Hope King, Makhabele Nolana Woolfork, Andrea Yunyou, Yuwa Edomwande, Erik Euler, Olivia Almendares, Suresh Nath Neupane, Melissa Briggs Hagen
{"title":"COVID-19 Deaths and Minority Health Social Vulnerability, in the U.S., January 1, 2020 through June 24, 2023.","authors":"Hope King, Makhabele Nolana Woolfork, Andrea Yunyou, Yuwa Edomwande, Erik Euler, Olivia Almendares, Suresh Nath Neupane, Melissa Briggs Hagen","doi":"10.1007/s40615-024-02192-w","DOIUrl":"https://doi.org/10.1007/s40615-024-02192-w","url":null,"abstract":"<p><strong>Background: </strong>Health disparities, leading to worse health outcomes such as elevated COVID-19 mortality rates, are rooted in social and structural factors. These disparities notably impact individuals from lower socioeconomic backgrounds and more socially vulnerable areas. We analyzed the relationship between COVID-19 deaths and social vulnerability using the Minority Health Social Vulnerability Index (MHSVI).</p><p><strong>Methods: </strong>COVID-19 death data in the U.S. was obtained from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, where COVID-19 deaths were defined using the ICD-10 code U07.1. MHSVI composite scores were calculated for 3089 U.S. counties and categorized into social vulnerability quartiles, where values ranged from 0 (lowest vulnerability) to 1 (highest vulnerability). Negative binomial regression was employed to determine death rate ratios for each quartile within each theme. Finally, a multivariate negative binomial regression including all MHSVI sub-themes, excluding the overall index ranking, was used to assess the association between each theme and COVID-19 death rates independently.</p><p><strong>Results: </strong>There were 1,134,272 COVID-19 deaths from January 1, 2020 through June 24, 2023. Adjusted rate ratios for COVID-19 deaths in the overall index ranking were 1.06 (95% CI 0.99-1.13), 1.14 (95% CI 1.06-1.22), and 1.41 (95% CI 1.31-1.52) for the second, third and fourth quartiles, respectively. Sub-themes of socioeconomic status (SES), household characteristics (HC), racial and ethnic minority status (REMS), housing type and transportation (HTT), and medical vulnerability (MV) revealed increasing death rates in higher vulnerability quartiles. The healthcare infrastructure and access (HIA) theme had decreasing death rate ratios of 0.74 (95% CI 0.71-0.78), 0.59 (95% CI 0.56-0.62), and 0.42 (95% CI 0.39-0.44) for the second, third, and fourth quartiles, respectively. Finally, the multivariate analysis showed that the HC, HTT, HIA, and MV themes were associated with COVID-19 deaths (P < 0.05).</p><p><strong>Conclusion: </strong>Counties that were identified as more socially vulnerable experienced higher death rates from COVID-19. These areas may need additional public health and social support during future pandemics.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stacey N Doan, Alexandra S Aringer, Jessica M Vicman, Thomas Fuller-Rowell
{"title":"Chronic Physiological Dysregulation and Changes in Depressive Symptoms: Testing Sex and Race as Vulnerability Factors.","authors":"Stacey N Doan, Alexandra S Aringer, Jessica M Vicman, Thomas Fuller-Rowell","doi":"10.1007/s40615-024-02189-5","DOIUrl":"https://doi.org/10.1007/s40615-024-02189-5","url":null,"abstract":"<p><p>Depression is a growing public health concern that affects approximately 5% of adults in their lifetime (WHO in Depression, 2021). Understanding the biological correlates of depression is imperative for advancing treatment. Of particular interest is allostatic load, a multisystem indicator of chronic physiological dysregulation (McEwen and Seeman in, Ann N Y Acad Sci, 1999). The current longitudinal study examined the association between allostatic load, depressive symptoms, and the moderating roles of sex and race. Participants consisted of 150 young adults (M<sub>age</sub> = 18.81) who reported their demographics and depressive symptoms at T1 and T2, a year and a half later. Allostatic load was computed using indicators of metabolic, cardiovascular, and neuroendocrine functioning. Allostatic load was found to predict changes in depressive symptoms. Moreover, interaction effects models revealed that the associations between allostatic load and depressive symptoms at follow-up were further influenced by sex, such that the relationship was significant for males, with pronounced effects for Black males in particular. Black males may be particularly vulnerable to the mental health consequences of biological dysregulation.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kimberly McDowell, Leah Wetherill, Bethany Pollock, Colin Halverson, Jennifer Ivanovich
