In recent years, the Latino population in the United States has experienced a notable shift in health outcomes, a phenomenon that has drawn significant attention from public health experts. The Duke School of Nursing’s Rosa Gonzalez-Guarda, PhD, MPH, RN, FAAN, Assistant Dean, PhD Program, joined with her colleague Jay Pearson, PhD, MPH, of Duke’s Sanford School of Public Policy, to take a closer look at this shift. The pair presented their findings in a paper recently published in JAMA Health Forum.

Historically, Latinos in the U.S. have experienced better health outcomes and lower mortality rates compared to the general population, despite facing considerable socioeconomic challenges. This phenomenon, often referred to as the “Latino Health Advantage,” has been attributed to various factors, including strong social networks, cultural practices, and the “healthy immigrant” effect.

“We wanted to highlight an overlooked health phenomenon for the largest minoritized group in our country,” said Gonzalez-Guarda. “Contrary to what most people think, Latinos have historically demonstrated a health advantage that has helped our country’s health profile by improving our life expectancy and morbidity and mortality statistics. This health advantage among Latinos has been largely driven by immigrants, white-identifying segments of the populations, and individuals of Mexican and Central American Origin.”

However, the COVID-19 pandemic dramatically altered this landscape. The pandemic exposed and exacerbated existing vulnerabilities within the Latino community. Many Latinos work in essential jobs that cannot be done remotely, increasing their risk of exposure to the virus. Additionally, socioeconomic disadvantages, such as lower access to healthcare and higher rates of underlying health conditions, have further compounded the impact of COVID-19 on this population.

“We wanted to bring this to the attention of healthcare providers, community leaders, and policy makers so that the health and social wellbeing of this population can be prioritized within the context of broader population health improvement efforts for the U.S.,” Gonzalez-Guarda explained.

“I think the most surprising thing I learned in writing this piece is that while there have been some rebounds in life expectancy among Latinos after the devastating effect of COVID-19, this has not been observed among young to middle-aged adults, an age when individuals are heavily invested in nurturing their families and working hard,” she continued.

Dr. Pearson agreed. “Recent immigrants from Mexico and Central America have very good health despite low socioeconomic measures (SES) in the context of health in the United States,” he said. “This health worsens over time as SES increases. This is directly opposite of what happens with all other groups in the country. We propose that stress associated with engaging with racially/ethnically discriminatory institutions to improve education, employment, and income, along with loss of health-supportive traditional sociocultural practices over time, combined to produce this phenomenon.”

In response to these findings, Gonzalez-Guarda and Pearson put forth several policy recommendations aimed at protecting and improving Latino health. These include enhancing worker protections to reduce occupational health risks, ensuring universal access to culturally appropriate health services, and fostering social inclusion for Latino immigrant families. Additionally, Gonzalez-Guarda was recently awarded a grant from NIH (1R01MD018920-01; MPI: Gonzalez-Guarda; Cervantes) to address factors contributing to these decays in health.

By addressing these systemic issues, policymakers can help mitigate the long-term health impacts of the pandemic on the Latino community and restore the health advantages that have historically benefited this population.

Read the full paper in the October 3, 2024 edition of JAMA Forum.

Dr. Gonzalez-Guarda was recently profiled as part of the Duke 100 Trailblazers project, in honor of Duke University’s Centennial celebrations.