Latiné immigrant heterogeneity: Striking health differences among Cuban refugee/migration waves to the United States

Latiné people differ markedly in our lived experiences in ways that are underappreciated. Meanwhile, variations in social experiences are known to be associated with differential health outcomes. We test whether immigration history is associated with health differences among U.S.-based Cuban refugees. Cubans from the circum-1980 Mariel Boatlift migration wave reported significantly higher instance and severity of disability on average than Early Cuban Exiles (1959-1962), Freedom Flight refugees (1965-1973), and Special Period (1990-2002) refugees. In contrast, disability among immigrants from Mexico to the U.S. across time-matched periods followed a different pattern. To help identify potential factors underlying the Cuban refugee pattern, we interviewed Miami-based Cubans. Participants described heightened discrimination in 1980s Cuba and U.S., which we hypothesize contributed to higher instances of disability refugees of that era. Our results suggest that understanding the history of Latiné immigration relative to country of origin, and the differential experiences of individuals both across and among ethnic groups, is imperative. A more nuanced understanding of the social determinants of immigrant health is important to help combat adverse factors in future generations. Significance Statement Even within a Latiné community from a single country of origin, we find that differential social experiences of immigrating to the U.S. are associated with variation in health outcomes. Understanding the social determinants of health within marginalized populations can help scientists, policymakers, and community-based organizers contextualize the conditions in which adverse health outcomes are arising and organize to combat these factors in future generations of refugees and immigrants coming to the United States.