Black Immigrants from Africa and the Caribbean Have Similar Rates of Diabetes but Africans Are Less Obese: the New York City Community Health Survey 2009–2013
- 9 Downloads
This study was designed to determine (a) whether the prevalence and odds of either obesity or diabetes differed in foreign-born black Africans and Caribbeans living in New York City (NYC) and (b) whether time in the United States (US) affected odds of either outcome.
Data were obtained from NYC Community Health Survey 2009–13 for 380 African-born blacks and 2689 Caribbean-born blacks. Weighted logistic regression estimated odds of obesity and diabetes, adjusting for age, sex, education, income, marital status, children < 18, BMI (diabetes models only), and time in the US.
Obesity prevalence in Africans (60.2%, male; age, 46.0 ± 13.5 years, (mean ± SD); BMI, 27.3 ± 5.6 kg/m2) was 16.7 and 30.2% in Caribbeans (39.3%, male; age, 49.7 ± 14.7 years; BMI, 28.0 ± 5.8 kg/m2). Prevalence of diabetes was 10.5% in Africans and 14.7% in Caribbeans. Africans had lower adjusted odds of obesity (aOR = 0.60 (95% CI, 0.40–0.90); P = 0.015), but there was no difference in diabetes odds between groups. Obesity odds were higher in African (aOR = 2.35 (95% CI, 1.16–4.78); P = 0.018) and Caribbean women (aOR = 2.20 (95% CI, 1.63–2.98); P < 0.001) than their male counterparts. Odds of diabetes did not differ between sexes in either group. Time in the US did not affect odds of either obesity or diabetes.
Africans living in NYC are less obese than Caribbeans, but odds of diabetes do not differ. Time in the US does not affect odds of either obesity or diabetes. Hence, BMI and diabetes risk profiles in blacks differ by region of origin and combining foreign-born blacks into one group masks important differences.
KeywordsBlack immigrants African Caribbean Obesity Diabetes
Margrethe F. Horlyck-Romanovsky was supported by the City University of New York Graduate School of Public Health and Health Policy. Melissa Fuster Rivera was supported by Brooklyn College, City University of New York. Sandra E. Echeverria was supported by the City University of New York Graduate School of Public Health and Health Policy. Katarzyna Wyka was supported by the City University of New York Graduate School of Public Health and Health Policy. May May Leung was supported by Hunter College, City University of New York. Anne E. Sumner was supported by the intramural programs of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health and the National Institute of Minority Health and Health Disparities. Terry, T-K. Huang was supported by the City University of New York Graduate School of Public Health and Health Policy.
The authors wish to thank Fangtao He with the New York City Department of Health and Mental Hygiene, Division of Epidemiology, Bureau of Epidemiology Services for data support.
Author Anne E. Sumner is supported by the intramural programs of National Institute of Diabetes and Digestive and Kidney Diseases and National Institute of Minority Health and Health Disparities of the National Institutes of Health.
Compliance with Ethical Standards
Conflict of Interest Statement
The authors declare that they have no conflict of interest.
Ethical Responsibilities of Authors
This manuscript has not been submitted to more than one journal for simultaneous consideration and has not been published previously. No data have been fabricated or manipulated to support our conclusions. No data, text, or theories by others are presented as if they were the author’s own. An abstract summarizing these findings was presented at the American Diabetes Association’s official 78th Scientific Sessions, Orlando, FL, June 22–26, 2018. It was printed in the Scientific Sessions’ Abstract Book, the July 2018 supplement to the journal Diabetes.
Consent to submit has been received explicitly from all co-authors. Authors whose names appear on the submission have contributed sufficiently to the scientific work and therefore share collective responsibility and accountability for the results.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
This is secondary data analysis of de-identified publicly available data. For this type of study, formal consent is not required.
- 1.Anderson M. Rising share of the U.S. black population is foreign born. Washington DC: Pew Research Center; 2015.Google Scholar
- 2.Brown A. Foreign-born share of population to reach historic high by 2060, even as share falls among Hispanics, Asians. 2015.Google Scholar
- 3.The Newest New Yorkers. Characteristics of the City’s Foreign Born Population. 2013 ed. New York, NY: Department of City Planning City of New York; 2013.Google Scholar
- 4.Lundy De La Cruz N, Jessup J, Murray L. Health of Black New Yorkers by country of birth. New York City: Department of Health and Mental Hygiene: Epi Data Brief (79); 2016. Available from: https://www1.nyc.gov/assets/doh/downloads/pdf/epi/databrief79.pdf.
- 7.Horlyck-Romanovsky MF, Wyka K, Echeverria SE, Leung MM, Fuster M, Huang TT-K. Foreign-born blacks experience lower odds of obesity but higher odds of diabetes than US-born blacks in New York City. J Immigr Minor Health. 2018. https://doi.org/10.1007/s10903-018-0708-7.
- 11.[Dataset] Community Health Survey 2002-2013. New York, NY: New York City Department of Health and Mental Hygiene; 2002–2013.Google Scholar
- 12.Mayer-Davis EJ, Beyer J, Bell RA, Dabelea D, D’Agostino R Jr, Imperatore G. Diabetes in African American youth: prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study. Diabetes Care. 2009;32(Suppl 2):S112–22. https://doi.org/10.2337/dc09-S203.CrossRefGoogle Scholar
- 14.Callwood GB, Campbell D, Gary F, Radelet ML. Health and health care in the U.S. Virgin Islands: challenges and perceptions. ABNF J. 2012;23(1):4–7.Google Scholar
- 15.Community Health Survey 2002-2013. New York, NY: New York City Department of Health and Mental Hygiene; 2002–2013.Google Scholar
- 17.O'Connor MY, Thoreson CK, Ricks M, Courville AB, Thomas F, Yao J, et al. Worse cardiometabolic health in African immigrant men than African American men: reconsideration of the healthy immigrant effect. Metab Syndr Relat Disord. 2014;12(6):347–53. https://doi.org/10.1089/met.2014.0026.CrossRefGoogle Scholar
- 18.Commodore-Mensah Y, Hill M, Allen J, Cooper LA, Blumenthal R, Agyemang C, Himmelfarb CD Sex differences in cardiovascular disease risk of Ghanaian- and Nigerian-born west African immigrants in the United States: the Afro-Cardiac Study. J Am Heart Assoc 2016;5(2). doi: https://doi.org/10.1161/jaha.115.002385.
- 20.Suzuki K. Ethnic enclaves. In: Gallagher CA, Lippard CD, editors. Race and racism in the United States: an encyclopedia of the American mosaic. Santa Barbara: Greenwood; 2014. p. 413–5.Google Scholar
- 23.Bingham BA, Duong MT, Ricks M, Mabundo LS, Baker RL Jr, Utumatwishima JN, et al. The association between stress measured by allostatic load score and physiologic dysregulation in African immigrants: the Africans in America study. Front Public Health. 2016;4:265. https://doi.org/10.3389/fpubh.2016.00265.CrossRefGoogle Scholar
- 25.Bank W. The World Bank in the Caribbean: overview. 2018. https://www.worldbank.org/en/country/caribbean/overview. Accessed 6 Jan 2019.
- 30.Sewali B, Harcourt N, Everson-Rose SA, Leduc RE, Osman S, Allen ML, et al. Prevalence of cardiovascular risk factors across six African Immigrant Groups in Minnesota. BMC Public Health. 2015;15. https://doi.org/10.1186/s12889-015-1740-3.
- 36.Pearl J, Mackenzie D. The Book of Why: the New Science of Cause and Effect. New York: Basic Books, Hachette; 2018.Google Scholar