Black Nativity and Health Disparities: A Research Paradigm for Understanding the Social Determinants of Health

Abstract

After more than a century of research and debate, the scientific community has yet to reach agreement on the principal causes of racialized disparities in population health. This debate currently centers on the degree to which “race residuals” are a result of unobserved differences in the social context or unobserved differences in population characteristics. The comparative study of native and foreign-born Black populations represents a quasi-experimental design where race is “held constant”. Such studies present a unique opportunity to improve our understanding of the social determinants of population health disparities. Since native and foreign-born Black populations occupy different sociocultural locations, and since populations with greater African ancestry have greater genetic diversity, comparative studies of these populations will advance our understanding of the complex relationship between sociocultural context, population characteristics and health outcomes. Therefore, we offer a conceptual framing for the comparative study of native and foreign-born Blacks along with a review of 208 studies that compare the mental and physical health of these populations. Although there is some complexity, especially with respect to mental health, the overall pattern is that foreign-born Blacks have better health outcomes than native-born Blacks. After reviewing these studies, we conclude with suggestions for future studies in this promising area of social and medical research.

Risk of Adverse Perinatal Outcomes Among African-born Black Women in California, 2011–2020

“…Further explorations by African country of origin and years of residence in the United States are needed, as increased exposure to stress over time (i.e., due to anti-Black racism and other forms of discrimination) may lead to a higher risk of adverse perinatal outcomes among African-born Black women. [69][70][71] Particularly important will be the examination of age at immigration given findings by Dominguez et al 70 that adult foreign-born Black pregnant women who arrive in the United States before 18 years of age reported experiencing racism at similar rates to United States-born Black pregnant women. Thus, it follows that the risk of adverse perinatal outcomes among foreign-born Black women who have lived in the United States for longer periods mirrors that of United States-born Black women.…”

The role of acculturation in the process of advance care planning among Chinese immigrants: A narrative systematic review

“…55 Recent evidence shows that acculturation, mostly capturing immigrants' birthplace and the duration of their stay in the host country, is associated with their health-related behaviors and health outcomes. 56,57 Chinese immigrants' acculturation influences chronic condition management in a complex way, which is shaped by various factors, such as their cultural background, their goals for acculturation, and the pressure they feel to assimilate. 58 The difference in their behavior indicates how Chinese immigrants understand the difference between cultural and societal norms and the strategies they took to manage this challenge.…”

Acute inflammation elicits decreased blood pressure but similar arterial stiffness in young African American adults

“…Further, an individual's ethnicity (country of origin) has been linked to their physiological health. For example, foreign‐born Hispanic Americans and foreign‐born African Americans have been identified as having more favourable health profiles than US‐born Hispanics (Crimmins et al., 2007 ; Hummer et al., 2007 ; Peek et al., 2010 ) and US‐born African Americans (Blanas et al., 2013 ; Ifatunji et al., 2022 ) – influencing use of a term known as ‘the healthy immigrant effect’. A limitation of the present study is that we did not ask participants to provide us with information about their country of birth or immigration status.…”