Navigating blackness: the interrelatedness of immigration policy and U.S. racial politics among Black African immigrants

The present study investigates nativity status and place–of–birth differences in suburban residence among black ethnic groups. The main objective is to evaluate the extent to which the relationship between black immigrants’ individual–level socioeconomic status characteristics and suburban outcomes conforms to the tenets of the spatial assimilation model. Using micro–data from the 2006–2010 American Community Survey, we employed logistic regression models to determine the effects of the relevant predictors on suburban residence of whites and black ethnic groups. The results reveal that black immigrants’ suburban outcomes vary depending upon the racial/ethnic background and nativity status of the reference group. While both black Caribbean and African immigrants are less likely to reside in the suburbs than native–born white households, they are more likely to do so than native–born black Americans, even when controlling for differences in income, education, and homeownership. We also find black immigrants’ probability of suburban residence varies by English language proficiency and length of time spent in the United States in ways that contradict the tenets of the spatial assimilation model.

Background and Purpose: Black African immigrants, which includes Ghanaian immigrants, experience discrimination in various forms in the United States. While research on African immigrant experiences of discrimination is very scanty, studies on Ghanaian immigrants’ experience of discrimination in employment and healthcare in the United States are at the bare minimum. This study is, therefore, important in contributing to filling the gap in the research by exploring the experiences of discrimination and racism in the workplace and the healthcare system among the Black African Immigrant population using the Ghanaian Americans sample. The study also explored the population's trust in the medical system in the United States and the factors that influence the population’s preferences in the choice of medical service providers. Method: The study adopted a qualitative design with a phenomenological approach. The participants were recruited from the Ghanaian American population, a subgroup of Black African immigrants, in New York City using a purposeful, convenient sampling strategy. Seven individuals were interviewed for the study using a semi-structured interview guide developed by the researcher. The data analysis involved a combination of semantic and latent coding and theming. The analysis was predominantly inductive, with the coding and themes guided by the meaning derived from the responses rather than a pre-conceived theory or framework. Findings: The findings show that accent is the leading immigrant identifier for Black African immigrants. The findings also indicate that while Ghanaian Americans experience discrimination in the workplace and employment, they experience no discrimination in the medical system and have high confidence in the medical system in the United States. This suggests that discrimination experiences can be an issue specific to Ghanaian Americans, and the population can experience discrimination in one aspect of their life while having a completely different experience in other aspects of their life. The findings further show that the doctor's competence is paramount for Ghanaian Americans when choosing doctors. However, they would prefer a competent doctor of the same culture as them to enhance communication and understanding between them and the healthcare provider about their health issues.

Purpose – Obesity and obesity-related health problems are a growing concern for many immigrants in the USA. The literature that examines the linkages between acculturation, resilience, obesity health risks, and obesity outcomes among Black African immigrants is sparse. The purpose of this paper is to ascertain whether the predictor variable of acculturation showed a significant association with two criterion variables, obesity health risk symptoms, and obesity; and whether resilience acted as a moderator between acculturation, obesity health risk symptoms, and obesity among Black African immigrants living in the USA. Design/methodology/approach – The study consisted of a quantitative correlational survey research design. Participants of the study were 55 Black African immigrants residing in three metropolitan areas of the USA. Findings – Higher levels of acculturation were associated with fewer obesity health risks. Higher levels of resilience were associated with the fewest obesity health risks when the participant also had high-acculturation levels. Resilience moderated between acculturation and obesity health risk symptoms. Neither acculturation nor resilience significantly predicted obesity. Furthermore, resilience did not moderate between acculturation and obesity. Research limitations/implications – A primary limitation was the very small sample size of the study. Future research would be needed to examine the overall determinants of obesity among immigrant populations. Furthermore, one limitation is that some of the questions on the Weight-Related Symptom Measure (Patrick et al., 2004) were sensitive in nature, and participants might have felt uncomfortable providing information about their weight. As a result, while self-reporting, they could have underestimated their body mass index status. For example, individuals who were already overweight or obese might have reported their body weights with lower accuracy than those who were of normal weight, thereby creating error in the dependent variable. Practical implications – Results from this study will help to promote health initiatives in Black African immigrant communities to link individuals to needed healthcare services. Originality/value – The literature that examines the linkages between acculturation, resilience, obesity health risks, and obesity outcomes among Black African immigrants is sparse. This study is the first to use the Reserve Capacity Model for a sample of Black African immigrants.

