Journal of Epidemiology and Community Health
Volume 71, Issue 8, 2017, Pages 786-793

Foreign-born blacks no different from whites for odds of stroke (Article)

Wirth L.S.* , Tobo B.B. , Hinyard L. , Vaughn M.G.
  • a Center for Outcomes Research, Saint Louis University, Saint Louis, MO, United States
  • b College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, United States
  • c Center for Outcomes Research, Saint Louis University, Saint Louis, MO, United States
  • d School of Social Work, Saint Louis University, Saint Louis, MO, United States

Abstract

Background Blacks have higher risk for stroke than whites. However, combining foreign-born and US-born blacks could mask important health differences. We examined the relationship between nativity and stroke risk in US adults. Methods Data were obtained from the National Health Interview Survey, 2006-2014. Study population (n=189, 409) included non-Hispanic whites and non-Hispanic blacks born in the Caribbean, and non-Hispanic blacks born in Africa. Logistic regression models were used to assess the association between stroke and race/ nativity, adjusting for covariates such as insurance status, hypertension, age and duration of US residence. Results Foreign-born blacks had similar odds of stroke (95% CI 0.58 to 1.60 for non-Hispanic blacks from the Caribbean, and 95% CI 0.17 to 1.10 for blacks from Africa), while US-born blacks had increased odds of stroke (95% CI 1.22 to 1.46) compared with non- Hispanic whites. When compared with US-born blacks, both non-Hispanic blacks from the Caribbean and Africa showed reduced odds of stroke: 95% CI 0.50 to 0.94 and 95% CI 0.21 to 0.75, respectively. After adding a race/nativity × age interaction term to the model however, compared with non-Hispanic whites, blacks from Africa aged < 65 years had lower odds of stroke (95% CI 0.13 to 0.72) while blacks from the Caribbean had similar odds of stroke at all ages. Conclusions Homogenising 'Blacks' may mask important differences based on nativity. Public health prevention efforts should consider the heightened risk of stroke among younger US-born blacks and focus on primary prevention for immigrant blacks. Also, national surveys should incorporate more ethnicity-related variables.

Author Keywords

[No Keywords available]

Index Keywords

immigrant population Stroke cerebrovascular accident Caucasian health risk human middle aged comparative study hypertension Aged Logistic Models Health Surveys resident population ethnology black population United States Humans migrant male Emigrants and Immigrants Africa Caribbean Region Caribbean disease control European Continental Ancestry Group statistical model public health health survey

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85024408191&doi=10.1136%2fjech-2016-208125&partnerID=40&md5=9be9ee390c64bab87043c1719fc71e63

DOI: 10.1136/jech-2016-208125
ISSN: 0143005X
Cited by: 1
Original Language: English