Racialized incorporation, migration timing, and cardiometabolic risk among Afro-Caribbean immigrants in the United States.

Abstract

Black populations in the United States are increasingly diverse due to immigration, yet population health research frequently aggregates U.S.-born and foreign-born Black adults, obscuring important intraracial heterogeneity. This study examines whether migration timing, duration of U.S. residence, ethnic origin, and regional settlement are associated with obesity as an indicator of cardiometabolic risk among Afro-Caribbean immigrants. We analyzed data from the National Survey of American Life (N = 976), a nationally representative survey of Black adults in the United States. Guided by a racialized incorporation framework, migration characteristics were conceptualized as indicators of differential exposure to racialized institutional contexts across the life course rather than proxies for cultural assimilation. Weighted logistic regression models estimated associations between obesity (BMI ≥30 kg/m²), migration characteristics, and socioeconomic and demographic factors. Modified Poisson regression models were estimated as sensitivity analyses. Earlier age at migration, residence in the Northeast, lower household income, and female gender were associated with greater odds of obesity. Obesity also varied across Caribbean-origin groups, with respondents from Trinidad and Tobago exhibiting lower odds than Jamaican immigrants. Although shorter duration of U.S. residence generally corresponded with lower obesity prevalence, these associations were not consistently statistically significant. Sensitivity analyses produced substantively similar findings. These findings demonstrate substantial intraracial heterogeneity in cardiometabolic risk, as reflected by obesity, among Afro-Caribbean immigrants. Interpreted through a racialized incorporation framework, the results suggest that migration timing and settlement patterns may reflect differential exposure to racialized institutional contexts that shape cardiometabolic health over the life course. Disaggregating Black immigrant populations can advance understanding of structural processes contributing to cardiometabolic inequities within the increasingly diverse U.S. Black population.