The paradox does not fit all: Racial disparities in asthma among Mexican Americans in the U.S.

Abstract

Mexican Americans have a lower prevalence of asthma than White Americans, Black Americans, and Other Hispanics. This is concordant with the Hispanic Paradox, which posits that Hispanics have good health and lower mortality than White Americans despite their relative socioeconomic disadvantages. However, the research is limited in relation to the effects of race on health, independent of ethnicity, among this population. In this study, the author disaggregated Mexican Americans, foreign-born and U.S.-born into two categories, White and Black Mexicans, in order to assess their likelihood of having an asthma diagnosis, compared to White Americans and to each other. This study used harmonized data from the National Health Interview Survey from 2000-2018 with a final analytic sample of N = 1,094,516. The analysis was conducted using binary logistic regression, controlling for acculturation and health behavior-related variables, as well as sociodemographic characteristics. In the results, Black Mexicans had a significant disadvantage in relation to their White counterparts and White Americans. The findings suggest there is an intra-ethnic racial disparity in asthma and the Hispanic paradox is not applicable across racial lines for Mexican Americans. These findings also suggest Black Mexicans' poor asthma outcomes are the byproduct of various mechanisms of racial inequality.