The relationship of acculturation to health outcomes among African immigrant adults: A life-course perspective

Abstract

Statement of the Problem: Acculturation has been shown to relate both positively and negatively to health outcomes in Hispanic and Asian immigrant populations. However, little is known about the relationship of acculturation to health outcomes among African immigrant adults over their life-course. Summary of Methods: A cross-sectional, mixed methods design using secondary baseline data from the African immigrant adult subsample (n=763) of the 2003 New Immigrant Survey (NIS) was employed. Key variables in the study were: current self-rated health and health behavior (outcomes), English proficiency and dietary change (primary acculturation predictors), country of origin (Ethiopia, Nigeria, "Other Sub-Saharan Africa"), duration of residence in U.S. (DOR), age at immigration, gender, education, marital status, (potential effect modifiers), age, pre-migration self-rated health and chronic disease (potential confounders), and food/beverages consumed pre-/post- immigration (qualitative data). Multivariate logistic regression and contextual content analysis were used to analyze the data. Results: Limited English proficiency (LEP) immigrants had higher odds of rating their health good/fair/poor (OR: 0.282, 95%CI: 0.158-0.503, p<.0001) and engaging in poor health behavior than English proficient immigrants (OR: 0.310, 95%CI: 0.165-0.585), p<.0003). English proficient women had lower odds of engaging in poor health behavior than English proficient men (OR: 0.3446, 95%CI: 0.2129-0.5576, p<.0001). Immigrants reporting moderate dietary change had higher odds of rating their current health as good/fair/poor than those with low dietary change (OR: 1.903, 95%CI: 1.143-3.170), p=0.0134). Immigrants residing in the U.S. > 5 years had higher odds of engaging in poor health behavior than those in the U.S < 5 years (OR: 2.030 95%CI: 1.314-3.135, p=0.0014). Immigrants > 41 years of age at immigration had higher odds of rating their health as good/fair/poor than those who arrived at a younger age (OR: 4.293, 95%CI: 1.830-10.071, p=0.0008). Immigrants with chronic disease had higher odds of rating their health as good/fair/poor current than those without chronic disease (OR: 4.173, 95%CI: 2.525-6.897, p<.0001). Conclusions: LEP, moderate/high dietary change, increased DOR, older age at immigration, being male, poor pre-migration health and chronic disease were associated with increased risk for poor health outcomes. More culturally/linguistically competent health promotion and interventions in this population are needed.