This paper explores the veracity of the Hispanic Paradox. I talk about the diversity and
complexity of both the Hispanic population and the paradox, and the importance to
concentrate on the needs of a specific group among Hispanics: the undocumented.
Addressing the health needs of the undocumented population will help us support their
children: most of whom are American citizens.
Recent articles and studies confirm the need for immigration laws and policies to mitigate the
suffering of undocumented Hispanics in America. Giving some type of relief to the
unauthorized population will contribute to better physical and mental health for this
population.
I also explore the need to concentrate on factors that have been protecting the Hispanic
population from having a more deteriorated health, and talk about the need for additional
research on protective factors such as social capital. Such focused research will contribute to
programs and services that specifically and successfully target the diversity of the Hispanic
population in America.
Introduction
The Hispanic Paradox is an idea that first gained wide attention in in the 1980s. The
paradox states that most Hispanics are less likely to suffer from the main causes of death and
subsequently die prematurely. Based on these more positive health outcomes, it could be
argued that Hispanics do not need as much attention to their health, given their protection
poorest and least educated in America, which points out different, yet important needs for
Hispanics.
Based on the studies I have reviewed, the conversations I have had with community
leaders, and the 12 plus years of experience in the field, I believe that there are certain
conditions that benefit the Hispanic population, including the social support that most of this
population enjoys. However, it would be devastating to think that the very concept that
implies Hispanics are at advantage closes the doors on the increasing need for programs,
interventions, and studies to help this population thrive.
The main purpose of this paper is to advocate for the need for an intervention that
takes advantage of the high value Hispanics give to their interpersonal relations in order to
better prevent and treat ailments affecting them. It should be noted that because the Hispanic
group is so diverse, it is impossible to create a “one size fits all” approach for this population;
I propose to focus first on the Mexican population because they are a large and important
group of immigrants. In addition, the largest share of the undocumented population is from
Mexico, which places them at higher risk due to the limited health services available for
them.
This paper also hopes to highlight the importance of creating programs that encourage
the Mexican population to value and continue to practice the customs that have resulted in
healthy pregnancies and successful deliveries, i.e., to resist acculturation practices that are
not healthy, as well as to adopt the behaviors that lead to eating healthier and more physical
activity – something that Mexicans who are selectively acculturating positive factors tend to
making adjustments to target additional Hispanic groups, including acculturated groups,
which may have lost connection to healthy practices from their countries of origin.
The study and understanding of these protective factors – social capital and low
acculturation - could additionally contribute to the creation of interventions that could
counteract other health problems currently affecting the Hispanic population and potentially
develop methods to anticipate and protect against future Hispanic health risk.
History
“The Hispanic Paradox” is a phenomenon public health researchers first discovered
and labeled in the 1980s. The paradox refers to the fact that most Hispanics, despite to high
rates of poverty and less access to education and health care, are less likely to suffer from
chronic disease or die prematurely.
Kyriacos Markides and Jeannine Coreil (1986), professors at the University of Texas,
were two of the first scientists to mention the paradox. Their paper, published in 1986,
concluded that, in the Southwest, the health status of Hispanics was very similar to the health
status of whites. They supported their findings using key health indicators such as infant
mortality, life-expectancy, mortality from cardiovascular diseases, and mortality from major
types of cancer.
However, even 30 years ago, Markides and Coreil (1986) observed that other health
indicators – diabetes, infectious and parasitic diseases – put Hispanics at disadvantage when
compared to their counterparts,already establishing a different –although not necessarily a
Before we review the more recent study development regarding the Hispanic
Paradox, it is important to understand the characteristics and diversity in the Hispanic
population in the US.
Hispanics Living in the U.S.
The Hispanic population is currently the largest minority group in the United States.
As of July 2015, this group constituted 17.6 percent of the nation’s total population. The
Hispanic population is also the fastest growing group in the United States. The 2015 ACS
projects there will be 119 million Hispanics in the United States in 2060 (U.S. Census
Bureau, 2016).
To be the fastest growing population can be a problem, especially when the
population increases at such a fast rate that communities struggle to respond to the high
demand of human and financial resources to meet the needs of the expanding population.
