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Assimilation and Health: Evidence From Linked Birth Records of Second- and Third-Generation Hispanics

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This study explores the effects of assimilation on the health of Hispanics in the United States, using ethnic intermarriage as a metric of acculturation. I exploit a unique data set of linked confidential use birth records in California and Florida from 1970–2009. The confidential data allow me to link mothers giving birth in 1989–2009 to their own birth certificate records in 1970–1985 and to identify second-generation siblings. Thus, I can analyze the relationship between the parental exogamy of second-generation Hispanic women and the birth outcomes of their offspring controlling for grandmother fixed effects as well as indicators for second generation’s birth weight. Despite their higher socioeconomic status, third-generation children of second-generation intermarried Hispanic women are more likely to have poor health at birth, even after I account for second-generation health at birth and employ only within-family variations in the extent of assimilation. I find that a second-generation Hispanic woman married to a non-Hispanic man is 9 % more likely to have a child with low birth weight relative to a second-generation woman married to another Hispanic. These results largely reflect the higher incidence of risky behaviors (e.g., smoking during pregnancy) among intermarried Hispanic women.

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  1. In a companion study (Giuntella 2013), I showed that modest positive selection on health at the time of migration can account for the initial advantage in birth outcomes of second-generation Mexicans. Moreover, a simple process of regression toward the mean reverses the apparent paradox and predicts a greater deterioration than that observed in the data. Yet, the convergence would have occurred more quickly if immigrants had not socioeconomically assimilated or if they had fully assimilated in the incidence of risky behaviors during pregnancy.

  2. Throughout the article, I use the term “intermarriage” loosely because I use only the father’s ethnicity regardless of the actual marital status.

  3. Economists have shown growing interest in studying the determinants of intermarriage (Bisin and Verdier 2000; Bisin et al. 2004) and the effect of family structure on the economic assimilation of immigrants (Baker and Benjamin 1997; Eckstein and Weiss 2002; Furtado and Trejo 2012; Meng and Gregory 2005). Most studies have focused on first-generation immigrants, suggesting that marrying a native is positively associated with the success of immigrants in the labor market. These studies have provided evidence that intermarriage may improve job prospects and increase the rate of economic assimilation by facilitating the adoption of the host country’s customs, improving language proficiency, and expanding social connections (Furtado and Theodoropoulos 2010).

  4. To gain access to the data and conduct this study, I obtained approval from the Florida Department of Health Institutional Review Board, the California Health and Human Service’s Committee for the Protection of Human Subjects, and the Boston University Institutional Review Board, where I conducted the analysis.

  5. I obtained data from the California Department of Public Health for the years 1970–1981 and 1989–2009.

  6. However, when I considered individuals whose mothers were born abroad and reported Hispanic origin, the results are substantially unchanged. In addition, only 0.06 % of second-generation Hispanic women in the sample reported black race. Excluding them from the analysis did not change the results.

  7. Regarding the matching of mothers to grandmothers, in California, I matched only one daughter in 84 % of the cases, I matched two daughters in 12 % of the cases, and I matched three or more daughters to each grandmother in 4 % of the cases. In Florida, I matched only one daughter in 80 % of the cases, I matched two daughters in 17 % of the cases, and I matched three or more daughters to each grandmother in approximately 3 % of the cases. Over the entire sample, the average number of children matched to each mother is 1.91; the average number of grandchildren linked to each grandmother is 2.50, and this figure would be 4.20 if it were conditioned on linking at least two second-generation sisters to their offspring.

  8. Because the information on father’s race is missing for 40 % of the sample, I do not use it in the main analysis. For those observations for which information on father’s race is available, only 2.37 % of second-generation Hispanic women had a black partner. Similarly using national data from the Natality Detail data (see the Possible Mechanisms section), I find that approximately 96 % of the non-Hispanic fathers of children born to Hispanic mothers report a white race, 3 % report black race, and 1 % report other races (American Indian, Alaskan, Asian, and Pacific Islander). Among those for whom information on father’s country of birth is available, 98 % of non-Hispanics were born in the United States. Controlling for father’s race or excluding black fathers from the analysis does not affect the main results.

  9. Data are available online (

  10. Using the 2000 U.S. Census Bureaus surname list, I consider as Hispanic any surname with a posterior probability of being associated with Hispanic ethnicity higher than .7, but the results are robust to the use of different thresholds. Furthermore, using self-reported ethnicity to define intermarriage yields similar findings.

