178236 US-Mexico border fertility and the Hispanic paradox

Wednesday, October 29, 2008

Francis C. Notzon, PhD , International Statistics Program, National Center for Health Statistics, Hyattsville, MD
Background: The “Hispanic paradox” has been described chiefly as the surprisingly low mortality of US Hispanics despite their low socioeconomic status. This has led to extensive discussion of the reliability of Hispanic mortality data. Information on Hispanic birth outcomes, particularly for border Hispanics, may provide additional evidence for the paradox.

Methods: 2004 birth and death certificate data provide information for the 44 border counties nearest the border for fertility, access to prenatal care, complications of pregnancy, and birth outcomes. Results are presented for Hispanics and non-Hispanic Whites and compared to data for border states and the nation.

Results: The total fertility rate for border Hispanics was 75% higher than for border non-Hispanic Whites and far above the national rate. Risk factors such as low income, low education and access to care were worst for border Hispanic mothers, exceeding risk factor levels for border non-Hispanic Whites and all race/ethnicity groups nationally; smoking rates were much lower for border Hispanics. Despite these problems, birth outcomes for border Hispanics for low birth weight (6.8%), preterm delivery (9.9%) and infant mortality (4.6/1000) were similar to rates for border non-Hispanic Whites and lower than national figures.

Conclusion: Border Hispanic women are among the most disadvantaged nationally for many risk factors, but their birth outcomes are surprisingly good. This provides further evidence for the “Hispanic paradox”, evidence that is not subject to many of the reliability issues associated with mortality data. Possible explanations include low smoking rate, good maternal nutritional stores, community support and others.

Learning Objectives:
- Learn the definition of the Hispanic paradox; - Describe the risk factor levels and outcomes for births to Hispanic mothers on the US-Mexico border; - Discuss the factors that may contribute to good birth outcomes for Hispanic mothers.

Keywords: Hispanic, Birth Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed all the data analysis and prepared the abstract for this presentation. In addition, I have been involved in research on the US-Mexico border for the past 15 years and have published numerous reports and articles on birth outcomes on the border.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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