Another interesting feature of U.S. Hispanics is that nearly all of this population lives
in the nation’s more than 3,000 counties, proving how important it is for this population to
live where other Hispanics are already established. Most Hispanics live near their source of
employment, which is common among other groups; however, Hispanics differ in the fact
that they purposely live in proximity to each other. A good example of how much Hispanics
value having a sense of community, is that as of July 2015, 54.5% of Hispanics lived in the
states of California, Florida, and Texas (U.S. Census Bureau, 2016) (see Figure 1). It is also
common for people from the same country of origin to live in the same cities or towns, or in
specific areas in larger cities; such is the case of Puerto Ricans who live mostly in New York,
Hispanic Financial and Health Insurance Status
Hispanic’s low income and reduced access to health services puts them at additional
hardship and disparity. In 2016, the United States Census Bureau reported that the median
income of Hispanic households in 2014 was $42,491, compared to $62,950 among
non-Hispanic whites. The 2015 ACS additionally noted that in 2014, the poverty rate among
Hispanics was 23.6%, compared to 10.1% among non-Hispanic whites (United States Census
In regards to health insurance, a factor that determines how early individuals seek
health services, the Centers for Disease Control and Prevention [CDC] (May, 2015) stated
that 41.5% of Hispanics lacked health insurance (compared to 15.1% of whites.) The CDC
(May, 2015) also showed that 15.5% of Hispanics reported delay or non-receipt of medical
care because they were concerned about the cost (compared to 13.6% of whites) (see Figure
2).
Diversity Among Hispanics
Despite the fact that Hispanics share a similar trait – they or their ancestors come
different backgrounds, both cultural and genetic. This makes it very difficult to talk about
this group as a whole when there is so much diversity.
The Hispanic population in the U.S. comes from 22 different Spanish-speaking
countries. According to the 2014 American Community Survey, 63.9 percent of Hispanics
living in the United States are of Mexican origin, 9.5 percent are Puerto Rican, and 3.7
percent are originally from Cuba, and the remainder is of some other Central American,
South American, or other Hispanic origin (United States Census Bureau, 2016).
Along with specific customs celebrated in the country where immigrants are coming
from, people in the Hispanic group also are distinct in their education and socioeconomic
backgrounds. This is mostly reflected in how and when they arrived in the U.S. For instance,
immigrants with VISAs and legal residency documents, tend to have more years of education
and better socioeconomic status than individuals who crossed the border on foot. Immigrants
with VISAS have to show proof of a stable economic status in order to be given permission
to enter the country, while undocumented immigrants’ motivation to leave their homelands
may be strongly related to their immediate lack of resources.
The Hispanic population also varies by nativity, native-born versus foreign-born. In
2010, the number of Latino immigrants reached a record 18.8 million. Since then, the growth
of foreign-born Latinos has declined. In 2012, the share foreign-born was 35.5% compared to
40% in the 2000s, while the U.S.-born Latino population continued to grow at a faster rate
Hispanic Paradox
More recent study development regarding the Hispanic Paradox highlight a positive
pattern on some health indicators but not others. According to a report published by the CDC
in 2015, the overall Hispanic all-cause mortality rate was 24% lower than for whites.
Hispanics also had overall lower death rates for most leading causes of death, including the
two leading causes of death cancer and heart disease, in which Hispanics’ rates were 28%
and 25% lower, respectively, than for whites.
Hispanics also showed no significant differences, when compared with whites, for
hypertension, uncontrolled hypertension, or high cholesterol (CDC, May 2015.) In addition,
multiple studies have shown that most Hispanic subgroups, except Puerto Ricans, have lower
infant mortality than infants of native-born women (Hummer, R.A., Powers, D.A., Pullum,
As for risk factors, Hispanics as a group, reported they smoked less: 43% less when
compared with whites (CDC, May 2015.) Because the use of tobacco products is the major
cause for many of the leading causes of death, some scientists have proposed that this is the
main causal factor of the Hispanic paradox (Felenon, 2013)
However, as mentioned by Markides and Coreil 30 years earlier, Hispanics are at a
comparative disadvantage in other health areas. Death rates were substantially higher for
Hispanics than whites for diabetes (51%), chronic liver disease and cirrhosis (48%), and
homicide (96%). In addition, death rates were somewhat higher than whites (about 8% higher
in each condition) for “hypertension and hypertensive renal disease,” “nephritis, nephrotic
syndrome, and nephrosis,” and “certain conditions originating in the perinatal period.” As of
risk factors, Hispanics showed a higher prevalence of obesity (23%) (CDC, 2015).
Possible Reasons for the Negative Health Outcomes Among Hispanics.
