Pregnancy Outcomes and Documentation Status Among Latina Women: A Systematic Review

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Abstract

Purpose: The impression that Latinas experience paradoxically good pregnancy outcomes in the United States persists, despite evidence showing that these outcomes are not enjoyed by all Latina subgroups. We conducted this systematic literature review to examine the relationship between documentation status and pregnancy outcomes among Latinas.

Methods: This review synthesizes empirical evidence on this relationship; examines how these studies define and operationalize documentation status; and makes recommendations of how a more comprehensive methodological approach can guide public health research on the impact of documentation status on Latina immigrants to the United States. We searched the literature within PubMed, Web of Science, Academic Search Premier, and Google Scholar in 2017 for relevant studies.

Results: Based on stringent inclusion criteria, we retained nine studies for analysis.

Conclusion: We found that evidence for the impact of documentation status on pregnancy outcomes among Latinas is not conclusive. We believe the divergence in our findings is, in part, due to variation in: conceptualization of how documentation status impacts pregnancy outcomes, sample populations, definitions of exposures and outcomes, and contextual factors included in models. Specific analytic challenges around sampling, measurement, and data analysis are identified. Suggestions for future research are offered regarding measurement of documentation status. Findings highlight the need for increased attention to documentation as an influence on Latina pregnancy outcomes.

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Most cited references 56

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Understanding racial-ethnic disparities in health: sociological contributions.

Ashley R. Williams, Michelle J Sternthal (2009)

This article provides an overview of the contribution of sociologists to the study of racial and ethnic inequalities in health in the United States. It argues that sociologists have made four principal contributions. First, they have challenged and problematized the biological understanding of race. Second, they have emphasized the primacy of social structure and context as determinants of racial differences in disease. Third, they have contributed to our understanding of the multiple ways in which racism affects health. Finally, sociologists have enhanced our understanding of the ways in which migration history and status can affect health. Sociological insights on racial disparities in health have important implications for the development of effective approaches to improve health and reduce health inequities.

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Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox.

Ana F. Abraido-Lanza, Debra Chao, Karen Flórez (2005)

Relative to non-Latino whites, Latinos in the United States have a lower socioeconomic status (SES) profile, but a lower all-cause mortality rate. Because lower SES is associated with poorer overall health, a great deal of controversy surrounds the Latino mortality paradox. We employed a secondary data analysis of the 1991 National Health Interview Survey to test the health behavior and acculturation hypotheses, which have been proposed to explain this paradox. These hypotheses posit that: (1) Latinos have more favorable health behaviors and risk factor profiles than non-Latino whites, and (2) Health behaviors and risk factors become more unfavorable with greater acculturation. Specific health behaviors and risk factors studied were: smoking, alcohol use, leisure-time exercise activity, and body mass index (BMI). Consistent with the health behaviors hypothesis, Latinos relative to non-Latino whites were less likely to smoke and drink alcohol, controlling for sociodemographic factors. Latinos, however, were less likely to engage in any exercise activity, and were more likely to have a high BMI compared with non-Latino whites, after controlling for age and SES. Results provided partial support for the acculturation hypothesis. After adjusting for age and SES, higher acculturation was associated with three unhealthy behaviors (a greater likelihood of high alcohol intake, current smoking, a high BMI), but improvement in a fourth (greater likelihood of recent exercise). Gender-specific analyses indicated that the observed differences between Latinos and non-Latino whites, as well as the effects of acculturation on health behaviors, varied across men and women. Results suggest that the health behaviors and acculturation hypotheses may help to at least partially explain the Latino mortality paradox. The mechanisms accounting for the relationship between acculturation and risky behaviors have yet to be identified.

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Beyond acculturation: immigration, discrimination, and health research among Mexicans in the United States.

Edna Viruell-Fuentes (2007)

Evidence suggests that, despite their lower socio-economic status, certain health outcomes are better for first-generation Mexican immigrants than their US-born counterparts. Socio-cultural explanations for this apparent epidemiological paradox propose that culture-driven health behaviors and social networks protect the health of the first generation and that, as immigrants acculturate, they lose these health-protecting factors. However, the prominence granted to acculturation within these explanations diverts attention from structural and contextual factors, such as social and economic inequalities, that could affect the health of immigrants and their descendants. The aim of this study is to offer a conceptual redirection away from individual-centered acculturation models towards a more complex understanding of immigrant adaptation in health research. To this end, 40 qualitative in-depth interviews were conducted with first- and second-generation Mexican immigrant women in Southeastern Michigan. The women's narratives highlighted a key process linked to their integration into US society, in which the second generation experienced a more pervasive and cumulative exposure to "othering" than the first generation. The findings point to "othering" and discrimination as potential pathways through which the health of immigrants and their descendants erodes. The paper concludes by proposing a conceptual model that locates "othering" processes within a structural framework, and by drawing implications for research on immigrant health and on discrimination and health.

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Author and article information

Journal

Journal ID (nlm-ta): Health Equity

Journal ID (iso-abbrev): Health Equity

Journal ID (publisher-id): heq

Title: Health Equity

Publisher: Mary Ann Liebert, Inc., publishers (140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA )

ISSN (Electronic): 2473-1242

Publication date (Electronic): May 2020

Publication date Collection: 2020

Publication date PMC-release: May 2020

Volume: 4

Issue: 1

Pages: 158-182

Affiliations

[ ¹ ]Oregon Health & Science University–Portland State University School of Public Health, Portland, Oregon, USA.

[ ² ]Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA.

Author notes

[*]

Much of the work in this area utilizes “Hispanic” as a descriptor, particularly the older literature. We utilize the term “Latina” both to reflect the current standards of this area of research and to be explicit about our focus on geographical boundaries and statehood, versus linguistic designations. For our reviewed literature, we maintain the authors' original terminology.

[*] [ ^* ]Address correspondence to: Dawn M. Richardson, DrPH, MPH, Oregon Health & Science University–Portland State University School of Public Health , 506 SW Mill Street, Suite 400, Portland, OR 97201, USA dawn.richardson@ 123456pdx.edu

Article

Publisher ID: 10.1089/heq.2019.0126

DOI: 10.1089/heq.2019.0126

PMC ID: 7241052

PubMed ID: 32440614

SO-VID: b737c570-4f56-41f4-8dd3-600cbeff74e0

License:

This Open Access article is distributed under the terms of the Creative Commons License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Pregnancy Outcomes and Documentation Status Among Latina Women: A Systematic Review

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Most cited references 56

Understanding racial-ethnic disparities in health: sociological contributions.

Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox.

Beyond acculturation: immigration, discrimination, and health research among Mexicans in the United States.

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