文章基本信息

标题：Variations in Health and Health Behaviors by Nativity Among Pregnant Black Women in Philadelphia
本地全文：下载
作者：Irma T. Elo ; Jennifer F. Culhane
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2012
卷号：100
期号：11
页码：2185-2192
DOI：10.2105/AJPH.2009.174755
语种：English
出版社：American Public Health Association
摘要：Objectives. We compared health behaviors and health outcomes among US-born, African-born, and Caribbean-born pregnant Black women and examined whether sociodemographic and psychosocial characteristics explained differences among these population subgroups. Methods. We analyzed data from a prospective cohort study conducted in Philadelphia, Pennsylvania, with a series of nested logistic regression models predicting tobacco, alcohol, and marijuana use and measures of physical and mental health. Results. Foreign-born Black women were significantly less likely to engage in substance use and had better self-rated physical and mental health than did native-born Black women. These findings were largely unchanged by adjustment for sociodemographic and psychosocial characteristics. The foreign-born advantage varied by place of birth: it was somewhat stronger for African-born women than for Caribbean-born women. Conclusions. Further studies are needed to gain a better understanding of the role of immigrant selectivity and other characteristics that contribute to more favorable health behaviors and health outcomes among foreign-born Blacks than among native-born Blacks in the United States. Studies examining health differences among immigrant subgroups and their native-born counterparts have largely focused on Hispanics. This literature consistently shows that Hispanics born outside the United States have lower mortality rates and better health and reproductive outcomes than do US-born Hispanics.^{1 – 3} These studies also reveal that the protective effect of foreign-born status varies by country of origin.^{4 , 5} For example, Cho et al. found that Mexican immigrants had better self-reported health status, fewer activity limitations, and fewer sick days confined to bed than did persons from Cuba and Central America,⁴ and Hummer et al. reported a similar variation for infant mortality rates.³ Far less is known about the health of foreign-born Black immigrants, who make up an expanding proportion of US immigrants. For example, in 1960 fewer than 1% of Black US residents were foreign born; by 2005 this figure increased to 8%.^{6 , 7} Studying health differentials among native-born and foreign-born Blacks may shed light on factors that contribute to racial health disparities in the United States. Previous studies showed that health behaviors, health status, and reproductive outcomes were more favorable among foreign-born Blacks than among native-born Blacks.^{3 , 8 – 10} However, only a handful of studies have examined health status¹¹ or birth outcomes^{12 – 15} among foreign-born Blacks by region of birth. These studies found that foreign-born Black women, whether from the Caribbean¹⁴ or Africa,¹² were less likely than US-born Black women to have low-birth-weight infants. A recent study of 2000 vital records for New York, New York, observed that although the risk of low birth weight was lower among infants of foreign-born Black mothers than among infants of native-born Black mothers, that risk varied by the foreign-born mothers' place of birth: infants born to women from the Dominican Republic had the lowest risk, and infants born to women from Haiti had the highest risk.¹⁵ Proposed explanations for more favorable birth outcomes and better health status among the foreign-born include selective migration, greater social support, and fewer adverse health behaviors.^{4 , 5 , 9 , 13 , 14 , 16 – 18} We examined the role of nativity in health behaviors and health status among pregnant Black women in Philadelphia, Pennsylvania. We compared health behaviors and status among Black women born in the United States, the Caribbean, and Africa. Our data, collected through extensive face-to-face interviews, allowed us to examine whether individual-level sociodemographic and psychosocial characteristics explained differences in behavior and health among Black women by region of birth.