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Introduction: E Pluribus Plures or E Pluribus Unum?

Marta Tienda and Faith Mitchell

Although the U.S. Hispanic population predates the founding of the United States, the recent emergence of Hispanics as the largest minority group is one of the most important demographic changes of the 20th century. Officially coined in the 1970s by congressional action and government regulation, “Hispanic” in fact refers to a population that differs enormously by history, nationality, social class, legal status, and generation.1 It encompasses both the descendants of early Spanish settlers in what is now the United States and immigrants and their offspring from Spanish-speaking countries in the Caribbean, Central America, and South America.2 Altogether, the category subsumes 20 nationalities, of which the most numerous are Mexicans (about two-thirds of Hispanics), Puerto Ricans, Cubans, Central and South Americans, and Spaniards.3

1  

In the papers, the terms Hispanic and Latino are used interchangeably.

2  

Excluded from the Hispanic label are Latin Americans who are not Spanish speaking, from the French-speaking Haitians (although they share the island of Hispaniola with the Spanish-speaking Dominicans) in the Caribbean to the English- and French-speaking Guyanese and Dutch-speaking Surinamese in South America. Brazilians are not Hispanic either—and do not consider themselves as such—although they are Latin Americans. In general, Portuguese-speaking people originating in Portugal and Brazil are excluded from the Hispanic category, which evolved from the Spanish-origin and Spanish-language population constructs used in 1970 and thereafter by the U.S. government.

3  

Since the Jones Act in 1917, all island-born Puerto Ricans are U.S. citizens by birth. However, those who are island-born are considered to have an immigration-like experience coming to the mainland that is comparable to that of other Hispanic immigrant groups.



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Hispanics and the Future of America 1 Introduction: E Pluribus Plures or E Pluribus Unum? Marta Tienda and Faith Mitchell Although the U.S. Hispanic population predates the founding of the United States, the recent emergence of Hispanics as the largest minority group is one of the most important demographic changes of the 20th century. Officially coined in the 1970s by congressional action and government regulation, “Hispanic” in fact refers to a population that differs enormously by history, nationality, social class, legal status, and generation.1 It encompasses both the descendants of early Spanish settlers in what is now the United States and immigrants and their offspring from Spanish-speaking countries in the Caribbean, Central America, and South America.2 Altogether, the category subsumes 20 nationalities, of which the most numerous are Mexicans (about two-thirds of Hispanics), Puerto Ricans, Cubans, Central and South Americans, and Spaniards.3 1   In the papers, the terms Hispanic and Latino are used interchangeably. 2   Excluded from the Hispanic label are Latin Americans who are not Spanish speaking, from the French-speaking Haitians (although they share the island of Hispaniola with the Spanish-speaking Dominicans) in the Caribbean to the English- and French-speaking Guyanese and Dutch-speaking Surinamese in South America. Brazilians are not Hispanic either—and do not consider themselves as such—although they are Latin Americans. In general, Portuguese-speaking people originating in Portugal and Brazil are excluded from the Hispanic category, which evolved from the Spanish-origin and Spanish-language population constructs used in 1970 and thereafter by the U.S. government. 3   Since the Jones Act in 1917, all island-born Puerto Ricans are U.S. citizens by birth. However, those who are island-born are considered to have an immigration-like experience coming to the mainland that is comparable to that of other Hispanic immigrant groups.

