Disparities in the United States Hispanic/Latino Populations

Healthcare Disparities (9/16)

What term is preferred by Americans of Latin American descent?

52% preferred Hispanic

29% preferred Latino

2% preferred Latinx

1% preferred Latine

15% no preference

Hispanic definition

Used to describe communities that are Spanish-speaking or of Spanish origin.

Spain and the Spanish-speaking nations of Latin America, such as Mexico, Cuba, and Argentina

Latino definition

A person with Latin American origin

Mexican (North America), Central American, South American, and Caribbean origin.

Latinx definition

A gender-neutral or non-binary alternative to Latino and Latina

More popularly used in the United States among academic, LGBTQIA+, and non-binary communities.

Latine definition

A gender-neutral or non-binary alternative to Latino and Latina

Latine replaces the “a” and “o” with the gender-neutral Spanish letter “e'“

How do Hispanic people have mixed views on how they describe their identity?

52% Hispanics identified with their family’s country of origin

29% used “Latino” or “Hispanic”

17% described themselves as “American”

Hispanic/Latino people are the ________ minority group in the US

• 63.7 million/ 19% of the population

LARGEST

• projected to exceed the white population by the census bureau by the middle of the 21st century

• several subsets within the population

Hispanic Americans are the youngest major racial or ethnic group —>

YOUNG POPULATION

• 31% of Hispanic Americans are under 18, compared to 22% of the nation

• The median age for Hispanic Americans is 29.8, nearly nine years lower than the median age of 38.5 for the entire US population

• About 8% of the Hispanic population is over 65, compared to 17% of the total population.

Education Attainment

88% of Hispanics, in comparison to 97% of non-Hispanic whites, had a high school diploma or higher

20.8% of Hispanics, in comparison to 25.8% of non-Hispanic whites and 16.5% of Asians had a bachelors degree or higher.

5.6% of Hispanics held a graduate or advanced professional degree, as compared to 14.3% of the non-Hispanic white population

Barriers to Education

• Need to support family

• English skills

• finances

• do not need an education for the career they want

Insurance Status

Hispanics have the HIGHEST insured rates of any racial or ethnic group within the US

• Private vs Public health insurance… in both sectors, less Hispanic/Latinos have coverage

• the uninsured rates vary by educational attainment

This data suggests that differences in insurance coverage by race and Hispanic origin stem partly from racial disparities, including inequities in educational attainment and unequal returns on the educational attainment achieved.

Percentage of people without health insurance in the US from 2010-2023, by ethnicity

Rates for Hispanic people are MUCH higher than other groups, 18% in 2023

Hispanic children are twice as likely as white children to be _______ (9.7% vs 4.9%)

UNINSURED

Factors contributing to this insurance gap

• immigrant parental status

• state-level Medicare expansion

• Language/literacy barriers

the CDC has cited some of the leading causes of death among Hispanic people as:

• heart disease

• cancer

• unintentional injuries (accidents)

• and stroke

Other health conditions and risk factors that significantly affect Hispanics are:

• poorly controlled HTN

• type 2 DM

• asthma

• chronic obstructive pulmonary disease

• HIV

• obesity

• Hepatitis C

Nearly 1 in 4 Hispanics (25%) have:

over 50% of Hispanics are expected to be diagnosed with type 2 diabetes in their lives

48% of the US hispanic population has __________ _______ ___________

high blood pressure

fatty liver disease (chronic liver disease)

_____ is the leading cause of death in the Hispanic population

CANCER

• hispanic women have a high rate of cervical cancer, and the second highest rate of dying from cervical cancer (after non-Hispanic Black women)

• Hispanic people have the second-highest rate of dying from liver cancer

• hispanic people are twice as likely to have a die from stomach cancer as non-Hispanic whites

What are barriers to healthcare?

• language barriers

• lack of paid sick leave

• lack of health insurance

• educational disparities

Hispanic people make up _______ of the labor force and they mainly work in service occupations.

one-fifth

Unemployment rates

The unemployment rate for Hispanic or Latin Americans in 2024 was 5.3% (a slight increase from 2023) highest ever was 12.5% in 2010…. higher than 3.6% overall employment rate in the US

The poverty rate for Latinos in the US is 17.2%

• the official poverty rate in the US was 11.1%

The median household income for Hispanics in the US in 2023 was $70,950 _____ the overall US median of $80,610

BELOW

Religion: most Hispanics are _____ ________

Roman Catholics

• religion plays a major role in health, illness, and daily life

• higher religiosity during Covid-19 was linked to LOWER depression and anxiety

• Religious organizations are seen as trusted and stable community partners for promoting health

• medical mistrust was more prevalent among those with immigrant parents who were active in church groups

Fatalistic views…

are shared by some Hispanic patients who believe that illness is God’s will or punishment for sinful behavior, and some incorporate prayer as a healing practice.

• Hispanic patients may choose to use home remedies and consult folk healers known as curanderos or curanderas, rather than pursue modern medicine

Understanding how social, structural, psychological, and cultural factors impact physical health and being aware of these factors can make a ____________________

significant difference in health outcomes

Beliefs affect:

• how and from whom a person will seek care

• how self-care is managed

• how health choices are made

• how a patient responds to a specific therapy

The average Hispanic family is _________ than the national average

LARGER

• cultural norms around gender, such as machismo and marianismo, may influence prevention, treatment, patient care, and health outcomes

  • men = protectors and financial supporters of the family

  • women = responsible for childrearing and household chores - primary force holding the family and home together

the ROLE of the FAMILY

the hispanic/latino family structure tends to be patriarchal and follows a rigid hierarchical structure

• family members provide social, emotional, and even financial support to each other.

