Wealth Doesn’t Always Equal Health
“Wealth equals health” has been a commonly accepted principle for decades. Beginning in 1967, the classic Whitehall studies revealed that higher-class British civil servants had lower risks of mortality from a wide range of diseases than their lower-class counterparts. Since then, much research has continued to support the idea that higher socioeconomic status (SES) means better health. And, this link between health and wealth seems like it may explain some important health disparities in the United States. For example, Black Americans, who tend to be lower SES than White Americans, live about four years less than White Americans.
But, there is one case where wealth does not necessarily equal health among Americans, as Dr. John Ruiz discussed at the Society for Personality and Social Psychology’s Social Personality Health Pre-Conference. Hispanics tend to be lower SES than non-Hispanic Whites. Despite this, Hispanics have a lower mortality rate than non-Hispanic Whites. As the Center for Disease Control reports, Hispanics are less likely to die from the 10 leading causes of death than non-Hispanic Whites. A recent meta-analysis of 58 studies involving over 4.6 million participants showed that Hispanics have about a 17.5% lower risk of death compared with other racial groups. This challenges the maxim that “wealth equals health.” Hispanics, despite being lower SES than non-Hispanic Whites, have better health outcomes.
Researchers often call this the “Hispanic Mortality Paradox.” What could lie behind this paradox? In his talk, Dr. Ruiz outlined several possibilities. Hispanics in the United States are less likely than Whites to engage in key risk behaviors such as smoking. But Hispanic health advantages are also present among non-smokers, suggesting that other factors must be at play.
It could be that Hispanics are more resilient in the face of illness. Supportive of this, a recent study showed that Hispanics tend to be hospitalized 2-3 days less per person. Or Hispanics may age differently from other racial and ethnic groups. In fact, some recent research indicates that Hispanics may have a slower rate of genetic aging than non-Hispanic Whites.
There may also be a role for culture in shaping these effects. Many values in Hispanic culture emphasize strengthening social bonds - values like simpatía (harmony in social relationships), familismo (importance of family), and respeto (respect for elders). Importantly, meta-analyses of studies show that social bonds can be as protective of health as not smoking or getting enough exercise, and Hispanic cultural values may facilitate these bonds. These, and other reasons, may all contribute to Hispanic people’s longevity in the face of adversity.
There’s one other reason why the “Hispanic Mortality Paradox” might exist. There is a growing disparity in the amount of biomedical research that is published using Hispanic participants, and very few studies that compare Whites with Hispanics. The current models of mortality risk may be miscalibrated by not including Hispanic participants. So, one way to shed light on this paradox is simply to gather more information, by encouraging researchers to include Hispanic participants in their studies. Further, since health risk may vary by Hispanic subgroup, researchers should record details about their Hispanic participants’ background.
These studies begin the process of illuminating how and why minority groups’ health may importantly differ from one another. This research counters a single notion of “minority health” and helps to turn some common notions like “wealth equals health” on their heads.
Lauren Howe is a 6th year PhD candidate in social psychology at Stanford University and the Shaper Family Stanford Interdisciplinary Graduate Fellow. Her research interests include social acceptance and social rejection, trust in experts, and patient-physician interactions.
The material is from work presented by John Ruiz during the Social Personality & Health Preconference.