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Hispanics and the Future of America The rapid growth and increasing diversity of today’s Hispanic population is primarily a result of major waves of migration from Puerto Rico after World War II, the exodus from Cuba after the 1959 revolution, and especially the surge of immigration from Mexico and Latin America since 1970. In 1960, approximately 4 percent of U.S. residents were Hispanic; today, they are close to 14 percent. Almost two-thirds of the foreign-born Hispanics have arrived since 1980, but fertility will overtake immigration as the driver of Hispanic population growth in the current decade. Continuing the fertility and immigration trends now under way, by 2030 Hispanics are projected to comprise about one-fourth of the U.S. population. Behind the numbers resides a complex story of diversity along many dimensions that will shape Hispanics’ social and economic narratives in the decades ahead. This volume, which serves as a companion to Multiple Origins, Uncertain Destinies: Hispanics and the American Future (National Research Council, 2006), provides detailed analyses using multiple sources to characterize this dynamic, eclectic population from multiple perspectives; to evaluate whether and in what ways Hispanics are distinctive from other immigrant and minority groups; and to assess the social integration prospects of recent arrivals and their descendants.4 Collectively, the volume documents how the growing Hispanic presence is being felt in schools, in workplaces, at the ballot box, and in health care systems throughout the nation. Two overarching themes unify the papers. One theme is whether apparent differences between Hispanics and other race and ethnic groups are real—that is, whether there is something distinctive about “Hispanicity” not shared by other groups. The second theme is whether Hispanics, particularly immigrants and their native-born offspring, are assimilating into the U.S. mainstream and along what dimensions. Because changes in the composition of the Hispanic population by national origin, immigrant status, and generation bear decisively on both themes, the authors have considered, where data permitted, both temporal and intergenerational changes in their analyses and inferences. Hispanics differ from non-Hispanics in several ways that set them apart from other race and ethnic groups in the United States: a youthful age structure; low average education levels; disproportionate concentration in unskilled jobs; a common ancestral language; and, among the foreign-born, a significant share who are legally undocumented. Each of these differences 4   Many of the authors used a common file of the March Current Population Survey for the years 1998, 1999, 2000, 2001, and 2002, including specially constructed variables for data about Hispanic ethnicities and generational cohorts defined by age at arrival and nativity of self and parents. Nonetheless, care should be used in comparisons across chapters.

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Hispanics and the Future of America has important implications for integration prospects, but collectively they appear to distinguish Hispanics from non-Hispanics. Yet the chapters in this volume also document significant temporal improvements in educational attainment, earnings, household income, homeownership, and political participation, which indicate that Hispanics are replicating the integration path of prior immigrant groups. Most comparisons between native- and foreign-born Hispanics reveal how much the growing representation of recent immigrants among their ranks masks the cultural assimilation and socioeconomic progress of later generations. Spanish-language maintenance is a telling example: the proliferation of Spanish in immigrant communities belies the rapid language shift that is under way. The vast majority—93 percent—of foreign-born Hispanics speak some Spanish at home, compared with only 63 percent of the native born. However, the preponderance of evidence shows that proficiency in and preference for Spanish decline over time and across generations. According to Rubén Rumbaut (Chapter 2), the grandchildren of the present wave of immigrants will for the most part be monolingual English speakers. Evidence that cultural expressions of ethnicity are rendered largely symbolic by the third generation notwithstanding, there are several reasons to expect that Hispanics’ integration experiences will deviate from those of earlier groups: success in the U.S. labor market now requires higher skill levels than was true in the past; there is a rising share of undocumented people among the foreign born; whether or not the Hispanic geographic dispersal now under way will promote or retard acceptance is still unclear; and the burgeoning second generation is coming of age as the majority society ages. Individually and collectively, these circumstances have profound implications for Hispanics’ terms of belonging and how their growing numbers will imprint the nation as a whole. The chapters in this volume use a variety of data sources to describe the changing contours and future prospects of the Hispanic population, focusing on several key social and institutional domains—the family, the labor market, educational institutions, health care systems, and the polity. Each provides nuance and detail that was used in crafting the companion volume, while providing a comprehensive treatment of specific topics. In the rest of this chapter we provide a brief synopsis of their main findings and offer concluding thoughts about risks and challenges facing the Hispanic second generation. THE HISPANIC POPULATION IN NUMBERS In “The Making of a People,” Rubén G. Rumbaut examines three aspects of the evolution of the Hispanic population: their historical origins,

