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Immigrants tend to have...

Better health than their US-born counterparts

Better health than Whites (sometimes)

Better health than nonmigrants in their countries of origin

Despite having...

worse healthcare access than their US-born counterparts

lower SES levels compared to white counterparts

*From "The Hispanic/Latinx 'Health Paradox'" class lecture (Larimore)*

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The Latinx population consists of U.S. born Hispanic/Latinos and immigrants. According to Alarcón's journal article, "Since the late 1990s, Hispanics in the USA (35·6% of whom are foreign born) have consistently constituted just over half of the total foreign-born population" (Alarcón 860). Thus, considering how immigration and immigrant status affects mental health would be necessary when discussing Latinx mental health.

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Alarcón, Renato D, et al. “Hispanic Immigrants in the USA:

Social and Mental Health Perspectives.” The Lancet          Psychiatry, vol. 3, no. 9, 2016, pp. 860–870., doi:10.1016/s2215-0366(16)30101-8.

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While Latinos tend to underutilize mental health resources, they still face major accessibility issues that prevent these resources from being priorities. Guarnaccia and Martinez's report explains that, "The two major barriers to receiving mental health care for Latinos are language barriers and lack of health insurance. Insurance issues are tied to the undocumented status of a significant portion of the Latino community and to the sectors of the economy where many recently arrived Latinos work" (Guarnaccia and Martinez 4-5). The restricted access of obtaining legal status documents is a form of institutional/structural racism, explained by Larimore in "Racism and Health, Not Race and Health," that is related to health because this forces immigrants to pay completely out of pocket to access therapy and medications (Larimore). The little to no presence of Spanish speaking therapists and counselors is a result of lack of race based medicine that is necessary for Latinos to take advantage of resources. Guarnaccia and Martinez further emphasize this need, "There is some data that when Latino clients see Latino (or bilingual/bicultural) therapists, they are more likely to remain in care and to have better outcomes. This is particularly true for recently arrived and Spanish speaking clients" (Guarnaccia and Martinez 6). This call to action directly relates to the importance of race-based medicine, mentioned in class lecture "Racism and Health, Not Race and Health," that seeks to accomodate medicine for races/ethnicities since medical practices and research use white people as the standard, thus leaving people of color like Latinx people in poor quality care (Larimore).

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Guarnaccia, Peter J., and Igda Martinez. New Jersey Mental Health Institute, Inc, 2002, Comprehensive In-Depth Literature Review and Analysis of Hispanic Mental Health Issues With Specific Focus on Members of the Following Ethnic Groups: Cubans, Dominicans, Mexicans and Puerto Ricans .

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Viruell-Fuentes defines acculturation as, "an individual-level process through which individuals acquire the 'behaviors, attitudes and values prevalent within American society'" (Viruell-Fuentes 2099). Acculturation applies to Latinx immigrants that adapt to U.S. culture across generations.

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The U.S. behaviors that affect the Latinx community is documented by Guarnaccia and Martinez. Their report states, "As Latinos acculturate to mainstream U.S. society, their mental health appears to worsen. This finding is best documented for Mexican Americans. This is particularly true for substance use and abuse disorders. Special preventive interventions are needed for recent immigrants to prevent the development of mental health problems" (Guarnaccia and Martinez 4). While Latinx immigrants may not adapt every popular behavior Americans have, this notable change in behavior creates negative physical and mental health effects. While acculturation is an arguable cause of the worsening of Latinx mental health, Guarnaccia and Martinez emphasize the effect it has over generations, “Second and later generation Mexican Americans are at higher risk for developing psychological disorder than new immigrants... acculturation to the larger society increases the risk of developing substance abuse disorders, as both drugs and drug abuse are more prominent in the U.S.” (Guarnaccia and Martinez 10). In comparison to immigrants or first generation Latinx people, second or later generation Latinx people have spent a longer time in U.S. society that allows them to adapt to more negative behaviors. Thus, acculturation remains a valid explanation for the deterioration of mental health as Latinx people participate in substance abuse behaviors over time.

