In the 2000 U.S. Census, 67% of Asians and 40% of Latinos were foreign born.101 Processes linked to migration make an important contribution to the observed mortality rates for these groups in Table 2. National data reveal that white, Black, Asian and Latino immigrants have lower rates of adult and infant mortality than their native born peers.102–104 However, with increasing length of stay and generational status, the health of immigrants declines. The pattern of immigrant health where time in the U.S. is associated with declining health is somewhat of a paradox, since one would expect that increasing length of stay would be associated with higher SES (as wages increased and working conditions improved) and thus better health. Hispanic immigrants, especially those of Mexican background, have low levels of SES and relatively low levels of access to health insurance in the United States. However, their levels of health are equivalent and sometimes superior to that of the white population. This pattern has been called the Hispanic paradox.105 Some research documents that poorer health is evident among second generation Latinos compared to immigrants, even though they have higher levels of SES than their first generation peers.106
