Objectives In examining the Hispanic health paradox, researchers rarely determine if the paradox persists across immigrant generations. This study examines immigrant respiratory health disparities among Hispanic children in terms of current asthma, bronchitis, and allergies using an expanded six-group immigrant cohort framework that includes citizenship and the fourth-plus generation. Study design Cross-sectional primary survey data from 1,568 caretakers of Hispanic schoolchildren in El Paso, Texas (USA) were utilized. Methods Data were analyzed using generalized linear models. Results Results indicate that a healthy immigrant advantage lasts until the 2.5 generation for bronchitis and allergies (p<.05), and until the third generation for asthma (p<10). Citizenship was not an influence on the likelihood of a child having a respiratory health condition. Conclusions Findings demonstrate the utility of the expanded six-group cohort framework for examining intergenerational patterns in health conditions among immigrant groups.

Conventional manners of operationalizing generational status in studies of health care access in the United States implicitly assume that individuals assimilate into U.S. culture by the 3rd generation. This limits understandings of immigrant health care access as it remains unknown if disparities persist beyond the 3rd generation. Survey data from caretakers of Hispanic schoolchildren in El Paso (Texas, USA; n = 1,568) were utilized in generalized linear models to analyze relationships between immigrant generational status and access to health care. Results showed that higher immigrant generations had better access to care. The greatest disparities between consecutive generational groups occurred between 1st generation noncitizens/naturalized citizens, the 2.5/3rd generations, and the 3rd/4th generations. Results reveal greater durability of barriers in access to health care than has previously been documented.