The Latino Health Paradox: Then and Now
By Matthew S. Berge
Eric Klingenberg’s Heat Wave: A Social Autopsy of Disaster in Chicago discusses the theory of the “Latino Health Paradox,” also referred to as the Latino Epidemiological Paradox (Klinenberg, 2015:19). The theory asserts that Hispanic and Latino Americans tend to have health outcomes that “paradoxically” are similar to, or in various cases better than, those of their U.S. non-Hispanic white equivalents, even if Hispanics have lower average income and education (Franzini et al., 2001). This phenomenon has been widely reported throughout the COVID-19 pandemic that ethnic-majority communities, especially those made up primarily of Latino and African Americans, have been disproportionately afflicted by the COVID-19 virus (CDC, 2020). Low socioeconomic status is almost universally associated with worse population health and higher death rates everywhere in the world (Mackenbach et al., 2008).
Data on race and ethnicity reveal that the percent of Hispanic or Latino, non-Hispanic Black, and non-Hispanic American Indian or Alaska Native people who have died from COVID-19 is higher than the percent of these racial and ethnic groups among the total U.S. population (CDC, 2020). This trend has proven true in my community; I grew up in an ethnic-majority community, where roughly 82% of the population is Hispanic or Latino, 13% are African American, with the remainder designated as Other.
To examine the Latino Health Paradox, I look to the higher survival rate of the Latino population survival rate during the 1995 Chicago heatwave. The higher survival rate for the Latino population of Chicago appears to be an enigma for natural and social scientists alike. The “Little Village” community of South Lawndale is five miles southwest of Chicago’s Loop and is similar demographically to the community where I grew up. In 2006, eighty-three percent of residents were Hispanic, and nearly half were foreign-born (Illinois.gov., 2016).
Klinenberg describes a white Polish population that “aged in place,” with the younger generations leaving the city for better prospects. Latinos began inhabiting Little Village, effectively reshaping the bustling community (Klinenberg, 2015:84). Moreover, the senior population of Little Village in 1995 was “roughly 46% white old-timers” the “social isolates” that had aged in place; in contrast, the senior white population of nearby North Lawndale was only 2% (Klinenberg, 2015:88). Additionally, while North Lawndale had a slightly larger senior population, Little Village had 300 more seniors living alone than North Lawndale. Yet Little Village only saw three heat-related deaths instead of the 19 heat-related deaths seen in North Lawndale (Klinenberg, 2015:87). Throughout the book, Klinenberg offers several explanations for why Little Village suffered less than North Lawndale. While his other points remain valid, I believe the primary factor was multigenerational households (Klinenberg, 2015:87).
The young take care of the elderly, check up on the elderly, and Little Village had a greater sense of community, breaking language barriers through religion and creating somewhat of a melting pot. Even if the “social isolates” primarily kept to themselves, their neighbors still recognized and checked upon them. One could surmise that the majority of the 31% of the senior population living alone in Little Village were disproportionately from the 46% of “white old-timers” who had “aged in place,” strengthening the argument that multigenerational families proved to be the leading cause of the “Latino Health Paradox” exhibited in the 1995 Chicago Heat Wave (Klinenberg, 2015:87–88).
When examining the Centers for Disease Control (CDC) data on COVID-19 case rates, it appears at first glance that the “Latino Health Paradox” is no longer relevant in the age of COVID-19. As of Dec. 14, 2021, Hispanic and Latino Americans comprised 24.7% of COVID-19 cases in the United States, second only to Whites (55.4%), according to CDC (2021). According to Cockerham in his text Medical Sociology, the Latino Health Paradox is “less of a paradox” because the Latino population in the United States is “relatively young” due to a “high birth rate” and “large-scale immigration” of primarily young adults and children (Cockerham, 2017:109). Moreover, this helps explain why the demographics of the senior population in Little Village were disproportionate to that of the general population, 85% Latino, while 46% of the senior population comprised “white old-timers” (Klinenberg, 2015:87). Furthermore, Latinos have higher rates of diabetes and obesity than the general population (Caballero, 2005); both of these conditions are considered public health epidemics (Cockerham, 2017:41) (CDC, 2020:4).
The CDC COVID-19 data show that the death rate for those in the Hispanic or Latino group is on par with the white demographic, with Latino people dying 1.1x more frequently than whites. The African American demographic experiences a death rate of 2.8x that of whites. The Black Lives Matter (BLM) movement was at the forefront of society following the murder of George Floyd at the hands of the police. BLM activists have brought attention to this issue because African Americans have long suffered from health disparities. If we defund the police, let us invest some of that money into public health policy initiatives to help avert disaster.
