Since first described by Markides and Coreil in 1986, multiple authors have attempted to unravel the curious finding that Hispanic Americans appear to, in spite of seemingly disadvantageous health factors, to have better outcomes than expected. While there have been some dissenting studies, the preponderance of evidence seems to support the finding, although the exact mechanism remains elusive. A computational analysis of the 2011-2016 data on the counties of Arizona and New Mexico contained in the Robert Wood Johnson Foundation’s County Health Rankings and Roadmaps confirmed that this Hispanic Paradox does indeed exist. However additional factors, such as the distribution and concentration of the Hispanic population, appear to be necessary in order for it to manifest. It is maximized once a critical level of population percentage and lack of acculturation are met. These levels are achieved in some counties in Arizona, but are absent in New Mexico, despite an average county Hispanic population percentage only 60% that seen in New Mexico. In this regard, the Hispanic Paradox appears to follow the same dynamics as that seen in the Roseto Effect described in the 1960’s and may be related to the differing effect of curanderismo in these areas.
Russell Gonnering, M.D.
Institution: Arizona State University
Department: School for the Science of Health Care Delivery
City: Elm Grove
Country: United States
Trained as an oculofacial reconstructive surgeon, I spent the first 25 years of my career caring for patients, teaching and performing basic and clinical science research. Along the way I was given increasing responsibilities for clinical quality improvement and realized the importance of clinicians' involvement in this activity. In 2006, changes in my professional trajectory led me to obtain a master's degree in medical management from USC. Soon afterwards I was introduced to complexity science and non-linear systems dynamics. While I still see patients, since 2007, my major academic thrust has been applying the tools of systems and complexity sciences to understanding performance, particularly in health care. I believe it is imperative to introduce the next generation of health care professionals to these tools, and that is the basis for my excitement with the School for the Science of Health Care Delivery at ASU.