Abstract PR-2: Within-group differences between native-born and foreign-born black men on prostate cancer risk reduction and early detection practices

Abstract

Abstract Background: The Healthy Immigrant Effect (HIE) phenomenon proposes that: (1) when immigrants arrive in the U.S., they are healthier than their locally born counterparts; and that (2) this health advantage dissipates over time. While this phenomenon has been well studied and documented among Asians and Hispanics, few studies have explored the HIE among blacks. Most research studies on prostate cancer (CaP) health disparities have focused on comparing Black men to other ethnic groups within the U.S. A research area that has been overlooked and understudied is the within-group differences among black men. We investigated the ethnic variations among native-born black men, African-born black men, and Caribbean-born black men on: (1) personal history of CaP; (2) discussion of CaP risk reduction and early detection with physician; (3) screening by digital rectal examination (DRE); (4) screening by prostate specific antigen (PSA); (5) CaP knowledge; (6) diet; (7) use of chemoprevention products; and (8) physical activity. Methods: This study was part of the Florida Prostate Cancer Disparity Project referred to as the PIPCaD project. The inclusion criteria were black men (regardless of country of origin) who were 35 years and older. Data collection took place primarily in five Florida counties. Using a previously validated survey, data were collected from over 3,400 black men. A one-way ANOVA analyses were carried out to determine if there were significant differences among the three groups on outcome variables. Results: Of the 3,410 responses received, 3,040 indicated their ethnicity: 2,405 were native-born black men, 315 were African-born black men, and 320 were Caribbean-born black men. We found significant differences on CaP knowledge level (F{2,3016} = 13.43, p<.001), vegetable consumption (F{2,3016} = 13.43, p<.001), use of chemoprevention products (F{2,3016} = 13.43, p < .001). Post hoc tests revealed that native-born men had significantly higher CaP knowledge compared to African-born and Caribbean-born men (p<.05). Chi-square test results comparing the three groups were significant for frequencies of meat consumption (χ2{2} = 45.2845, p <.001), discussion of CaP risk-reduction and early detection with a doctor (χ2{2} = 3.81, p =.022), and insurance status (χ2{2} = 8.5071, p <.014). Relative to diet, significantly more native-born men reported meat products make up the biggest portion of their meal. Over 70% of native-born men reported eating meat at least four to six times a week compared to 64% African-born men and 62% Caribbean-born men. Although African-born men were the least insured of the three groups, more men in this group reported that they discuss CaP risk-reduction and early detection with a physician every chance they get compared to native born and Caribbean-born men. In addition, the frequency of chemoprevention use was highest among African-born men. Discussion: Given the significant number of foreign-born blacks in the U.S., it is important to disaggregate the data of native-born and foreign-born blacks to identify knowledge gaps and develop effective programs and policies to address disparities. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):PR-2.