A Comprehensive Analysis of Morbidity Life Expectancies Among Older Hispanic Subgroups in the United States: Variation by Nativity and Country of Origin.

BACKGROUND AND

objectivesAlthough a clear advantage in mortality has been documented among older Hispanic subgroups, particularly the foreign-born, research examining health selectivity in morbidity life expectancies among older Hispanics are scarce. Differences in sociocultural characteristics among Hispanic subgroups may influence racial/ethnic and nativity disparities in morbidity. Research examining the heterogeneity among older Hispanic subgroups may further our understanding of why some Hispanics are able to preserve good health in old age, while others experience a health disadvantage. Thus, the primary goal of this analysis is to examine racial/ethnic, nativity, and country of origin differences in morbidity life expectancies among older adults in the United States. RESEARCH DESIGN AND

methodsWe used individual-level data (1999-2015) from the National Health Interview Survey to estimate Sullivan-based life tables of life expectancies with morbidity and without morbidity by gender for U.S.-born Mexicans, foreign-born Mexicans, U.S.-born Puerto Ricans, island-born Puerto Ricans, foreign-born Cubans, and whites in mid-life (age 50), and late-life (age 65).

resultsHispanics are heterogeneous in morbidity life expectancies. Among females, U.S.-born Mexicans, foreign-born Mexicans, and island-born Puerto Ricans spent more late-life years with morbidity than whites. For men, U.S.-born Puerto Ricans were the only Hispanic subgroup disadvantaged in the number of years lived with morbidity. Conversely, foreign-born Cubans exhibited the healthiest outcomes of all groups, regardless of gender. DISCUSSION AND IMPLICATIONS: Reducing the risk for late-life morbidity must be informed by a comprehensive understanding of a wide range of factors that shape health among older adults. Research should avoid pan-ethnic groupings that overlook important differences in chronic disease risk profiles among Hispanic subgroups. Recognizing the various sociocultural and environmental processes that underlie Hispanic subpopulations is important for development and implementation of social and public health policies aimed at ameliorating negative health outcomes of late-life morbidity among minority and immigrant groups.