{"title":"Exploring Genetic Counselors' Experiences with Indigenous Patient Populations.","authors":"Kimberly McDowell, Leah Wetherill, Bethany Pollock, Colin Halverson, Jennifer Ivanovich","doi":"10.1007/s40615-024-02194-8","DOIUrl":"https://doi.org/10.1007/s40615-024-02194-8","url":null,"abstract":"<p><p>This study investigates the preparedness of genetic counselors in addressing the potentially unique elements and considerations of Indigenous patients in the United States and Canada. Considering the healthcare disparities Indigenous populations face, particularly in specialty care, this study aims to assess the preparedness of genetic counselors in addressing the unique needs and cultural considerations of Indigenous patients. An online survey was utilized, and a subset of participants was selected to be interviewed. Results reveal genetic counselors felt less competent with Indigenous patients compared to non-Indigenous patients, especially in specific aspects of genetic counseling such as responding to cultural issues or identifying resources. Factors such as increased years of experience and more exposure to Indigenous populations during graduate training correlated with higher self-rated competency. Despite a patient population that is on average 7% Indigenous by self-report, genetic counselors lacked exposure to Indigenous encounters in graduate programs and professional training. These findings underscore the importance of enhancing genetic counseling education and exposure to Indigenous training opportunities such as voluntary events or Indigenous guest speakers to improve cultural competency and address healthcare disparities for Indigenous communities.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brenda Bustos, Abhery Das, Allison Stolte, Samantha Gailey, Tim A Bruckner
{"title":"The Supplemental Nutrition Program for Women, Infants, and Children and Birth Outcomes Among Hispanic Mothers in California: A Sibling Control Design.","authors":"Brenda Bustos, Abhery Das, Allison Stolte, Samantha Gailey, Tim A Bruckner","doi":"10.1007/s40615-024-02187-7","DOIUrl":"https://doi.org/10.1007/s40615-024-02187-7","url":null,"abstract":"<p><strong>Background: </strong>Participation in the Supplemental Nutrition Program for Women, Infants, and Children (WIC) during pregnancy appears to reduce risks of preterm birth and low birthweight. Many pregnant women who receive WIC benefits, however, also participate in Medicaid (Medi-Cal in California). This co-participation raises the question of whether WIC per se confers these perinatal health benefits.</p><p><strong>Methods: </strong>We use a unique, sibling-linked dataset of California births to estimate birth outcomes relating to program receipt (i.e., No WIC or Medi-Cal; WIC alone; Medi-Cal alone; and WIC and Medi-Cal). We also contribute to the literature by focusing on Hispanic mothers who represent the largest fraction of births in California, as well as the highest proportion of WIC recipients in the state. We specifically assessed the relation of differential program receipt on preterm birth (< 37 weeks) and low birthweight (< 2500 g). We restrict our analytic sample to births between 2007 and 2015 (n = 942,274).</p><p><strong>Results: </strong>Our sibling-control results show lower odds of low birthweight (OR: 0.82, 95% CI: 0.77, 0.87) and preterm birth (OR: 0.87, 95% CI: 0.83, 0.90) when Hispanic mothers receive WIC benefits during pregnancy compared to when the mothers do not receive WIC benefits. While births associated with receipt of both WIC and Medi-Cal also exhibit lower odds of preterm birth (OR: 0.86, 95% CI: 0.79, 0.92), the protective findings do not extend to low birthweight.</p><p><strong>Conclusion: </strong>Our results extend previous work in other states and should stimulate additional research on whether participation in multiple means-tested programs reduce racial/ethnic disparities in adverse birth outcomes.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashley N T Williams, Angela VanArsdale, Rachel Hirschey, Natoshia Askelson, Sarah H Nash