Currently, at 272 million globally, the number of international migrants across the globe already exceeds the projections of many experts for 2050 (IOM, 2020). Emigrants from the developing regions to Western industrialized countries constitute a significant proportion of these recent global migrants and, not surprisingly, have attracted a fair share of this debate. Until the past decade, research on migrants to Western host societies has focussed largely on the challenges they face in or pose to their host societies (Fisher, 2013; Juswiak et al., 2014). It is safe to say that there is now an increasing interest in exploring their experiences as resilient and contributing members of their new homelands. The target populations for research, however, have not shifted much from the more established migrant groups within specific Western countries (Babatunde-Sowole et al., 2016). The experiences of more recent newcomers like Sub-Saharan (Black) Africans in less travelled destinations like Canada remain highly under-researched (Okeke-Ihejirika, Yohani, et al., 2020) This special issue is not by any means an attempt to provide exhaustive accounts to fill huge gaps in their histories and lived experiences. Rather, we wish to present a few insightful snapshots of their lives that hopefully underscore the need for more studies that could inform their transition and integration into Canada and to other comparable Western host societies where their numbers are growing. In effect, these four articles vividly point to what a potentially robust body of literature could lend to future research, policy and practice in migration and settlement. Until the 1980s, the popularly dubbed “Africa's black debate,” which ushered in what has become an endemic economic and political crisis, noted that Africans travelled to the West mainly to acquire higher education (Okpewho & Nzegwu, 2009). Currently, African migrants constitute one of the fastest growing immigrant groups in Western advanced countries. This special section will feature important findings from new empirical research, critical analysis of already documented evidence and theoretical and conceptual discourses. The issue includes contributions from four Western-based scholars, three in Canada and one in Australia. While this special issue features the works of a selected few, the areas of interest, quality of inquiry and flow of analyses demonstrate the wide range of interdisciplinary expertise. Most of the contributors are well known in the field of migration and settlement, and their research and scholarship have charted new paths within their fields of expertise as well as in broader interdisciplinary discourses. Their expertise in various fora of academic debates easily lends themselves to the central focus of the special edition which we have entitled: African International Migration to the West: Transnational, Empirical and Contextual Discourses. We hope that what this special section lacks in terms of the volume and number of contributors is to a reasonable extent compensated for by the broader reach of their collective analyses into existing discourses. Moreover, the four articles in this special section are strategically positioned to speak to a number of key factors that are crucial in understanding African migration to the West, including the challenges they face with transition and integration, their identities within the Western host mainstream and amid other marginalized populations, particularly, other Black populations, immigrant and otherwise. Our estimates, however, lean heavily on the Canadian context. First, we seek to capture as much as possible, life before and after migration; immigrants' experiences beyond the geophysical boundaries of their new host societies. The unprecedented rise of migrants crossing national and continental borders either in search of a better life or fleeing political conflicts has captured global concerns, but only in one direction. There is an increasing focus on migrants' safe passage, adequate support systems for transition and integration, and recognition of their strengths and contributions as members of their new society (United Nations, 2018). Philomina Okeke-Ihejirika and Ike Odimegwu draw attention to what often emerges as a one-sided conversation, bringing back into focus one crucial area that these global debates are taking attention away from the dire conditions of life in migrant-sending regions that produce both regular and irregular migrants. Beyond the focus on life before migration, virtually all the authors place their analyses of African migrant' lives within the context of recent turns in immigration theory, building on a number of key understandings. They reflect the shift towards transnationalism – the flow of people and goods across national boundaries propelled by forces of global capitalism and the exigencies of political upheaval (Okeke-Ihejirika & Salami, 2018). We stress a more easily agreed upon notion in the field that immigrants do not willingly sever ties to their homeland as they anchor themselves in a new soil. The previous static understanding of migration as a linear journey with little or no turnarounds or connections with original homelands has been replaced by an understanding that migrants are informed by and inform cultural identities and practices in homelands, diasporic communities and their host societies. As individuals, families and communities, the experiences and viewpoints of transnationals are marked by multiple social intersections, including gender, race, ethnicity, religion and language. Transnational ties are not only reciprocated in many ways, but (Mensah et al., 2013) also extend beyond their countries of origin, occurring in multiple spaces and modes, including digital platforms (Ibid). This special section also includes empirical research on the conditions of life in immigrant-sending countries that propel migration and ways they might be linked to the prospects of successful transition and integration in host societies (see Okeke-Ihejirika & Odimegwu, 2022). Second, we want to signal in more subtle forms some of the commonalities that Blacks in many Western industrialized countries share and some of the ways in which newcomers from Africa differ from older Western-based African origin populations. Sophie Yohani and Linda Kreitzer as well as Thashika Pillay's articles demonstrate some of the shared experiences and points of departure. Resilience is a facet of this commonly shared experience that is echoed in the analyses of the special section authors. The focus on Black resilience in the face of daunting discrimination is also timely; the United Nations declaration, affirming the Decade for People of African Descent (UNPAD 2015–2024), among others public policy research findings, not only give voice to an existing problem but urge a global response with measurable impact (United Nations, 2013). People of African origin are generally viewed as highly resilient mainly due to a protracted history of oppression and exploitation as well as marginalization in varied contemporary contexts (Ibid). But despite their resilience, people of African descent have disproportionately poor socio-economic indicators, including child poverty, poor education and training outcomes, precarious employment status, unique forms of systemic racisms and mental health stigmas (Statistics