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

Abstract

Background: Africans immigrants in the United States are the least-studied immigrant group, despite the research and policy efforts to address health disparities within immigrant communities. Although their healthcare experiences and needs are unique, they are often included in the “black” category, along with other phenotypically-similar groups. This process makes utilizing research data to make critical healthcare decisions specifically targeting African immigrants, difficult. The purpose of this Scoping Review was to examine extant information about African immigrant health in the U.S., in order to develop lines of inquiry using the identified knowledge-gaps. Methods: Literature published in the English language between 1980 and 2016 were reviewed in five stages: (1) identification of the question and (b) relevant studies, (c) screening, (d) data extraction and synthesis, and (e) results. Databases used included EBSCO, ProQuest, PubMed, and Google Scholar (hand-search). The articles were reviewed according to title and abstract, and studies deemed relevant were reviewed as full-text articles. Data was extracted from the selected articles using the inductive approach, which was based on the comprehensive reading and interpretive analysis of the organically emerging themes. Finally, the results from the selected articles were presented in a narrative format. Results: Culture, religion, and spirituality were identified as intertwined key contributors to the healthcare experiences of African immigrants. In addition, lack of culturally-competent healthcare, distrust, and complexity, of the U.S. health system, and the exorbitant cost of care, were identified as major healthcare access barriers. Conclusion: Knowledge about African immigrant health in the U.S. is scarce, with available literature mainly focusing on databases, which make it difficult to identify African immigrants. To our knowledge, this is the first Scoping Review pertaining to the healthcare experiences and needs of African immigrants in the U.S.

Meaning in life and impact of COVID-19 pandemic on African immigrants in the United States

“…Most African immigrants come from Nigeria, Ethiopia, Egypt, Ghana, and Kenya, and made up half of the foreign-born African population in the U.S in 2015 ( Anderson, 2017 ). Despite the growing number of immigrant population in the United States, health researchers often overlook them ( Suárez‐Orozco and Carhill, 2008 ) and tend to focus more on African Americans, Latino, Asian, and other immigrant populations ( Cunningham et al., 2008 ; Omenka et al., 2020 ). Further, most studies on African Americans and health inequities leave out African immigrants ( Commodore-Mensah et al., 2018 ; Venters and Gany, 2011 ), overlooking how their immigrant backgrounds affect their health ( Chaumba, 2011 ).…”

Maintaining cultural identity: A systematic mixed studies review of cultural influences on the self‐care of African immigrants living with non‐communicable disease

“…This information could be used by nurses and other healthcare providers to encourage adherence to Western medicines. At least, questions related to use of herbal remedies should be asked during healthcare visits (Omenka et al, 2020).…”

“…walking) may be more effective in promoting physical activity than individually based physical activity recommendations. Others have noted that the predominant Western cultural view of the body differs significantly from that of sub‐Saharan Africans and African immigrants who equate higher weight with prestige, beauty and happiness and lower weight with poverty and illness (Agyemang et al, 2009; Cooper Brathwaite & Lemonde, 2016; Mbanya et al, 2010; Omenka et al, 2020). Cultural expectations about body image, size and general physical appearance can negatively influence willingness to modify the diet and participate in exercise (Joseph et al, 2018).…”

“…African immigrants’ experiences with and perceptions regarding use of herbal remedies may negatively influence their adherence to prescribed western medications. (Omenka et al, 2020). Additionally, good experiences with the use of herbal remedies in the past, easy accessibility and minimal costs of herbal remedies, compared with more expensive western medicines, may make adherence to prescribed medications suboptimal (Sellers et al, 2006).…”

Strengthening Culturally Competent Health Communication

“…6,11 A lack of English-language proficiency along with poor living conditions further compound social stigma and a mistrust of medical institutions and public health resources. 13 Having fled situations of oppression, often from their own governments, and facing rumors, misinformation, and information overload upon resettlement, refugee populations tend to be highly suspicious of institutional and governmental messaging. 14 As indicated by US Centers for Disease Control and Prevention reports, socioeconomically impoverished communities have suffered the brunt of the pandemic disproportionately 15 and for a superdiverse community like Clarkston, the impact has been uniquely challenging.…”