The intersection of race, ethnicity and health in Afro Latino communities

By Lourdes Medrano, American Heart Association News

Maria Solis Belizaire of New York started a group for Latino runners in 2016 that was inclusive of her Afro Latino heritage. (Photo courtesy of Maria Solis Belizaire)
Maria Solis Belizaire of New York started a group for Latino runners in 2016 that was inclusive of her Afro Latino heritage. (Photo courtesy of Maria Solis Belizaire)

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Maria Solis Belizaire knows heart disease and other cardiovascular conditions run in her family. Her father survived a heart attack in his late 30s when she was a teenager, and both of her grandmothers had multiple heart surgeries.

Solis' family health history is one reason she started running. In 2016, she started a community of Latino runners in New York that was inclusive of her Afro Latino roots. That community has grown to thousands of members who run together to improve their physical and mental health.

"For a lot of people, running is a way of dealing with depression or other health issues that forced them to do something," said Solis, whose mother was Puerto Rican and father was of Belizean and Mexican descent. "For me, it's part of trying to have a healthy heart."

Health disparities among Hispanic people, who make up nearly 20% of the U.S. population, are well documented. They have disproportionately higher death rates from diabetes and a higher prevalence of obesity and uncontrolled high blood pressure – all of which can contribute to heart disease, according to the Centers for Disease Control and Prevention.

But limited research also has found disparities for a growing part of the population that identifies as Afro Latino, Black people with cultural roots in Latin America and the Caribbean. A study published in the Journal of Immigrant and Minority Health in 2007 found Afro Latino people are more likely than white Hispanic people to report fair or poor health. Other research shows they may have slightly higher rates of high blood pressure and diabetes than their white Hispanic peers.

Extensive research still is needed to understand the health of Afro Latino people as a unique population, said Dr. Katia Bravo-Jaimes, an adult congenital cardiologist at the Mayo Clinic in Jacksonville, Florida. Research most often has focused on the Hispanic population as a homogenous group, which can conceal health disparities within subgroups.

"The main problem that we have when we are encountering cardiovascular disease risk studies in different populations is that they lump everybody together" within the overall Hispanic population, she said. "And 'Hispanics,' in reality, is such a broad category because the ethnicity is based on the culture, values and language that these people share, whereas race is much more based on physical characteristics that are related to ancestry."

Nearly 1.2 million people in the U.S. identified as Black Hispanic in the 2020 Census, which was the first time "Afro Latino" was counted. But a Pew Research Center survey found there may actually be an estimated 6 million adults who identified as Afro Latino in 2020.

Maria Solis Belizaire at the Golden Gate Bridge in San Francisco. A running group she started has grown to thousands of members. (Photo courtesy of Maria Solis Belizaire)
Maria Solis Belizaire at the Golden Gate Bridge in San Francisco. A running group she started has grown to thousands of members. (Photo courtesy of Maria Solis Belizaire)

Although research has found higher mortality among Afro Latino people than white Hispanic people, drivers of health inequity remain understudied, said Dr. Adolfo Cuevas, an assistant professor in the School of Global Public Health at New York University in New York City. He was the lead author of a 2016 review of research in the American Journal of Public Health on the intersection of health and race within the Latino population.

"We went as far as these scientific search engines allowed us to go to identify scientific papers that examined race or skin tone within the Latino population in relation to health," said Cuevas, who identifies as Afro Latino with roots in the Dominican Republic. "And we were surprised that there were so few scientific articles that have focused on skin tone and race within the Latino population, even though these are one of the more important aspects of the Latino-lived experiences."

In a 2019 Pew survey of Hispanic adults, about 64% of respondents with darker skin reported they had experienced discrimination, or had been treated unfairly, compared with about half of respondents with lighter skin. This form of discrimination is known as colorism.

The stress associated with being treated differently because of race and ethnicity can negatively affect health, Cuevas said. Experiencing discrimination may increase the chance of dying, especially from cardiovascular-related causes, according to a 2023 study in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

"Racism and colorism affect life chances for Afro Latinos and ultimately their health," Cuevas said. "For example, despite having higher levels of education compared to white Latinos, they have higher unemployment rates and lower income."

Cuevas said health disparities may be more prevalent among Afro Latinos because they experience the inequities associated with both their race and their ethnicity.

In their analysis, Cuevas and his colleagues found that health disparities among Afro Latino people in comparison with white Hispanic people "looked almost exactly like" the disparities seen among non-Hispanic Black people compared to white people. "Afro Latino people have poor maternal health, poor infant health – and even when it comes to the health of children and adults, it's much poorer," he said.

A 2020 study in the Journal of Immigrant and Minority Health found that compared to non-Hispanic white people, Black Hispanic people had a higher risk of hospitalization and death than white Hispanic people.

Cuevas said his current research emphasizes the need for improved studies that examine racial inequities across various aspects of health.

"We have to collect better data, especially if we're focusing on Latino health, to capture the multidimensionality of what race is," he said. "That will give us a better understanding of the Latino health profile."

For Afro Latinos like herself, Solis said it's important to consider "the unique blend of genetic and cultural elements" that play a role in vulnerability to heart disease.

"Understanding these factors and promoting awareness within our community is essential for prevention and care," she said.

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