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The Hispanic health paradox for older Americans: an empirical note

International Journal of Health Economics and Management volume 19, pages 33–51 (2019)Cite this article

Abstract

Previous researchers have found that Hispanic immigrants tend to have better health than could be reasonably explained by their socioeconomic status and other demographic variables. The main objective of this study is to re-investigate the Hispanic health paradox covering the period from 1992 to 2012. Main contributions of the paper include using a data set of older Americans from the Health and Retirement Study. More importantly, we use two new measures of health. Previous research on the paradox had primarily used mortality or morbidity to measure health. In contrast, the HRS includes a measure of self-reported poor health from which we construct a latent health variable. Using both poor health and latent health we find that even among our sample of older Americans that Hispanic Immigrants remain more healthy than could be explained by their socioeconomic status and their other health inputs.

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Notes

  1. J.P. Smith and B. Edmonston, The New Americans: Economic, Demographic and Fiscal Effects of Immigration. Washington, DC: National Academy Press, 1997.

  2. For examples, Auster et al. (1969), Grossman (1972), Newhouse and Friedlander (1980), Rosen and Taubman (1982), Leigh (1983), Berger and Leight (1989), Kenkel (1991), Thornton (2002, 2011) and Tseng and Olsen (2016).

  3. According to MEPS, Hispanics include immigrants from Spanish speaking countries such as Puerto Rico, Cuba, Dominica, Mexico, Central or South America, Latin American and Latino. Non-Hispanics include U.S.-born citizens, legal residents and immigrants from Asia, Europe, Africa, and all other parts of the world except those Spanish speaking countries just described.

  4. For example, Hummer et al. (2000), Singh and Siahpush (2002) and Lin et al. (2003).

  5. See Table 16.1—Selected Studies on Hispanic Health outcomes in Franzini et al. (2001).

  6. The HRS (Health and Retirement Study) is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. More information is available at: http://hrsonline.isr.umich.edu/.

  7. Studies like Currie and Madrian (1999), Dwyer and Mitchell (1999), Baker et al. (2004) and Hamaaki and Noguchi (2009) discuss these issues related to self-reported health.

  8. Individuals who are economically inactive are inclined to under-report their health status retrospectively to rationalize their status.

  9. This approach has been used in studies like Disney et al. (2006) that uses objective health indicators as well as other personal characteristics and Jones et al. (2010) which uses only the objective health indicators, in creating the latent health stock.

  10. Unfortunately, the HRS does not distinguish between documented and undocumented immigrants. Hence, we cannot test whether differences exist as they might between these two groups of Hispanic immigrants.

  11. This includes the impact of both being an immigrant, which as noted in the text, is an approximate 10% improvement in health, and the impact of being an Hispanic immigrant separately, which varies from 8.14% up to 14.4%.

References

  • Abraido-Lanza, A. F., Dohrenwend, B. P., Ng-Mak, D. S., & Turner, J. B. (1999). The Latino mortality paradox: A test of the “salmon bias” and healthy migrant hypothesis. American Journal of Public Health, 89(10), 1543–1548.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Anderson, K. H., & Burkhauser, R. V. (1985). The retirement-health nexus: a new measure of an old puzzle. Journal of Human Resources, 20(3), 315–330.

    Article  Google Scholar 

  • Auster, R., Leveson, I., & Sarachek, D. (1969). The production of health, an exploratory study. Journal of Human Resources, 4, 411–436.

    Article  Google Scholar 

  • Baker, M., Stabile, M., & Deri, C. (2004). What do self-reported, objective, measures of health measure? Journal of human Resources, 39(4), 1067–1093.

    Article  Google Scholar 

  • Berger, M., & Leight, J. (1989). Schooling, self-selection, and health. Journal of Human Resources, 24, 433–455.

    Article  Google Scholar 

  • Bound, J. (1991). Self-reported versus objective measures of health in retirement models. Journal of Human Resources, 26, 106–138.

    Article  Google Scholar 

  • Bound, J., & Burkhauser, R. (1999). Economic analysis of transfer programs targeted on people with disabilities. In O. Ashenfelter & D. Card (Eds.), Handbook of labor economics (Vol. 3C, pp. 3417–3528). Amsterdam: Elsevier Science.

