Chronic Disease Health Differentials across Hispanic Subgroups in New York City

Research into the “Hispanic Paradox,” the phenomena where Hispanic groups characterized by low socioeconomic status still enjoy relatively good health, has not fully explored whether all ethnic subgroups within the Hispanic population enjoy similar health advantages. Studying Hispanic health in a city with a variety of ethnic subgroups will inform theories for the Hispanic Paradox as well as provide rationale for approaching the Hispanic population as a heterogeneous group rather than a single entity. Data from the 2004 NYC Health and Nutrition Examination Survey (HANES) were used to estimate prevalence of obesity, hypertension, hypercholesterolemia, and diabetes in a population-based sample of NYC Hispanic adults (n=1,999) and show two key findings. First, health statuses among the foreign-born worsen as duration in the U.S. increases. For example, the prevalence of obesity among foreign-born Hispanics residing in the U.S. less than 10 years was significantly lower than foreign-born Hispanics residing in the U.S. greater than 10 years and U.S.-born Hispanics (15.4% vs. 34.6%, p<0.0001 and vs. 39.7%, p<0.0001, respectively). Second, multivariate logistic regression showed no differential in the prevalence of chronic diseases among the various Hispanic ethnic subgroups when controlling for age and nativity. Acculturation studies suggest that Hispanics lose culture-related protective factors such as low-fat food consumption after immigrating. Thus, observing the behavioral lifestyle of these immigrants in regards to diet may provide insight into producing a healthier community in the U.S. Population approaches such as structural improvements in the food environment and systems that support healthier behaviors are needed.