Latina Birth Outcomes in California: Not so Paradoxical
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Objectives To investigate Latina-White differences in birth outcomes in California from 2003 to 2010, looking for evidence of the often-cited “Latina paradox” and assessing the possible role of socioeconomic factors in observed differences. MethodsUsing statewide-representative data from the California Maternal and Infant Health Assessment, an annual population-based postpartum survey, we compared rates of preterm birth (PTB) and low birth weight (LBW) in five groups: U.S.-born non-Latina Whites (“Whites”), U.S.-born Mexican–Americans, U.S.-born non-Mexican Latinas, Mexican immigrants, and non-Mexican Latina immigrants. Logistic regression models examined the relative likelihood of PTB and LBW for women in each Latina subgroup compared with Whites, before and after adjustment for socioeconomic and other covariates. Results In unadjusted analyses, women in each Latina subgroup appeared more likely than White women to have PTB and LBW, although the increased likelihood of LBW among Mexican immigrants was statistically non-significant. After adjustment for less favorable socioeconomic characteristics among Latinas compared with Whites, observed differences in the estimated likelihoods of PTB or LBW for Latina subgroups relative to Whites were attenuated and (with the exception of PTB among U.S.-born Mexican Americans) no longer statistically significant. Conclusions We found no evidence of a “Latina paradox” in birth outcomes, which some have cited as evidence that social disadvantage is not always health-damaging. As observed in several previous studies, our findings were non-paradoxical: consistent with their socioeconomic disadvantage, Latinas had worse birth outcomes than non-Latina White women. Policy-makers should not rely on a “Latina paradox” to ensure good birth outcomes among socioeconomically disadvantaged Latina women.
KeywordsLatina paradox Disparities in preterm birth Low birth weight Socioeconomic factors
The data used for this study were produced with funding from the California Department of Public Health, Maternal, Child and Adolescent Health Program. The study was supported in part by a grant from the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (Sanchez-Vaznaugh K01HL115471). The content in this article is solely the responsibility of the authors and does not necessarily represent the official views of the funding institutions.
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