American-born Black adults are more likely to die from cardiovascular disease than Black immigrants
For years, research has suggested that immigrants in the United States have better health outcomes than those who are born here, partially because immigrants tend to already have healthier lifestyles. However, physicians also believe this good health probably fades the longer immigrants stay in the U.S., where cheap, highly processed foods are widely available and consumed. A Penn State College of Medicine study muddies these beliefs.
Dr. Alain Lekoubou Looti, an assistant professor of neurology and public health sciences at the College of Medicine, found that both recent Black immigrants and those who had been in the U.S. for 15 years or longer were less likely to die earlier in general and from cardiovascular disease than Black adults born in the U.S.
“Even after adjusting for multiple covariates, such as socioeconomic status and education levels, these results were really surprising to us,” said Lekoubou, a neurologist at Penn State Health Milton S. Hershey Medical Center. “To see that persistent gap between Black people born elsewhere and those who were born here — we don’t have any clear or solid explanation.”
The researchers examined data on nearly 65,000 Black adults aged 25 to 74 from the Centers for Disease Control and Prevention’s National Health Interview Survey (NHIS) from 2000 to 2014, with linked mortality files through 2015. Almost 4% of the individuals were African immigrants and 8% were from the Caribbean and Central and Latin America.
In the time period the researchers studied, there were 4,329 deaths, with 935 caused by cardiovascular disease and 205 from a stroke. In every case, deaths were lower among immigrants, even those who had lived in the U.S. for longer than 15 years — immigrants had 54% lower death rates overall and 40% lower death rates from cardiovascular disease.
Lekoubou said one of the biggest takeaways from this study is the need to stop assuming Black patients are a homogenous group.
“I think we have to be careful when we use race to identify patients because, as this research shows, when we are talking about ‘Black people’ and their risk of cardiovascular disease, it may not be the same for everyone,” he said. “There are probably some differences within these groups that need to be accounted for when we are talking to those patients.”
This article is based on research presented at the 2022 American Stroke Association International Stroke Conference.
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