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Hispanics and the Future of America contemporary diversity, and the social construction of the catchall “Hispanic” category. Hispanics are at once a new and an old population, made up both of recent immigrants and groups who claim a history that precedes the establishment of the nation. The ethnic groups now labeled as Hispanics—the 20 nationalities from Latin America and Spain itself—were not “Hispanics” or “Latinos” in their countries of origin; they only became so in the United States, where the use and meaning of the label itself continues to evolve. Rumbaut’s chapter highlights the differences that most clearly distinguish the Hispanic population from non-Hispanics, while at the same time illustrating and emphasizing the group’s vast heterogeneity. Reviewing the historical record and drawing on data from the decennial census, the Children of Immigrants Longitudinal Study, and other published sources, he addresses several fundamental questions, among them: In what way can this diverse group be considered a unique population? Does Hispanic represent a cohesive and self-conscious ethnic group, sharing a sense of peoplehood akin to that of African Americans, or is the label Hispanic merely an administrative convenience? And by designating themselves “some other race,” are Hispanics revamping the U.S. racial classification? In answering these questions, Rumbaut identifies a confluence of circumstances that shapes a distinctive profile for Hispanics as a whole and for particular Hispanic ethnic groups. These include the history of the incorporation of particular groups (with detailed attention to those from Mexico, Puerto Rico, and Cuba, who account for more than three-fourths of the Hispanic population on the U.S. mainland); the different national origins that are subsumed by the label (focusing on the characteristics of the nine largest groups); racial categorization (including the increasing use of Hispanic or Latino as racial rather than ethnic identities); immigration and naturalization patterns; and intergroup and intergenerational differences in linguistic acculturation and social status. Rumbaut claims that Hispanics, who collectively comprise half of all immigration to the United States, differ collectively and decisively from non-Hispanic immigrants in two key respects—a common language and the social class disadvantages of the immigrant generation. Unlike most immigrants from Europe and Asia, who speak various languages, Hispanics speak Spanish. More than 28 million people in the United States in 2000 reported speaking Spanish at home—some 10 million more than spoke all other languages combined. Second, among foreign-born adults, non-Hispanics are four times as likely to have college degrees as Hispanics, while Hispanics are three times as likely as non-Hispanics to lack a high school diploma. This comparative human capital disadvantage of Latin American immigrants, which relegates them to the lower rungs of the occupational structure, is reduced significantly but not eliminated by the

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Hispanics and the Future of America U.S.-born generations. As other chapters elaborate, that central fact has profound long-term implications for the social and economic prospects of their children’s generation and is also the basis for common stereotypes that disparage and stigmatize the population as a whole. “The Demographic Foundations of the Latino Population,” by Jorge Durand, Edward Telles, and Jennifer Flashman, uses data from multiple sources to characterize the dimensions and components of Hispanic population change. They trace Hispanics’ youthful age structure to high rates of immigration and fertility and discuss how changing immigration policies, social networks, and other factors contribute to the changing volume, composition, and settlement patterns of legal and illegal labor flows from Latin America. These demographic foundations—the components of growth, the changing age structure, and new settlement patterns—are fundamental to understanding how the growing Hispanic presence will affect schools, labor markets, and social institutions. Durand, Telles, and Flashman also show how historical settlement patterns that concentrated Mexicans in the Southwest, Puerto Ricans in the Northeast, and Cubans in South Florida have evolved in recent years. Although traditional settlement areas, such as California, Texas, and New York, still house the largest Hispanic communities, the most rapid growth is occurring in states that had tiny Hispanic populations just 15 years ago. Significantly, the Hispanic geographic dispersal predominantly involves recent immigrants. In Nevada, for example, the Hispanic population more than tripled between 1990 and 2000, while Hispanics quadrupled their presence in Georgia and nearly quintupled their numbers in North Carolina. It is too early to tell whether the new settlement patterns will promote or retard integration prospects of new immigrants. On the subject of identity, Durand, Telles, and Flashman observe, like Rumbaut, that despite class, race, and national differences, Hispanics have found ways to coalesce on the basis of a shared language and, above all, a common identity forged by a panethnic label. Their chapter concludes with the projection that, despite uncertainty about the size of future immigration flows, the Hispanic population is likely to continue its growth trend for at least two decades because of its youthful age structure and fertility rates above the national average. Residential location is a powerful predictor of well-being because of the myriad social amenities that are unequally distributed across space, such as affordable housing, quality schools, public safety, and transportation. Location also influences access to jobs that pay family wages, as well as the likelihood of mingling with nonminority groups. Therefore, in “Redrawing Spatial Color Lines: Hispanic Metropolitan Dispersal, Segregation, and Economic Opportunity,” Mary J. Fischer and Marta Tienda examine trends in spatial segregation, school segregation, homeownership, and employ-