    Google Scholar 

  • Clark, L., & Hofsess, L. (1998). Acculturation. In S. Loue (Ed.), Handbook of immigrant health (pp. 37–59). New York, NY: Plenum Press.

    Chapter  Google Scholar 

  • Currie, Janet, & Madrian, Brigitte C. (1999). Health, health insurance and the labor market. In Orley Ashenfelter & David Card (Eds.), Handbook of labor economics (Vol. 3C, pp. 3309–3416). New York: Elsevier Science.

    Google Scholar 

  • Datta Gupta, N., & Larsen, M. (2010). The impact of health on individual retirement plans: Self-reported versus diagnostic measures. Health Economics, 19(7), 792–813.

    Article  PubMed  Google Scholar 

  • Disney, R., Emmerson, C., & Wakefield, M. (2006). Ill health and retirement in Britain: A panel data-based analysis. Journal of Health Economics, 25(4), 621–649.

    Article  PubMed  Google Scholar 

  • Dowd, J. B., & Todd, M. (2011). Does self-reported health bias the measurement of health inequalities in US adults? Evidence using anchoring vignettes from the Health and Retirement Study. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 66(4), 478–489.

    Article  Google Scholar 

  • Dwyer, Debra, & Mitchell, Olivia S. (1999). Health problems as determinants of retirement: Are self-rated measures endogenous? Journal of Health Economics, 18(2), 173–193.

    Article  CAS  PubMed  Google Scholar 

  • Franzini, L., Ribble, J. C., & Keddi, A. M. (2001). Understanding the Hispanic paradox. Ethnicity and Disease, 11, 496–518.

    CAS  PubMed  Google Scholar 

  • Gasso, G., & Rosenzweig, M. (1982). Estimating the emigration rates of legal immigrants using administrative and survey data. Demography, 19, 279–290.

    Article  Google Scholar 

  • Goldman, D. P., Smith, J. P., & Sood, N. (2006). Immigrants and the cost of medical care. Health Affairs, 25(6), 1700–1711.

    Article  PubMed  Google Scholar 

  • Grossman, M. (1972). The demand for health: A theoretical and empirical investigation. New York: National Bureau of Economic Research.

    Google Scholar 

  • Hamaaki, J., & Noguchi, H. (2009). Does health status matter to people’s retirement decision in Japan?: An evaluation of ‘justification hypothesis’ and measurement errors in subjective health. Mimeo, presented at iHEA 7th World Congress on Health Economics.

  • Hummer, R. A., Rogers, R. G., Amir, S. H., Forbes, D., & Frisbie, W. P. (2000). Adult mortality differentials among Hispanic subgroups and non-Hispanic whites. Social Science Quarterly, 81, 459–476.

    CAS  PubMed  Google Scholar 

  • Jones, A. M., Rice, N., & Roberts, J. (2010). Sick of work or too sick to work? Evidence on self-reported health shocks and early retirement from the BHPS. Economic Modelling, 27(4), 866–880.

    Article  Google Scholar 

  • Kenkel, D. (1991). Health behavior, health knowledge, and schooling. Journal of Political Economy, 99, 287–305.

    Article  Google Scholar 

  • Leigh, J. (1983). Direct and indirect effects of education on health. Social Science and Medicine, 17, 227–234.

    Article  CAS  PubMed  Google Scholar 

  • Liao, Y., Cooper, R. S., Cao, G., Durazo-Arvizu, R., Kaufman, J. S., Luke, A., et al. (1998). Mortality patterns among adult Hispanics: findings from the NHIS, 1986 to 1990. American Journal of Public Health, 88(2), 227–232.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lin, C. C., Rogot, E., Johnson, N. J., Sorlie, P. D., & Arias, E. (2003). A further study of life expectancy by socioeconomic factors in the National Longitudinal mortality Study. Ethnicity and Disease, 13, 240–247.

    PubMed  Google Scholar 

  • Markides, K. S., & Coreil, J. (1986). The health of Hispanics in the southwestern United States: An epidemiologic paradox. Public Health Reports, 101(3), 253–265.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Marmot, M. G., Adelstein, A. M., & Bulusu, L. (1984). Lessons from the study of immigrants mortality. The Lancet, 323(8392), 1455–1457.

