The Resilience of the Hispanic Paradox: An Ecological Study of Cultural Density, Poverty, and Mortality in Florida (2020-2024)

Introduction: The “Hispanic paradox” describes the observation that Hispanic communities may experience lower mortality rates than expected given socioeconomic disadvantage. This study aims to evaluate whether Hispanic cultural density is independently associated with lower all-cause mortality across Florida counties, after accounting for county-level poverty, rurality, and primary care workforce (PCW) density. Methods: We conducted a cross-sectional ecological study across all 67 Florida counties. The primary outcome was age-adjusted all-cause mortality (per 100,000 persons) averaged over 2020-2024. Exposures included county-level poverty rate, Hispanic population density, rurality, and PCW density. We utilized both frequentist multiple linear regression and Bayesian model comparison to quantify the strength of evidence. Results: The mean county-level all-cause mortality rate was 868.8 deaths per 100,000. In the multivariable regression model (R2 = 0.605), higher poverty was strongly associated with increased mortality (B = 15.25; p < 0.001). Conversely, higher Hispanic population density was independently associated with lower mortality (B = -5.72, 95% CI (-7.96, -3.48), p < 0.001) after adjustment for poverty, rurality, and PCW density. Bayesian analysis yielded very strong evidence, with a Bayes factor of inclusion (BFinclusion > 1.8 x 105) for the inclusion of Hispanic density as a predictor. Conclusions: In Florida, county-level poverty is strongly associated with higher all-cause mortality. Independently, higher Hispanic population density is associated with lower mortality across counties after adjustment for key covariates. These ecological associations do not establish causality, but they are consistent with the hypothesis that cultural density may be linked to population-level resilience in the context of socioeconomic deprivation.