Read in Spanish
In early December 2021, I was seeing a physical therapist for a shoulder injury. At one point, the physical therapist alternated between me and another patient in the bed next to me who had just had knee replacement surgery. I was eavesdropping on their conversation while the physical therapist straightened the other patient’s leg and bent his knee.
The patient was in pain and was anxious to finish the difficult part of the treatment. The therapist encouraged the patient to continue. At one point the patient asked to stop the treatment. The therapist replied, “Te queda una semanita más.” This means, “You only have one week left.” The patient agreed to continue the treatment.
By adding the suffix “ita” to the word “semana” (week), the therapist provided the patient with a perspective on how much treatment they had left in a way that sounded shorter, even though there was still a full week left.
This ability to downplay or exaggerate a situation simply by adding a suffix is a distinctive feature of the Spanish language that may contribute to the surprising health resilience that researchers have documented in the U.S. Hispanic population, known as the “Hispanic Paradox.”
As a Hispanic quantitative psychologist, I have been involved in research on stress and cardiovascular health at the University of Miami since 1988. Most recently, I was an investigator in the Hispanic Community Health Study/Latino Study, an observational study of over 16,000 adults documenting the health of Hispanic residents of diverse backgrounds in four U.S. urban communities.
Unravelling the Hispanic Paradox
Nearly 30 years ago, researchers reported that Hispanics in the United States were living longer and had lower rates of heart disease than non-Hispanic whites, even though they had a higher prevalence of heart disease risk factors such as obesity and diabetes, and experienced stress from discrimination and low wages.
Last year, 696,962 people died in the United States from heart disease, which is linked to the interaction of environmental and genetic factors such as smoking, a sedentary lifestyle and a high-fat diet. These behaviors contribute to heart disease and stroke.
Stress also plays a role in heart disease. How you respond to stress also matters. The extent to which language facilitates emotional processing of stress may be important for heart disease. So Spanish may be an advantage. Having grown up bilingual, I believe this to be true.
The seemingly contradictory phenomenon of Hispanics having a lower overall rate of heart disease despite their higher health risks has come to be known as the “Hispanic Paradox.” Before the COVID-19 pandemic, Hispanics were living an average of three years longer than whites, according to the Centers for Disease Control and Prevention.
The causes of this resilience have intrigued researchers for decades, who have proposed a variety of explanations, from statistical bias to bean consumption to cultural values such as “familismo,” the idea that Hispanic culture prioritizes family over the individual.
Family ties alone cannot explain the Hispanic paradox
I became intrigued by this phenomenon when I participated in the Hispanic Community Health Study in 2008. My initial attempts to find an explanation for the Hispanic Paradox led me to examine whether the family unit might offer some protection against early life stress.
In that study, I estimated the prevalence of adverse childhood experiences among Hispanics in the United States. If family is a source of resilience, we would expect to see lower rates of abuse, neglect, and family breakdown. But to my surprise, these adverse experiences were actually quite high in this population. In fact, 77% of the study population reported at least one adverse experience, and about 29% reported experiencing four or more by age 18.
This led me to realize that the resilience seen in the Hispanic Paradox doesn’t necessarily come from the safety net of family.
Explore how culture can contribute
I then looked at other cultural resources, such as social support and optimism, factors that may buffer the effects of stress.
Is Hispanic culture more optimistic than American culture? Optimism helps you see stress as temporary and manageable. Being optimistic helps you feel like you can handle stress.
I came across a paper on positivity in human language. The researchers developed a “happiness index” and applied it to measure the number of positive words in different sources in different languages. They analyzed books, newspapers, music lyrics, and tweets, for example.
The paper’s chart showed the distribution of the happiness index by source and language, and the results were surprising: the sources with the highest happiness index were Spanish.
Once I identified Spanish as my area of focus, everything started to fall into place. I turned to linguistic analysis to look at the role of language in emotion. Current emotion theory explains that language is necessary for the brain to shape emotions. Research shows that emotions affect blood pressure and heart rate stress response and recovery. And stress response and recovery play a central role in the development of heart disease.
In other words, the rich and positive emotional expressions in Spanish may not only influence culture over time, but also our emotional responses to stress.
Contribute verb
However, it may not just be positive language that contributes to improved cardiovascular health among Hispanics: there are other linguistic features that promote emotional expression.
For example, consider the two forms of the verb “to be.” In English, it’s simply “are.” But in Spanish, it can be a temporary state of being: “estar,” or a more permanent state, “ser.” This is useful when thinking about negative situations: “I could be overweight” in English; “I could be permanently overweight” in Spanish, which would translate to “ser gorda,” but could also be “estar gorda,” which means to be temporarily overweight. The latter is temporary, suggesting the possibility of change, which in itself is a motivator for change.
Spanish is one of the Romance languages that uses the conditional mood of verbs. The conditional mood expresses hypothetical situations, hopes, and possibilities. For example, consider the “magical realism” of Colombian author Gabriel Garcia Marquez, who used the conditional mood to express the possibility of an alternative reality.
Spanish allows the language to diminutive or exaggerated expressions simply by adding suffixes, thus expanding the range of emotions and perceptions. In this way, the therapist in this example helped her patient through a difficult stage in treatment.
While English is the language of science, precise and concise, I think the flowery nature of Spanish contributes to a culture that supports the expression of emotions, and in so doing, helps Spanish speakers manage their responses to stress.
This article is republished from The Conversation, a nonprofit, independent news organization that provides facts and trusted analysis to help people make sense of a complex world. Author: Maria Magdalena Labre, University of Miami
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María Magdalena Llabré receives funding from the NIH.
