Barrio advantage, gender, Health Care Reform, health insurance, Hispanic Enclave, Hispanic Paradox, intersectionality, marriage, poverty


We examined Hispanic enclave paradoxical effects on cancer care among socioeconomically vulnerable people in pre-Obamacare California. We conducted a secondary analysis of a historical cohort of 511 Hispanic and 1,753 non-Hispanic white people with colon cancer. Hispanic enclaves were neighborhoods where 40% or more of the residents were Hispanic, mostly first-generation Mexican American immigrants. An interaction of ethnicity, gender and Hispanic enclave status was observed such that the protective effects of living in a Hispanic enclave were larger for Hispanic men, particularly married Hispanic men, than women. Risks were also exposed among other study groups: the poor, the inadequately insured, Hispanic men not residing in Hispanic enclaves, Hispanic women and unmarried people. Implications for the contemporary health care policy debate are discussed.

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