Canada, 2020; Taylor et al., 2020). Many of them wrestle with limited social support due to migration and separation from families of origin, anti-Black racism, and from lack of knowledge of how the Western host society system operates. In December 2013, the United Nations General Assembly adopted resolution 68/237, proclaiming 2015–2024 the International Decade for People of African Descent (UNPAD) a time for concerted action to address their plight in more meaningful and effective ways. This proclamation recognizes “that people of African descent represent a distinct group whose human rights must be promoted and protected” (United Nations, 2013). This publication, we hope, will not only find its place among many others as the UNPAD comes to a close but may further contribute to new paths in research, policy and practice aimed at alleviating the systemic inequities these populations bear, which are not about to disappear after 2024. Beyond these commonalities, there are several differences that a hugely diverse population of Black (continental) Africans share in a new homeland which, in many ways, set them apart from other Black populations. In general, these immigrants and refugees come from about 40 ex-colonies of mainly Britain (e.g. Kenya, Nigeria and Uganda) and France (e.g. Mauritania, Senegal and Côte d'Ivoire) and form the majority of African newcomers (Flahaux & De Haas, 2016; Tettey & Puplampu, 2005). Often they are lumped with either the broader immigrant population or a large and growing pool of Blacks (Statistics Canada, 2019). The rise in the latter is largely fuelled by inflows of highly educated continental Africans in search of a better life abroad. In Canada, for instance, Black African immigrants and refugees grew from just 1.9% of newcomers to Canada before 1971 to 13% in 2016 (Statistics Canada, 2017) making Africa second among Canada's immigrant-sending regions. The population of African immigrants in Australia has grown from the late twentieth century into the twenty-first century. They come from virtually every country in Africa, with Black Africans increasingly representing a larger proportion of the newcomers from the continent. According to the Australian Census figures, the population of Sub-Saharan Africans living in Australia doubled between 2001 and 2011 (Gatwiri & Anderson, 2021). By 2016, their numbers had risen to 388,683, representing about 1.7% of the total population. Although a relatively small proportion of the national population, Black Africans the significant rise in their population year after year has not gone unnoticed (Ibid). Overall, Black Africans are socially diverse but share a longing for community life rooted in religion and culture, punctuated by the popular maxim of Ubuntu – I am because we are (De Liefde, 2007; Dube, 2009; Mnyaka & Motlhabi, 2005; Mosavela et al., 2015) healthy gender relations, family well-being and cohesive communities sustain Ubuntu (Okeke-Ihejirika, Creese, et al., 2020). Farida Fozdar and Sophie Yohani and Linda Kreitzer, in their contributions underscore the crucial importance of community building to Black African newcomers' transition and integration, identifying some of the potential consequences of limited support, especially in the case of mental health. Black African newcomers' history and immigration trajectories differ significantly from other Blacks. They are relatively young, mainly from non-settler colonial societies and even more importantly, unfamiliar with anti-Black racism. Unlike more established and older Black populations, African Black immigrant cohorts do not experience the high rates of single-parent, female-headed households or economically marginalized men (Morrissey, 1989; Quinlan, 2006; Quinlan & Flinn, 2003), stemming from long-standing systemic inequities rooted in slavery and colonization. These differences render new and unique constellations to the barriers they face in rebuilding their lives. One of the special section articles by Pillay explores such barriers in the context of education. Black youth, as Pillay's article demonstrates, must navigate formal education systems that are structured to benefit and perpetuate the very settler colonial state apparatus that marginalizes them. Third, this special section also aligns with one major point of emphasis for International Migration – a policy perspective on research findings. In this regard, we welcome a fairly rare contribution to Western debates – a perspective from the African continent that vividly portrays life before migration, the push and pull factors that forcefully compel emigration, and the implications for the societies left behind. Based on the existing literature and the findings of our own research, we argue that policymakers and service providers do not yet fully recognize the complexities of these communal relations, their protective functions when understood from an emic (within culture) perspective, and ways such relations may mediate the lives of Black African newcomers in Western societies. These newcomers often lack the necessary support and information to reappraise their cultural worldviews, social hierarchies and patterns of male–female interactions, let alone confront new social and economic barriers posed by anti-Black racism and discrimination. Consequently, the early years of transition are characterized by severe deskilling, financial hardship, domestic violence, parent–child conflict mental ill-health and lateral violence and tensions; these challenges could also result from already established patterns carried over from countries of origin, some of which are exacerbated by racism (Okeke-Ihejirika, Yohani, et al., 2020). The lack of reliable, accurate pre-arrival information further complicates these barriers (Ibid). Fourth and finally, this issue not only exposes the limitations of existing literature on African migrants but also points the way for future research. While each article provides recommendations specific to the issues addressed, the contributors unanimously highlight a major gap – much of what we know about this population rests largely on small purposive samples of newcomers from a handful of African countries. Thus, collectively, this issue highlights an urgent need for studies that employ larger samples with a diversity of participants and more quantitative work. In this regard, we call for research that fans critical debates about how to conceptualize, research and support Black newcomers from Africa. In their bid to identify major empirical and theoretical gaps to inform new directions for research and knowledge mobilization, we urge researchers to critique, rather than wholly accept, existing research agendas without probing their sociocultural, economic and political contexts, which often are innately Eurocentric; our own research findings, for instance, show that for Black Africans, resilience is not simply about survival; it is about building thriving communities of fully functioning citizens of their new host societies (Okeke-Ihejirika, 2020; Okeke-Ihejirika, Creese, et al., 2020). In this regard, there is an urgent need for research using wider samples, more quantitative work and longitudinal tracking in order to gain a better understanding of Black African immigrants, the challenges they face as newcomers and the strengths they could bring to the process of transition and integration.

