Does the Hispanic health advantage extend to better management of hypertension? The role of socioeconomic status, sociobehavioral factors, and health care access

Abstract

Hispanics in the United States (and foreign-born Hispanics in particular) have relatively favorable health given their lower socioeconomic status compared to, for example, non-Hispanic whites. This phenomenon is often called the Hispanic Health Paradox (HHP). This study examines whether the previously documented HHP in hypertension prevalence extends to its management using clinical and self-reported measures from the 2007-2012 National Health and Nutrition Examination Surveys. Multivariate models adjusting for demographic, socioeconomic, and socio behavioral characteristics show an advantage among foreign-born Mexicans in hypertension prevalence relative to non-Hispanic whites (adjusted OR=0.85). However, compared to non-Hispanic whites, foreign-born Mexicans were 38 percent less likely to receive treatment recommendations and, when advised to undergo treatment, were 60 percent less likely to adhere to treatment. Adjusting for healthcare access and utilization dramatically reduces disparities in control between foreign-born Mexicans and non-Hispanic whites, suggesting that insufficient systematic access to and use of quality healthcare erodes the HHP and contributes to the deterioration of health throughout the immigrant experience. Without appropriate interventions, particularly in health care access and utilization, poorer hypertension management among foreign-born Mexicans may negatively affect the Hispanic health profile, increase risk of cardiovascular disease-related mortality, and erode the Hispanic health advantage in the future.

Disparities in Peripheral Artery Disease Hospitalizations Identified Among Understudied Race-Ethnicity Groups

“…For medical expenses, Asian or Pacific Islander patients paid the highest medical expenses among racial-ethnic groups, which could also indicate a more complicated hospitalization case among these Asian/Pacific Islander patients. Poor socioeconomic status may lead to underreporting and may contribute to the development of PAD in similar conditions ( 37 – 39 ). It is plausible that demographic groups with less affordable medical care in the early stage of the disease were more likely to have critical cases at the hospitalization point, which was what we observed in our current study and was consistent with the patterns identified in previous studies ( 40 , 41 ).…”

Sick Days: Logical Versus Survey Identification of the Foreign-Born Population in the United States

“…The foreign-born population participates in the labor force at a high rate but also faces systemic obstacles to accessing and utilizing health care. As a result, this population may be less likely to receive a diagnosis for objective health measures such as type 2 diabetes or heart disease (Bacon, Riosmena and Rogers 2017; Barcellos, Goldman and Smith 2012; Hsueh et al 2020). Thus, an encompassing health indicator such as self-reported number of sick days may provide immigration and health researchers an additional and alterative measure of health.…”

Challenges for the prevention of hypertension among international migrants in Latin America: prioritizing the health of migrants in healthcare systems

“…Specifically, this health advantage has been described among migrants from South America, Afro-Caribbean countries and Mexico living in EE. UU, whose prevalence were lower than the native-born populations (41)(42)(43). Explanatory models describe a possible positive self-selection favoring migration among healthier and younger people, as well as those better skilled and better resourced.…”