The Hispanic Paradox: A Moderated Mediation Analysis of Health Conditions, Self-Rated Health, and Mental Health among Mexicans and Mexican Americans

Abstract

This study investigates how mediating (e.g. history of health conditions) and moderating (e.g. self-rated health) factors are associated with nativity status on depression and anxiety in Mexican immigrants. Using data from the 2019 National Health Interview Survey (NHIS), results found a significant direct association between nativity status and anxiety and depression. Additionally, the association between nativity status and mental health was mediated by the history of health conditions, and self-rated health was a significant moderator in both mediation models. Study findings are discussed within the context of barriers to care, current literature, and strengths-based interventions. Future research can expand upon these findings by examining the specific types of physical and mental health conditions that may support the Hispanic Paradox, as well as how self-efficacy and internal locus of control are associated with the paradox within this population.

Impact of COVID-19 Pandemic on Health Behaviors and Outcomes by Age Group and Race Ethnicity: Results From Behavioral Risk Factor Surveillance System Data

“…25 For many health outcomes, this paradox has been reported with a direct association between nativity status and mental health issues among Hispanics. 26 Second, Familism is a cultural trait described in Hispanic culture that emphasizes the role of family in terms of support, obligation, and reference. 27,28 Familism has been shown to have a protective effect on mental health by promoting resilience among those with Mexican-descent.…”

Hispanic Suicides in Miami-Dade County, Florida, 2008–2018

“…Moreover, Mexican Americans had the lowest proportion of suicides in this study. Although studies have consistently reported greater poverty rates, lower educational attainment, increased literacy barriers, and decreased access to health care among Mexican Americans, this cultural group appears to buffer psychosocial stressors more effectively than other Hispanic subgroups, resulting in lower negative outcomes including anxiety, depression, drug misuse, and suicide (Alegria et al, 2008; Dominguez et al, 2015; Hernandez et al, 2022). The maintenance of family values, religious faith, social connectedness, and socio-cultural traditions are some factors that may protect Mexican American immigrants from emotional distress, psychiatric morbidity, and suicide (Alegria et al, 2008; Hernandez et al, 2022; Silva & Van Orden, 2018).…”

Educational tools to dismantle disparities by addressing social determinants of health

“…The fourth reflection was based on the segment titled: "Becoming American" using the following question to reflect on the effect of migration and acculturation on health disparities: "Identify differences in culture between USA-born Americans and Mexican immigrants and explain how the process of acculturation would benefit the health of both groups by providing examples to support your argument". This reflection question was chosen due to Hispanic immigrants to the USA reporting lower physical and mental health concerns than USA-born Americans (Hernandez et al, 2022). There was neither a right nor a wrong answer to the reflections.…”

“…Although the health profile of Americans has improved over time, health disparities persist (AHRQ, 2022). The urgency of addressing health disparities in the United States of America (USA) is evident by one of the overarching goals of "Healthy People 2030", which aims to "create social, physical, and economic environments that promote attaining the full potential for health and well-being for all" (Healthy People 2030, 2022. Evidence suggests that healthcare professionals may unknowingly contribute to the persistence of health disparities in the USA (Hall et al, 2015).…”