The Latino Health Paradox

1. The Latino Health Paradox New Brunswick, NJ July 19, 2006 William A. Vega Professor of Psychiatry Robert Wood Johnson Medical School

2. Percent Distribution of Hispanicsby Type: 2002 Source: Current Population Survey, March 2002, PGP-5

3. Age Distribution by Sex and Hispanic Origin: 2002 Non-Hispanic White Hispanic Male Female Male Female Note: Each bar represents the percent of the Hispanic (non-Hispanic White) population who were within the specified age group and of the specified sex. Source: Current Population Survey, March 2002, PGP-5

4. Latino paradox defined • Superior morbidity and mortality rates of Latinos are contrary to expectations of the health gradient effect of social status on health • What can be learned from these superior health outcomes of Latinos? Scribner 1996-AJPH • Why is there resistance to believing these data? Historical bias.

5. Where are the health advantages of Latinos? • All cause mortality lower rates for Latinos: 35% lower for heart disease*, 43% lower for cancers, 25% lower for stroke • Life expectancy at birth: Whites 77.3, Latinos 82.5, A.A. 71.1, Asians 83.7 • Most of the mortality advantage of Latinos is due to superior health of immigrants – selection effects?

6. Lifetime DSM-IV Rates (%) of Substance Disorders in Mexican Women and Mexican-origin Women in U.S. 1 NESARC. 2 from M. Medina-Mora et al., in press.

7. Lifetime DSM-IV Rates (%) of Substance Disorders in Mexican Men and Mexican-origin Men in U.S. 1 NESARC. 2 from M. Medina-Mora et al., in press.

8. NLAAS dual diagnoses rates for U.S. national sample of Latinos • Any alcohol abuse/dependence with or without drug dependence, and a co-occurring non-addictive DSM-IV disorder • Total for immigrant women 0.68%,men 5.25% • Total for U.S. born women 7.33%, men 16.22%

9. Past

11. Future