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RACIAL STRATIFICATION in HEALTH AMONG WHITE, BLACK and OTHER MEXICANS a Dissertation by GUADALUPE MARQUEZ-VELARDE Submitted to T

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RACIAL STRATIFICATION in HEALTH AMONG WHITE, BLACK and OTHER MEXICANS a Dissertation by GUADALUPE MARQUEZ-VELARDE Submitted to T RACIAL STRATIFICATION IN HEALTH AMONG WHITE, BLACK AND OTHER MEXICANS A Dissertation by GUADALUPE MARQUEZ-VELARDE Submitted to the Office of Graduate and Professional Studies of Texas A&M University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Chair of Committee, Dudley L. Poston Co-Chair of Committee, Verna M. Keith Committee Members, Mary Campbell Mark Fossett Maria Perez-Patron Head of Department, Denis O'Hearn August 2018 Major Subject: Sociology Copyright 2018 Guadalupe Marquez-Velarde ABSTRACT I analyzed eight health outcomes among NH Whites, NH Blacks, White Mexicans, Black Mexicans and Other Mexicans taking into consideration acculturation-related and sociodemographic covariates. I developed my hypotheses on the basis of research based on the Latino Paradox and on the literature dealing with racial health disparities using the Latin Americanization thesis as theoretical framework. In the empirical analyses, using Integrated Health Interview Survey Data and binary logistic regression, both White Mexicans and Other Mexicans were reported to have a health advantage consistent with the Latino Paradox but Black Mexicans were not shown to have this advantage. I argued that this instance of health stratification based on a pigmentocracy is consistent with Bonilla-Silva’s theory. One of the main contributions of this research is the disaggregation of Mexicans into distinct racial categories in order to determine how race affects their health independently of ethnic status. Mexican ethnoracial groups are not homogeneous in terms of their health outcomes. I concluded from this empirical exercise that not all Mexicans are equally advantaged in terms of health as we have come to expect based on the Latino Paradox literature. Black Mexicans seem to be particularly disadvantaged compared to NH Whites and to a lesser extent vis-à-vis White Mexicans and NH Blacks. Thus, the micro and macro mechanisms of race (and racism) that produce health inequalities are apparently having an effect on this population. ii ACKNOWLEDGEMENTS I would like to thank my committee chair, Dr. Dudley L. Poston, and my committee members, Dr. Verna M. Keith, Dr. Mary Campbell, Dr. Maria Perez-Patron, and Dr. Mark Fossett, for their guidance and support throughout the course of this research. I also would like to acknowledge Dr. Jane Sell, Dr. Wendy Moore and Dr. Sara Grineski. Thank you Dudley for your unwavering support and encouragement. Verna, thank you for helping me develop my critical skills, fine-tuning my research abilities and providing constant guidance. Mary, thank you for your detail-oriented feedback and encouragement. Jane, thank you for always being there for me, helping me navigate this program and the job market. Sara, thank you for being my academic mentor for almost ten years. I also would like to thank my dear friends and colleagues Gabe Miller, Dr. Nicole Jones, Dr. Apryl Williams, Vanessa Gonlin, Dr. Ceylan Engin, Dr. Angelica Menchaca, Stephanie Ortiz and Dr. Betty Aldana Marquez. Thank you for being support and inspiration; I could not have done this without you. My gratitude also goes to the Hispanic/Latino Graduate Student Association for being a part of my graduate school family. Finally, thank you Mario, Mom, Ivette, Andres, Rene, Tiare, Zoe and Brodie for the love and support throughout this journey and always. iii CONTRIBUTORS AND FUNDING SOURCES This work was supervised by a dissertation committee consisting of Dr. Dudley L. Poston, Dr. Verna M. Keith, Dr. Mary Campbell and Dr. Mark Fossett from the Department of Sociology as well as Dr. Maria Perez-Patron from the Department of Epidemiology and Biostatistics. All work for the dissertation was completed independently by the student. Graduate study was supported by a diversity fellowship from Texas A&M University Office of Graduate and Professional Studies. The research for this dissertation was partially funded by two Summertime for Advancement in Research awards from the College of Liberal Arts at Texas A&M University. iv NOMENCLATURE NH Non-Hispanic NHIS National Health Interview Survey IHIS Integrated Health Interview Survey INEGI Instituto Nacional de Estadística y Geografía v TABLE OF CONTENTS Page ABSTRACT ..................................................................................................................... ii ACKNOWLEDGEMENTS ………………………………………………………... ...... iii CONTRIBUTORS AND FUNDING SOURCES …………………………………. ...... iv NOMENCLATURE ……………………………………………………………….. ...... v TABLE OF CONTENTS …………………………………………………………......... vi LIST OF FIGURES ………………………………………………………………... ...... viii LIST OF TABLES ………………………………………………………………… ....... ix CHAPTER I INTRODUCTION …………………………………………………… ...... 