Physical-psychiatric comorbidity: Implications for health measurement and the Hispanic Epidemiological Paradox

•Physical-psychiatric comorbidity (PPC) is a health measure capturing co-occurring physical and mental health problems.•There are important group differences in PPC by ethnicity, nativity, and gender.•Island-born Puerto Rican men experience the highest rates of PPC, which is partly explained by sociodemographic factors.•Mexicans and Other Latinos (regardless of nativity status and gender) experience lower risk of PPC.

Few studies examine the co-occurrence of physical and psychiatric health problems (physical-psychiatric comorbidity), and whether these patterns differ across social groups. Using the National Comorbidity Survey-Replication and National Latino and Asian American Study, the current study asks: what are the patterns of physical-psychiatric comorbidity (PPC) between non-Hispanic Whites and Latino subgroups, further differentiated by gender and nativity? Does the PPC measurement approach reveal different patterns across groups compared to when only physical or only psychiatric health problems are the health outcomes of interest? To what extent do sociodemographic characteristics (SES, stress exposure, social support, immigration-related factors) explain PPC differences between groups? Results reveal that compared to U.S.-born non-Hispanic White men, island-born Puerto Rican men experience elevated PPC risk. Mexican and Other Latino women and men experience relatively lower risk of PPC relative to their non-Hispanic White counterparts. Social factors explain some of the health disadvantage of island-born Puerto Rican men, but do not explain the health advantage of Mexicans and Other Latinos.