Are black Hispanics black or Hispanic? Exploring disparities at the intersection of race and ethnicity

Background Disparities in health among blacks and Hispanics compared to whites individuals exist for a number of health measures; however, the health profile of individuals who are both black and Hispanic is not well known. We sought to determine whether race and ethnicity have synchronous or independent effects on health-related outcomes. Methods We combined the National Health Interview Survey for 2000-2007 to identify 896 black Hispanics. We selected health-related outcomes where white Hispanics and non-Hispanic blacks significantly differed. We computed adjusted prevalence estimates for black Hispanics and compared them to determine whether their health-related outcomes more closely resemble white Hispanics or non-Hispanic blacks. All prevalence estimates were adjusted for age, sex, education, marital status, income and survey year. Results Black Hispanics' health behaviours resembled white Hispanics or were similar to both white Hispanics and non-Hispanic blacks. For health services outcomes, they resembled non-Hispanic blacks. However, their health status was influenced by both race and ethnicity, with black Hispanics resembling both white Hispanic and non-Hispanic black people. Conclusion We conclude that health behaviour interventions incorporating knowledge of Hispanic cultures may be sufficient to reach black Hispanics. However, health services or health status, interventions targeted broadly to Hispanic people may not be sufficient. In some respects black Hispanic people comprise a distinct subgroup that may require targeted attention in public health interventions.