1 Race and Health ……………………………………………………. .................. 5 Latino Epidemiological Paradox …………………………………….................. 6 The Latin Americanization Thesis …………………………………. .................. 7 Main Contributions and Methodology ……………………………… ................. 9 Chapter Organization ………………………………………………. .................. 10 CHAPTER II LITERATURE REVIEW …………………………………………… ..... 12 The Epidemiological Paradox ……………………………………… .................. 12 Racial Inequalities in Health …………………………………....… .................. 22 Racial Discourse in Mexico ………………………………………… ................. 31 The Latin Americanization Thesis …………………………………. .................. 37 CHAPTER III HYPOTHESES, METHODS AND DATA ………………………......... 40 Hypotheses…………………………………………………… ............................. 40 Data and Sample …………………………………………………… .................. 41 Variables of Interest ……………………………………………….. ................... 42 Statistical Analysis and Software …………………………………..................... 45 CHAPTER IV RESULTS ………………………………………………………….. ...... 48 Asthma ……………………………………………………………… ................. 50 vi Cancer ………………………………………………………………. ................. 51 Chronic Illness ……………………………………………………… ................. 52 Distress ………………………………………………………………................. 54 Heart Disease ……………………………………………………….. ................. 55 Liver Disease ……………………………………………………….................... 56 Self-Rated Health …………………………………………………… ................. 56 Diabetes …………………………………………………………….................... 57 CHAPTER V DISCUSSION AND CONCLUSIONS ……………………………... ..... 59 White Mexicans Will Have Better Health Outcomes than NH Whites……… ..... 60 White Mexicans Will Have Better Health Outcomes than NH Blacks……… ..... 61 Black Mexicans Will Have Poorer Health Outcomes than NH Whites……… .... 62 Black Mexicans Will Have Better Health Outcomes than NH Blacks………...... 62 Black Mexicans Will Have Poorer Health Outcomes than White Mexicans… .... 63 Other Mexicans Will Have Better Health Outcomes than NH Whites………...... 64 Other Mexicans Will Have Better Health Outcomes than NH Blacks………. ..... 64 REFERENCES ………………………………………………………………………. ... 70 APPENDIX A TABLES …………………………………………………………….. .... 93 APPENDIX B FIGURES ……………………………………………………………. ... 110 vii LIST OF FIGURES FIGURE Page 1. Modified Version of the Latin Americanization Thesis ............................................... 110 2. White Mexicans Percentage Change in Odd Ratios in Reference to NH Whites......... 111 3. White Mexicans Percentage Change in Odd Ratios in Reference to NH Blacks ......... 112 4. Black Mexicans Percentage Change in Odd Ratios in Reference to NH Whites ......... 113 5. Black Mexicans Percentage Change in Odd Ratios in Reference to NH Blacks ......... 114 6. Black Mexicans Percentage Change in Odd Ratios in Reference to White Mexicans . 115 7. Other Mexicans Percentage Change in Odd Ratios in Reference to NH Whites ......... 116 8. Other Mexicans Percentage Change in Odd Ratios in Reference to NH Blacks ......... 117 viii LIST OF TABLES TABLE Page 1. Weighted Percentage Distributions and Means of Sample Respondents by Monoracial and Ethnoracial Groups across Dependent and Independent Variables ................................................................................................................... 93 2. Logistic Regression Analysis of Asthma, with the Coefficients Expressed in Odds Ratios, using Non-Hispanic Whites as Reference Category……………… 94 3. Logistic Regression Analysis of Asthma with the Coefficients Expressed in Odds Ratios using the Different Monoracial and Ethnoracial Groups as Reference Categories ........................................................................................... 95 4. Logistic Regression Analysis of Cancer with the Coefficients Expressed in Odds Ratios using Non-Hispanic Whites as Reference Category ......................... 96 5. Logistic Regression Analysis of Cancer with the Coefficients Expressed in Odds Ratios using the Different Monoracial and Ethnoracial Groups as Reference Categories ............................................................................................ 97 6. Logistic Regression Analysis of Chronic Illness with the Coefficients Expressed in Odds Ratios using Non-Hispanic Whites as Reference Category ....... 98 7. Logistic Regression Analysis of Chronic Illness with the Coefficients Expressed in Odds Ratios using the Different Monoracial and Ethnoracial Groups as Reference Categories .............................................................................. 99 8. Logistic Regression Analysis of Distress with the Coefficients Expressed in Odds Ratios using Non-Hispanic Whites as Reference Category ....................... 100 9. Logistic Regression Analysis of Distress with the Coefficients Expressed in Odds Ratios using the Different Monoracial
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