Infant mortality rates

for Hispanic infants, the morality rate is 5.03 per 1,000 live births, which is HIGHER than Asian women and white women, but lower than American Indian, Alaska Native, and Black women

Life expectancy

the life expectancy in 2024, for Hispanic people, is higher than other ethnicities, except for Asian people. (80 years - positive trend)

The Hispanic Paradox

the Hispanic Epidemiological Paradox:

despite a significantly more disadvantaged risk factor profile, Hispanic people tend to outlive non-hispanic whites by several years. They have a lower mortality rate than non-hispanic whites, despite having a higher prevalence of risk factors for chronic diseases such as heart disease, diabetes, and cancer.

• lower incomes, lack of high school/advanced degrees —> lower infant morality ate and higher life expectancy

Factors that might contribute to the Hispanic paradox

• differences in healthcare access and quality

• differences in lifestyle factors such as diet and physical activity

• differences in cultural beliefs about health and illness

Salmon Bias hypothesis

some sick or dying Hispanics may return to their country of origin to receive care or to be with family. If these deaths were not recorded in the US it would artificially lower the mortality rate for Hispanics in the US

the Healthy Migrant Effect

• the idea that immigrants are healthier than the general population in their country of origin

• migration is physically and emotionally demanding, so those who migrate tend to be younger, healthier, and more resilient

• it helps explain why Hispanic immigrants may initially show lower rates of chronic disease, but these rates increase the longer they reside in the US

Immigrant definiton

an individual admitted to the US (or any other country) as a lawful permanent resident

Refugee definition

Any person who is outside of the country their nationality or, does not have a nationality, or is outside the country where they last lived and who is unable or unwilling to return to and unable or unwilling to avail themselves of the protection of that country because of persecution, or a well-founded fear of persecution, on account of race, religion, nationality, membership in a particular social group, or political opinion. 

Migrant definition

•A person who moves away from their place of usual residence, whether within a country or across an international border, temporarily or permanently

•International Organization for Migration-- >is an umbrella term and is not defined under international law.

immigration Health Issues

Immigrants, refugees, and migrants, especially if recently resettled in the U.S., may face many health disparities.

Factors leading to these disparities may include:

• Lack of health insurance

• Barriers to access to quality healthcare

• Workplace conditions

• Education

• Income and wealth gap

Recent U.S. immigration policies have led to substantial fears among immigrant and non-immigrant communities alike, setting the stage for a public health crisis. 

Examples of immigrant health issues

• High prevalence of PTSD, anxiety, and depression

• Higher prevalence of chronic conditions (DM, HTN, heart disease, malnutrition)

• Concentrated in jobs (construction and agriculture), carrying an increased risk of accidents, exposure to chemicals, & health issues from adverse weather conditions. 

• Delay or forgo necessary care due to lack of insurance, high costs, and other barriers.

• This delay in care can lead to more complex and expensive conditions to treat in the long run, negatively affecting overall health.

Other immigrant health issues

About 3 in 10 Immigrant Adults say they have had __________ obtaining respectful and culturally competent health care

challenges

What is the CDC doing?

• Providing disease surveillance, improving public health capacity at border crossings, and supporting outbreak responses

• Supporting international vaccination and parasite treatment programs for refugees resettling to the United States

• Providing guidance for pre-departure and post-arrival screening and treatment of refugees

• Developing and sharing culturally and linguistically appropriate health education and communication materials 

• Sharing relevant health information with U.S. health departments and healthcare providers providing care after they arrive in the U.S.

• Conducting additional research on public health issues that impact migrants

U.S.-Mexico Border and Binational Health

•The U.S. and Mexico are connected through border and binational communities that share social and environmental conditions.

•This connectedness affects communicable disease risks.

•CDC works with U.S.-Mexico partners to prevent and control disease spread across borders, and binational communities, and protect the health of border residents, d other mobile populations.

Migration and the Social Determinants of Health

• has a potential to impact health outcomes - changes in living conditions and access to healthcare

• determined by how good/available the services in the host community/country

• differences in the disease profiles and health risk factors between migrant and host populations, or inequalities in the access/uptake of preventative interventions and treatment outcomes.

•The process of migration includes different phases (pre-departure, travel and transit, destination and integration, and return), where the health of migrants can be adversely affected or positively enabled.
•Human mobility can also impact public health in relation to the prevention and control of emerging infectious diseases.

Sources of healthcare

About 7 in 10 immigrant adults say they go to a private doctor’s office (43%) or community health clinic (CHC) (30%) when they are sick or need health advice, but nearly one in five (17%) say they do not have a place other than an emergency room.

SUMMARIZE: Hispanic/Latino Disparities

• Higher rates of uninsurance

• Disproportionate burden of infectious disease

• Chronic disease disparities

• Impact of social determinants

SUMMARIZE: Immigration Disparities

• Limited access to public health programs

• language and cultural barriers

• fear and misinformation

• discrimination in healthcare settings

• occupational health risks