The Latino Paradox: Mental Health Appears to Not Be an Exception

Years ago, in a college class, I learned that socioeconomic status was commonly used as a predictor of health outcomes in most countries. I remember this well because my professor chose to exemplify global cases with extreme pictures of poverty and ghastly pathologies. What my sensationalist instructor forgot back then was to address how international migration would affect the locally observed epidemiologic correlation.

Today, with a growing population of Latinos in America, a paradox continues to gain statistical force based on mortality data. Upon arrival, struggling low-income Latino immigrants are generally healthier than most segments of the U.S. population.

The story appears to change within years. Length of residence in the U.S., as research suggests, may be associated with health deterioration.

Even though this phenomenon hasn’t been deciphered completely and the diversity of the Latino community complicates the equation, we are beginning to understand that the prevalence and manifestation of mental illness particularly differ between Latino immigrants and those born in the United States. Recent comparison studies have shown that:

• U.S.-born Latinos are at significantly higher risk than immigrant Latinos for major depressive episodes , social phobia, posttraumatic stress disorder, anxiety disorders and substance dependence and abuse.
• Compared to U.S.-born Mexican Americans and Puerto Ricans, Mexican immigrants who have lived fewer than 13 years in the U.S. or Puerto Ricans who have resided in Puerto Rico, experience lower levels of depression and other mental disorders.
• The incidence of mental illness among recent immigrant Mexicans and whites in comparison to their non-immigrant counterparts demonstrates that the immigrants, independently of ethnicity, experience fewer mental health disorders.

Birthplace and cultural variance have a significant correlation with subsequent risk for many psychiatric disorders. For most Latino immigrants without a history of trauma in their homeland, foreign nativity appears to initially serve a protective role against mental illness, even with the stress and poverty often associated with immigration.

What May Account for the Latino Paradox?

As I dig for possible explanations, more questions emerge:

• The American experience is highly determined by the constraints of economic success. As an immigrant, coping with the acculturation process and being disconnected from a familiar network, keeping up with one or two jobs and maintaining meaningful relationships commonly represent a continuous challenge. Would the chronic stress of balancing all of these aspects partially explain overall health deterioration?
• Almost inevitably, as Latino immigrants assimilate and adjust to their new environment, we adopt new behaviors. Research has demonstrated that we tend to consume more high-calorie foods, alcohol and tobacco products. We live more sedentary lives. Are accumulated unhealthy choices to blame for decline in health overall?
• The strains of immigration are not restricted to the migrant parents; they permeate the lives of the entire family. Conversely, Latino-American children exhibit health behaviors typical of Americans in their socioeconomic group, which generally tend to have higher rates of smoking and drinking. Children also struggle finding an identity while battling prejudice and discrimination, sometimes in the context of illegal immigration.
• The paradox may also have to do with institutional differences. Personally, coming from Colombia, with a different system of public health services and networks of support, I wonder about the role of culture in the spectrum of mental health diagnoses and treatments. Considering the lack of access to mental health services in the U.S. due to financial and linguistic barriers—and alternative help-seeking behaviors from extended families among Latinos—can the relative “strength” of Latino immigrants be a reflection of under–reporting and under-diagnosis, rather than truly lower prevalence?

There is Hope

As previously noted, the reasons behind the Latino health paradox may be tied to an array of different factors. And even though mortality rates support the notion of health advantages, they should not lead to hasty conclusions regarding the state and health outcomes of the subgroups that make up the Latino community.

Latinos, without a doubt, are at risk for psychiatric disorders. We cannot be ignored in mental health research and the development of treatment interventions; services need to be offered that fit our individual needs. NAMI advocates for access to services, treatment, support and research, and is fully committed to raising mental health awareness and building a community for hope for all those in need.

Help NAMI speak out on behalf of all individuals and families affected by mental illness.

• Learn about NAMI resources for the Latino community
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