In Immigration and the Remaking of Black America, sociologist Tod G. Hamilton confronts the trope that black immigrants have always achieved social and economic outcomes superior to African Americans. While conventional narratives pathologize African Americans as being culturally deficient compared to immigrants, Hamilton challenges this interpretation and offers a new reading of how black immigration trends are shaping the United States by using original and innovative statistical analysis. In eight chapters, Hamilton attempts to provide a new framework to understand an array of socio-economic disparities among the black population of America.Weaving together history and sociology, Hamilton examines the outcomes of black immigrants from fourteen countries across Africa and the Caribbean. The early chapters provide a sweeping yet thoughtful synthesis of black immigration since the twentieth century, the extant literature on labor market disparities, and Hamilton's own theoretical considerations. Importantly, Hamilton documents how scholars have feuded over how to weigh assumptions of cultural inferiority against structural barriers when comparing African Americans to black immigrants. Though the former has often been presumed, Hamilton posits that empirical evidence does not lend support to cultural theories. Rather, prior comparisons have failed to fully account for variations within the black immigrant population, the changing racial contexts from pre- and post–civil rights eras, and the implications of selective migration.In the remaining chapters, Hamilton uses regressions and statistical modeling to explore historical and contemporary disparities in labor market outcomes, homeownership, health, and intermarriage. Though inequalities between whites and blacks are stark, Hamilton employs three methodological tools that prove instructive and reveal gaps between black immigrants and African Americans as well as within the African American population itself. First, when comparing black immigrants vis-à-vis African Americans, Hamilton disaggregates the latter into “movers” (those who internally migrated, traditionally from South to North) and “nonmovers,” in order to better reflect the positive effects of selective migration and hold any questions of cultural difference constant. This distinction proves pivotal in his investigation and helps to account for various unobserved factors. Second, Hamilton implements a cohort analysis that traces black immigrant populations over their tenure in the United States. Lastly, Hamilton provides a detailed gendered analysis that reveals how black immigrant women fair in relation to both their male counterparts as well as African American women. Hamilton adds further nuance by separating black immigrants by native country to uncover new regional disparities. While readers untrained in sociological statistics may find Hamilton's models complicated, his analysis and interpretation are clear and incisive.In almost all contemporary areas of analysis, black immigrants have similar or slightly better outcomes than African American movers, who in turn, consistently outperform nonmovers. In reviewing labor market disparities, Hamilton's findings challenge prior assumptions that black Caribbean immigrants in the early twentieth century held advantages over African Americans. While their outcomes did improve with their duration in the United States, contemporary data reveals that over time almost all black immigrant labor force participation rates converge or surpass those of black and white Americans. In regard to homeownership, newly landed black immigrants own homes at lower rates than African Americans. However, using cohort analysis, Hamilton determines that homeownership rates of all black immigrant arrival cohorts since 1970 have improved, converged, or surpassed those of African American movers. Moreover, while health statistics reveal some of the widest racial disparities, black immigrants report “fair” or “poor” health at the same rate as white Americans. Interestingly, Hamilton finds that immigrant health deteriorates over time, possibly due to exposure to the effects of racism and discrimination. Lastly, intermarriage is one of the best indicators of social acceptance. Since the civil rights movement, white intermarriage with Hispanics and Asians has increased considerably; intermarriage with blacks, however, accounts for only 12 percent of all interracial marriages. Hamilton's findings lead him to conclude that W.E.B. Du Bois's color line of the twentieth century has shifted from Black-White to one that is Black-Nonblack. Together these findings indicate that both selective migration and historical context—namely migration in the post–Civil Rights Era—play a pivotal role in shaping immigrant outcomes.While Black Immigration challenges long-held notions of cultural inferiority, uncovers new patterns of stratification, and encourages future researchers to disaggregate the black population, some may find that it does not appropriately grapple with the impact of mass incarceration. Though Hamilton notes incarceration as a methodological limitation, he only does so as a variable impacting African Americans. Mass incarceration is a defining structure of modern American racial politics and Hamilton emphasizes the role of historical context and the post–Civil Rights Era as important for shaping immigrant outcomes, yet the book does not consider how the carceral system impacts black immigrants. Nevertheless, Hamilton presents socio-economic data and comprehensive analysis that will prove useful to historians and sociologists alike.