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In the same article, Alarcón addresses the intersectionality between racism, immigration, and health. Some studies in Alarcón's article mentioned that, "For instance, some studies indicate that immigrants are more likely to report experiences of discrimination than their U.S.-born co-ethnics... the association is greater for immigrants with longer residence in the United States, as compared to those who had lived in the country for a shorter time" (Alarcón 2101). This discrimination relates to the idea of racism, not race affecting health from class lecture "Racism and Health, Not Race and Health." One of the sectors under racism and health is personally-mediated/interpersonal racism where discrimination can negatively impact mental health by forcing a person to reconsider self worth or impact chances of achieving something big like a job (Larimore).

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Whether or not the Hispanic Health paradox holds for mental health is a highly debated subject. Guarnaccia and Martinez argue that the paradox does hold, "The immigrants might have been expected to experience greater stress due to migration and lower economic and educational levels… recent immigrants are often the hardiest members of their communities and experience a significant improvement in living conditions compared with their home communities in Mexico. Over time, longer term residents and U.S.-born Mexican Americans respond with a sense of deprivation after they compare their status to the standards of living in the U.S., fitting with a social stress approach” (Guarnaccia and Martinez 15). The idea that Latinx migrants are healthier than white U.S. citizens still holds true, though Guarnaccia and Martinez emphasize that this only occurs because of the comparison to the poorer conditions of the country of origin. This paradox starts to unravel as generations get bigger.

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In contrast, some people like Alacarón believe the paradox cannot be applied for mental health. Alacarón explains, “Although the prevalence among Hispanics was consistently lower than in non-Hispanic white people, the authors caution that aggregating Hispanic people into a single group masks a substantial variability in the lifetime risk of psychiatric disorders, which seems to be a persuasive argument” (Alacarón 864). With a diverse and huge group like Hispanic/Latinx, data collection and generalized conclusions for the group are very hard to make, thus, the general conclusion that Hispanics have better health than white people is an arguable statement because mental health varies across ethnicity and nationality. This idea relates to the data reliability hypothesis mentioned in class lecture "The Hispanic/Latinx 'Health Paradox'". The data of mental illnesses is not consistent across Mexicans, Puerto Ricans, Cubans, etc., thus the incorrect data collections that have been made and used to wrongly combine all these different experiences with mental health gives a false narrative of Latinx mental health (Larimore).

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When discussing Latinx health in general, including mental health, immigration status and the social status of further generations must be considered to acknowledge the entire community.

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Discrimination directly affects mental health due to the correlation between racism and health as seen in personally-mediated/interpersonal racism.

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Lack of accessibility of mental health resources is greatly seen for Latinx people because they are less likely to have insurance and English is not their first language. Latinx people already underutilize these resources, they would continue to do so if it meant paying more out of pocket and not being able to communicate with a therapist or medical provider effectively.

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Acculturation is a valid cause of the worsening of mental health because of the adaptation to U.S. behaviors of substance abuse and its growing prominence across generations.

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The Hispanic Health Paradox is a debated topic that does not have a general consensus. It holds true when considering how immigrants still have better mental health since their living condition in the U.S. is better than their country of origin. It can be proven wrong as the evidence collected for this conclusion is not valid. The Latinx community is too diverse and large for data collections and conclusions to be accurate.

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Viruell-Fuentes, Edna A., et al. “More than Culture: Structural Racism, Intersectionality Theory, and Immigrant Health.” Social Science & Medicine, Pergamon, 9 Feb. 2012, www.sciencedirect.com/science/article/pii/S0277953612000822.

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Larimore, Savannah. "Racism and Health, Not Race and Health." Washington University in St. Louis, Missouri. 29 Sept. 2021, Louderman Hall. Class Lecture.

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Larimore, Savannah. "The Hispanic/Latinx 'Health Paradox'" Washington University in St. Louis, Missouri. 03 Nov. 2021, Louderman Hall. Class Lecture.

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Mental health is already a rarely talked about subject. When discussing public and population health issues, most of them tend to center around tangible health problems like cardiovascular disease, maternal mortality, diabetes, etc. More research should be done on population risks of mental health as now more than ever as the pandemic further exaggerates this issue. Within the Latinx community, there is little to no conversation around the importance of prioritizing mental health. Should these conversations be more accessible and taken seriously, there can be more individual responsibility in seeking mental health resources.