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Migration Selection, Protection, and Acculturation in Health: A Binational Perspective on Older Adults

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Demography

Abstract

In this article, we test for four potential explanations of the Hispanic Health Paradox (HHP): the “salmon bias,” emigration selection, and sociocultural protection originating in either destination or sending country. To reduce biases related to attrition by return migration typical of most U.S.-based surveys, we combine data from the Mexican Health and Aging Study in Mexico and the U.S. National Health Interview Survey to compare self-reported diabetes, hypertension, current smoking, obesity, and self-rated health among Mexican-born men ages 50 and older according to their previous U.S. migration experience, and U.S.-born Mexican Americans and non-Hispanic whites. We also use height, a measure of health during childhood, to bolster some of our tests. We find an immigrant advantage relative to non-Hispanic whites in hypertension and, to a lesser extent, obesity. We find evidence consistent with emigration selection and the salmon bias in height, hypertension, and self-rated health among immigrants with less than 15 years of experience in the United States; we do not find conclusive evidence consistent with sociocultural protection mechanisms. Finally, we illustrate that although ignoring return migrants when testing for the HHP and its mechanisms, as well as for the association between U.S. experience and health, exaggerates these associations, they are not fully driven by return migration-related attrition.

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Notes

  1. Also note that the Latino immigrant advantage in mortality seems to be robust to the existence of various kinds of data artifacts (Elo et al. 2004; Markides and Eschbach 2005).

  2. It is unclear whether the same patterns hold for the various other health outcomes that Crimmins et al. (2005) examined because the analytical strategy they followed did not involve similar cross-sample comparisons allowing separate tests for emigration and return migration selection.

  3. Life expectancy for both sexes in the United States is 78 years, while in Mexico, it is two years lower (World Health Organization WHO 2009). Although this difference is nontrivial, it is perhaps less than expected given the large income and development gap between the two countries (Kuhn 2010).

  4. About 60 % to 70 % of U.S. migrants came from this region between 1925 and 1980, the period in which the members of the cohorts under study emigrated to the United States for the first time (Durand and Massey 2003: chapter 3). In analyses not shown, we restricted the MHAS sample to individuals living in high-migration states, finding similar results to those using the full sample.

  5. Our results do not change substantially if we ignore this restriction, which eliminates 36 % of all return migrants. We deem these tests, however, as more conservative than those using the full sample of return migrants.

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Acknowledgments

We thank four anonymous reviewers and Stewart Tolnay (Demography Editor during the review process) for their comments and suggestions. We have also benefited from conversations with Agustín Escobar-Latapí, Randall Kuhn, Craig McIntosh, Chris Woodruff, René Zenteno, and participants of UCSD’s Center for U.S.-Mexican Studies seminar series (May 2008). We also thank Nancy Mann, Janet Clear, and the editorial staff at Demography for thorough editing assistance. We acknowledge research support from NIA to Rebeca Wong and Alberto Palloni via Grants R01AG025533, R01AG018016, and R37AG025216, and to Fernando Riosmena from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Grant R03HD066061 and the University of Colorado’s College of Arts and Sciences’ Dean’s Fund for Excellence. We also acknowledge Center Grants P30HD05876, P30AG17266, and D43TW01586 to the Center for Demography and Ecology, Center for Demography of Health and Aging, and Fogarty International Population Center, University of Wisconsin–Madison; Center Grant R24HD041041 to the Population Research Center, University of Maryland; and Center Grants R21HD51146 and R24HD066613 to the Population Center, University of Colorado at Boulder. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NICHD, or the National Institutes of Health.

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Authors and Affiliations

  1. University of Colorado at Boulder, 483 UCB, Boulder, CO, 80309, USA

    Fernando Riosmena

  2. University of Texas Medical Branch, Galveston, TX, USA

    Rebeca Wong

  3. University of Wisconsin, Madison, WI, USA

    Alberto Palloni

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  1. Fernando Riosmena
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Correspondence to Fernando Riosmena.

Appendix

Appendix

Table 7 Means (and SDs) of health and sociodemographic indicators among U.S.-born NH whites and Mexican-origin groups observed in the United States and Mexico, men ages 50 and older (weighted estimates)
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Table 8 Wording in select questions measuring health indicators used in the 1997–2007 National Health Interview Surveys (NHIS) and the 2001 Mexican Health and Aging Study (MHAS)
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Table 9 Summary of groups and hypothesis tests
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Table 10 Adjusted odds ratios for men of Mexican origin according to nativity, migration status, and U.S. experience, relative to U.S.-born non-Hispanic whites
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Riosmena, F., Wong, R. & Palloni, A. Migration Selection, Protection, and Acculturation in Health: A Binational Perspective on Older Adults. Demography 50, 1039–1064 (2013). https://doi.org/10.1007/s13524-012-0178-9

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