Many of the negative health outcomes in the Hispanic population have a direct link to
the places where they live, work, and play, along with the lack of available health and social
services for this population. For instance, the high rate of death by homicide suggests that
Hispanics might live in more dangerous neighborhoods. Similarly, the fact that some of the
chronic conditions listed above end up in death may suggest that the lack of available
services prevents Hispanics from having regular check ups, which would allow a timely
diagnosis and earlier intervention for some of these conditions.
Findings by Country of Origin, Nativity, and Gender
Though most Hispanic subgroups have similar or lower mortality rates when
the whole Hispanic population by origin, nativity, and gender revealed variation in estimates
for a number of analyzed factors.
Variation by Country of Origin. Compared with whites, Mexicans and Puerto
Ricans showed 80% greater death rates for diabetes. Mexicans also had an 80% greater death
rate for chronic liver disease/cirrhosis. Puerto Ricans, on the other hand, had nearly twice the
prevalence of self-reported cancer (+84%) and heart disease (+87%) compared with
Mexicans.
As for risk factors, self-reported smoking prevalence also differed by Hispanic origin:
21.6% of Puerto Ricans, 18.2% of Cubans, 13.0% of Mexicans, and 9.2% Central and South
Americans reported themselves as smokers. When compared to whites – whose smoking
percentages are 23.8% – Puerto Ricans and Cubans shared similar numbers.
In regards of the large death rates for diabetes among Mexicans and Puerto Ricans,
we can say they are mainly related to the diets among these populations. Recent reports show
that a rich diet in fatty and sugary foods among Mexicans is the main cause of the high rates
of obesity and overweight among their population. Puerto Ricans, on the other hand, have a
limited access to fresh produce because they live in an island. Most products have to be
imported and it drives prices up, making it more difficult for islanders to afford healthy
options.
About the high rates of cancer and heart disease among Puerto Ricans when
compared to other Hispanic groups, one could argue that the use of tobacco among this
population is what is driving those numbers up. However, Cubans – who also reported
and Puerto Ricans are legal residents; which allows both groups to enjoy benefits other
Hispanic populations do not have.
These differences among Hispanic groups further show the necessity for programs to
specifically target their unique risk factors. Tailored programs have the great potential to
reverse some of the health conditions among these groups.
Variation by Gender. As for differences by gender, hypertensive Hispanic men were
48% more likely than hypertensive Hispanic women to have uncontrolled blood pressure.
There were also notable differences in risk factor by gender: 8.9% higher among Hispanic
women, and 17.7% among Hispanic men (CDC, May 2015).
Variation by Place of Birth. In addition, smoking prevalence varied significantly by
nativity: 17.7% of Hispanics born in the U.S. and 10.3% of foreign-born individuals reported
themselves as smokers (CDC, May 2015.)
What Studies on the Hispanic Paradox Do Not Address.
Although it is interesting that, in general, Hispanics live longer and have lower rates
of death, the research supporting the paradox fails to fully investigate key elements affecting
immigrant health such as the lack of documentation and its effects on Hispanics’ quality of
life. Some of the areas in which unauthorized immigrants are affected due to their legal status
are: 1) nonexistent or inadequate health services, 2) risk of deportation, and 3) mental illness.
Policies to address the legal situation of the large undocumented populations are
necessary so that public health officials can finally focus on keeping this population healthy.
The belief that Hispanics enjoy better health than other ethnicities can be used as an excuse
needed programs and services. This is particularly important given the country’s highest
birthrate is among Hispanics.
Lack of Documentation and How it Affects Quality of Life Among Hispanics.
Lack of legal documentation among Hispanics is probably the main cause of the
growing disparities affecting the Hispanic population. Lack of documentation, for instance, is
one of the biggest barriers impeding Hispanics from unlocking the benefits of higher
education, well-paid jobs, and access to health care; all indicative factors of a higher
socio-economic standing and a more positive health status.
Statistics. It is hard to establish a specific number but it is possible that there are at
least 11 million undocumented people living in the U.S., a large part of them are Hispanics.
According to the Pew Research Center (2017), most unauthorized immigrants are from Latin
America (78%). Although the numbers from Mexico have declined over the past decade, the
largest share of the undocumented population is still from Mexico (52.5%);.
Because the Mexican population is the largest unauthorized population in the country,
their needs for services are greater. For instance, this population - at constant fear of
deportation - are in greater need for programs to deal with anxiety and depression. Programs
and services need to be in place to quickly address these conditions, helping this population
to recognize their feelings and deal with them before they worsen.
