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theses

African born - Blacks are the fastest growing immigrants in the United States comprising 4.8% of the total foreign-born population. African-born Blacks are also culturally, ethnically, religiously, educationally diverse from their U.S-born and other foreign-born Black counterparts. The pathway by which they arrive and reasons for migrating into the United States (U.S.) also differentiate them from each other. Yet, most studies of Blacks in the U.S. largely overlook the heterogeneity within this group rather consolidating them as one monolithic group which may have implications for the health status of the African-born Black residing in the United States.

The cardiovascular health of African-born Blacks in the U.S. has been largely unexamined despite recent studies reporting an upsurge in the burden of cardiovascular disease in Sub-Saharan Africa. It is likely that African-born Blacks are migrating into the U.S. with cardiovascular risk factors and diseases that they are unaware of due to subpar healthcare systems already overburdened, lack of effective preventive strategies and lack of economic resources to treat effectively even when aware. In addition, immigrant populations are often identified as a vulnerable population due to their limited English language proficiency, immigration status, lack of socioeconomic resources, and stigma and marginalization due to religious and cultural background. In the case of the African-born Black this is further exacerbated by racial discrimination due to the color of their skin resembling their U.S.-born counterpart which elevates their risk of poor health and inadequate medical care in the United States. Lastly, acculturation has been linked to adopting lifestyle behaviors such as poor diet, lack of physical activity, smoking status and being obese that further increase the risk of African-born Blacks developing cardiovascular diseases.

African-born Blacks in the U.S. often report a higher likelihood of being uninsured, often have inadequate health insurance coverage, usually identify no usual source of care or healthcare provider and often do not get the needed preventive services. This study aimed to determine whether healthcare utilization is associated with cardiovascular health among African-born and U.S.-born Blacks and to evaluate whether the associations depended on length of stay.

Understanding the healthcare utilization of African-born Blacks and its association with their cardiovascular health could help in reducing the disparities in the gaps observed between Blacks and Whites in the U.S and elucidate how and if the gaps observed can be attributed to African-born Blacks being lumped in with U.S.-born Blacks. There is a need to disaggregate data on African-born Blacks in national databases on the health-related risk behaviors, chronic health conditions, use of preventive services, access to healthcare and healthcare utilization of African immigrants.

ETD_10686

Ph.D.

Includes bibliographical references

doi:10.7282/t3-8bqa-j267

ETD doctoral

The author owns the copyright to this work.