Psychological distress and its potential risk factors among Black and White adult immigrants in the United States - National Health Interview Survey 2005-2018.

In recent years there has been an increase in Black African immigrants to Australia; however, there is no social psychological research that directly examines community attitudes towards this group. Here, the findings of a community survey in Western Australia are reported using data collected from 184 Australian participants. We were particularly interested in prejudiced attitudes and the function of attitudes towards Black African immigrants. On prejudice, a reliable and valid instrument measuring attitudes towards Black African immigrants was constructed. On functions, the most frequently reported function of attitude was ‘value-expressive’ (‘My attitudes give expression to my values’), followed by experiential-schematic (‘Helps me to make sense of the world’) and indirect experiential-schematic (‘Media, friends and family help me to make sense of the world’). While there was no significant difference between immigrant-accepting versus immigrant-rejecting participants on the value expressive or the experiential schematic functions, rejecting participants scored higher on the indirect experiential schematic function, highlighting the salience of second-hand information. The participants' most important reason for potentially changing their own attitudes towards Black African immigrants, however, were direct experience (experiential-schematic), followed by values (value expressive) and indirect experience (indirect experiential-schematic), two functions that were equally important. Qualitative open-ended interviews about attitudes converged with these themes, and added ‘integration’ by assimilating Australian culture, and not being involved in criminal activities (which highlights again a role for the media). We discuss these findings and derive a clear direction for anti-prejudice strategies at community and government levels.

