Abstract

Introduction: The differences in the risk of cardiovascular disease (CVD) among Black ethnic groups in the U.S. remain largely unexplained. African immigrants are particularly likely to have high rates of hypertension and diabetes, and less likely to be screened, diagnosed or receive treatment. Objective: To examine the association between social determinants of health (SDoH) and hypertension and diabetes among African immigrants. Methods: The African Immigrant Health Study was a cross-sectional study of 465 African immigrants living in the Baltimore-Washington metropolitan area. Data collection was performed through a combination of physical examinations and questionnaires. The outcomes were self-reported hypertension and diabetes. Elements of SDoH collected were education, income, health insurance, employment and marital status. Logistic regression analyses were used to assess the association between SDoH and hypertension/diabetes. Results: The mean age of participants was 46.8(±11.5) years and 60% were women; 64% had ≥ college degree, 83% were employed, 67% had health insurance, and 70% were married/co-habiting. Mean body mass index was 30.7 (±18.3) kg/m 2 . The prevalence of hypertension and diabetes was 32%, and 13% respectively. The odds of diabetes were higher amongst those who were unemployed [aOR: 2.86 (1.39-5.56)] ( Table ). Education, health insurance, income and marital status were not associated with hypertension or diabetes after accounting for age and sex. Conclusion: Among African immigrants, we observed that those who were unemployed had a higher likelihood of self-reported diabetes than those who were employed. Additional studies are needed to further study the contributions of social determinants of hypertension and diabetes as well as and developing health policy and interventions to improve cardiovascular health.

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