Non-existent or Inadequate Health Services. Many programs are not available to
the undocumented population because they must show proof of legal residency in order to
qualify for services. For instance, in order to receive comprehensive health benefits – as the
ones covered by Medicaid – or to qualify for health insurance as stipulated by the Affordable
Although other health services are available in the communities where the
unauthorized population work and reside, the available programs rarely treat complex health
conditions. Such is the case of community clinics that have surfaced as a result of the
growing needs of the undocumented population. These organizations often lack the human
and financial resources to meet the needs of this group. For instance, due to lack of funding,
most community clinics have rigid schedules and can only take a low number of new clients
per week, forcing the new and ill patients to either wait until their condition gets worse, or to
visit the Emergency Room if they are seriously ill and need immediate attention.
Risk of Deportation. Undocumented Hispanics additionally face the risk of
deportation. Knowing that they are at constant risk of deportation brings fear and anxiety
among this population, which increases stress levels and can negatively impact individuals’
physical and mental health (American Psychological Association, 2017).
The unauthorized population currently faces a higher fear of deportation under the
current administration. The Pew Research Center (2017), which administered a survey before
President Trump’s inauguration, asked Hispanics about their fear of deportation. Survey
results show that worries about deportation among immigrants are greatest for those who do
not hold U.S. citizenship and do not hold a green card: 67% of individuals in these categories
say they worry a lot (45%) or some (22%) about the deportation of themselves or someone
close to them. And among immigrants who are lawful permanent residents, 66% say they are
worried about deportation of themselves or someone close to them. Both of these groups are
Although these numbers do not show a large change when compared to survey results
in 2013, these figures are expected to worsen. President Trump used campaign rallies to
voice his negative opinion about illegal immigration and, as president, has used his powers to
enforce immigration laws more strictly than prior administrations. President Trump has
recently dispatched the full force of the federal government to find, arrest and deport those in
York Times, February 2017.) He also continues to advertise his plan of building a wall along
the U.S.-Mexico border, implying that immigrants coming through the border are a threat to
the country.
Mental Health. Anyone moving to a different country faces nostalgia and sadness.
However, when individuals leave their countries because no other viable alternative
guarantees survival for them and their families, the intensity of those feelings can be a lot
stronger. Most times, these immigrants are living very much in exile because they do not
have a place to go back to: the violence and lack of resources in their countries of origin have
made it impossible for them to live there safely.
Such is the case of tens of thousands of women and unaccompanied children risking
their lives in their journeys from Central America to the U.S., hoping for a better life in this
country. There is strong evidence that individuals’ direct experience with crime, particularly
in Honduras and El Salvador, are highly motivated to attempt to cross the border into the U.S
despite the risks of the journey. The Department of Homeland Security has stated that
Salvadoran and Honduran children come from extremely violent regions where they perceive
the risk of traveling alone to the U.S. preferable to remaining at home (American
Immigration Council, 2016.)
These families experience drastic and traumatic changes: the uprooting from their
countries of origin and dealing with the aftermath of being a victim of crime and other
traumatic experiences in their homelands can be devastating, especially for children. As if
that were not enough, for many immigrants from Hispanic countries you add to these
stressors a corrosive political climate that discourages integration; we have a recipe for
Hispanics, and especially those immigrating in difficult circumstances like the
women and children mentioned above are in desperate need of mental health services.
Unfortunately, and despite their growing needs for social, mental and behavioral health
services, Hispanics have less access to them when compared to other populations. Mental
Health: Culture, Race and Ethnicity pointed out that Latinos have less access to mental health services, are less likely to receive mental health services, receive poorer-quality
mental health services, and are underrepresented in the treatment research (Bernal,
Galloza-Carrero & Saez-Santiago, 2009).
The National Alliance of Mental Illness (2004) additionally stated that a poor
patient-provider interaction and a lack of cultural knowledge have resulted in many Latino youth
with mental illnesses being misdiagnosed as having anger problems or conduct disorders.
Source: AIC
Need of Additional Research
Research is an important aspect of keeping a population healthy. Without proper
knowledge about the behaviors of a population, scientists cannot understand and address
their needs. Listed below are a number of high priority research topics that would be a good
start towards getting important answers to important questions concerning Hispanic health,
its antecedents, and potential ameliorating factors and effective programs.