    Article  Google Scholar 

  • Mohanty, S. A., Woolhandler, S., Himmelstein, D. U., Pati, S., Carrasquillo, O., & Bor, D. H. (2005). Health care expenditures of immigrants in the United States: A nationally representative analysis. American Journal of Public Health, 95(8), 1431–1438.

    Article  PubMed  PubMed Central  Google Scholar 

  • Newhouse, J., & Friedlander, L. (1980). The relationships between medical resources and measures of health: Some additional evidence. Journal of Human Resource, 15, 200–218.

    Article  CAS  Google Scholar 

  • Peri, Giovanni, The Effect of Immigrants on U.S. Employment and Productivity. FRBSF Economic Letter 2010-26, August 30, 2010. http://www.frbsf.org/publications/economics/letter/2010/el2010-26.html

  • Reichert, J., & Massey, D. S. (1979). Patterns of U.S. migration from a Mexican sending community: A comparison of legal and illegal migrants. International Migration Review, 13, 599–623.

    Article  CAS  PubMed  Google Scholar 

  • Ricardo, D. (1819). On the principles of political economy and taxation. London: John Murray.

    Google Scholar 

  • Rosen, S., & Taubman, P. (1982). Some Socioeconomic Determinants of Mortality. In J. V. Der Gagg, W. B. Neeman, & T. Tsukahara (Eds.), Economics of health care (pp. 255–271). New York: Praeger Publishers.

    Google Scholar 

  • Scribner, R. (1994). Letter to the editor. Journal of American Medical Association, 271, 1238.

    Article  CAS  Google Scholar 

  • Scribner, R. (1996). The health outcomes of Mexican Americans. American Journal of Public Health, 86(3), 303–305.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Shai, D., & Rosenwaike, I. (1987). Mortality among Hispanics in metropolitan Chicago: An examination based on vital statistics data. Journal of Chronic Disease, 40(5), 445–451.

    Article  CAS  Google Scholar 

  • Singh, G. K., & Siahpush, M. (2002). Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: An analysis of two national data bases. Human Biology, 74, 83–109.

    Article  PubMed  Google Scholar 

  • Smith, J. P., & Edmonston, B. (1997). The New Americans: economic, demographic and fiscal effects of immigration. Washington, DC: National Academy Press.

    Google Scholar 

  • Sorlie, Paul D., Backlund, Eric, Johnson, Norman J., & Rogot, Eugene. (1993). Mortality by Hispanic status in the United States. Journal of American Medical Association, 270(20), 2464–2468.

    Article  CAS  Google Scholar 

  • Stephen, E. H., Foote, K., Hendershot, G. E., & Schoenborn, C. A. (1994). Health of the foreign-born population: United States, 1989-90. Advance Data, 241, 1–12.

    Google Scholar 

  • Thornton, J. (2002). Estimating a health production function for the U.S.: Some new evidence. Applied Economics, 34(11), 59–62.

    Article  Google Scholar 

  • Thornton, J. (2011). Does more medical care improve population health? New evidence for an old controversy. Applied Economics, 43(24), 3325–3336.

    Article  Google Scholar 

  • Tseng, H., & Olsen, R. (2016). The U.S. health production function: Evidence from 2001 to 2009. International Journal of Health Economics and Management, 16(1), 51–64.

    Article  PubMed  Google Scholar 

  • Vega, W. A., & Amaro, H. (1994). Latino outlook: Good health, uncertain prognosis. Annual Review of Public Health, 15, 39–67.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Economics, Missouri State University, Springfield, USA

    Reed Olsen & Subhasree Basu Roy

  2. Department of Economics, University of North Carolina at Charlotte, Charlotte, USA

    Hui-Kuan Tseng

Authors
  1. Reed Olsen
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  2. Subhasree Basu Roy
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  3. Hui-Kuan Tseng
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Correspondence to Reed Olsen.

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Olsen, R., Basu Roy, S. & Tseng, HK. The Hispanic health paradox for older Americans: an empirical note. Int J Health Econ Manag. 19, 33–51 (2019). https://doi.org/10.1007/s10754-018-9241-4

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  • DOI: https://doi.org/10.1007/s10754-018-9241-4

Keywords

  • Hispanic health paradox
  • Health production function
  • Latent health

JEL

  • I10
  • J10
  • J14