The Latino Health Experience: Past and Future

• Authors: Noreen Goldman (Princeton University) and Anne R. Pebley (University of California, Los Angeles)
• Title: The Latino Health Experience: Past and Future 
• Journal: National Academy of Sciences

Latinos make up a large and growing share of the United States' population, yet public conversations about Latino health have often been shaped by the so-called Hispanic Paradox. That model highlights Latin individuals’ relatively long life expectancy despite below-average socioeconomic status and reduced access to healthcare. Noreen Goldman, the Hughes Rogers Professor of Demography and Public Affairs at the Princeton School of Public and International Affairs, and Anne Pebley of the University of California, Los Angeles, examine this phenomenon further.

“Although many studies have shown that Latinos live longer than the White and Black populations, researchers have devoted much less attention to the many health challenges suffered by Latinos,” Goldman said. “Over the past two decades, we explored various health outcomes in the Latino population to obtain a better understanding of the health disadvantages faced by Latinos despite their high life expectancy.”

The team also looked at how immigration and deportation shape the makeup of the Latino population and, in turn, affect health patterns. The team’s analysis pays particular attention to occupations, unequal access to healthcare, and the limits of self-reported health measures due to language and cultural differences.

The research highlights several major findings about Latino health in the United States. 

First, Latinos have maintained a life expectancy advantage over White individuals for much of the past two decades, but that advantage coexists alongside clear health disadvantages, including higher rates of obesity, diabetes, disability, and functional limitations. 

Pebley explained that “these disadvantages appear to be due primarily to social factors like lower income, less education, more people working at physically challenging and hazardous jobs, and poorer access to health insurance and healthcare.”

Second, the COVID-19 pandemic exposed how fragile the mortality advantage can be. During 2020 and 2021, Latinos experienced steep losses in life expectancy, linked to social and economic vulnerabilities such as crowded multigenerational households, frontline work with high exposure risk, lower-quality healthcare access, and limited Spanish-language health information.

Third, Goldman and Pebley found that higher socioeconomic status does not appear to improve health for Latinos to the same extent that it does for Whites.

“It's complex. Part of it may be structural and interpersonal discrimination in employment, as well as access to health insurance, quality health care, and a good education. But socioeconomic differences in health, health behaviors in countries of origin and the US, and selective in- and out- migration by socioeconomic status and health also play a role.” Pebley says.

Lastly, the study found that Latino workers, specifically first-generation immigrant workers, are more likely to hold physically demanding jobs than other groups, which can result in elevated rates of functional limitations and disability later in life.

“Our findings suggest that a greater likelihood of employment in physically challenging and hazardous jobs and continued social and economic disadvantages underlie many of Latinos' health concerns, including relatively high rates of disability and functional limitations and a large loss of life during the COVID-19 pandemic,” Goldman said. “We speculate that many of the health challenges faced by Latinos in recent years are likely to worsen due not only to continued inequalities but also to increasing stress and poorer access to healthcare from ongoing anti-immigrant policies and the prospect of future epidemics.”