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Hispanics and the Future of America ment outcomes for native- and foreign-born Hispanics since 1980. Focusing on the 100 largest metropolitan areas, which they sort into three strata—traditional metros, new Hispanic destinations, and other large metros—they consider whether, where, and how Hispanics’ new settlement patterns alter the racial and ethnic landscape. Fischer and Tienda conclude that the Hispanic geographic scattering, which began during the 1970s and gained momentum during the 1990s, is a significant agent of urban social transformation, both because of the pace of change and because of the large number of places involved. Widespread declines in racial residential segregation during the 1990s, especially in areas where Hispanics have recently emerged on the scene, suggest that the newcomers may serve as a buffer between blacks and whites, but it is too early for definitive conclusions. The movement of Hispanics into non-Hispanic communities, as well as the varying levels of segregation and integration they experience in those settings, has broad implications for intergroup relations and for the contours of ethnic and racial stratification more generally. The implications for school segregation and homeownership of the Hispanic geographic scattering are mixed. What is the most clear is that changes in labor demand are the major force attracting Hispanics to new destinations throughout the nation. The rapid expansion of immigrant job niches in the new destinations—notably, construction, domestic maintenance and repair services, nondurable manufacturing, and personal and household services—largely explain why the Hispanic dispersal disproportionately involves immigrants, among whom recent arrivals predominate. FAMILY, SCHOOL, AND WORK In large part, Hispanics’ current economic and social status reflects their youthful age structure, their low average education levels, and the large shares of recent immigrants with limited English skills. Owing to the dominance of Mexicans, who are the least educated of all Hispanic groups, the foreign-born Hispanic population is disproportionately concentrated at the bottom rungs of the occupational and wage structure. Hispanic immigrants with less than a high school education are relegated to unstable, low-wage jobs that offer few or no social benefits and poor working conditions. Chapters 5-8 examine connections among family, school, and work and their implications for Hispanic’s economic well-being. Family “Hispanic Families in the United States: Family Structure and Process in an Era of Family Change,” by Nancy S. Landale, R. Salvador Oropesa,

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Hispanics and the Future of America and Cristina Bradatan, situates trends in Hispanic families in the context of significant changes in U.S. family life. These trends include the rising age of marriage, an increase in cohabitation, a dramatic shift in the proportion of children born outside marriage, high divorce rates, high rates of female family headship, and a growing share of children with restricted access to their fathers’ resources. Using data from the census, the National Center for Health Statistics, and published sources, the authors document trends in several indicators of family change, systematically comparing Hispanic national subgroups with non-Hispanic whites and non-Hispanic blacks. They also examine generational variation in family patterns within Hispanic subgroups, paying particular attention to whether the strong family orientation—sometimes termed “familism”—that is part of Hispanic immigrant culture is retained over time and across generations or whether Hispanics are also experiencing what has been termed “family decline.” Landale, Oropesa, and Bradatan identify several patterns that are consistent with claims that Hispanics are more familistic than non-Hispanics, such as higher fertility (with the exception of Cubans), larger households, and greater prevalence of extended living arrangements in comparison with non-Hispanic whites and blacks. Also, with the exception of Puerto Ricans and Cubans, Hispanic women are more likely to be married at a young age (20-24) than are non-Hispanics. Their analysis also notes signs of declining familism, especially for Mexican-origin Hispanics. On every indicator used, they found that the second and third (or later) generations exhibited less traditional family behavior than the first generation. Most worrisome, say the authors, is the rise of nonmarital fertility for all Hispanic groups and the rising percentage of children living in mother-only families across generations. Intermarriage is a crucial indicator of assimilation because, by blurring racial and ethnic boundaries or reducing the numbers who self-identify as Hispanic, it has direct implications for the future size and shape of ethnic populations, as well as for the persistence of Hispanic as an ethnic category. Examining racial and ethnic mixing in sexual partnerships of various types, including marriage, cohabitation, and parenthood, Landale, Oropesa, and Bradatan find evidence that as the number of children of mixed ethnic backgrounds grows, boundaries among Hispanic subgroups and between Hispanics and non-Hispanics are weakened. That Hispanics of Mexican origin are less likely to intermarry than other Hispanic subgroups implies fewer exits from the Mexican American population due to mixed racial-ethnic backgrounds of offspring (and consequent identity shifts) compared with other nationalities.

