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Keywords

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

Abstract

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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