Second-Generation Decline: Disparities in Cardiovascular Disease Between African Americans and Afro Caribbeans

Abstract

ABSTRACT Studies show that Black immigrants have better cardiovascular health than African Americans, but few have explored the reasons for these disparities. While we know that the cardiovascular health of Black immigrants worsens over time in the United States, much less is known about the relative cardiovascular health of second-generation Black immigrants. We draw on novel data from the only nationally representative survey of African Americans and Afro Caribbeans to assess these cardiovascular disparities and the relative contribution of differences in psychosocial stress, discrimination, and health behavior. After developing an index measure of cardiovascular disease, we show that second-generation Afro Caribbeans have the worst outcomes, followed by African Americans, Afro Caribbeans who have been in the country for more than 15 years, and those who have been in the country for less than 15 years. We find little support for the role of psychosocial stress, discrimination, and health behavior in these cardiovascular disparities, including the fact that the second generation has the poorest cardiovascular health.