The death rate among the Latino demographic is low, considering the high rate of obesity and diabetes in these communities (Schneiderman et al., 2014). However, sufferers of these exact conditions are at “high risk” of developing “severe” COVID-19 (Popkin et al., 2020). Further, Hispanics are the least likely racial and ethnic group to see a doctor with health problems (Alcalá et al., 2017). My community is considered underserved by the National Health Service Corps, and our local recreation center became a free COVID-19 test site. With that in mind, Latinos in my community may have tested positive without seeking further care. As was the case in Heat Wave, only time will tell. Once we have enough statistical data available, perhaps someone will conduct a social autopsy on the mishandling of the COVID-19 pandemic, as all signs point to a global disaster.
Another similarity I found between the 1995 Chicago heatwave and the ongoing COVID-19 pandemic was the response of public officials and their complete aversion to accountability. Indeed, Mayor Daley constantly deflected any criticism, questioned the scientific data, and led the news media to question whether this disaster was “really real,” as is mentioned numerous times throughout Heat Wave (Klinenberg, 2015:27). In the initial stages of the heatwave, the risks were never appropriately addressed; however, that is not to say that no one tried at all.
Veteran firefighter Robert Scates says he was “well aware” of how they should respond to an emergency of this sort. He called the chief and deputy chief paramedics multiple times, only to be met with disdainful words, instructing him to “stop being so paranoid” (Klinenberg, 2015:131–133). Klinenberg notes “no one in Chicago” had truthfully “realized the risks” that were at play in an extreme heat event like this, even though the health department had “modeled an emergency heat plan” years before disaster struck. However, they failed to act and implement this plan. This dismissal of the facts by public officials, who wished to downplay the heatwave early on, is all too familiar to the revelations brought to light by Bob Woodward, who in 2020 conducted taped interviews with the President, exposing exactly how much Trump had known about the virus a month before the shutdown began. He claimed that he withheld this information from the public because he allegedly “didn’t want to create a panic” (Trump, 2020).
I believe the most flawed aspect of the public policy in Chicago in the 1990s was the concept of a “reinvented government” using an “entrepreneurial state” model (Klinenberg, 2015:139). From the perspective of someone born in the late 1980s, it appears that once the Berlin Wall had fallen, public officials thought instituting free-market capitalism into every aspect of life, including the social safety nets meant to serve the poor and disenfranchised masses, was a great idea. Instead, like the military before them, these services became different industrial complexes, with public programs run by private corporations with little oversight. With that in mind, it is unsurprising that the “privatized city services” that were part of the entrepreneurial state failed the citizens of Chicago, for they had a mayor heralded as a “fiscally responsible administrator.” Sadly, however, Daley was far from a socially responsible administrator; his decisions led to “murder by public policy” (Klinenberg, 2015:136–140). Daley, akin to Trump, preferred to govern by Public Relations, or more accurately, propaganda.
The strangest thing about Americans and the media we consume is that many people are unwilling to believe that propaganda is persistent in our culture and media. Google’s definition of propaganda is “information, especially of a biased or misleading nature, used to promote or publicize a particular political cause or point of view,” as for Public Relations,” the professional maintenance of a favorable public image by a company or other organization” (Google, n.d.). When viewed in the realm of politics, these definitions are somewhat synonymous. During this phase of the entrepreneurial state, the Chicago government went overboard in its “public relationships” endeavor, going so far as to “manage” a local cable channel to “show off the government” programs in action (Klinenberg, 2015:166–167). When the Soviets produced films promoting public works during the Cold War, these would be dismissed as communist propaganda. However, I see little difference between political public relations and propaganda in this context.
The capitalist system was the root cause behind the societal failures during the 1995 Chicago heatwave. My opinion only strengthened as I read about Mayor Daley’s “entrepreneurial state” and his “government by public relations” (Klinenberg, 2015:167). In a city, the local government is the primary social institution. This is another story of how an institution failed to serve the community they were supposed to protect. Klinenberg compared his work to the research conducted by Kai Erikson for Everything in Its Path: Destruction of Community in the Buffalo Creek Flood, a social autopsy of the devastation of the Pittson Mining Company disaster in West Virginia in 1972. (Klinenberg, 2015:18).
However, I drew many correlations between Mayor Daley’s response to the heatwave and President Trump’s response to COVID-19. One can can see how in the last quarter-century, all the issues involved in “governing by public relations” have only been exacerbated by innovations like the internet. Klinenberg mentions the 24-hour local television news stations’ role in the propaganda campaign. Nevertheless, we now have several national cable news networks constantly spinning whichever narrative is best for their image or perhaps the image of the politicians they appease.
References
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Caballero, A. E. (2005). Diabetes in the Hispanic or Latino population: genes, environment, culture, and more. Current diabetes reports, 5(3), 217–225.
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