Trends in the Mexican infant mortality paradox over the past two decades

Purpose: Mexicans in the United States have lower rates of several important population health metrics than non-Hispanic whites, including infant mortality. This mortality advantage is particularly pronounced among infants born to foreign-born Mexican mothers. However, the literature to date has been relegated to point-in-time studies that preclude a dynamic understanding of ethnic and nativity differences in infant mortality among Mexicans and non-Hispanic whites. Methods: We assessed secular trends in the relation between Mexican ethnicity, maternal nativity, and infant 'mortality between 1989 and 2006 using a linked birth-death data set from one US state. Results: Congruent to previous research, we found a significant mortality advantage among infants of Mexican relative to non-Hispanic white mothers between 1989 and 1991 after adjustment for baseline demographic differences (relative risk = 0.78, 95% confidence interval, 0.62-0.98). However, because of an upward trend in infant mortality among infants of Mexican mothers, the risk of infant mortality was not significantly different from non-Hispanic white mothers in later. periods. Conclusions: Our findings suggest that the "Mexican paradox" with respect to infant mortality is resolving. Changing sociocultural norms among Mexican mothers and changes in immigrant selection and immigration processes may explain these observations, suggesting directions for future research. (C) 2014 Elsevier Inc. All rights reserved.