DENTON (UNT), Texas — Confirming the existence of the Hispanic Mortality Paradox, a new analysis of health studies, led by a University of North Texas psychologist shows that the Hispanic-American participants’ survival rates from heart disease and other medical conditions were substantially higher than that of the non-Hispanic white and African-American participants.

John Ruiz, assistant professor of psychology, said the existence of the paradox — the finding that Hispanic Americans tend to have health outcomes that are equal or better than those of white Americans, even though Hispanics’ socioeconomic status is, on the average, lower and so associated with worse health — has long been debated. He worked with researchers at Brigham Young University to determine survival rates of specific diseases by different racial and ethnic groups. Past studies had focused only on death certificates and census counts, not causes of death.

For the analysis, which is published on the American Journal of Public Health website, Ruiz and Patrick Steffen and Timothy B. Smith from BYU identified 58 past longitudinal studies that provided quantitative data regarding individual Hispanic-American mortality rates. All of the studies were published from January 1990 to July 2010, and involved more than 4 million participants in all ethnic groups. Participants in 13 of the studies had no health conditions at the time of the initial survey, while those in the other 45 studies had been diagnosed with cancer, heart disease, HIV/AIDS and other medical conditions such as lupus, diabetes, kidney disease and strokes. The participants were followed for the studies for as long as 33 years, but the average time was 6.9 years.  

Analysis showed that the Hispanic-American participants in the studies tracking heart disease patients were 25 percent more likely to be living at the conclusion of the studies than the participants in the other groups, while Hispanic-American participants with no health conditions at the start of the studies were 30 percent more likely to be living.

The researchers combined study participants with diabetes, kidney disease, stroke and other health conditions except for HIV/AIDS and cancer into one category.  Hispanic-Americans with those health conditions were 16 percent more likely to be living at the end of the studies than those in other races. In addition, Hispanic-Americans with HIV/AIDS and cancer faced the same mortality risk from these diseases as those in the other two ethnic groups, Ruiz said.

Overall, the Hispanic participants in all of the studies had a 17.5 percent lower mortality rate as compared their non-Hispanic white and African-American counterparts, regardless of age, he said..

“The difference in mortality risk among the races was even wider for the oldest participants,” Ruiz said.

A 2011 Pew Hispanic Center report noted that far fewer Hispanic-Americans graduate from high school and obtain college degrees than Americans in other ethnic groups, and that Hispanic-American households’ median income is lower than that of other households. Nearly one-fourth of Hispanic-Americans live in poverty, and a larger percentage has no health insurance, the report said.

These factors should contribute to higher mortality rates at younger ages for Hispanic-Americans, a group that the U.S. Department of Health and Human Services reports having a life expectancy of 80.6 years — nearly three times higher than the national average.  

Ruiz said cultural differences could play a role in explaining the Hispanic Mortality Paradox.

“Hispanics are very social, and family support is important to them. They also respect their elders and include them in family dynamics. And social support has been shown to contribute to better health,” he said. “Social behaviors and cultural values may buffer against the stress of economic and environmental disadvantages in regard to health.”

In addition, Hispanic-Americans may experience “resilience at several points in the course of disease,” Ruiz said.

“Hispanics might be less susceptible than some other races to illness in general or to specific conditions with high mortality rates, such as cardiovascular disease. It’s also possible that the rate of disease progression might be slower among Hispanics, resulting in lower morbidity and greater longevity,” he said.

Ruiz says the results demonstrate the need to move beyond questioning the existence of the Hispanic Mortality Paradox and onto investigating the causes of the resilience.