Online Program

Absence of the “hispanic paradox” for assault mortality

Monday, November 4, 2013

Maria C. Mejia de Grubb, MD, MPH, Department of Family & Community Medicine, Meharry Medical College, Nashville, TN
Barbara Kilbourne, PhD, Department of Family & Community Medicine, Meharry Medical College, Nashville, TN
Courtney Kihlberg, MD, MSPH, Department of Family & Community Medicine, Meharry Medical College, Nashville, TN
Robert S. Levine, MD, Department of Family & Community Medicine, Meharry Medical College, Nashville, TN
Background: Despite economic vulnerability, U.S. Hispanics generally have lower mortality than non-Hispanics. Purpose: Describe U.S. Hispanic assault mortality. Methods: Mortality rates (and 95% Confidence Intervals) were obtained from the Compressed Mortality Files for 1999-2009 from the public CDC WONDER website. Results: Of 35,329 Hispanic assault deaths, 24,430 (69%) were due to firearms. Overall, Hispanic mortality rates for firearm and for non-firearm assault each exceeded that for non-Hispanics by 30%. However, among American Indian/Alaska Natives, Asian/Pacific Islanders, Blacks, and Whites, only Hispanic Whites were at a disadvantage relative to non-Hispanics, and this was only apparent for males. Risk of both Hispanic firearm (14.0 (95% Confidence Interval 13.7,14.2)) and non-firearm (3.3 (3.1,3.4)) assault mortality was highest at ages 15-24 years, with Hispanic White males in this age group being particularly affected. Within this Hispanic age-gender group, firearm assault mortality was highest in large central metropolitan areas (34.0 (33.2, 34.8) versus 8 (6.3, 9.9) in non-core, non-metro areas). In contrast, this group showed no significant differences across six classes of urbanization for non-firearm assault mortality. Among Hispanic White males ages 15-24 years, firearm assault was highest in the West (32.5 (31.7, 33.4)) and Midwest (28.3 (26.5, 29.9)), while for non-firearm assault, the highest rate occurred in the Northeast (7.7(6.9, 8.4)). Conclusions: The “Hispanic paradox” does not apply to assault, but the overall Hispanic disadvantage is driven by relatively higher rates among Hispanic White males, and particularly by firearm assault among urban males ages 15-24 years residing in the West and Midwest.

Learning Areas:

Diversity and culture
Planning of health education strategies, interventions, and programs
Program planning
Public health or related research

Learning Objectives:
Describe demographic and geographic variations in assault mortality (firearm and non-firearm) among US Hispanics. Assess the ethnic differences and epidemiological variations in assault mortality among the US Hispanic population as a potentially useful tool for public health planning.

Keyword(s): Homicide, Hispanic

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Public health practitioner and a Preventive Medicine Resident in training actively involved in research, especially among minority populations. Among my scientific interests has been the understanding of cancer related health disparities among US Hispanic/Latino.
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.