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Hispanics and the Future of America Education Youth reared in families with only one parent or by parents with low education levels face formidable challenges as they enter a monolingual U.S. school system. Over one-fourth of Hispanic adults have less than a ninth-grade education, with Mexican Americans averaging the lowest educational levels and Cuban Americans and other Hispanics the highest. “Barriers to Educational Opportunities for Hispanics in the United States,” by Barbara Schneider, Sylvia Martinez, and Ann Owens, uses data from the Census Bureau, the College Board, and the Department of Education to examine the institutional and student-level factors behind the poor scholastic achievement and low educational attainment levels of Hispanic youth. By examining the entire educational trajectory, from preschool to college, the authors illustrate the lasting consequences of suboptimal early school experiences of Hispanic students for their final attainment, emphasizing how transitions between levels affect the likelihood of school persistence. The high school dropout rate for Hispanic students (28 percent in 2000) is more than double that of non-Hispanic whites and blacks. However, very high dropout rates for foreign-born Hispanics—43 percent in 2001—inflate the average figures because many adolescent immigrants never enter the U.S. system. Among the issues that increase Hispanic students’ vulnerability to failure are lower levels of exposure to preschool literacy activities; biased teacher assessments of non-English speakers during the early school years; the quality of relationships between Hispanic students and non-Hispanic teachers; the concentration of Hispanic students in large, urban schools that, more often than not, represent suboptimal instructional environments; and failures of the academic guidance programs directing Hispanic students toward college preparatory courses. The authors also examine various objective indicators of academic success, including cognitive test performance, high school completion, and college enrollment. They show that Hispanic students trail non-Hispanic whites on most outcomes, including school readiness, elementary school math and reading scores, and the share of students who take SAT or advanced placement exams. Schneider, Martinez, and Owens claim that different factors influence scholastic success throughout the school process. Before Hispanic students begin formalized schooling, family resources are critically important: at this stage, the confluence of low parental English proficiency and educational attainment combined with limited educational resources at home hinders Hispanic parents from engaging their children in early literacy activities that contribute to academic success. In elementary school, teacher stereotyping and low expectations for Hispanic students further undermine their academic achievement. And, in high school, Hispanic students receive lim-

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Hispanics and the Future of America ited guidance about college-oriented coursework and are among the least likely either to take high-level mathematics and science courses or to enroll in four-year colleges. After high school, the cost of higher education and immigrant parents’ unfamiliarity with the complex policies and practices of the U.S. education system foment low rates of Hispanic college attendance, particularly at four-year institutions. As discussed by the authors, students who enter the labor force immediately after high graduation embark on a course that virtually ensures a lifetime of low wages. Although rising numbers of Hispanic high school graduates are enrolling in college—about one in three in 2000—their degree completion rate four years later trails that of non-Hispanic whites. In part this is because Hispanic students are more likely than other groups to enroll in two-year colleges and less likely to transfer to a four-year institution. Despite this discouraging picture, Schneider, Martinez, and Owens are optimistic that further improvements are possible with strategic interventions, provided that academic interventions for Hispanic youth become a national priority. The authors also identify strategic interventions to overcome the barriers Hispanic parents face in connecting with monolingual public schools. Moreover, they argue that Hispanic-serving institutions can play a pivotal role in promoting educational achievement at the college level. Work and Well-Being Based on analyses of public-use census data and the Current Population Survey, in “Hispanics in the U.S. Labor Market” Brian Duncan, V. Joseph Hotz, and Stephen J. Trejo chart trends and differentials in employment and earnings and compare the life-cycle patterns of schooling and work between Hispanics and both non-Hispanic blacks and non-Hispanic whites. To address whether Hispanics experience economic mobility, they also evaluate changes in Hispanics’ earnings over time and across generations. The authors conclude that the large gaps in human capital—both educational attainment and proficiency in English—between native- and foreign-born Hispanics and relative to non-Hispanics—both whites and blacks—decisively influence their labor market outcomes.5 For immigrants, the effect of these disadvantages is multiplied by the imperfect transferability of 5   Only about one-third of Hispanic immigrants speak English “very well,” compared with 90 percent of the U.S. born (and 99 percent of U.S.-born whites and blacks); Mexicans have the lowest levels of proficiency and Cubans and Puerto Ricans have the highest.

