African Americans and Caribbean blacks in the U.S.: Do perceived neighborhood factors affect their self-reported physical health differently?

We examined the existence of differences in the self-reported physical health status and perceived neighborhood factors of African Americans and Caribbean blacks, and assessed whether there are dissimilarities in how perceived neighborhood factors affect the self-reported physical health status. The immigrant health hypothesis, place stratification theory, and theoretical propositions relating neighborhood characteristics to health outcomes provided the theoretical perspectives for the study.

Past studies not only established that individual socioeconomic status (SES) differences alone do not fully explain racial health disparities (Avecedo-Garcia et al, 2003) but also revealed that residential neighborhood context is related to racial health disparities (Williams & Collins, 2001, Kawachi & Berkman, 2003a). Also, Read, Emerson, and Tarlov (2005) noted that health disparities among blacks are concealed when all blacks are aggregated as a single group. Caribbean black immigrants constitute 4.4% of the black population in the United States and form the largest black immigrant subgroup (Logan & Deane, 2003). The current study takes advantage of the National Survey of American Life (NSAL) 2001-2003, a nationally representative data which oversampled Caribbean blacks and African Americans to address the following research questions: 1)Are there differences in the self-reported physical health status of African Americans and Caribbean blacks? 2) Do African Americans and Caribbean blacks perceive their residential neighborhoods differently? 3) Do perceived residential neighborhood factors affect the self-reported physical health status of African American and Caribbean blacks differently?

From analysis, significantly less Caribbean blacks self-reported physical health as “fair” or “poor” compared with African Americans (16.2% versus 20.3%, p-value 0.0001). African Americans were more likely to perceive low level of amenities in their neighborhood compared to Caribbean blacks (29.9% versus 16.9%, p-value 0.0001). Also, African Americans and Caribbean blacks had similar perceived level of high crime and high drug problem -- 47.1% versus 46% (p-value 0.833) and 39.7% versus 35.4% (p-value 0.322) respectively. Logistics regressions showed that the odds of self reporting poor physical health among Caribbean blacks and African Americans is significantly associated with neighborhood disadvantage but no significant ethnic differences in the neighborhood disadvantage effect(odd ratio 1.07, p-value 0.714, for African Americans compared to Caribbean blacks).