As the United States celebrates National Hispanic Heritage Month, it is a good a time for all Americans to consider what researchers have dubbed the Latin paradox.
Despite having less income, schooling and access to health insurance, U.S. Hispanics live longer and die at significantly lower rates from leading causes of death than non-Hispanic whites. Hispanic boys and girls born in 2017 will live on average 78.2 and 83.3 years, respectively, according to U.S. Census Bureau projections. These averages are longer than those for non-Hispanic whites, Blacks, American Indians or Alaska Natives.
Foreign-born Hispanics, moreover, have been shown to have a lower prevalence of risk factors and better health outcomes than U.S.-born Hispanics, according to a review of national health survey data published by the Centers for Disease Control in 2015.*
None of this is to suggest U.S. Hispanics do not face significant health challenges. While they showed lower death rates for nine of the 15 leading causes of death in the United States in 2013, Hispanics died at higher rates from diabetes (51% higher), chronic liver disease and cirrhosis (48%) and had a higher prevalence of diabetes and obesity compared with whites, according to the CDC report.
Still, the findings support the notion that immigrants from Latin America generally tend to arrive with healthier lifestyles that result in longer and healthier lives than native-born Americans.
That’s a legacy worth celebrating during Hispanic Heritage Month, said Dr. Aram Alexanian, a Spanish-speaking family doctor with Novant Health Primary Care Gilead.
“Hispanic communities generally experience intense family bonds with immediate and extended family members when they immigrate to this country,” said Alexanian, who immigrated to Illinois from Mexico at age 11. “We often have family structures that span households. Those provide a huge benefit to one’s health, whether it be physical health or mental health. The more those structures break down, the more our lifestyles can change in ways that undermine our physical and mental well-being.”
With that in mind, here are five things every American can do to live a longer, healthier life.
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In the long term, immigrants tend to embrace the local diet, which in the United States includes packaged foods high in vegetable oils, sugar and salt – all ingredients that increase our chances of developing chronic illnesses. This is one aspect of the American lifestyle Latinos would be better off avoiding.
“I can tell you from personal experience,” Alexanian continued, “that when we first moved to the U.S. from Mexico, my mom still cooked. We never ate out. Going to Pizza Hut was a huge treat for us. As time went on, though, we became more apt to hit McDonald’s and Burger King. The problem is that, most restaurants cook for your palate, so you’ll come back. They don’t cook for your health.”
In addition to avoiding processed meats, sugar and trans fats, he advises choosing healthier options. Whether eating at home or at restaurants, substitute whole-grain breads for biscuits and white bread and swap out white rice with healthier brown or wild rice.
Upon arriving in the United States, many non-English speaking immigrants take jobs that are either entry-level or require significant manual labor. They can spend much of their day framing houses, mowing lawns, cleaning buildings or tending to livestock and crops. As they move up the socioeconomic ladder, they and their descendants are inclined to be less active. This less active lifestyle has contributed to the country’s obesity epidemic, which is a precursor to many chronic illnesses.
“There needs to be a conscious effort to not become sedentary, because part of what's happening is that with many of these higher paying jobs, you sit all day,” said Dr. Alexanian. “Also, in Mexico and many other Latin American countries, you walk to a lot of places. In the U.S., you drive everywhere.”
Regular exercise has been shown to strengthen bones and muscles, improve sleep quality, reduce the risk of cancer, diabetes and depression, be good for the brain, increase energy, and slow mental and physical decline among the elderly.
“Twenty to 40 minutes of exercise per day is ideal, but any increase in physical activity is beneficial,” Alexanian said.
Reduced sleep has been linked to seven of the 15 leading causes of death in the United States, including cardiovascular disease, cerebrovascular disease, accidents, high blood pressure and diabetes, which afflicts many U.S. Hispanics, according to a 2018 analysis of medical research. One study found individuals who slept less than six hours each night had a tenfold greater risk of premature mortality than those who obtained seven to nine hours of sleep. Sleep loss can also undermine our immune system and ability to resist infectious illnesses, including COVID-19.
“Your brain just has to relax, and if you are scrolling through your work emails starting to think about all the things you have to do in the morning, you mind is revving up,” said Alexanian “Your bed is for sleep only. Smart devices have to go.”
Avoiding large meals, caffeine or alcohol within two hours of bedtime is also critical to your “sleep hygiene.” There are many things you can do to improve sleep hygiene, including having consistent sleep and wake times; making sure the bedroom is dark, quiet and relaxing; removing TVs and other electronic devices from your bedroom and getting regular exercise.
“People think they sleep better after they drink, but alcohol interferes with your sleep architecture,” Alexanian said. “For example, if you snore, it will get worse and your sleep apnea will get worse, and sleep apnea is not good for your health on many levels. So if you have a partner who snores, encourage them to bring it up with their doctor.”
Some research indicates that strong family, faith and social ties help drive the Latin Paradox by providing a kind of resilience that not only helps them overcome life’s many obstacles, but enhances their overall mental and physical well-being.
“We are social beings,” said Alexanian. “We need to be around people we like and love – whoever that social group is. As COVID-19 has shown us, loneliness is not a good thing, especially for the elderly.”
Federal surveys show that just 14% of Hispanics smoke, compared with 24% of non-Hispanic whites. Tellingly, Puerto Rican males – 26% of whom smoke – have the worst overall health with higher cancer rates and heart problems than any other Hispanic group in the United States.
Hispanic students, meanwhile, are just as likely as their non-Hispanic peers to smoke cigarettes, and Hispanic middle schoolers substantially outpace their white counterparts when it comes to smoking some tobacco products, e-cigarettes and hookahs.
While many people realize smoking can hurt their lungs, there is less awareness about how it increases the risk of heart disease and stroke, the second and fourth largest cause of death among U.S. Hispanics, according to CDC data.
“I think we can all agree that sense of community in Latin culture is very strong,” said Alexanian. “So if you are not going to do it for yourself, do it for others, because secondhand smoke has very harmful effects.”
* Specifically, the prevalence among foreign-born Hispanics of obesity, high blood pressure, smoking, heart disease and cancer was 23%, 29%, 42%, 47% and 48% lower, respectively, than among U.S.-born Hispanics.