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Hispanics and the Future of America schooling and work experience obtained in foreign countries. Although undocumented workers may experience higher levels of market discrimination than legal residents, the authors claim that legal status plays a smaller role in their labor market standing than their relative lack of human capital. To make their case, Duncan, Hotz, and Trejo standardize employment and earnings rates for differences in educational attainment and English language proficiency and show that Hispanics fare almost as well as whites with respect to both employment and labor market earnings. This is in stark contrast to blacks, for whom similar adjustments do not significantly reduce racial disparities in labor market outcomes. Finally, the authors show how increased educational attainment between first- and second-generation Hispanics translates into appreciable improvements in their employment and earnings both in absolute terms and relative to whites, noting that socioeconomic progress between the second and later generations is less clear. Although a scenario of downward mobility is possible, more likely this reflects a higher tendency for the more successful among later generations to “opt out” of Hispanic ethnicity, thereby introducing a downward bias in their measured economic status. The large heterogeneity of the “third plus” generation is an additional source of potential bias. In “Economic Well-Being” Cordelia Reimers paints a detailed portrait of Hispanic household incomes, illustrating a close correspondence with labor market experiences. Her chapter uses the various social arrangements described in preceding chapters—national origin, family structure, education, and earnings—to analyze total household income, which is a measure of economic well-being that includes the earnings of all household members, plus unearned income from public benefits and other sources. She uses Current Population Survey data for 1998-2002 to depict variation in income packaging among working-age Hispanics, including contributions from earnings, public benefits, and the incomes of extended household members. Reimers also compares poverty rates and household income sources for elderly Hispanics, who are more likely than non-Hispanic whites and blacks to have worked in jobs that do not offer pensions. Paralleling the variation in education levels and household structure among Hispanic groups, she documents wide dispersion in median household incomes and poverty rates, with large disparities across nationalities and generations. First-generation Puerto Ricans and Dominicans are at the bottom on most measures of economic well-being and Mexicans near the bottom, while U.S.-born South Americans and Cubans rank close to non-Hispanic whites. Later generations of every national origin are better off than immigrants, and, like Duncan and his colleagues, she notes that most of the improvement occurs between the first and second generations. Reimers cautions that cross-sectional differences among generations do not necessarily reflect future intergenerational change because the parents and

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Hispanics and the Future of America grandparents of today’s second- and third-generation Hispanics are not necessarily comparable to contemporary immigrants from the same country. Overall, her findings support claims in other chapters that the future economic well-being of Hispanics in the United States hinges crucially on education and family structure of new immigrants and their U.S.-born children and grandchildren. HEALTH STATUS AND HEALTH CARE Although less frequently considered in analyses of employment and earnings, health status is an important dimension of human capital that influences productivity and economic well-being. “The Health Status and Health Behaviors of Hispanics,” by José J. Escarce, Leo S. Morales, and Rubén G. Rumbaut, provides a comprehensive overview of Hispanics’ physical and mental well-being, comparing Hispanic nationalities and generations to the extent that available data permit. The authors review existing literature and use data from the National Center for Health Statistics, the National Health Interview Survey, and other sources. Many findings reported by Escarce, Morales, and Rumbaut encourage optimism about Hispanics’ health status. For example, with the exception of Puerto Ricans, Hispanics have lower age-adjusted mortality than non-Hispanic whites despite their lower socioeconomic status, which is usually associated with higher mortality. Research on this “epidemiological paradox” suggests that Hispanics’ mortality advantage is concentrated among the foreign born, and that selective migration (i.e., the tendency for immigrants to be healthier than the people who stay behind) is partly responsible. For most U.S.-born Hispanics, in whom selective migration is not a competing explanation, mortality rates are at least as favorable as those for non-Hispanic whites. Birth outcomes present a similar paradox in that Hispanic women have a comparable or lower incidence of low birthweight babies and infant mortality rates than non-Hispanic white women, again with the exception of Puerto Ricans. As with mortality, the advantage is greater for foreign-born Hispanics; why it obtains also for U.S.-born Hispanic women remains poorly understood. That acculturation appears to worsen the health status of Hispanics is cause for concern. Deleterious effects of acculturation are especially evident among second-generation youths and in birth outcomes. In fact, recent trends in overweight and obesity among Hispanic youth suggest that the Hispanic population will be increasingly burdened by the complications of obesity, including diabetes, hypertension, and cardiovascular disease, in the decades to come. As a result, the U.S. health care system may be faced with much larger numbers of Hispanic patients suffering from chronic conditions and their consequences.

