Latino/a paradox: A test of the healthy migrant and acculturation hypotheses

Background: Latina women have better birth outcomes than expected given their socio-demographic profiles. The healthy migrant hypothesis argues that only the healthiest women emigrate and bring a health advantage with them; the acculturation hypothesis contends that the good health outcomes are a result of protective cultural values that wane with acculturation. The current study sought to determine whether evidence for either hypothesis could be found by exploring relationships between acculturation and birth complications in a sample of immigrant Latinas.

Methods: The Latinas in this study comprise a subsample (n=147) of participants in a longitudinal study that evaluated the efficacy of a cognitive-behavioral intervention on preventing perinatal depression. Years in the US, a continuous measure of acculturation (M=4.1, SD=3.9), was measured at a prenatal baseline interview. Adverse birth outcomes were extracted from labor and delivery records. Associations were tested with Pearson's product-moment and point-biserial correlations.

Results: A composite measure of 38 birth outcomes was not associated with acculturation. However, inadequate weight gain, anemia, and meconium staining were negatively related to acculturation whereas inadequate prenatal care, preeclampsia, low birthweight, and 1-minute and 5-minute APGAR scores lower than 8 were positively related to acculturation.

Discussion: The results of the current study showed patterns of associations between acculturation and birth outcomes in two different directions, thereby ruling out the healthy migrant hypothesis (a biological explanation) and providing preliminary support for the acculturation hypothesis (a psychosocial explanation). The results show that immigrant Latinas experience negative birth outcomes that are not commonly explored in research.