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Length of hospital stays may contribute to Hispanic Mortality Paradox

John RuizFor nearly three decades, researchers have pondered the Hispanic Mortality Paradox — why Hispanics in the U.S. tend to outlive non-Hispanic whites by several years, despite having, in general, lower income and educational attainment levels that are associated with shorter lives.

New research suggests that the Hispanic Mortality Paradox may be related to illness survival and recovery advantages. A study by researchers from UNT and the University of Texas Southwestern Medical Center found Hispanics were hospitalized significantly fewer total days during a 12-month period than both non-Hispanic whites and non-Hispanic blacks, and were more likely to survive the hospital stay, regardless of the condition that admitted them to the hospital.

The study, led by psychology professor John Ruiz and recently published in the Journal of Latina/o Psychology, focused on more than 23,000 patients, ages 18 and older, who were admitted to Parkland Hospital in Dallas from Jan. 1 to Dec. 31, 2008. The Hispanic patients consisted of 31.7 percent of the sample. Non-Hispanic blacks were 34.7 percent and non-Hispanic whites were 33.6 percent.

Parkland was chosen for the study because of the racial and ethnic diversity of its patients. The hospital also historically serves Dallas County residents of low socioeconomic status, with less than 30 percent of Parkland’s patients having individual health insurance.

Ruiz collaborated with researchers from the UT Southwestern Medical Center’s Division of Psychology and Parkland Hospital and three UNT graduate students. The team examined anonymous admission records for patients with all conditions, except for childbirth-related visits unless childbirth produced complications.

After the researchers accounted for age, gender and admitting diagnosis, they discovered that Hispanics were hospitalized for significantly fewer days during their first admission for the 12-month period. Hispanics were in the hospital an average of 6.24 days, compared to an average of 6.61 days for non-Hispanic blacks and 7.24 days for non-Hispanic whites.

Over the entire 12 months, which included additional hospital stays, Hispanics were hospitalized an average of 8.28 days — more than a full day less than both non-Hispanic blacks, at 9.76 days, and non-Hispanic whites, at 9.55 days.

Hispanics are the fastest-growing ethnic population in Texas, and are less likely to have health insurance than other ethnic groups. U.S. Census data from 2012 show 39 percent of Texas' Latino population was uninsured, compared with 17 percent of whites and 22 percent of blacks. 

Ruiz notes that the study results suggest that Hispanics may be less of a health economic burden than many people believe.

“Considering that the estimated cost of community hospitalization in the United States was $9,700 in 2010, the average cost for the Hispanic patients in the study would have been $14,754.96, compared with $17,018.10 for non-Hispanic whites,” he says.

And although the Hispanic patients in the study were more likely than non-Hispanic whites to be readmitted during the year after an initial hospital stay, they were less likely to die in the hospital than non-Hispanic whites. In addition, Hispanic patients were more likely to be discharged to their families when they left the hospital, instead of being sent to rehabilitation centers or nursing homes, Ruiz says.

“This may suggest that Hispanic patients’ recovery was more complete, although more data is needed to clarify this possibility,” he says.

In a previous study, Ruiz and researchers from Brigham Young University analyzed Hispanics’ and other ethnic groups’ mortality rates from cancer, heart disease and other diseases, as presented in 58 studies conducted by other researchers over 20 years. Ruiz and the BYU researchers discovered that Hispanic participants in all of the studies had a 17.5 percent lower mortality rate as compared their non-Hispanic white and non-Hispanic black counterparts, regardless of age. In the studies that tracked heart disease patients, Hispanics 25 percent more likely to be living at the conclusion of the studies than the participants in the other groups.

Ruiz and the research team are currently conducting a follow-up study on hospital stays for Hispanics and other ethnic groups that uses admission records from 2008-2013. The six-year study will allow the researchers to track the number of hospital stays for Hispanic patients with cancer and other long-term illness.

- Nancy Kolsti, News Promotions

Posted on: Fri 14 November 2014

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