“…These differences may also reflect nativity differences in behavioral, cultural, and lifestyle factors such as smoking, physical activity, dietary habits, and nutrition, which are known to have an effect on health outcomes (20,26,27). The comparatively negative health outcomes among U.S.-born black adults may be related to social factors such as race/ethnicity discrimination, lower educational attainment, lower income, and higher poverty compared to immigrant black adults (20,21).…”