In researching for this article, I came across a curious terminology used by public health specialists when referring to mortality in the Hispanic community. Through comparative studies, researchers have come up with something called “the Latino paradox” because, compared to non-Latino whites, Latinos have a worse socioeconomic profile but a lower mortality rate.
That is, despite all the obstacles imposed by centuries of oppression and inequality, our resilience has ended up being an epidemiological paradox.
But just as our mortality rates are low, our cultural context, a product of specific elements of our society’s history, tradition, ideology, or social norms, also entails gender inequalities reflected in dangerous behaviors such as suicidal ideation.
Taking a closer look at the numbers
In recent years Latinos have grown to more than 60 million people in the United States, making us the largest ethnic or racial minority group in the country. Statisticians estimate that these numbers will double by 2060, making up more than 25% of the country’s population.
Historically, compared to other racial/ethnic groups, Hispanics have had a lower risk of suicide ideation, attempts, and death in the United States. However, suicide rates among U.S. Hispanics have steadily increased since 2000.
Despite the size of the population, suicide among Hispanics remains relatively understudied, and the reluctance of the Hispanic community to talk about mental health makes it difficult to know how to prevent suicide in this population.
In 2015, suicide was the 11th leading cause of death among Hispanics of all ages (a rate of 5.84 per 100,000) in the United States, but the third leading cause of death among Hispanics aged 10-34 years. Compared to non-Hispanic whites, Puerto Ricans and Mexican Americans have fewer annual suicides per case of major depression. Based on the National Institute of Mental Health-funded Collaborative Psychiatric Epidemiologic Surveys (2001-2003), rough estimates place the lifetime prevalence of suicide ideation and attempts among Hispanics at about 11.35% and 5.11%, respectively.
The story is different among Latinas
However, recent research has indicated a dramatic increase in suicide rates among Hispanics in the United States over the past decade. The increase in suicide rates among Hispanics appears to be attributable to Hispanic women, especially among young adults.
Mortality data from the Centers for Disease Control and Prevention (CDC) suggest that for Hispanic men, suicide rates have remained relatively stable from 2000 to 2015 over the lifetime, showing only a slight decline. However, during the same period, rates among Hispanic women have increased by 50% overall, while they have increased by nearly 100% among young and middle-aged adults.
For some researchers, the psychological profiles of suicidal Latina adolescents and the risk factors for suicidal behavior among Latinas may not be that different from non-Hispanic suicidal adolescents.
The particular case of Latina adolescents thus appears to be the convergence of cultural and familial factors with the developmental, social, and individual factors often associated with suicidal behaviors.
Latinas face different obstacles within the community
For Luis H. Zayas and Allyson M. Pilat, researchers at the Center for Latino Family Research at Washington University in St. Louis, the struggle of the developing Latina adolescent can best be characterized as a complicated convergence of forces-developmental processes, social and peer group factors, cultural traditions and bicultural challenges, unique individual characteristics (i.e., personal experiences, emotional and psychological state, etc.), and family dynamics and relationships.
Together, these forces test their psychological and emotional capacities to either resist and resolve conflicts adaptively, drawing on individual resiliencies and psychological strengths, or succumb to them, setting the stage for suicidal behavior.
At first glance, Latina women and adolescents face the same struggles as other adolescents: self-esteem, body image, peer relationships, academic achievement, and identity formation. However, it appears that relationships and the notion of autonomy carry specific connotations for Hispanic women insofar as female socialization is associated with loyalty to the family.
As the researchers continue, the primacy that traditional Hispanic cultures place on the family in a person’s life adds a unique element to the experience of adolescent Latinas. Hispanic familism dictates that the “I-in-relationship” manifests through a strong loyalty to the family, which places the maintenance and stability of the family at the center of what the responsible “I” must do. Hispanic familism is known to imply a significant obligation to the family, which sometimes includes sacrificing the needs of the individual for those of the family.
“The complication that the adolescent Latina faces is the conflict between her developmental movement toward autonomy from the family, especially parents, and her desire also to maintain the connection with them,” Zayas and Pilat write. “This autonomy-relatedness dynamic creates intrapersonal tension (possibly confusion and guilt) and interpersonal strains between the adolescent and her parents.”
In essence, and on pain of being reductionist, the researchers surmise that “the pull of the connection to the family and its cultural traditions and the counter-pull of the adolescent need for increased autonomy generate psychological conflict, as well as family tension.”
Suicide and the dilemma of acculturation
Another important factor and source of frustration and pain for young Latinas is the process of adapting to a new culture, known as “acculturation.”
In the case of Latinas, this involves adopting values, beliefs, and behaviors that often differ from and are opposite to those of their own family.
“The discrepancy in acculturation (e.g., that the child wants to embrace more rapidly the ways of the new culture, which can mean greater autonomy among girls, and that her parents want her to behave in the manner that is traditional for a girl in the society or country of origin) contributes to the tension that can bring about a psychological and family crisis for the adolescent.”
The family as the origin and solution to the problem
If one thing is clear from the research of epidemiologists and family health specialists, it is that, in the Latino community, the family is the origin and, quite often, the solution to the problems complained about by its members.
Because of the value of families that exists in the Hispanic community — understood as a value that places the family as the primary unit, in contrast to American culture or the Western tradition where the individual is placed at the center — for Hispanics, the family does not simply define how one behaves with parents and siblings, aunts and uncles and grandparents; the ethos of the Hispanic family lies in its centrality to the identity of the individual and how it governs their behavior.
Operating from the perspective that the family in Hispanic culture occupies a central position in the lives of individuals, the best approach is to work and open dialogue around mental health in Hispanic families. This also involves education and breaking down prejudices and taboos that ultimately prevent prevention.