  11. Information on father’s surname is missing for approximately 13 % of third-generation births. However, information on self-reported ethnicity is available in 99 % of the sample. In Online Resource 3, I show that using father’s self-reported ethnicity to define intermarriage yields substantially identical results (see Table S8).

  12. Adequate prenatal care is defined as beginning prenatal care in the first trimester of pregnancy. Access to first-trimester care is a conventional way to assess the access to care for pregnant women (

  13. Note that the information on marital status is available only for a subsample of the observations and relies on apparent marital status.

  14. For this measure, I consider children who were reported dead within a year. However, most of the children who died in their first year of birth died in their first week.

  15. The APGAR scale is determined by evaluating the newborn baby on five criteria (appearance, pulse, grimace, activity, and respiration) on a 10-point scale.

  16. As a robustness check, I also estimate a probit model; see Table S7 in Online Resource 3.

  17. The number of times a woman has given birth.

  18. When the estimates are broken down by country of origin, the coefficient on intermarriage is positive and significant for Mexicans (0.004; SE = 0.002), although it is positive but not statistically significant for Cubans (0.006; SE = 0.007) and Puerto Ricans (0.003; SE = 0.012). Using information on father’s country of origin to define intermarriage and excluding U.S.-born Hispanic men results are similar (0.009; SE = 0.009), but the results are not precisely estimated given that we have information on father’s country of origin for only a subsample of the data.

  19. Because LBW due to shortened gestational age has different causes and different short- and long-run consequences than those cases due to intrauterine growth restriction, I estimate the baseline specification of column 4 controlling nonlinearly for gestational weeks. The estimated effect is only marginally smaller (0.004; SE = 0.002).

  20. Restricting the analysis to third-generation children born after 1995 (2000), the point estimates are larger but not statistically different from the main results illustrated in the article (see Online Resource 3).

  21. Similar results are obtained when analyzing alcohol consumption, although the differences are not significant for gestational hypertension. Results are available upon request.

  22. Using only first-generation immigrants or including all individuals reporting a given ethnic origin, which includes second and later generations, yields similar results.

  23. However, it is possible that a pregnant Hispanic woman married to a non-Hispanic man feels additional stress from her child’s loss of ethnicity (i.e., many third-generation Hispanics do not speak Spanish).

  24. The result on white non-Hispanic women is robust not only to the addition of the father’s and mother’s education but also to the separate analysis of women who married equally, more-, or less-educated Hispanic men (results available upon request). In addition, when controlling for grandmother fixed effects and the previous generation’s birth weight, I find that marrying a high school dropout has no significant effect on the risk of LBW among children born to non-Hispanic U.S.-born mothers.

  25. The TUS-CPS is an NCI-sponsored survey of tobacco use and policy information that has been administered as part of the Current Population Survey (CPS) since 1992. The CPS is a monthly survey conducted by the U.S. Census Bureau for the U.S. Department of Labor, Bureau of Labor Statistics. Results are available upon request.

  26. Although the prevalence of smoking among Hispanics is lower than the prevalence among non-Hispanic whites, smoking prevalence among Hispanic men is substantially higher than among Hispanic women and is not statistically different from the prevalence observed among non-Hispanic whites (Agaku et al. 2014). Hispanic women are also much more likely than non-Hispanic white women to quit smoking during pregnancy (Osterman et al. 2013).

  27. These results are available upon request.

  28. Including information on maternal weight gain and maternal diabetes leaves the estimates practically unchanged. The results are available upon request.

  29. For instance, maternal dietary practices are significant determinants of health at birth, and there is evidence of unhealthy assimilation with respect to dietary habits (Guendelman and Abrams 1995). Using the American Time Use Survey, I find evidence that among immigrants of Hispanic origin, intramarriage is positively associated with time spent on food preparation and consumption.


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I am grateful to Francisca Antman, Randall Ellis, Delia Furtado, Rania Gihleb, Kevin Lang, Claudia Olivetti, and Daniele Paserman for their comments and useful suggestions. I am also thankful to Yasmine Serrano (Florida Department of Health) and Julie Turner (California Department of Public Health), who were extremely helpful with the data collection process. I would like to thank all the participants at the AlpPop 2015 Conference, the 2015 annual meeting of the Population Association of America, as well as all seminar attendees at the University of Manchester and the University of Oxford. Any errors are my own. The project was made possible by generous funding from the Boston University Institute for Economic Development.

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Correspondence to Osea Giuntella.

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Giuntella, O. Assimilation and Health: Evidence From Linked Birth Records of Second- and Third-Generation Hispanics. Demography 53, 1979–2004 (2016).

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