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Hispanics and the Future of America However, in “Access to and Quality of Health Care,” José J. Escarce and Kanika Kapur warn that Hispanics already face numerous barriers to receiving timely, appropriate, and high-quality health care—some because they are poor and others because of features specific to the population. This chapter, which reviews evidence on Hispanics’ access to and quality of health care, also presents new data from recent national surveys to show how national origin, English fluency, and citizenship status are associated with access to, and quality of, health care. The authors use data from the National Heath Interview Survey, the Medical Expenditure Panel Survey, and other sources to document barriers to access, with particular attention to the role of health insurance coverage and sources of care, patterns of health care utilization, and the quality of health care received. Escarce and Kapur find that, in comparison with non-Hispanic whites, Hispanics’ lower access to health care and lack of a usual source of care largely reflects their lower levels of insurance coverage. Hispanics use prenatal care and many preventive services less than non-Hispanic whites, make fewer visits to physicians and other medical providers, and have lower total medical care expenditures, including expenditures for prescription drugs. Foreign-born Hispanics, except for Puerto Ricans, consistently have much worse access indicators than U.S.-born Hispanics. Nationality breakdowns reveal that Puerto Ricans and Cubans are more likely than Hispanics of Mexican origin to have health insurance coverage and a usual source of health care; as such, they register more physician visits and higher expenditures for medical care. Studies on the quality of health care for Hispanics are even more limited than those about access to care, but available data suggest that the quality of the medical treatment for Hispanics is similar or slightly worse than that for non-Hispanic whites. For Spanish speakers, however, language not only poses an important barrier to access but also has a negative influence on patients’ experiences with care. The chapter raises several issues for policy makers by drawing attention to the large (and rising) disparities in health insurance coverage by economic status. It calls attention to inadequacy of current approaches for providing health insurance coverage and health care to populations of low socioeconomic status. In particular, given recent trends in the provision of employer-sponsored health insurance, Escarce and Kapur project that the number of uninsured Hispanics will grow rapidly over the next few years, even if immigration drops. If this does occur, the number of uninsured Hispanics will further strain health care delivery systems, especially the so-called health care safety net, particularly in the new communities in which Hispanics are settling.

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Hispanics and the Future of America CIVIC AND POLITICAL ENGAGEMENT Hispanics participate in social transformation through their political participation and civic engagement. However, a major characteristic of Hispanics’ political behavior is their low civic engagement, clearly evident across a range of electoral, civic, and organizational activities. Most notable, among registered voters Hispanics’ voter turnout rates trail those of non-Hispanic whites and blacks. There is widespread consensus that lower participation levels largely reflect differences in population composition between Hispanic and non-Hispanic populations—especially differences in the share of noncitizens. Yet, with each election, claims of Hispanics’ political influence grow, and increasing efforts are made to capture “the Hispanic vote.” In “Latino Civic and Political Participation,” Louis DeSipio questions assumption that Hispanics represent a singular voice at the ballot box. Major sources for his analysis include census data and various published analyses. On the issue of an identifiable Hispanic political community, DeSipio argues that perceptions are more apparent than real. He notes that mass and elite interests diverge considerably, although this division is narrowing. Over the past 20 years, Hispanic elites, particularly non-Cuban Hispanic elites, have organized primarily as Hispanics and not around their national origin identities. The boards of directors of major Hispanic organizations—including the Mexican American Legal Defense and Education Fund (MALDEF), the League of United Latin American Citizens (LULAC), the National Council of La Raza (NCLR), the National Association of Hispanic Elected and Appointed Officials (NALEO), the Tomás Rivera Policy Institute (TRPI), and the Congressional Hispanic Caucus—reflect both the Hispanic community’s diversity and shared issues. In contrast, at the mass level, national identities remain salient in defining the contours of Hispanic civic engagement. Although many Hispanics do not identify with panethnic labels or understand what they share in common with people of other national origins, DeSipio claims that a set of issues that bridge national origin groups and generations loosely cohere into a common political agenda. These issues, which include public education, social services, health issues, and the enhancement of government capacity in domestic politics, are neither outside the American mainstream nor particularly controversial, although they can potentially shift national debates by matters of degree. Still, the extent to which Hispanics have successfully organized around shared political agendas is limited by institutional and demographic barriers that are not unique to Hispanics, but that have a disproportionate effect because of their demographic composition, notably two large population segments

