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Health Status Among US Hispanics: Ethnic Variation, Nativity, and Language Moderation

Jerant, Anthony MD*; Arellanes, Rose MD, MPH*; Franks, Peter MD†

doi: 10.1097/MLR.0b013e3181789431
Original Article

Background: The relationship between health status and Hispanic ethnicities, language, and nativity is poorly understood, due to the limitations and conflicting findings of previous studies.

Objectives: To examine the effects of language and nativity on health status in Hispanic ethnic subgroups and non-Hispanic whites (whites).

Research Design: Cross-sectional analyses of data from the 1998–2004 National Health Interview Survey linked to the 1999–2005 Medical Expenditure Panel Survey. Health status was regressed on race/ethnicity, interview language, and nativity, with adjustment for demographic and socioeconomic variables.

Subjects: A total of 16,489 Hispanics (13,522 Mexicans, 778 Cubans, 1360 Puerto Ricans, and 829 Dominicans) and 45,422 whites.

Measures: SF-12 mental (MCS-12) and physical (PCS-12) component summary scores.

Results: In adjusted analyses, Mexicans had significantly higher MCS-12 scores than other Hispanics and whites, with the largest advantage noted for Spanish-speaking Mexicans. Ethnic origin * nativity interaction effects were significant for both MCS-12 [adjusted Wald test, F (3236) = 7.27, P = 0.0001] and PCS-12 [F (3236) = 4.75, P = 0.0031]. Continental US-born Mexicans had worse mental and physical health status than non-US-born Mexicans. By contrast, continental US birth was associated with better mental health status for Cubans and Dominicans, and better physical health status for Puerto Ricans.

Conclusions: Complex interactions exist among language, nativity, ethnicity, and health status among Hispanics. Mexicans have better health status than whites and other Hispanics, and the moderating effects of nativity and language differ for Mexicans compared with other Hispanics. Future research should approach Hispanics as a diverse grouping rather than a monolithic entity.

From the *Department of Family and Community Medicine, University of California Davis School of Medicine; and the †Center for Healthcare Policy and Research, Department of Family and Community Medicine, University of California Davis School of Medicine, Sacramento, California.

Supported in part by the Primary Care Outcomes Research Fellowship Program at the University of California Davis School of Medicine.

Reprints: Anthony Jerant, MD, Department of Family and Community Medicine, University of California Davis School of Medicine, 4860 Y Street, Suite 2300, Sacramento, CA 95817. E-mail: afjerant@ucdavis.edu.

© 2008 Lippincott Williams & Wilkins, Inc.