Protective Factors Among Hispanics Worth Additional Research
Two protective factors constantly mentioned in research about health among
Hispanics are social support and acculturation. Although the importance of these two
concepts has been stated multiple times, there is a need for additional research to unravel the
power of these elements and, where appropriate, translate that new found knowledge into
designing programs and health services that are going to make a positive impact on the
Hispanic population.
Social Support. Social support has a positive effect on both physical and mental
health. Stansfeld (2006) defined this concept as the resources provided by other persons. For
instance, social support can be demonstrated both emotionally – offering consolation or
listening to the distressed person, – and practically – doing something for the person in
distress, such as taking care of their children, helping with chores, and sharing resources with
them.
Other scientists have used the term ‘structural social capital’ to define a similar
concept. Structural social capital has been described as having ties to families or
community-based institutions. For instance, this concept can be measured by the number of times per
superior biomarkers of health (e.g., lower cholesterol levels) and a longer life (McElroy,
Muennig & Singer, 2016).
The Alameda County Study specifically showed that people with low scores on the
social network index had the highest mortality rates. Social integration was also found to be
significantly associated with a lower five-year mortality risk for both women and men
(Stansfeld, 2006.)
Social capital is a promising concept in future research for Hispanics because they
tend to be a lot more social than other groups. Hispanics have more traditional,
family-centered values than native-born groups, potentially explaining why health and longevity
deteriorate with every generation in the U.S. (McElroy, Muennig & Singer, 2016.)
Social capital, therefore, should be used to the advantage of this population by
making sure that existing programs and services are utilizing the power of positive social
pressure among Hispanics to help them meet their health goals. The CDC, for instance,
created a lifestyle change program, Prevent T2, to teach minority populations about diet and
the importance of physical activity. The curriculum also encourages participants to set and
meet goals that will help them to prevent type 2 diabetes. In addition, the diabetes prevention
program has a group format that allows 10-15 participants to meet once a week to learn about
diet and exercise and to incorporate the new concepts into their daily routine. Together, they
share ideas, celebrate successes, and overcome obstacles.
Prevent T2 is available in Spanish and Hispanic participants are currently benefiting
from it throughout the country. Because the diabetes prevention program utilizes the power
of social capital, it would be interesting to use this platform to explore the benefit of this
beneficial to compare the success rates of attendees who are participating in the program with
friends and relatives versus attendees who are part of a group with people they did not know
prior to the program (see additional promising programs and resources in the Appendix
section).
Acculturation. Acculturation is defined as the cultural changes that result from
sustained contact between two or more distinct cultures. In other words, acculturation is the
gradual process in which individuals start adopting cultural beliefs, values, behaviors, and
language of the host culture (Fabrett, Gonzalez, and Knight, 2009.)
Acculturation is a concept worth of additional research because is highly related to
health status among Hispanics. There is evidence that the health habits and health status of
Hispanic immigrants deteriorate with length of stay in the United States, as well as in
succeeding generations. The following health indicators, for example, worsen with increased
acculturation: rates of infant mortality, low-birth weight, overall cancer rates, high blood
pressure, and adolescent pregnancy (Amaro & Vega, 1994.)
In addition, multiple negative behaviors increase with acculturation: decreased fiber
consumption, decreased breast feeding, increased use of cigarettes, increased alcohol
consumption, and driving under the influence of alcohol. Some studies have also documented
that depressive symptomatology increases with acculturation (Amaro & Vega, 1994.)
Many studies have also stated that acculturation is a cause of stress among the
foreign-born. Alegria & Woo (2009), for example, shared that acculturative stress can result
in issues such as language problems, perceived discrimination, perceived cultural
incompatibilities, and commitment or lack of commitment to protective values such as
There are, however, some exceptions to the trend toward worsening health and health
habits with acculturation. Some dietary habits, for example, higher protein foods, oftentimes
improve with acculturation. Body mass index, diabetes, and obesity also decrease with
increased socioeconomic status and acculturation (Amaro & Vega, 1994.)
The Impact of Acculturation on Social Capital Among Hispanics. Studies
targeting the correlation among acculturation, social capital, and health status among
Hispanics have provided some insight on how these factors can protect the health of this
population. In Alameda County in California, for example, low acculturated Hispanic
mothers living in “Hispanic enclaves” – communities where at least 30 percent of the
population are Hispanic – gave birth to a lower proportion of low birth weight infants than
non-Hispanic whites women living in the same enclaves. These communities created an
environment supportive of motherhood, including the promotion of healthy pregnancies and
good nutrition, while condoning the use of cigarettes, alcohol, and other drugs (Franzini,
Keddie & Ribble, 2001).
