Latine Reproductive Health and Data Inequities Across the Life Course: A Call to Action

Reproductive health indicators represent important life course events. Yet, reproductive health events including contraceptive use, preventive screenings, pregnancy, childbirth, and menopause are not holistically considered when assessing well-being among US birthing populations. During the past four decades, a significant and robust body of literature revealed discontinuity and persistent, differential inequity across reproductive health indicators for Latine subgroups.1–3 National reproductive health indicators during the 1980s to 1990s on infant mortality rate (IMR), preterm birth (PTB), and low birth weight (LBW) reveal unfavorable outcomes for Puerto Rican and Mexican-origin individuals compared with Cubans.2,4 Early findings have been confirmed by a contemporary body of work that links adverse reproductive indicators with social determinants including poverty, race, education, and nativity (place of birth).4–6 While past scholars have illuminated Latine reproductive health inequities, little action has been taken to reduce long-standing data inequity by subgroup. While historically disaggregated national health data demonstrated disparities in reproductive health outcomes by Latine subgroups,2,3 post-2000 census and health statistics data aggregation (Table 1, Appendix A [available as a supplement to the online version of this article at https://ajph.org], and https://bit.ly/4eSh3Pk). Data aggregation obscures differences in reproductive health outcomes across subgroups. In addition, key social determinants including sociodemographic factors such as poverty, race, and nativity are often not employed to contextualize reproductive health indicators or as potential predictors of inequitable outcomes.5 An exemplar of this aggregation reveals itself in the "Hispanic paradox," 7 a term coined in 1986 to describe the observed mortality advantage among Latine people despite substantial socioeconomic disadvantage.5 This paradox builds on two erroneous premises: (1) social determinants and health are not interrelated, and (2) Latine people are predominantly immigrants. Although the latter speaks to the epidemiological paradox that immigrants are healthier than US-born individuals, only about one third of Latine individuals at any time are immigrants.8 Moreover, the paradox narrative has been challenged4,9 as it belies data-driven subgroup differences of reproductive health outcomes4 and disregards Latine heterogeneity and the impact of social and political det