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Hispanics and the Future of America that are ineligible to vote—foreign-born adults who have not become naturalized citizens and school-aged youth. DeSipio argues that for Hispanics to use politics effectively, democratic institutions must be more responsive to their demands. Casting an eye to the future, he anticipates that the Hispanic electorate will grow incrementally over successive election cycles, gradually raising the chances that Hispanics will become the swing vote in electoral outcomes. However, the tensions between the low levels of political engagement across Hispanic subgroups and the reality of diverse political interests may undermine the likelihood of this outcome. He suggests that an increase in the number of elected national Hispanic leaders is needed to fortify a Latino politics that has been unfolding over the past 30 years. RETROSPECT AND PROSPECT Because of their large numbers, rapid growth, and unprecedented geographic dispersal, Hispanics will affect American society in profound ways even as they experience considerable transformation as a people. Numbering about 10 million today, children of Hispanic immigrants—both legal and undocumented—are projected to grow to 26 million over the next 25 years. With a median age below 13 years in 2000, most second-generation Hispanics are now enrolled in school; by 2030 the majority will be in the labor force. Because college attainment is increasingly mandatory for labor market success and English proficiency is vitally important for navigating health care systems and meaningful civic engagement, Hispanics’ economic prospects may hinge crucially on their mastery of English and their success in closing postsecondary education gaps with non-Hispanics. With time, most immigrant communities become ethnic groups, and within three generations, most expressions of ethnicity are rendered largely symbolic as cultural, structural, spatial, and marital assimilation blurs ethnic distinctions. Hispanic communities are undergoing these processes. The key question, as yet unanswered, is whether “Hispanic” will eventually prove to be a symbolic identity for people of Latin American descent or whether it will become an enduring marker signaling membership in a disadvantaged minority group. Assuming that Hispanic is rendered a largely symbolic identity in the future, two alternative scenarios are conceivable. One is e pluribus unum: Will Hispanicity become a real panethnic identity defined by a collective sense of peoplehood? The alternative is e pluribus plures: Will expression of nationalities persist and possibly reassert themselves in order to preserve the cultural foundation of group identity? If Hispanicity becomes synonymous with minority group status in the future, would this, in turn, redefine racial boundaries into black, white, and brown, thereby undermining

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Hispanics and the Future of America “unum?” Although this extreme scenario seems highly unlikely, it is unclear how the burgeoning second generation will resolve Hispanics’ long-standing quest for recognition and empowerment. As several chapters document, there are many signs that Hispanicity will become a symbolic identity rather than that of a disadvantaged minority. Since 1980, U.S.-born Hispanic adults have closed the educational attainment gap with non-Hispanic whites by more than half a year. Furthermore, there is ample evidence of intergenerational economic mobility, particularly between the first and second generations, which shows in annual earnings, median household income, and homeownership rates. Following the pathways of prior immigrant groups, the language shift from Spanish to English is virtually complete by the third generation. Whether these trends will continue, and at what pace, depend on several factors that are currently in flux. The factors include the level and composition of future immigration flows; whether Hispanic immigrant’s geographic dispersal accelerates spatial and social assimilation; whether growing numbers of foreign-born Hispanics become citizens and vote; the future vitality of the U.S. economy; and, especially, significant gains in educational attainment. In sum, the momentous generational transition now under way is a pivotal, yet unwritten, chapter of the Hispanic integration narrative. REFERENCE National Research Council. (2006). Multiple origins, uncertain destinies: Hispanics and the American future. Panel on Hispanics in the United States, Marta Tienda and Faith Mitchell, editors. Committee on Population, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.