Barrio advantage or segregation disadvantage: Impact of ethnic density on health among older Mexican Americans and African Americans

Objectives. Inconsistencies in literature convolute the relationship between high-density ethnic communities and health outcomes. On one hand, studies on African Americans document negative health effects associated with living in high-density African American communities. On the other hand, high-density Hispanic communities have been shown to foster a protective effect on health and health outcomes; this is termed the "barrio advantage." Therefore, we examined the role of ethnic density in predicting health outcomes in older Mexican Americans and older African Americans by comparing rates of chronic diseases and disability and determined if social support systems in older Mexican Americans mediate health outcomes.;Methods. We conducted an analysis of a cohort of 3,050 Mexican Americans, 2,790 African Americans, and 4,184 White Americans, aged 65 years and older, from two large datasets: Established Populations for Epidemiologic Studies of the Elderly (EPESE) and the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE). We examined the prevalence of three chronic conditions documented to be the most widespread in these ethnic and age groups (heart disease, diabetes, and cancer) and one disability measure (Activities of Daily Living) at baseline in relation to ethnic density percentage derived from the US Census. In addition, specific to Mexican Americans, we performed a mediation analysis to understand if social support mediates the relationship between ethnic density and chronic condition.;Results. Adjusting for covariates, older Mexican Americans were less likely to suffer from chronic conditions and disability compared to older African Americans and older White Americans. Mexican Americans are more likely to reside in high-density neighborhoods compared to African Americans. Furthermore, Mexican Americans who reside in high-density neighborhoods are less likely to suffer from chronic conditions and disability compared to African Americans. Finally, the effect of the "barrio advantage" is mediated by social support systems, verified by a mediation analysis according to the criterion of Baron and Kenny.;Conclusion. Older Mexican Americans have lower prevalence of chronic conditions, such as heart disease and cancer, and disability compared to older African Americans. Furthermore, older Mexican Americans are more likely to reside in high-density ethnic communities; this has been shown to foster a protective effect against certain chronic conditions such as heart disease and cancer. Similarly, the results also confirm this effect in older African American communities, contradicting the idea that negative health outcomes are associated with high-density African American communities. Finally, the impact of social support has been shown to mediate the effect of the "barrio advantage" among older Mexican Americans. Therefore, the advantages of residing in increasing ethnic density communities outweigh the disadvantages (such as poverty, violence, and crime) shown to affect the communities among these two minority groups.