Across the globe, a significant number of immigrants frequently encounter discrimination and social exclusion in their host nations, prompting discussions regarding policies and societal attitudes toward these groups. This study is guided by the structural social work framework which provides a very important structure to understand the experiences of Black African immigrants in Australia. Drawing on the case of Black African immigrants in Australia, this study investigates the effects of discrimination and social exclusion on their wellbeing. This research builds upon existing literature concerning the discrimination and social exclusion of immigrants, incorporating the perspectives of 27 social workers and immigrants who have resided in Australia for at least of 2 years. We conducted semi-structured interviews with eight social workers and 19 Black African immigrants purposefully selected from Brisbane, Townsville, Melbourne, and Sydney. These interviews were conducted both face-to-face and online via Zoom, Teams, and WhatsApp calls. We audio-recorded and transcribed the interviews, employing a thematic analysis approach with the assistance of NVivo software to analyze the data. Our findings reveal that Black African immigrants often experience discrimination, primarily manifested through their perceptions of exclusion and discrimination in job recruitment, social environments, and social contexts. Participants emphasized that discrimination in its various forms affects their wellbeing. Our findings contribute to the scholarship on wellbeing. We argue that interventions aimed at enhancing the wellbeing of Black African immigrants should address discriminatory and exclusionary systems, advocate for policy reform, and re-emphasize the role of practitioners as agents of social activism and change.

Racism-based experiences among Black African immigrants in the United States are a growing concern due to the prevalence of these events and risk for negative health (mental, behavioral, and physical) outcomes. This integrative review appraised published studies (2012–2023) addressing the relationship between racism-based experiences and adverse health for Black African immigrants. Articles were identified using structured search terms in several databases (APA PsycINFO, CINAHL, PubMed, Web of Science), Google Scholar, and citation mining. A total of fourteen studies met the inclusion criteria. Studies found a significant positive association between racism-based experiences and adverse mental (n = 9), behavioral (n = 3), and physical (n = 2) health outcomes. Racism-based experiences appear to have mental, behavioral, and physical health consequences for Black African immigrant adults. Given the growing population of Black African immigrants in the United States, more work is needed to elucidate the relationship between racism-based experiences and negative health outcomes.

