Significance

The population of the United States has continued to grow in recent decades fueled to a large extent by immigration from Latin America, especially Mexico. The Hispanic population is expected to grow from around 55 million today to approximately 120 million in 2050, or around 30 percent of the total population (Passel and Cohn, 2008). The Hispanic population is also aging rapidly with persons 65 and older projected to increase from 2.9 million in 2010 to around 17.5 million in 2050 or around 19.8 percent of the total older population of the United States (Vincent and Velkoff, 2010). The proposed RCMAR investigators have demonstrated a long-standing interest in the health of older people, especially of older Mexican Americans in Texas and the Southwestern United States.

The literature on aging in the Hispanic and Mexican American populations has had an interesting history. Beginning with the mid-1980s, an “epidemiological paradox” was identified to reflect a relatively favorable health and mortality profile of the Hispanic population of the Southwest (Markides and Coreil, 1986; Hayes- Bautista, 1992; Franzini et al, 2001). By the early 1990’s the literature began suggesting a Hispanic mortality advantage which was confirmed by the first-ever life tables for the Hispanic population for 2006 which showed a 2.5-year life expectancy at birth advantage for Hispanics over non-Hispanic Whites and a 7.7-year advantage over African Americans (Arias, 2010). It is widely assumed that the Hispanic mortality advantage is driven by immigrant health selection coupled with superior health behaviors and strong family systems and it is especially present in the Mexican-origin population which accounts for about two-thirds of the Hispanic population (Markides and Eschbach, 2011).

Despite the Mexican American population’s greater longevity, the literature has provided consistent evidence that by the time they reach old age persons of Mexican origin become more disabled because of changes in health behavior but also because of high rates of poverty, obesity, diabetes, as well as a lifetime of substandard medical care (Tovar et al, 2007; see also Hayward et al, 2014). Data from the Hispanic EPESE for those aged 75 and over have suggested recent increases in disability among Mexican Americans which have been accompanied by increases in diabetes as well as cognitive impairment (Beard et al, 2009; Markides and Gerst, 2011). Despite considerable progress in the literature, considerable gaps in knowledge remain especially the kind of knowledge needed to improve the health status of elderly Mexican Americans. In addition, there has been a scarcity of minority investigators who bring a unique and important perspective to this research.

References

• Angel, J.L., Rote, S., Brown, D., Angel R., Markides, K. Nativity status and sources of care assistance among elderly Mexican-Origin Adults. Journal of Cross-Cultural Gerontology, 29: 243-258, 2014. PMC4304657
• Arias, E., (2010). United States life tables by Hispanic origin. Vital and Health Statistics, Washington, D.C.; National Center for Health Statistics, 2(152).
• Beard, H.A., Al Ghatrif, M., Samper-Ternent, R.A., Gerst, K., and Markides, K.S. Treends in diabetes prevalence and diabetes-related complications in older Mexican Americans from 1993-1994 to 2004-2005. Diabetes Care 2009, 32(12): 2112-1.
• Flores, D.V., Rote, S., Angel, J., Chen, N. Downer, B., Markides, K.S. Depressive Symptoms in Child Caregivers of Very Old Mexican Americans (in review).
• Franzini, L., Ribble, J.C., Keddie, A.M., Understanding the Hispanic Paradox. Ethnicity and Disease, 11: 496-518, 2001.
• Hayward, M.D., Hummer, R.A., Chiu, C.T., Gonzalez-Gonzalez, C., & Wong, R. (2014). Does the Hispanic Paradox in U.S. Adult Mortality Extend to Disability? Population Research and Policy Review, 33(1), 81-96. doi:10.1007/s11113-013-9312-7
• Hayes-Bautista, D., (1992). Latino health indicators and the underclass model: from paradox to new policy models. In A. Furino (ed.) Health Policy and the Hispanic, 32-47. Boulder, CO. Westview Press.
• Markides, K.S. & Coreil, J. (1986). The health of Hispanics in the Southwestern United States – An epidemiologic paradox. Public Health Reports. 101, 253-265.
• Markides, K.S. & Eschbach, K. (2011). Hispanic Paradox in Adult Mortality in the United States. In E. Crimmins and R. Rogers (Eds) International Handbook of Adult Mortality. 225-238 New York Springer Publishers.
• Markides, K.S. & Gerst, K. (2011). Immigration, Health and Aging in the United States. In R. Settersen and J. Angel (Eds), Handbook of the Sociology of Aging. New York: Springer, 103-116.
• Passel, J.S., Cohn, D. (2008). U.S. Population Projections: 2005-2050. Washington, D.C.: Pew Hispanic Center.
• Tovar, J.J., Angel, R.J., Eschbach, K., Espino, D.V., Markides, K.S. (2007). Hispanic Established Populations for the Epidemiological Studies of the Elderly; selected longitudinal findings. Aging Health, 3(3): 225-331.
• Vincent, G.K., Velkoff, V.A. (2010). The next four decades: The Older population in the United States: 2010-2050: US Department of Commerce, Economics and Statistics Administration, US Census Bureau.
• Wong, R., Diaz, J.J., Espinoza, M. Health Care Use among Elderly Mexicans in the U.S. and in Mexico: The Role of Health Insurance. Research on Aging, 28(2); 393-408, 2006.