Why Are Asians and Hispanics So Healthy?

City/county ranking of Virginia health outcomes based on potential years of life lost before age 75. Source: Robert Wood Johnson Foundation

The Robert Wood Johnson Foundation has issued its annual Healthy Community report for the United States. As usual, the information is packaged in such a way as to highlight the health disparities between racial/ethnic groups. But the findings for Virginia, which the state-level report largely overlooks, do not fit the dominant institutional-racism narrative. It turns out that Asians are the healthiest racial/ethnic group by far. It also turns out that, despite lower incomes and education levels, Hispanics are healthier than whites. The only finding that conforms to the narrative is the blacks are the least healthy of any group.

The info-graphic to the right shows differences in health outcomes (potential years of life lost before age 75) by place and by race/ethnicity. The “place” metric compares the differences in health outcomes by city or county. There is a wide disparity (as also seen in the map above) between localities with high incomes and high levels of education and localities with low incomes and education. The worst pockets of unhealth are in far Southwest Virginia, Southside, the Eastern Shore, and older cities. No surprises there.

Far more interesting is the disparity between racial/ethnic groups, which many researchers and commentators persist in defining as a gap between whites on the one hand and blacks and Hispanics on the other — a gap matching the socio-economic divide and consistent with the paradigm of America as a nation afflicted with institutional racism and discrimination.

Yet of all major racial/ethnic groups, Asians are the healthiest. By far. Here in Virginia, according to the study, Asians experienced the lowest level of “premature deaths,” measured by years lost per 100,000 — only 2,600. Hispanics fared next best, with 3,100 years lost, whites with 6,200, and blacks with 8,700.

Another remarkable finding: Whites reported the highest incidence of poor mental health days: 1.6 for Asians, 2.7 for Hispanics, 3.5 for blacks, and 3.8 for whites.

Results conformed to stereotype for poor or fair health, while self-reported “poor health days” showed almost no difference between whites, blacks, and Hispanics. Asians reported the fewest poor health days.

The comparative good health of Hispanics in Virginia is all the more remarkable given that, as the report documents but takes little note of, Hispanics have lower high school graduation rates, have less health insurance, and have a higher rate of teen births than any other group.

Asians and Hispanics do not fit the dominant narrative of the relationship between race and health in the United States. It strikes me that these anomalies are worth exploring. Persuading public health researchers to dig deeper may be a hard thing to do, however. The received wisdom, once established, is a hard thing to dislodge.

Update: And then there’s this headline from the Roanoke Times: “Report finds death rates rise for white, middle-class Virginians.”