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Health care, education and income are considered predictors of health. The more you have, the healthier you should be. Unless you are Hispanic.
Latinos, generally speaking, are among the least affluent in the U.S. and can have severely limited access to health care. Yet certain cancers and heart disease just don’t seem to affect the population in the way that researchers expect. Latinos have better outcomes when it comes to cancer and heart disease - and they have longer life expectancy. This phenomenon is so baffling, researchers have even given a name to it: the Hispanic paradox.
The paradox itself is controversial. Some studies have supported its existence and others have refuted it. Its critics say faulty data has skewed findings or there are other factors at play. And the researchers who defend it, saying that Latinos experience better-than-expected health, have no way to explain it.
“Some people think the Hispanic culture has something to do with it,” said Rebecca Siegel, epidemiologist for the American Cancer Society who co-authored a paper that said cancer was becoming the leading cause of death among Latinos. “No one really knows.”
Some clinicians are worried that the paradox may change the way Latinos are treated by their physicians.
If the Hispanic paradox doesn’t exist, then we really need to take that away and focus on the cardiovascular health and overall health of Hispanic population
“The Hispanic paradox confuses a lot of practitioners,” said Carlos Rodriguez, an associate professor at Wake Forest University and a leading investigator of a national study of cardiac structure and function in Latinos across the United States. “It may lull some medical practitioners to under treat Hispanics or not focus on cardiovascular risk.”
The paradox is such a concern that Rodriguez said he is currently working on a national scientific advisory for the American Heart Association about the topic.
Those who challenge the paradox submit two theories to back up their arguments. One, called the healthy migrant effect, posits that recent arrivals generally have better health than assimilated generations in part because of healthier lifestyles and habits in their homeland.
Another, the salmon bias, proposes that statistics show a false longevity. According to this theory, people like to die in their birthplace and immigrants return home when they lose their jobs or become seriously ill. This means their deaths are not counted in the U.S., skewing the findings and adding to the myth.
Even though other studies have refuted these theories, none can explain what is happening or why -- in part because the data available is too limited to draw conclusions about the entire population.
But available data indicates that Latinos tend to drink and smoke less than whites, major risk factors for cancer and heart disease. Still, they are less likely to take preventative measures to secure their health. Latinas are less likely to get PAP tests or mammograms than whites.
And as beneficial as the paradox may seem, Latinos are not immune to all ailments --they have higher mortality than whites from diabetes, liver disease, cervical cancer and AIDS.
“If the Hispanic paradox exists, maybe it is something that can be spread to other populations,” said Rodriguez. “And if the Hispanic paradox doesn’t exist, then we really need to take that away and focus on the cardiovascular health and overall health of Hispanic population.”