The existing literature on the differences in the internalization and perception of racism between Black African immigrants and African Americans in the United States has produced myriad data. However, what is lacking is a systematic conceptualization of the revealed patterns and trends. Moreover, the few attempts in this regard are primarily based on a single geopolitical understanding of space in the United States, relegating the geopolitical space of Africa to the back burner. This paper attempts to bridge these gaps by proposing not just a multidisciplinary framework for conceptualization, but also a multi-space plane that cuts across both the American and African geopolitical spaces. The framework proposed in this paper consists of concepts drawn from sociology, negotiation studies, conflict resolution, and international studies. With this, I argued that the differences in self-conception, the availability of BATNA and externalities owing to the transnational identity of Black African immigrants grant them (Black African immigrants) the leverage of a relatively less internalized base of racism than their Afro-American counterparts. Within this context, this paper aims to provide one of many frameworks for assessing racism in the American context. Concomitantly, it adds to the growing body of literature advocating for intersectionality and a multidisciplinary approach as ideally suited to exploring and understanding the complexities associated with racial discourses.

Access to Regular HIV Care and Disease Progression among Black African Immigrants

<b>Background:</b> Black African immigrants–individuals born in sub-Saharan Africa who now reside in the United States, irrespective of citizenship status–represent one of the nation’s fastest‐growing immigrant groups. Although they contend with migration stress, racism, cultural dislocation, and socioeconomic hardship, they remain among the least likely to seek or receive mental-health services. This persistent under-utilization, coupled with scant empirical attention, leaves their distinct needs largely invisible in mental-health research and policy.<br /> <b>Purpose:</b> This integrative review examines multilevel factors influencing mental health service (MHS) utilization specifically among Black African immigrants in the United States, foregrounding structural, cultural, and psychosocial barriers.<br /> <b>Methods:</b> Following integrative review methodology [1], 19 peer-reviewed studies published between 2000 and 2025 were analyzed using thematic synthesis and constant comparative analysis. A conceptual framework grounded in intersectionality, Stigma and race-related stressors, and structural competency guided the review.<br /> <b>Results:</b> Five major themes emerged: (1) underutilization despite need, (2) structural barriers and systemic exclusion, (3) cultural and religious interpretations of mental illness, (4) stigma and silence within communities, and (5) the role of acculturation and identity. These themes highlight the complex interplay of stigma, systemic racism, and sociocultural dynamics influencing help-seeking behaviors.<br /> <b>Conclusion:</b> MHS underutilization among Black African immigrants is shaped by interlocking individual, cultural, and structural barriers. Culturally and structurally responsive interventions are urgently needed to improve access and engagement. The review underscores the importance of population-specific research, disaggregated data, and community-partnered models of care.

ABSTRACTThis study focuses on the ways in which black African immigrants (BAIs) in Johannesburg claim ethnic identities through strategic practices involving multiple affordances that go beyond language competence. Drawing on a qualitative study consisting of data from interviews with BAIs, this article argues that BAIs claim specific ethnic identities through self-styling, for instance, wearing clothes they perceive to be ‘ethnic’ style markers and in some cases bleaching their skin as part of their in-group identity work. Extending the idea of language crossing, the article contends that although these practices resemble elements of crossing, BAIs are not necessarily taking on out-group ethnic identity markers as would be the case in language crossing; instead, these practices are for in-group self-identification and extend beyond tokens to other affordances. These self-styling practices do not necessarily represent solidarity or identification with a particular group per se, but rather, are indicative of a strategic choice necessitated by the state of precarity which BAIs face in South Africa. The conclusion drawn from these practices is that self-styling disarticulates the close relationship between language and ethnicity, allowing BAIs to claim an ethnic identity even in instances where they have limited or no proficiency in the relevant language.

