Incident Stroke in the United States and Foreign Born Black Individuals.
There is a paucity of information about the association between nativity and stroke prevalence among Black individuals in the United States.
We assessed stroke prevalence among individuals who identified as Black in the 2000-2018 National Health Interview Survey. Respondents were stratified by age (25-55 or 56-74 years) and location of birth (United States; Caribbean, South, and Central America [CSCA]; and Africa). Factors associated with stroke prevalence were assessed using logistic regression, adjusting for sociodemographic and medical characteristics.
Among 64,717 respondents who identified as Black, 88.3% were born in the United States, 8.0% were born in CSCA, and 3.7% were born in Africa. Prevalence of stroke was 4.3%, 1.5% and 0.8%, respectively. Foreign born individuals had lower odds of stroke (adjusted OR 0.44, 0.34-0.57 for CSCA and 0.39, 0.23-0.63 for Africa). The odds of stroke were lowest for those who had recently immigrated at the time of the survey (adjusted OR < 15 years 0.27, 95% CI 0.15-0.47).
Among individuals who identify as Black, there may be a healthy immigrant effect. Homogenizing racial and ethnic groups may mask key epidemiologic trends and limit targeted interventions.
We assessed stroke prevalence among individuals who identified as Black in the 2000-2018 National Health Interview Survey. Respondents were stratified by age (25-55 or 56-74 years) and location of birth (United States; Caribbean, South, and Central America [CSCA]; and Africa). Factors associated with stroke prevalence were assessed using logistic regression, adjusting for sociodemographic and medical characteristics.
Among 64,717 respondents who identified as Black, 88.3% were born in the United States, 8.0% were born in CSCA, and 3.7% were born in Africa. Prevalence of stroke was 4.3%, 1.5% and 0.8%, respectively. Foreign born individuals had lower odds of stroke (adjusted OR 0.44, 0.34-0.57 for CSCA and 0.39, 0.23-0.63 for Africa). The odds of stroke were lowest for those who had recently immigrated at the time of the survey (adjusted OR < 15 years 0.27, 95% CI 0.15-0.47).
Among individuals who identify as Black, there may be a healthy immigrant effect. Homogenizing racial and ethnic groups may mask key epidemiologic trends and limit targeted interventions.