Introduction
Although Latino immigrants, especially noncitizens, endure structural factors that
may increase their risk of death at younger ages, little is known about their risk
of death in young adulthood. This study evaluates mortality differences across citizenship
status among young Latino adults (aged 18–44 years) in the U.S.
Methods
This study used the National Health Interview Survey (1998–2014) with mortality follow-up
through 2015. Cox regression models adjusted for age and sex were used to determine
baseline differences in mortality. Models adjusted for socioeconomic factors (i.e.,
English proficiency, education, poverty, and health insurance) were used to determine
whether socioeconomic conditions attenuate mortality differences.
Results
Participants included noncitizens (n=48,388), naturalized citizens (n=16,241), and U.S.-born citizens (n=63,388). Noncitizens (hazard ratio [HR]=1.40, 95% CI=1.31, 1.51), but not naturalized
citizens (HR=1.04, 95% CI=0.94, 1.16), were at greater risk of all-cause death than
U.S.-born citizens. Both noncitizens (HR=2.46, 95% CI=2.07, 2.92) and naturalized
citizens (HR=1.76, 95% CI=1.40, 2.21) were more likely to die of cancer. Noncitizens
were also at a greater risk of death because of cardiometabolic diseases (HR=1.46,
95% CI=1.20, 1.78) and accidents (HR=1.33, 95% CI=1.14, 1.55). Socioeconomic factors
attenuated differences in all-cause, cardiometabolic, and accidental deaths, but not
differences in cancer mortality.
Conclusions
Contrary to the long-held notion of the healthy migrant, young Latino immigrants,
especially noncitizens, are at increased risk of death than their U.S.-born counterparts.
Efforts to reduce these disparities should focus on improving their socioeconomic
conditions and healthcare access early in adulthood.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
American community survey (ACS). U.S. Census Bureau. https://www.census.gov/programs-surveys/acs. Updated December 15, 2021. Accessed December 31, 2021.
- Structural racism and health inequities: old issues, new directions.Du Bois Rev. 2011; 8: 115-132https://doi.org/10.1017/S1742058X11000130
- Understanding immigration as a social determinant of health: cardiovascular disease in Hispanics/Latinos and South Asians in the United States.Curr Atheroscler Rep. 2021; 23: 25https://doi.org/10.1007/s11883-021-00920-9
- A window of opportunity is opening to improve immigrant health: a research and practice agenda.Am J Public Health. 2021; 111: 398-401https://doi.org/10.2105/AJPH.2020.306128
- Migrant workers and their occupational health and safety.Annu Rev Public Health. 2018; 39: 351-365https://doi.org/10.1146/annurev-publhealth-040617-013714
- Nativity status and cardiovascular disease mortality among Hispanic adults.J Am Heart Assoc. 2017; 6 (e007207)https://doi.org/10.1161/JAHA.117.007207
- Mortality of foreign-born and U.S.-born Hispanic adults at younger ages: a reexamination of recent patterns.Am J Public Health. 2007; 97: 1297-1304https://doi.org/10.2105/AJPH.2006.094193
- Linkage methods and analytical support for NCHS linked mortality data.National Center for Health Statistics, Centers for Disease Control and Prevention, 2021 (Updated September 13, 2021. Accessed December 30, 2021)
- More than culture: structural racism, intersectionality theory, and immigrant health.Soc Sci Med. 2012; 75: 2099-2106https://doi.org/10.1016/j.socscimed.2011.12.037
- Cancer mortality rates among U.S. and foreign-born individuals: United States 2005–2014.Prev Med. 2019; 126105755https://doi.org/10.1016/j.ypmed.2019.105755
- Cancer facts & figures for Hispanics/Latinos 2018-2020.American Cancer Society, Atlanta, GA2021 (Published 2018. Accessed July 6, 2021.)
- Unpacking Hispanic ethnicity-cancer mortality differentials among Hispanic subgroups in the United States, 2004-2014.Front Public Health. 2018; 6: 219https://doi.org/10.3389/fpubh.2018.00219
- Immigration status and disparities in the treatment of cardiovascular disease risk factors in the Hispanic community health study/study of Latinos (visit 2, 2014-2017).Am J Public Health. 2020; 110: 1397-1404https://doi.org/10.2105/AJPH.2020.305745
- Citizenship status and the prevalence, treatment, and control of cardiovascular disease risk factors among adults in the United States, 2011-2016.Circ Cardiovasc Qual Outcomes. 2020; 13e006215https://doi.org/10.1161/CIRCOUTCOMES.119.006215
Young adult expansion. California Department of Health Care Services. https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/YoungAdultExp.aspx. Updated December 12, 2021. Accessed December 30, 2021.
- Excess deaths associated with COVID-19, by age and race and ethnicity - United States, January 26-October 3, 2020.MMWR Morb Mortal Wkly Rep. 2020; 69: 1522-1527https://doi.org/10.15585/mmwr.mm6942e2
Article Info
Publication History
Published online: February 07, 2022
Identification
Copyright
© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