{"title":"Experiences of Racism in Health Care and Medical Mistrust Shape Cancer Prevention and Control Behaviors Among Black Residents of Black Hawk County, Iowa: A Qualitative Study.","authors":"Ashley N T Williams, Angela VanArsdale, Rachel Hirschey, Natoshia Askelson, Sarah H Nash","doi":"10.1007/s40615-024-02199-3","DOIUrl":"https://doi.org/10.1007/s40615-024-02199-3","url":null,"abstract":"<p><strong>Background: </strong>Non-Hispanic Black Iowans have substantially higher incidence of and mortality from cancer than their non-Hispanic White (NHW) counterparts in all but the oldest age groups; rates are particularly high in Black Hawk County, which contains the city of Waterloo, a highly segregated city with a documented history of redlining and distinct racial differences in the social drivers of health.</p><p><strong>Objective: </strong>To gather perspectives on race, racism, healthcare, and engagement with cancer prevention and control behaviors, among Black individuals living in Black Hawk County, Iowa.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 20 individuals (10 male, 10 female), questions included experiences in healthcare and feelings towards the healthcare system, trust of the healthcare system, experiences of racism or other perceived biases within healthcare, and how experiences of racism/bias and/or feelings towards the healthcare system impact desire or ability to participate in cancer prevention and control activities.</p><p><strong>Results: </strong>Almost all interviewees reported both positive and negative experiences in healthcare. Nine themes emerged from analysis of the interviews: everyday racism and racism in healthcare, medical mistrust, need for more Black healthcare professionals, communication with healthcare professionals, need to break down cultural stigma around cancer, need and desire for community education around health and cancer, ability to choose, self-advocacy, and social support.</p><p><strong>Conclusions: </strong>There are substantial barriers for Black individuals engaging with cancer prevention and control behaviors in Iowa. Multi-level interventions are needed to address structural, healthcare facility, and individual-level barriers to care; interventions may build on existing resiliencies within the community.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ozi Amuzie, Joshua Radack, Nancy Yang, Alejandra Barreto, Daria Murosko, Sara C Handley, Scott A Lorch, Heather H Burris, Diana Montoya-Williams
{"title":"National Variation in Black Immigrant Preterm Births and the Role of County-Level Social Factors.","authors":"Ozi Amuzie, Joshua Radack, Nancy Yang, Alejandra Barreto, Daria Murosko, Sara C Handley, Scott A Lorch, Heather H Burris, Diana Montoya-Williams","doi":"10.1007/s40615-024-02198-4","DOIUrl":"10.1007/s40615-024-02198-4","url":null,"abstract":"<p><p>Preterm birth rates among Black individuals continue to be inequitably high in the USA. Black immigrants appear to have a preterm birth advantage over US-born counterparts. This national cross-sectional study of singleton non-Hispanic Black individuals in the USA from 2011 to 2018 aimed to investigate if the Black immigrant preterm birth advantage varied geographically and how this advantage associated with county-level social drivers of health. Generalized linear mixed models explored the odds of preterm birth (< 37 weeks) by birthing person's nativity, defined as US- versus foreign-born. In county-level analyses, five measures were explored as possible sources of structural risk for or resilience against preterm birth: percent of residents in poverty, percent uninsured, percent with more than a high school education, percent foreign-born, and racial polarization. County-level immigrant advantage among foreign-born compared to US-born Black individuals was defined by a disparity rate ratio (RR); RR < 1 indicated a county-level immigrant preterm birth advantage. Linear regression models at the level of counties quantified associations between county-level factors and disparity RRs. Among 4,072,326 non-Hispanic Black birthing individuals, immigrants had 24% lower adjusted odds of preterm birth compared to US-born Black individuals (aOR 0.77, 95% CI 0.76-0.78). In county-level analyses, the immigrant advantage varied across counties; disparity RRs ranged from 0.13 to 2.82. County-level lack of health insurance and education greater than high school were both associated with immigrant preterm birth advantage. Future research should explore policies within counties that impact risk of preterm birth for both US-born and immigrant Black individuals.