COLLEGE PARK, Md. - A newly published paper by University of Maryland’s Dr. Gniesha Dinwiddie, Assistant Professor of African American Studies, and alumna Laurén Doamekpor, Senior Fellow at the National Center for Health Research, concludes that while foreign-born Blacks have a health advantage compared to U.S.-born Blacks, this advantage dissipates due to over exposure to stress that “gets under the skin,” causing physiologic dysregulation which makes individuals more susceptible to disease. The report draws on analysis of nine years of data from the National Health and Nutrition Examination Survey of Adults in the United States, demonstrating that stress contributes to negative health outcomes for Black immigrants.
Published by the American Journal of Public Health, the study is the first to use data from a nationally representative sample to investigate nativity differentials in physiological dysregulation measured by Allostatic load. Allostatic load is the cumulative impact of physiological responses to acute, chronic or long-term stress generated by social conditions that continuously activate hormonal responses to stressful conditions and increase disease susceptibility.
The study notes that the pathways leading to physiological dysregulation are different for the Black population. For Black immigrants, time in the U.S., duration of stay, and acculturation contributes to high Allostatic Load for this population. In contrast, acute life event stressors linked to marital disruption such as being widowed, divorced or separated from their spouse were predictive of high Allostatic Load for U.S. born Blacks.
Also, foreign and U.S. born Blacks had fairly different socio-demographic profiles where a larger proportion of immigrants lived below the poverty line but twice as many had a college degree or higher compared to U.S. born Blacks. However, lower socioeconomic status did not play a role in high Allostatic Load for foreign-born Blacks, which is contrary to the literature which suggests that low socioeconomic environments directly influence high levels of Allostatic load for the general population.
The paper makes a significant contribution to the study of minority health and health disparities because it uses novel biological markers to explore the cumulative impact of stress on health for an understudied immigrant population. Moreover, the findings reinforce that the “healthy immigrant hypothesis” or “health paradox”—a unique feature of the Hispanic immigrant population—can be extended to understand Black immigrant health. The “healthy immigrant hypothesis” (foreign born Hispanics have a health advantage over U.S. born Hispanics) and the “health paradox” (given their lower expected socioeconomic status, Hispanics display better health outcomes compared to Whites) have been investigated in previous studies by Dinwiddie et al. (2014), also published in the American Journal of Public Health.
In the current study, the researchers noted that this documented “health advantage” for Black immigrants dissipates as they adapt to the U.S. cultural context. This health deterioration may be explained by overexposure to race-related stress and to racism, which are more powerful predictors of health declines than are diet and adverse health behaviors as previously assumed.
“A major objective of Healthy People 2020 is to identify particular aspects of the ‘social determinants of health’ that contribute to health vulnerability for race/ethnic groups and to implement interventions that will decrease health disparities. We hope that the results of our study can be used to create policy that reduces exposure to the social risk factors that condition acute and chronic stressors in which Blacks are continuously over exposed to,” Dinwiddie said. “Moreover, developing appropriate interventions tailored to specific needs of a diverse Black population are tantamount for eliminating health disparities and improving population health.”
February 23, 2015