Neighborhood context and mortality among older Mexican Americans: Is there a barrio advantage?

Objectives. We examined whether Mexican Americans living in high-density Mexican American neighborhoods experience increased morbidity and mortality compared with the rates observed among Mexican Americans living in low-density areas. Methods. We conducted a prospective analysis of a cohort of 3050 Mexican Americans aged 65 years or older. We examined prevalence of 6 medical conditions and survival over 7 years of follow-up in relation to percentage of Mexican Americans in the census tract. Results. With adjustment for covariates, odds for disease prevalence among older Mexican Americans as a function of percentage of Mexican Americans in the census tract were 0.33 (95% confidence interval [CI] = 0.16, 0.71) for stroke, 0.28 (95% CI = 0.11, 0.70) for cancer, and 0.31 (95% CI = 0.10, 0.98) for hip fracture. The hazard ratio for all-cause mortality over 7 years' follow-up was 0.64 (95% CI = 0.42, 0.96). Conclusions. Sociocultural advantages conferred on Mexican Americans by living in high-density Mexican American neighborhoods outweigh the disadvantages conferred by the high poverty of those neighborhoods.