Health disparities in the Latino population

Abstract

In this review, the authors provide an approach to the study of health disparities in the US Latino population and evaluate the evidence, using mortality rates for discrete medical conditions and the total US population as a standard for comparison. They examine the demographic structure of the Latino population and how nativity, age, income, and education are related to observed patterns of health and mortality. A key issue discussed is how to interpret the superior mortality indices of Latino immigrants and the subsequent declining health status of later generations. Explanations for differences in mortality include selection, reverse selection, death record inconsistencies, inequalities in health status, transnational migration, social marginality, and adaptation to environmental conditions in the United States. The utility of the public health social inequality framework and the status syndrome for explaining Latino disparities is discussed. The authors examine excess mortality from 8 causes: diabetes, stomach cancer, liver cancer, cervical cancer, human immunodeficiency virus/acquired immunodeficiency syndrome, liver disease, homicide, and work-related injuries. The impact of intergenerational changes in health behavior within the Latino population and the contributory role of suboptimal health care are interpreted in the context of implications for future research, public health programs, and policies.

Figures

Figure 1

Age-adjusted rates of death from all causes for all persons and for Latinos, United States, selected years between 1990 and 2005. Data were obtained from the National Center for Health Statistics (20).

Figure 2

Age-adjusted rates of death from diabetes mellitus for all persons and for Latinos, United States, selected years between 1990 and 2005. Data were obtained from the National Center for Health Statistics (20).

Figure 3

Age-adjusted rates of death from selected cancers for all women and for Latinas, United States, 2001–2005. Data were obtained from the US Cancer Statistics Working Group (59).

Figure 4

Age-adjusted rates of death from selected cancers for all men and for male Latinos, United States, 2001–2005. Data were obtained from the US Cancer Statistics Working Group (59).

Figure 5

Age-adjusted rates of death from chronic liver disease for all persons and for Latinos, United States, selected years between 1990 and 2005. Data were obtained from the National Center for Health Statistics (20).

Figure 6

Age-adjusted rates of death from human immunodeficiency virus disease, for all persons and for Latinos, United States, selected years between 1990 and 2005. Data were obtained from the National Center for Health Statistics (20).

Figure 7

Age-adjusted rates of death from homicide for all persons and for Latinos, by age group, United States, selected years between 1990 and 2005. Data were obtained from the National Center for Health Statistics (20).