Trends in national and county-level Hispanic mortality in the United States, 2011–2020

Abstract

Hispanic populations generally experience more adverse socioeconomic conditions yet demonstrate lower mortality compared with Non-Hispanic White (NHW) populations in the US. This finding of a mortality advantage is well-described as the “Hispanic paradox.” The Coronavirus Disease 2019 (COVID-19) pandemic has disproportionately affected Hispanic populations. To quantify these effects, we evaluated US national and county-level trends in Hispanic versus NHW mortality from 2011 through 2020. We found that a previously steady Hispanic mortality advantage significantly decreased in 2020, potentially driven by COVID-19-attributable Hispanic mortality. Nearly 16% of US counties experienced a reversal of their pre-pandemic Hispanic mortality advantage such that their Hispanic mortality exceeded NHW mortality in 2020. An additional 50% experienced a decrease in a pre-pandemic Hispanic mortality advantage. Our work provides a quantitative understanding of the disproportionate burden of the pandemic on Hispanic health and the Hispanic paradox and provides a renewed impetus to tackle the factors driving these concerning disparities.

Understanding the role of access in Hispanic cancer screening disparities

“…This results systematic differences in care access and quality, including for cancer screening 13,14 . Yet, numerous studies have demonstrated a seemingly paradoxical relationship between socioeconomic characteristics and health outcomes in Hispanic populations 15,16 . For example, Hispanic individuals are less likely to have health insurance 17 and have, on average, lower incomes and lower educational attainment, 18 which are characteristics associated with lower rates of preventive care and cancer screening use 5,18 .…”

“…13,14 Yet, numerous studies have demonstrated a seemingly paradoxical relationship between socioeconomic characteristics and health outcomes in Hispanic populations. 15,16 For example, Hispanic individuals are less likely to have health insurance 17 and have, on average, lower incomes and lower educational attainment, 18 which are characteristics associated with lower rates of preventive care and cancer screening use. 5,18 Despite this, Hispanic adolescents have higher rates of human papillomavirus vaccine initiation nationally 19 and data on cancer screening use are mixed across cancer types and data sources.…”

Disparities in Late-Stage Breast and Colorectal Cancer Diagnosis Among Hispanic, Non-Hispanic White, and Non-Hispanic Black Patients: a Retrospective Cohort Study of Texas Medicare Beneficiaries

“…Importantly, the Census considers race and Hispanic origin separately, meaning anyone who identifies of Hispanic ethnicity may be of any race [ 20 ]. In the past years, Hispanic Americans across the USA have seen improvements in trends in mortality and other health outcomes that rival or even at time exceed those of non-Hispanic White Americans, commonly known as the Hispanic paradox [ 21 , 22 ]. This paradox has recently altered, given the disproportionate health and mortality impact of COVID-19.…”