The Hispanic health paradox across generations: the relationship of child generational status and citizenship with health outcomes

•A healthy immigrant advantage lasts until the 3rd generation for asthma.•A healthy immigrant advantage lasts until the 2.5 generation for bronchitis.•A healthy immigrant advantage lasts until the 2.5 generation for allergies.•Citizenship was not an influence on having a respiratory health condition.

ObjectivesIn examining the Hispanic health paradox, researchers rarely determine if the paradox persists across immigrant generations. This study examines immigrant respiratory health disparities among Hispanic children in terms of current asthma, bronchitis, and allergies using an expanded six-group immigrant cohort framework that includes citizenship and the fourth-plus generation.Study designCross-sectional primary survey data from 1568 caretakers of Hispanic schoolchildren in El Paso, Texas (USA), were utilized.MethodsData were analyzed using generalized linear models.ResultsResults indicate that a healthy immigrant advantage lasts until the 2.5 generation for bronchitis and allergies (P < 0.05), and until the third generation for asthma (P < 0.10). Citizenship was not an influence on the likelihood of a child having a respiratory health condition.ConclusionsFindings demonstrate the utility of the expanded six-group cohort framework for examining intergenerational patterns in health conditions among immigrant groups.