While I would not dispute the work described, I would also not say that
this resolves the paradox, since there are many other areas, many other
states, etc. that demonstrate differences.

There are differences in Hispanics in family structure, religion, and
physical differences that impact key areas. Also it would be interesting to
hear comments regarding genetics. The Hispanic cultures in the US are a mix
of aboriginal and European. Many if not most aboriginal peoples did not
have the same level of intermarriage and contact with European cultures
resulted in grave consequences.


The differences in medical school admission are interesting and also
opposite to others in the nation:
Mexican American males are admitted at a rate of 1 allopathic medical
student per 1000 or 20% of the 1 in  200 national average for citizens and
residents of medical school age (18 - 24 census data) compared to 1994 -
2000 US MD grads from AAMC data. Mexican American females have 1 in 1300
admissions, The reductions may be due to family and cultural areas
regarding higher education and professions. All other lower income
populations have greater to much greater female probability of admission
that involve college and are seen in medical school admissions:
Rural males 1 in 500 compared to females at 1 in 300
Black males 1 in 600 compared to females at 1 in 300 (reversed a couple of
decades ago)
Native American rural males have ended contributions to family medicine,
Native females from rural areas still manage to negotiate the long and
winding path through barriers of income and education to college and
medical school and choice of family medicine and have the highest levels of
distribution of any physicians with over 50% rural and nearly 40%
underserved locations (national for US physicians is 11% rural and 6.5%
underserved) But we sadly miss the male rural Native American
contributions, just as we miss the other rural and lower income
contributions of so many groups.

Studies in family medicine regarding family structure at one time seemed
promising regarding pregnancy outcomes.

Lower birth weight in Hispanics of aboriginal background appear to not be
linked to adverse outcomes making infant mortality and birth weight
adjustments a problem. - can't remember the source at a conference on this

There are many dimensions to consider and most studies only consider 2. As
we see so many time in socioeconomics, studies are often "digging in the
wrong place" often looking at factors that are related to the real factors.

Robert C. Bowman, M.D.
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