Race/ethnicity and all-cause mortality in US adults: revisiting the Hispanic paradox

Am J Public Health. 2012 May;102(5):836-43. doi: 10.2105/AJPH.2011.300345. Epub 2011 Dec 15.


Objectives: We examined the association between race/ethnicity and all-cause mortality risk in US adults and whether this association differs by nativity status.

Methods: We used Cox proportional hazards regression to estimate all-cause mortality rates in 1997 through 2004 National Health Interview Survey respondents, relating the risk for Hispanic subgroup, non-Hispanic Black, and other non-Hispanic to non-Hispanic White adults before and after controlling for selected characteristics stratified by age and gender.

Results: We observed a Hispanic mortality advantage over non-Hispanic Whites among women that depended on nativity status: US-born Mexican Americans aged 25 to 44 years had a 90% (95% confidence interval [CI] = 0.03, 0.31) lower death rate; island- or foreign-born Cubans and other Hispanics aged 45 to 64 years were more than two times less likely to die than were their non-Hispanic White counterparts. Island- or foreign-born Puerto Rican and US-born Mexican American women aged 65 years and older exhibited at least a 25% lower rate of dying than did their non-Hispanics White counterparts.

Conclusions: The "Hispanic paradox" may not be a static process and may change with this population growth and its increasing diversity over time.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Black or African American / statistics & numerical data
  • Female
  • Health Surveys
  • Hispanic or Latino / classification*
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Mortality / ethnology*
  • Proportional Hazards Models
  • Sex Distribution
  • Socioeconomic Factors
  • United States / epidemiology
  • United States / ethnology
  • White People / statistics & numerical data