Abstract
OBJECTIVES: In the United States, Hispanic mothers have birth outcomes comparable to those of White mothers despite lower socioeconomic status. The contextual effects of Hispanic neighborhoods may partially explain this "Hispanic paradox." We investigated whether this benefit extends to other ethnic groups. METHODS: We used multilevel logistic regression to investigate whether the county-level percentage of Hispanic residents is associated with infant mortality, low birth weight, preterm delivery, and smoking during pregnancy in 581,151 Black and 2,274,247 White non-Hispanic mothers from the US Linked Birth and Infant Death Data Set, 2000. RESULTS: For White and Black mothers, relative to living in counties with 0.00%-0.99% of Hispanic residents, living in counties with 50.00% or more of Hispanic residents was associated with an 80.00% reduction in the odds of smoking, an infant mortality reduction of approximately one third, and a modest reduction in the risks of preterm delivery and low birth weight. CONCLUSIONS: The health benefits of living in Hispanic areas appear to bridge ethnic divides, resulting in better birth outcomes even for those of non-Hispanic origin.