# Background This study aims to explore the differences in the management of diabetes outcomes and prevalence among black Africans, white and South Asian populations living in western countries from published evidence. This review incorporates findings from differences in diabetes management outcome among black Africans compared to white and South Asian populations. # Methods A systematic search of major electronic databases with peer review publications was conducted. PubMed, CIHNAL, Medline, Web of Science, Scopus, and Science direct databases were searched from 2007-2018. Relevant journals and citations from references were searched for selection in the review. Data were analysed to understand differences in diabetes outcomes among these populations. # Results Fifteen articles met the inclusion criteria out of the sixty-six articles retrieved and included in the review. Majority of the articles were cross-sectional quantitative studies (n=10) and qualitative studies (n=5). Diabetes prevalence and outcome measures such as haemoglobin A1c, blood pressure, cholesterol and body mass index were reported to be higher among black African than white populations. The data showed disparity in diabetes management among black Africans as compared to white and South Asian groups. # Conclusions The poorer health outcomes reported among black Africans as compared to white and South Asian populations suggest poor diabetes management. Further research is needed to understand why there is such disparity in the health outcome of black African populations living with diabetes in western countries. There is a need to have a consistent target outcome measure in studies. Further synthesis was not possible due to differences in outcome measures used by studies reviewed.

The number of black Caribbean immigrants in America is growing with the most prevalent countries of origin being the Bahamas, Haiti, Colombia, the Dominican Republic, and Trinidad and Tobago (Schmidley & United States Bureau of the Census, 2001). According to the Bureau of Census (2000), nearly 2.8 million foreign-born immigrants come from the Caribbean region, yet these groups remain largely invisible in America (Waters, 1999). Until recently, there was very little attention given to understanding the experiences of black Caribbean immigrants. This is because, as immigrants, their status is overshadowed by immigration related to Mexico and other Latin American countries--regions that, along with Asia, represent the Largest flow of immigrants to America since the 1980s (Schmidley & U.S. Bureau of the Census, 2001). Doe to their physical appearance, they are often seen as part of the black American community, despite differences in language, culture, and religion. Their invisibility means that they are not seen as having to face unique issues or having distinct needs. This invisibility, along with the stereotypical images of life in the Caribbean, requires examination for adult education programs serving black Caribbean immigrants. This article explores some of the issues facing Caribbean Americans and bow, from an adult educator's perspective, these issues impact adult learning. Economic Reality and Patterns of Immigration The emigration of black Caribbean persons to the United States can be understood as part of a global pattern of labor migration from poorer countries to wealthier ones (Butcher, 1994). This movement is propelled by the expansion of the global capitalist economy under the hegemony of U.S. economic interests. Where the former colonial powers--England, Spain, and France--dominated the histories and economies of the islands of the Caribbean, the United States has emerged as the dominant economic force in the region and prompted many persons to migrate to America in search of economic opportunity (Daneshvary, 1994). Poverty rates throughout the Caribbean are high: 80% in Haiti, 34% in Jamaica, and 21% in Trinidad and Tobago (U.S. Central Intelligence Agency. Directorate of Intelligence, 2001). The economy of the region is fragile, although individual islands such as Puerto Rico and Bahamas have comparatively strong economies. Because of the media images of idyllic Caribbean islands, most Americans are unaware of the economic and social problems facing Caribbean residents. Acculturation Issues Black Caribbean immigrants do not arrive in the United States as empty cultural containers waiting to be Americanized. They come with perceptions, images, and values on issues of race, class, and gender relations that are shaped by the home country Similarly, they display multiple forms of identity related to the diverse racial, ethnic, and urban contexts in which they settle and work. For the majority, of Caribbean immigrants, incorporation into American society is a two-fold process. First, most immigrant workers are integrated into the service sector of the economy, which means they have a relatively weak position in the labor market. Second, because race is fundamental in the American social hierarchy, access to resources, rewards, and power as a black immigrant is significantly limited (Hacker, 1992). Consequently, for many black Caribbean immigrants, there is a clear understanding that categories of race and ethnicity as defined in American society are different than in many Caribbean societies. These definitions are used to mark boundaries of social location and therefore place black Caribbean immigrants in a kind of double jeopardy as they seek employment and education opportunities as immigrants. It must be understood that the nations of the Caribbean are also characterized by linguistic diversity in addition to separate histories of colonization and liberation. …