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Despite greater poverty, less education, and less access to care, Hispanics tend to have similar or better health than whites

In general, people who are poorly educated and financially disadvantaged have less access to care and poorer health than those who have more advantages. However, that is not the case for Hispanics, especially Mexican Americans, living in the United States. Despite higher rates of poverty, less education, and worse access to health care than non-Hispanic whites, the health of Hispanics is similar to or better than that of non-Hispanic whites, according to a recent review of studies on the topic. The research was led by Leo S. Morales, M.D., Ph.D., of RAND Health, and supported by the Agency for Healthcare Research and Quality (HS09204).

The review confirmed that Hispanics—whether Mexican American, Puerto Rican, Cuban, or members of another group—are less educated than most non-Hispanic whites, and their low socioeconomic status is associated with unhealthy behaviors, especially among the most acculturated. These range from smoking and poor diet to lack of exercise and obesity (about half of Mexican Americans are overweight compared with one-third of whites). Many studies have shown that Hispanics lack sufficient access to health services due to financial, transportation, and linguistic and cultural barriers. For example, in 1997, 37 percent of Hispanic nonelderly adults lacked health care coverage compared with 24 percent of blacks and 14 percent of non-Hispanic whites.

Yet, Hispanic and white infant mortality rates were comparable (6.1 vs. 6.3 per 1,000 live births); the projected 1999 life expectancy at birth was 1 to 2 years greater for Hispanics than whites; and the 1995 age-adjusted, all-cause mortality rate for Hispanics was 18 percent below that of whites. Differences emerged in disease-specific mortality rates. Non-Hispanic whites had higher mortality rates than Hispanics for heart disease, cerebrovascular disease, cancers, chronic obstructive pulmonary disease, pneumonia and influenza, and suicide. Conversely, Hispanics had higher mortality rates than non-Hispanic whites due to chronic liver disease, HIV/AIDS, unintentional injuries, and homicide.

See "Socioeconomic, cultural, and behavioral factors affecting Hispanic health outcomes," by Dr. Morales, Marielena Lara, M.D., M.P.H., Raynard S. Kington, M.D., Ph.D., and others, in the November 2002 Journal of Health Care for the Poor and Underserved 13(4), pp. 477-503.

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