The utilization of supportive environments, such as the one mentioned above,
deserves additional research. How can scientists utilize this strong element and apply it into
other problematic behaviors among the Hispanic population? How can programs and health
services promote healthy behaviors among Hispanics even as they are acculturating? And,
how can this positive social pressure additionally influence Hispanics – at a higher risk for
Conclusion
Although some of the statistics concerning the Hispanic paradox are still relevant
today, it is necessary for scientists and public health leaders to change their focus on the
pressing issues in order to work on the pressing issues affecting the Hispanic community
today instead.
For instance, undocumented Hispanics continue to face mental and physical problems
because of the limitation in programs and services for them. Mental illness, the fear of
deportation, and nonexistent or inadequate health programs and services are, unfortunately,
mainly the result of a broken immigration system. Public health leaders must advocate for
resources to address the growing needs of a population that have been in the country for
years, and that does not seem to be going anywhere any time soon.
The lack of accurate categorization and data among Hispanics as a whole and their
component subgroups is an additional topic that must take priority in the agendas of public
health officials. Lack of funding on the research sector is harming the Hispanic population in
the U.S. Without it, scientists cannot understand and address the needs of this growing
population. Programs and health services for Hispanics need to specifically address their
needs taking in consideration the uniqueness of the cultures among the different Hispanic
groups.
Furthermore, there is a critical need for Hispanic scientists and public health leaders
in the science sector. Hispanics scientists and researchers, or academicians from other
ethnicities with a true commitment to the welfare of the Hispanic population will represent
this population a lot better and will do a much better job at supporting and promoting
research institutes listed on the Appendix section need to be part of all major universities
across the country. The presence of such institutes, are not only supporting the Hispanic
residents living in the surrounding areas, these are also motivating students to pursue a
degree that focuses on the Hispanic populations.
A true passion for the Hispanic population, along with the necessary resources, will
push for investigatory and pilot projects about promising interventions that will focus on the
protective factors among the Hispanic population. The development of tailored prevention
programs and health care platforms designed for the specific needs of this population can
help Hispanics cope with stressors they face and help utilize the strengths they possess to
reach the highest health outcomes possible. These interventions must include and take
positive advantage of the natural health promoting, protective social capital, and familismo
Appendix: Resources for Providers & Academicians Working with the Hispanic Population
Promising Programs and Partnerships Lay Health Advisor Model
Vision y Compromiso: The Promotor Model
Established in 2000, Visión y Compromiso (VyC) is the leading organization in California providing training, leadership and ongoing advocacy and support to ‘Promotores’ and Community Health Workers.
http://www.visionycompromiso.org/wordpress/about-us/the-promotor-model/ Research Institutes
The Mecklenburg Area Partnership for Primary Care Research (MAPPR)
Mecklenburg Area Partnership for Primary Care Research (MAPPR) is committed to studying barriers to healthcare access for the underserved and vulnerable populations in Charlotte-Mecklenburg. Using Community Based Participatory Research (CBPR), we involve key stakeholders, including community members and patients, in all components of the research process.
https://www.mapprnc.org/researchprojects UCLA; Latin American Institute (LAI)
Established in 1959 at UCLA, the Institute is committed to excellence in its exchange of knowledge with students, specialists, and the surrounding community, and equips leaders and scholars with the information and skills required for understanding complex Latin American societies.
http://www.international.ucla.edu/lai#.WO_gX2U4lPM
UNC Charlotte Urban Institute & The Latin American Coalition: Mecklenburg County Latino Community Needs Assessment
This report was undertaken for the purpose of assessing the community service needs of Mecklenburg County’s Latino residents; and from this perspective, offers recommendations to public and private service providers. The research methodology for this study was multi-faceted and carried out over 11 months. Nearly 500 Mecklenburg County Latinos provided information and ideas, 231 service providing agencies and organizations participated; and local, state, and federal data sources were used in the analyses.
https://ui.uncc.edu/sites/default/files/pdf/2006LatinoNeeds_Report_Final7-11-06.pdf UMass: Mauricio Gaston Institute for Latino Community Development and Public Policy The Gaston Institute was established at the University of Massachusetts, Boston, through the initiative of Latino community activists and academicians in response to a need for improved understanding of Latino experiences and living conditions in Massachusetts. The institute informs policy makers about issues vital to the Commonwealth's growing Latino community and to provide this community with information and analysis necessary for effective
Appendix: Resources for Providers & Academicians Working with the Hispanic Population
Resources for Professionals Cultural Competency
NAMI Latino Outreach Resource Manual.
