Doctoral Disseratation Research: Living the "Latina Paradox": An Ethnography of Pregnant Latinas in Cleveland, Ohio

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Even though Latin American women (Latinas) represent a low-income group, maintain low education rates and low access to healthcare, their infant health outcomes (e.g. infant mortality and birth weight) resemble those of whites who generally have more education, higher income, and improved access to care. Epidemiologists refer to Latinas' unexpected positive infant health outcomes as the "Latina paradox." Studies suggest that immigrant Latinas and first generation US-born Latinas are more likely to have positive birth outcomes when compared to second generation US-born Latinas. In addition, with each US-born generation and increasing rates of acculturation, Latinas' infant health outcomes decline and no longer mirror those of whites. This dissertation research by a medical anthropology doctoral student from Case Western Reserve University will seek to understand what it is that protects Mexican women in Cleveland, Ohio from poor infant health outcomes, and what it is that erodes with each generation that places them at greater risk of having unhealthy outcomes. Using data gathered from case studies, ethnographic interviews, and structured questionnaires, this project will determine whether and to what extent Mexican women's ethnic/minority identity, immigrant status, and generation may impact their use of informal prenatal care (e.g. use of non-biomedical providers, uncertified/lay midwives, family/friends, and herbalists) and/or medically pluralistic pregnancy management practices (e.g. informal + biomedical) which may in fact protect Mexican immigrant and first generation US-born women from poor infant health outcomes. This proposed project will not only contribute to the anthropological scholarship on reproduction, Latinos, and migration, but it will also build upon previous work conducted in public health and epidemiologyA broader impact of this proposed research is that it will provide a much needed and clearer understanding of how sociocultural factors contribute to the "Latina paradox"; new knowledge that will be of great interest to health care providers, policy makers, and the general public. Additionally, this research will further the education and training of a doctoral student.