Awareness of High Blood Pressure by Nativity Among Black Men: Implications for Interpreting the Immigrant Health Paradox

Abstract

IntroductionDifferences in the social determinants of health and cardiovascular health outcomes by nativity have implications for understanding the immigrant health paradox among black immigrants. We aimed to understand whether blood pressure awareness, a precursor to achieving blood pressure control among hypertensive patients, varied by nativity among a sample of black men.MethodsData were collected from 2010 through 2014. In 2016, we conducted logistic regression models using data from a large sample of urban-dwelling middle-aged and older black men. All men in the study had measured high blood pressure at the time of enrollment and were also asked whether they were aware of having high blood pressure. Independent variables included demographics, socioeconomic status, access to care, and health-related behaviors.ResultsForeign-born participants were significantly less likely than US-born participants to report awareness of having high blood pressure (P < .001). We observed a significant positive relationship between proportion of life spent in the US and being aware of having hypertension (β = 0.863; 95% CI, 0.412–1.314; P < .001). This relationship remained after adjusting the model for salient independent variables (β = 0.337; 95% CI, 0.041–0.634; P = .03).ConclusionsDifference in hypertension awareness by nativity may skew surveillance estimates used to track health disparities by large heterogeneous racial categories. Our results also indicate that prior health care experience and circumstances should be considered when studying the immigrant health paradox.

Barriers to accessing preventive health care among African-born individuals in King County, Washington: A qualitative study involving key informants

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Understanding the Healthcare Experiences and Needs of African Immigrants in the United States: A Scoping Review

“…For instance, foreign-born blacks have been found to have lower rates of cardiovascular diseases including heart disease and obesity, than US-born blacks (47). To understand the role of the immigrant health paradox in health disparities among black US immigrants, focus on the differences in health outcomes by nativity is required (48). Also, there exists a strong distrust of the experiences (51).…”

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