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解析西班牙裔健康悖论

Unraveling the Hispanic Health Paradox
Journal of Economic Perspectives · 2023 · José M. Fernández、Mónica García-Pérez、Sandra Orozco-Alemán

中文摘要

2019年,美国西班牙裔的预期寿命分别比非西班牙裔白人和非西班牙裔黑人高出3.0年和7.1年,尽管其家庭实际收入比非西班牙裔白人家庭低26个百分点。从多种健康指标来看,西班牙裔的健康结果似乎与非西班牙裔白人相当,甚至更好。这被称为西班牙裔健康悖论。本文强调,在围绕关键健康结果讨论这一悖论时,按祖源和年龄结构对西班牙裔人群进行细分十分重要。本文还概述了鲑鱼偏误和健康移民效应等主要解释,并进一步强调医疗保健的可及性与利用在这一讨论中的作用。忽视这些偏误来源,会对广泛使用的全国性数据集中西班牙裔患病情况和死亡率的测量产生重要影响。

Abstract

In 2019, Hispanics in the US had a life expectancy advantage of 3.0 years and 7.1 years over non-Hispanic Whites and non-Hispanic Blacks, respectively, despite having real-household income values 26 percentage points lower than Non-Hispanic White households. Hispanics appear to have equal or even better health outcomes relative to non-Hispanic Whites across various health measures. This is known as the Hispanic health paradox. This paper underscores the importance of disaggregating Hispanics by ancestry and age profile when discussing the paradox across key health outcomes. It also provides an overview of the leading explanations, such as the salmon bias and the healthy immigrant effect. Further, it highlights the role of healthcare access and usage in this discussion. Ignoring these sources of bias have important consequences for how morbidity and mortality among Hispanics are measured within widely used national datasets.
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