Graduate Thesis Or Dissertation


Examining Hypertension Prevalence and Health Behavior Practices of Sub-Saharan African Immigrants in the United States Public Deposited

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  • African-born population is one of the fastest growing group in the United States. Very little is known about their socio-demographic characteristics, health behavior practices and long-term health. The purpose of this study was to examine hypertension prevalence, health behavior practices and the impact socio-demographic factors have on these outcomes among Sub-Saharan African immigrants in the U.S.This dissertation conducted a cross-sectional, quantitative descriptive research study that utilized a comparative, correlational design. Using the 2003 New Immigrant Survey (NIS), secondary data analysis of 763 Sub-Saharan African immigrants was conducted. Descriptive statistics and binary logistic regression were conducted using SPSS, version 22. Descriptive variations were assessed between Sub-Saharan Africans and foreign-born populations from other regions including Eastern Europe, [(Russia (n=115); Poland (n=196); Ukraine (n=145)], and China (n= 467), as well as Mexico (n=1163).Variables in the study included socio-demographic characteristics such as: age, gender, education attainment, marital status, household income, country region of origin, English Proficiency, and duration since leaving country of birth, as well as visa type when entered theUnited States. Health variables included smoking, alcohol consumption, and physical activity, pre-immigration self-rated health, current self-rated health, and health care utilization in the last year as well as hypertension status.Descriptive analysis indicated that Sub-Saharan African population was fairly young and highly educated. The average age was 34.7 years and about 50% of the sample held a bachelors or an advanced degree. This population was also relatively new to the U.S and fairly healthy. As a group, African-born population has been living outside of their countries of origin for approximately 5 years. A majority did not smoke or drink alcohol, and most of them engaged in light or vigorous physical activity. Hypertension prevalence among this population was 9%. A majority (65%) of the Sub-Saharan immigrants rated their overall health to be in very good or excellent condition.Descriptive results of other immigrants groups showed the average age to be 45 years for those born in China and Mexico, 37 years for participants born in Poland, 41.5 years for Russian-born, and 38.5 years for those born in Ukraine. A majority of Russian-born and Ukrainian immigrants (~59% and 53% respectively) reported having a bachelors and or an advanced degree. A small proportion (about 9%) of individuals born in Mexico indicated having a bachelors and or an advanced degree. Individuals born in China have resided outside of their country of birth for as long as 66 years with a mean of 37 years.Across the board, all immigrant populations were physically active, with over 95% of each group participating in either light or vigorous physical activity. Over 30% of Russian-born smoked, about 40% of Mexican-born drank alcohol. Hypertension prevalence was approximated 11% among those from Ukraine and Poland, 10% among Mexican-born, about 8% and 7% among Russian and Chinese born respectively. Similar to Sub-Saharan African immigrants, mostof the other foreign-born populations indicated that their health was better after emigrating to the U.S. and rated their current health as excellent, very good or good. The majority of all the immigrant groups in the study did not see a health care provider in the last year.Binary logistic regression results revealed that being married (OR=. 529), having household income of $50,000 or more (OR=. 068), engaging in vigorous physical activity (OR=. 413) and having entered the United States on visitor-type visa (OR=. 405) were all statistically associated with lower likelihood of reporting high blood pressure. Health behavior analyses indicated that female African immigrants had lower odds (OR = .708) of consuming alcohol compared to male counterparts. Also, an increase in education attainment was associated with lower odds of smoking (OR=. 233).More studies on factors impacting health outcomes of Sub-Saharan African immigrants are needed. In particular, longitudinal studies with an ecological perspective can help to identify complex factors that shape health trajectories of this population and contribute to effective health interventions.
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