Revisiting the Hispanic mortality advantage in the United States: The role of smoking

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More than three decades of health disparities research in the United States has consistently found lower adult mortality risks among Hispanics than their non-Hispanic white counterparts, despite lower socioeconomic status among Hispanics. Explanations for the " Hispanic Paradox" include selective migration and cultural factors, though neither has received convincing support. This paper uses a large nationally representative survey of health and smoking behavior to examine whether smoking can explain life expectancy advantage of Hispanics over US-born non-Hispanics whites, with special attention to individuals of Mexican origin. It tests the selective migration hypothesis using data on smoking among Mexico-to-US migrants in Mexico and the United States. Both US-born and foreign-born Mexican-Americans exhibit a life expectancy advantage vis-à-vis whites. All other Hispanics only show a longevity advantage among the foreign-born, while those born in the United States are disadvantaged relative to whites. Smoking-attributable mortality explains the majority of the advantage for Mexican-Americans, with more than 60% of the gap deriving from lower rates of smoking among Mexican-Americans. There is no evidence of selective migration with respect to smoking; Mexicans who migrate to the US smoke at similar rates to Mexicans who remain in Mexico, with both groups smoking substantially less than non-Hispanic whites in the US. The results suggest that more research is needed to effectively explain the low burden of smoking among Mexican-Americans in the United States.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalSocial Science and Medicine
StatePublished - Apr 2013
Externally publishedYes

Bibliographical note

Funding Information:
This research was completed with funding from the National Institutes of Health (grant F31-AG039188-01 ). I am grateful to Samuel Preston, Irma Elo, Michel Guillot, Douglas Ewbank, Laura Blue, and Allison Sullivan for helpful comments and critiques.


  • Cigarette smoking
  • Hispanic paradox
  • Life expectancy
  • Mexican
  • Migration
  • Selection
  • U.S.A.


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