The Latina Paradox

Are Latinas Having Healthier Babies Than Their White Counterparts?: A Closer Look into the Latina Paradox

What is it?

The Latina paradox, which is an ancillary of the Latino-health paradox, is the epidemiological observation that rates of low birth weight, infant mortality, premature babies, and pregnancy complications are lower among Latinas (mothers born in Mexico and a few other immigrant sending countries) when compared to their white counterparts and other immigrant populations in the US. This trend occurs despite Latina immigrant mothers’ “disadvantaged risk profiles,” which include low levels of education, low income, and poor access to prenatal care, all of which are strongly associated with birth complications. In fact, according to statistics published in the American Journal of Public health (AJPH), in the year of 2002, the US Latino population had a low-birthweight incidence of 6.5 percent, whereas the incidence was much higher among non-Latino Whites and African Americans, 6.9 percent and 13.4 percent respectively. Such statistics and others provide further evidence that such a paradox exists. Surprisingly, greater assimilation into the US health care system is actually correlated with a decline in this paradox. The“Latina paradox” is most evident among Mexican-born women. But why does such a trend exist?

Explaining the Paradox

Truly Paradoxical: Though varying theories have been posited about the paradox, some questioning its validity and many others vehemently trying to assess why it exists, no one theory has garnered an overwhelming amount of support. Thus, it is safe to say, more work needs to be done in solving this paradox.

The Healthy Migrant Hypothesis: The healthy migrant hypothesis centers around evidence that suggests migrants from other countries that come into the US tend to be healthier than their fellow countrymen to begin with. As a result, it can be said that the healthiest Latinos migrate to the United States in the first place and thus they give rise to healthier babies. Though this hypothesis is always considered with the Latina paradox, it does have its flaws. For one, this hypothesis does not account for why the trend seen in the Latina paradox is not seen among other immigrant groups. Why aren't lower rates of pregnancy complications present among other immigrant groups, such as Asians or Africans as well, both of whom are also considered in the healthy migrant hypothesis.

Defining the Latino Identity: According to the Huffington Post, skeptics of the Latina paradox have also considered the possibility that existence of this paradox is a result of a statistical error due to the vast diversity of the Latino population and not much more than that. The Latino population, for example, encompasses everyone from Mexican Americans to Puerto-Rican Americans alike. Thus, many argue that issues that exist with self-identifying as a Latino American have resulted in the statistical error that is the Latina paradox. However, this perspective is rather difficult to bear, because the Latina paradox has been observed many times and in many places since its initial conception and thus it has becomes less likely that it is a result of a statistical error from incorrect identification.

Marianismo: The American Journal of Public Health (AJPH) has also examined marianismo, an archetype of womanhood that has existed in Mexican culture for some time, as a possible contributor to the existence of the Latina paradox. Marianismo espouses ideals of femininity and womanhood that are largely based on Catholic ideals. According to the AJPH, aspects of marianismo that potentially explain the existence of the Latina paradox are "strong cultural support for maternity, healthy traditional dietary practices, and the norm of selfless devotion"(AJPH). These ideals serve as protective factors in pregnancies and can be seen as contributing to the healthier pregnancy outcomes that are characteristic of the Latina Paradox.

Aspiration: In the anthropological work "Patient Citizens, Immigrant Mothers", a book investigating why the Latina paradox exists, Alyshia Galvez highlights the theme of “aspiracion[aspiration]” . She uses "aspiration" to explore the underlying causes of the Latina paradox. “Aspiracion” is a Spanish verb that aptly describes the sentiments Latina women feel towards their migration to the US, their pregnancy, and their knowledge of prenatal care. The term encapsulates how these women see themselves as agents of upwards mobility for their family, a role they believe is tied to both successful migration to the US and the delivery of healthy children. Hence, these women view their pregnancies as blessings and are confident in their knowledge about what is best for their babies. To Galvez, Latina women's positive perspective on their pregnancy and unwavering faith in their own ability to manage their pregnancy fill the gap created by poor access to prenatal care and correspondingly contribute to the Latina paradox.

Intergenerational Knowledge Transfer and other Social Support: Throughout her book, Galvez also discusses the prominent role of kinship relationships, especially female kinship relationships, in shaping the pregnancy experiences and outcomes of Mexican women in Mexico and in America soon after their migration. Such relationships almost always involve mothers, sisters, and especially the mothers of the pregnant woman's husband. Galvez argues that such relationships contribute to the Latina paradox. For example, mothers of the woman themselves or of the woman's significant other transmit knowledge about best foods for pregnant mothers, prenatal care practices, and advice about general wellbeing to their pregnant daughters, often even after their daughters have migrated to the US. This is known as intergenerational knowledge transfer and is considered to be an important contributor to the Latina paradox. As Galvez notes, Latina women enjoy these strong kinship relationships both during and after their pregnancies, which result in multiple sources of advice for taking care of oneself and her baby throughout the process. Thus, these increased sources of care and support afforded by the cultural and social resources of Latinas, Galvez notes, likely counteracts poor prenatal care and contributes to the Latina paradox. Other social support, such as from the community as a whole, is also seen among Latinas in their home countries and in the US and is further believed to contribute to the paradox.

Why Should We Care?

Increasing efficiency and outcomes of American prenatal care: Pregnancies of other immigrant populations and that of white populations exhibit higher rates of low birth-weight babies and pregnancy complications compared to that of Latinas. This is despite the fact that Latinas have poor access to prenatal care and even when access is fair, they do not use prenatal care as often as other populations. Thus, perhaps a closer investigation of Latina prenatal care usage, including their use of the American model and also other cultural factors that take the place of prenatal care, should be conducted. The knowledge from such an investigation can then be used to adjust the American prenatal care system to lead to better pregnancy outcomes for all women. Considering the contribution of strong relationships to the Latina paradox, this adjustment of prenatal care based on the model used by Latina women may even lead to lower costs for the American healthcare system as it would focus on relationships instead of more time in the hospital or more time with expensive equipment, tests, or treatment.

Rising Beyond the Rhetoric that Providing Prenatal Care to Undocumented Immigrants Would be Too Costly: According to Undocumentedpatients.org, access to prenatal care for women who are undocumented immigrants differs drastically across the country, because of state-level policies and interpretations. Thus, it is important to consider extending prenatal care to undocumented Latina immigrants at a more federal level, especially because costs for such programs may not be as high as certain rhetoric would suggest. After all, Latinas as a group have already shown that they are smart connoisseurs of prenatal care, using it more efficiently than other groups to achieve better pregnancy outcomes.