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sociocultural, Behavioral, and Physical Correlates of Excessive Social Media Use, Addiction, and Motivation Toward Reduction in a Hispanic College Student Sample.","authors":"Marcos Lerma, Theodore V Cooper","doi":"10.1007/s40615-024-02183-x","DOIUrl":"https://doi.org/10.1007/s40615-024-02183-x","url":null,"abstract":"<p><p>Social media use has been associated with adverse health consequences. However, there is limited research assessing correlates of social media use, addiction, failure to control use, and motivation to reduce use in a Hispanic sample. This study aimed to fill this gap by assessing factors within the National Institute of Minority Health and Health Disparities Research Framework. Participants were Hispanic college students (n = 273) residing either in the United States or Mexico who completed an online survey. Univariate analyses determined independent variables to be assessed in four linear regression models. Results indicated that weekly social media use was negatively associated with sex, attentional impulsivity, and social comparison and positively associated with social media craving (SMC). Social media addiction was positively associated with frequency of posting in Spanish, Fear of Missing Out, SMC, and home restriction of social media use. Social media self-control failure was negatively associated with acculturative language and positively associated with frequency of posting in English, attentional impulsiveness, SMC, and home restriction of social media use. Motivation to reduce social media use was positively associated with residing in the United States. Clinical implications include targeting key factors through tailored interventions aimed at promoting adaptive social media use patterns.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hector Ismael Lopez-Vergara, William Rozum, Jodi M Sutherland Charvis, Sydney Iacoi, Chrystal Vergara-Lopez, L A R Stein
{"title":"Experiences of Discrimination and Alcohol Involvement Among Young Adults at the Intersection of Race/Ethnicity and Gender.","authors":"Hector Ismael Lopez-Vergara, William Rozum, Jodi M Sutherland Charvis, Sydney Iacoi, Chrystal Vergara-Lopez, L A R Stein","doi":"10.1007/s40615-024-02191-x","DOIUrl":"https://doi.org/10.1007/s40615-024-02191-x","url":null,"abstract":"<p><p>Although discrimination is an important social determinant of alcohol involvement, there is a dearth of research testing these associations across race/ethnicity and gender. This is an important research gap given that experiences of discrimination and therefore links with alcohol involvement may vary as a function race/ethnicity and gender intersectional identities. We tested for measurement invariance in discrimination and alcohol involvement and examined group differences in means and covariances. The sample consisted of n = 1187 young adults (ages 18-26; n = 193 Black women, n = 209 Latina women, n = 186 White women, n = 198 Black men, n = 203 Latino men, and n = 198 White men). We found evidence for differential item functioning for discrimination and alcohol involvement that violated assumptions needed to make manifest between-group comparisons. To model the source and degree of differential item functioning, we used partial measurement invariance and dropped a discrimination item that did not reliably overlap with the latent factor for White women. After accounting for differential item functioning, Black women and men reported the highest discrimination, followed by Latinx women and men, and then White women and men. White women reported the most alcohol involvement, followed by White men, Latina women, Latino men, Black men, and Black women. Discrimination and alcohol involvement were positively associated for all groups except White women, though effect sizes varied with Black men exhibiting the largest effect. An intersectionally valid understanding of discrimination and alcohol involvement may necessitate statistical approaches that can test for (and model) differential item functioning prior to making between-group quantitative comparisons.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel A Zajdel, Evelyn J Patterson, Erik J Rodriquez, Monica Webb Hooper, Eliseo J Pérez-Stable
{"title":"Self-identified Race and Ethnicity and How this is Perceived: Associations with the Physical and Mental Health of Incarcerated Individuals.","authors":"Rachel A Zajdel, Evelyn J Patterson, Erik J Rodriquez, Monica Webb Hooper, Eliseo J Pérez-Stable","doi":"10.1007/s40615-024-02186-8","DOIUrl":"https://doi.org/10.1007/s40615-024-02186-8","url":null,"abstract":"<p><strong>Objectives: </strong>The singular focus on self-identified race and ethnicity in health disparities research may not fully convey the individual and structural components of experiencing race in society, or in a racialized context such as prison. Processes of racialization create boundaries between incarcerated individuals and regulate their daily interactions and access to resources, with possible effects on well-being. However, the relationship between perceived race and health has not been examined within the imprisoned population.