By: Gabriella Watson, MS, Science Programs Coordinator
Hispanic Heritage Month, running from September 15 through October 15, is a time to recognize and celebrate the diverse Hispanic cultures, languages, and traditions that contribute to the rich identity of the United States. This annual celebration is also a time to highlight and address the unique health care needs and disparities experienced by individuals of different backgrounds within the broader Hispanic community.
Diversity Among Hispanics
In 2020, 62.1 million individuals in the United States identified as “Hispanic or Latino” accounting for 19% of the total U.S. population – making them the second largest racial and ethnic group in the country. By 2050, it is estimated that the Hispanic population will reach upwards of 128 million, with Latinas making up to 25% of the overall female population in the United States. A majority (65%) of Hispanics were born in the United States, including the 8.5 million Puerto Ricans who are citizens by birth. Among the various racial and ethnic groups in the United States, the Hispanic community stands out as one of the most diverse. In 2019, 61.5% of all Hispanics were of Mexican heritage and 9.7% were of Puerto Rican heritage. Meanwhile, there were approximately 1 million individuals originating from Cuba, El Salvador, the Dominican Republic, Guatemala, Colombia, and Honduras. Within each of these groups, many individuals further identify as Afro-descendent or of indigenous background.
Hispanic Health in the United States
Hispanic individuals across the country face unique health disparities, risk factors, and barriers to care – with variables such as language, socioeconomic status, insurance, immigration status, genetics, geographic location, and acculturation all working together to influence and shape health outcomes. In particular, the Hispanic population in the United States is disproportionately affected by obesity, with approximately 42.5% of Hispanic adults classified as obese, which in turn increases their risk for metabolic syndrome, diabetes, cardiovascular disease, and cancer. An estimated 50% of Hispanics will develop diabetes over their lifetime. Hispanics also have higher rates of chronic kidney disease and cirrhosis. Among the challenges to Hispanic women include being less likely to receive regular mammograms and pap tests and having a higher mortality rate from breast and cervical cancers compared to their non-Hispanic white counterparts.
The Hispanic Paradox
Amidst these disparities emerges what has been called the “Hispanic Paradox,” which declares that despite social disadvantages (e.g., lower income, lower rates of insurance coverage), Hispanic Americans have longer life expectancy and lower morality for most leading causes of death than compared to non-Hispanic white Americans. For instance, despite the increased prevalence of risk factors for cardiovascular disease (e.g., obesity), Hispanics have a 25% lower death rate from cardiac disease and 20% lower prevalence of congestive heart disease than non-Hispanic whites. Similarly, Hispanics have a 30% lower mortality and 20% lower morbidity due to cancer than non-Hispanic whites. This epidemiological trend was first identified nearly 40 years ago and was subsequently validated by the National Center for Health Statistics in 2010 and the Centers for Disease Control and Prevention in 2013. A recent STAT article also examined the history of this paradox but noted that adhering to it may have its shortcomings. Specifically, it spotlighted many researchers who are part of a growing conversation about how grouping individuals from diverse backgrounds together can lead to an incomplete picture of Hispanic health in the United States.
The Need for Data Disaggregation in Research
Our understanding of Hispanic health cannot end at the Hispanic Paradox; the paradox should push us to improve research in these subpopulations and dive deeper into disparities, differences, and distinctions. Overall, 20.8% of Hispanic adults have multiple chronic conditions, compared to 25.6% of non-Hispanic white adults. However, research has shown that an estimated 27.3% of Puerto Ricans have multiple chronic conditions. Looking at obesity, rates vary from 26.8% among South American males to up to 51.4% among Puerto Rican females – and Hispanics born in the United States have higher rates (47.1%) of obesity than those who are foreign-born (36.3%). In general, Hispanics have lower health insurance coverage, while Mexican foreign-born individuals experience the greatest health insurance disparity.
Evidently, the broad categorization of “Hispanic or Latino” in research obscures crucial health disparities among specific subgroups within the Hispanic population.
The importance of collecting expanded, detailed racial and ethnic data, along with language and migration-related information, cannot be overstated. These data points will enable researchers to identify and address the specific health needs and disparities among Hispanic subpopulations and provide truly equitable health care for all.
To learn more about Hispanic health, this Hispanic Heritage Month and all year long, explore these resources:
- HHS Office of Minority Health
- National Alliance for Hispanic Health
- National Association of Hispanic Nurses
- National Hispanic Medical Association
- National Hispanic Health Foundation
- National Minority Quality Forum
- NIH National Institute on Minority Health and Health Disparities
* Note: the terms “Hispanic” and “Latino” are used interchangeably throughout this blog. When referencing a primary source, SWHR follows an internal policy of using the race and ethnicity terminology from the original source.