Diabetes and the Hispanic Health Paradox: insights from Hispanics in Canada

The Hispanic Health Paradox suggests that Hispanics and their culture may possess certain protective factors that mitigate the negative impact of lower socioeconomic status on health. Much of the existing literature has focused on the United States. Such paradoxical advantage on diabetes was explored among Hispanics in Canada.

Secondary data from four cycles of the Canadian Community Health Survey from 2015 to 2018 were examined. Multivariate logistic regression analyses were conducted with the following samples: Hispanics (1,799), Non-Hispanic White (168,225), and other racialized groups (33,730). The statistical and practical significance or strength and precision of the predictor-outcome relationships were estimated with odds ratios (OR) and their 95% confidence intervals (CIs) that were derived from regression statistics.

Despite overall lower socioeconomic status, Hispanics were about 79% less likely than Non-Hispanic Whites to have diabetes. Hispanic ethnicity significantly interacted with age, sex, income, and immigration status in predicting diabetes risk. Hispanic ethnicity was most protective for middle-aged adults (OR = 0.72) but not seniors. Hispanic males experienced greater protection (OR = 0.77) than females (OR = 0.90). Low-income Hispanics showed the strongest protective effects (ORs = 0.62-0.85). Recent immigrants to Canada (<10 years) exhibited moderate protection (ORs = 0.90-0.93), though unexpectedly, Canadian-born Hispanics had the lowest risk (OR = 0.59).

These findings highlight the nuanced and paradoxical protective effects of Hispanic ethnicity on diabetes risk.