http://www.nami.org/TextTemplate.cfm?Section=Multicultural_Support1&Template=/ ContentManagement/ContentDisplay.cfm&ContentID=43251
Mental Health
Mental Health: A Guide for Latinos and their Families (30-minute DVD along with a companion guidebook on mental health).
http://www.psychiatry.org/practice/professional-interests/diversityomna/diversity-resources/ mental-health-a-guide-for-latinos-and-their-families-english
News Worth Exploring Diabetes in Mexico
NPR, Diabetes in Mexico: An Epidemic and the Number 1 Killer.
http://www.npr.org/sections/goatsandsoda/2017/04/05/522038318/how-diabetes-got-to-be-the-no-1-killer-in-mexico
NPR, In Diabetes Fight: Lifestyle Changes Prove Hard to Come by In Mexico.
References
Alegria, M. & Woo, M. (2009). Conceptual issues in Latino mental health. In Azmitia, M. et al. (Ed.), Handbook of U.S. Latino psychology (pp. 15-30). Thousand Oaks, CA: SAGE.
Amaro, H. & Vega, W. (1994). Latino outlook: good health, uncertain prognosis. LaVeist, T. (Ed.), Race, ethnicity, and health (pp.47-75). San Francisco, CA: Jossey-Bass.
American Immigration Council. (2016). Understanding the Central America refugee crisis: why they are fleeing and how U.S. policies are failing to deter them. Retrieved from
https://www.americanimmigrationcouncil.org/research/understanding-central-american-refugee-crisis
American Psychological Association. (2017). Stress Effects on the Body. Retrieved from http://www.apa.org/helpcenter/stress-body.aspx
Centers for Disease Control and Prevention. (May, 2015). Vital signs: leading causes of death, prevalence of diseases and risk factors, and use of health services among Hispanics in the United States – 2009-2013. Morbidity and Mortality Weekly Report (MMWR). Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6417a5.htm?s_cid=mm6417a5_w
Coreil, J. & Markides, K. (1986). The health of Hispanics in the Southwestern United States: an epidemiologic paradox. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477704/pdf/pubhealthrep00183-0027.pdf Fabrett, F., Gonzales, N. & Knight, G. (2009). Acculturation, enculturation, and the psychosocial
adaptation of Latino youth. In Azmitia, M. et al. (Ed.), Handbook of U.S. Latino psychology (pp. 15-30). Thousand Oaks, CA: SAGE.
Felenon, A. (2013). Revisiting the Hispanic paradox in the United States: the role of smoking. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3588600/
Franzini, L., Keddie, A. & Ribble, J. (2001). Understanding the Hispanic paradox. LaVeist, T. (Ed.), Race, ethnicity, and health (pp.47-75). San Francisco, CA: Jossey-Bass.
McElroy, R., Muennig, P. & Singer, E. (2016). Social capita and the paradox of poor but healthy groups in the United States. Retrived from
http://link.springer.com/article/10.1007%2Fs10903-016-0396-0
Pew Research Center. (April, 2014). Hispanic nativity shift: U.S. births drive population growth as immigration stalls. Retrieved from
Pew Research Center. (February, 2017). Latinos and the new Trump administration: growing share say situation of U.S. Hispanics is worsening. Retrieved from
http://www.pewhispanic.org/2017/02/23/latinos-and-the-new-trump-administration/ Stansfeld, S. (2006). Social support and social cohesion. In Marmot, M. & Wilkinson, R. (Ed.),
Social Determinants of Health (pp. 148-171). Oxford, NY: Oxford University.
The Huffington Post. (May, 2015). The Latino health paradox in 4 essential graphs. Retrieved from
http://www.huffingtonpost.com/2015/05/12/latino-health-paradox-cdc-report_n_7261628.html
The New York Times. (February, 2017). The new Trump deportation rules allow far more expulsions. Retrieved from https://www.nytimes.com/2017/02/21/us/politics/dhs-immigration-trump.html?_r=0
United States Census Bureau. (2015). Income and poverty in the United States: 2014. Retrieved from https://www.census.gov/content/dam/Census/library/publications/2015/demo/p60-252.pdf
