast-food joint, is a pricey excursion reserved for holidays and anniversaries.

"Here with $2, you can eat a hamburger every day," said Gerardo Velasquez, Ortega de Velasquez's husband.

There's poverty in Honduras and, because of it, stress. But people live at a different pace.

"This country is very fast," said Ortega de Velasquez. "People don't get sleep. They go to bed late and they get up early."

She left Honduras in 1999, a year after her husband did, and ended up in Oxnard. He works as an computer programmer at USC. She takes English classes in hopes of finding a job but also works on keeping her family's life like it was in Honduras.

She gets up at 5 a.m. every day to make her husband a breakfast of egg whites, beans and tortillas. At night, they eat as a family. Her children, ages 11 and 8, go to bed at 8 p.m.

She hopes the food, discipline and exercise mean healthier, longer lives.

"My grandma died when she was 100 years old and 2 months," she said. "My mother is 82 years old and she feels like she's 30."

All the theories are guesswork. Funding for more studies and real answers is desperately needed, said Hayes-Bautista.

If researchers can find the key to the longer life expectancies, they may be able to reduce disease rates for all races and ethnicities.

Hayes-Bautista is convinced there are reasons to explain the paradox. It doesn't just happen.

"There is something there, a mechanism," he said. "Because we haven't bothered to look at it, we don't know what it is. My hunch is it's staring us right in the face."

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Visit Ventura County Star (Camarillo, Calif.) at www.vcstar.com







Source: (c)2012 Ventura County Star (Camarillo, Calif.) Distributed by MCT Information Services


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