</p><p><strong>Design: </strong>We used data from the 2016 Survey of Prison Inmates (n = 23,010) to assess how self-identified race, perceived race, and the discordance between racial self-identification and perception were associated with the physical (number of chronic conditions) and mental health (psychological distress) of American Indian and Alaska Native, Asian, Black, Latino, White, and multiracial incarcerated individuals.</p><p><strong>Results: </strong>Reported perception as Latino was associated with better mental and physical health relative to perception as White. Perceived Latino identity was more strongly associated with physical and mental health than a Latino self-identity. Reported perception as Black was associated with less psychological distress than perception as White, but this relationship dissipated after accounting for self-identified race. In contrast, perceived and self-identified multiracial incarcerated individuals reported worse health than their White counterparts. Having a discordant (vs. concordant) racial identity was associated with worse physical and mental health among imprisoned persons regardless of race.</p><p><strong>Conclusion: </strong>The use of a single, unidimensional measure of race and ethnicity in health disparities research does not fully reveal racialization's influence on health, specifically for those experiencing incarceration.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oluwaseun T Emoruwa, Gabe H Miller, Gbenga I Elufisan, Guadalupe Marquez-Velarde, David Ademule, Hannah M Lindl, Olusola A Omisakin, Guizhen Ma, Stephanie M Hernandez, Verna M Keith
{"title":"Physical Health Among Black Immigrants by Region of Birth: A Test of the Racial Context Hypothesis.","authors":"Oluwaseun T Emoruwa, Gabe H Miller, Gbenga I Elufisan, Guadalupe Marquez-Velarde, David Ademule, Hannah M Lindl, Olusola A Omisakin, Guizhen Ma, Stephanie M Hernandez, Verna M Keith","doi":"10.1007/s40615-024-02167-x","DOIUrl":"https://doi.org/10.1007/s40615-024-02167-x","url":null,"abstract":"<p><strong>Objective: </strong>We test the Racial Context Hypothesis by examining the association between racial context of origin and five physical health outcomes (self-rated health, activity limitation, functional activity limitation, lifetime hypertension, and lifetime cancer) among U.S.-born Black Americans and Black immigrants in the United States.</p><p><strong>Design: </strong>This cross-sectional study used 2000 through 2018 waves of the National Health Interview Survey (NHIS). Our subsample was limited to adults 18 years of age or older who self-identified as Black and selected a distinct global region of birth if not U.S. born (N = 212,269). We employed zero-order logistic regression models to estimate the relationships between each measure of health and racial context by region of birth.</p><p><strong>Results: </strong>Supporting the Racial Context Hypothesis, we found Black immigrants from racially mixed (Mexico, Central America, the Caribbean, South America) and majority-Black contexts (Africa) had lower odds of being in fair or poor self-rated health [aOR 0.786; 0.616; 0.611], reporting any activity limitation [aOR = 0.537; 0.369; 0.678], reporting functional activity limitation [aOR 0.619; 0.425; 0.678], reporting lifetime hypertension diagnosis [aOR 0.596; 0.543; 0.618], and reporting lifetime cancer diagnosis [aOR 0.771; 0.326; 0.641] compared to U.S.-born Black Americans. After controlling for sociodemographic and socioeconomic covariates, Black immigrants from majority-White contexts (Europe) did not significantly differ from U.S.-born Black Americans on these five physical health measures.</p><p><strong>Conclusion: </strong>This study expands our understanding of the \"Black immigrant advantage\" by showing that Black immigrants from predominantly Black and racially mixed regions rated their health status as poor or fair less often, experienced less activity or functional activity limitations, and had a lower risk of lifetime hypertension and cancer compared to U.S.-born Black Americans. The significant associations persisted even after controlling for sociodemographic and socioeconomic characteristics. Black immigrant health is not homogenous, and the racial context of origin Black immigrants come from has an association with their health outcomes.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}