Disparities in prevalence of physical and cognitive disabilities among blacks in the United States: Examining the effects of nativity

Background: Research on health disparities in the U.S. often treats blacks as a monolithic group, and ignores the potential effect of nativity on the patterns of health and disease. This study examines the effects of nativity on disparities in rates of disabilities among whites and subgroups of blacks.

Methods: Data from the 2005 American Community Survey were used. The analytical adult subsample included U.S.-born whites (n=1,563,814), U.S.-born blacks (n=169,304), and foreign-born blacks from Europe (n=753), Central/ Southern America (n=1975), Caribbean islands (n=11,087), and sub-Saharan Africa (n= 4,416). Logistic regression models compared whites vs. all blacks [Model I], whites vs. subgroups of U.S.- and foreign-born blacks [Model II], and US-born blacks vs. subgroups of foreign-born blacks [Model III]. Demographic (e.g., gender), acculturation (e.g., English fluency) and socio-economic characteristics (e.g., educational attainment) were included as covariates.

Results: Model I showed that blacks as a group were more likely than U.S.-born whites to have a disability. In Model II, compared to whites, U.S.-born blacks had higher odds and blacks born in Central/Southern America, Caribbean islands, and sub-Sahara Africa lower odds of having a disability. Model III reconfirms the advantage foreign-born blacks, except those from Europe, have over US-born blacks in rates of disability. Disparities in rates of disability remained significant after controlling for demographic, acculturation, and socio-economic characteristics.

Conclusions: Foreign-born blacks, except those from Europe, have lower rates of disability than U.S.-born whites and blacks. Effects of nativity should be considered in research and programs to reduce disparities in disability in the U.S.