HEALTH RISKS, NUTRITION ASSESSMENT AND DISEASE PREVALENCE AMONG AFRICAN IMMIGRANT GROUPS IN ATLANTA GEORGIA Background: Though past studies have suggested immigrants are generally healthier than the native population, the immigrant acquisition of chronic diseases, such as obesity, hypertension and diabetes, over time, is poorly understood among African immigrants. Objective: The objective of this study was to evaluate the health status, health risks chronic disease prevalence, and acculturation among immigrants from Ghana, Kenya and Nigeria. Participants/setting: 130 adult African immigrants living in Atlanta and attending any of four church health fairs. Participants completed anthropometric, health status assessments and a Home Environment Family connections Survey. Main outcome measures: BMI, waist circumference, blood glucose, blood pressure, fruit consumption frequency, availability of sugared sweetened drinks and physical activity were assessed and compared among African immigrant groups. Statistical analysis: Prevalence was calculated. Independent sample t-test, one-way ANOVA, and Pearson correlation coefficients were used to compare anthropometrics while demographic and categorical survey data was compared using chi-squared tests. Results: There was a statistically significant difference in the mean BMIs of African Immigrants (Nigeria and Ghana) (p=0.013) but not in the waist circumferences (p>0.05). High blood pressure prevalence in Ghanaian, Nigerian and Kenyan immigrants was 42.6 %, 36.8 %, and 25.8 % respectively. The prevalence of diabetes in Ghanaian, Nigeria and Kenyan immigrants was 18.8 %, 11.8 %, and 4.9 % respectively. Obesity prevalence in Nigerian, Kenyan and Ghanaian immigrants was 52.6 %, 45.8 %, and 31.1 % respectively. There were no statistically significant associations between the Years of Stay status and disease prevalence (p>0.05). There were no statistically significant associations between the BMI status and the availability of sugared sweetened drinks in the household, fruit consumption frequency, or the physical activity of African immigrants. Conclusion: African immigrants appear to have a slightly lower prevalence of diabetes, but a higher prevalence of hypertension and obesity than the United States population. Acculturation did not play a strong role in determining the health trajectories of African immigrants. Grouping immigrants by their country of origin does provide another important dimension in understanding the variation in immigrant health as each group had significant differences in the prevalence of diseases.

Historically, Liberian immigrants to the United States tended to be wealthy, educated individuals who wanted their children to acquire a Western education. The thirteen-year Liberian Civil War resulted in a new wave of U.S. migration. Many recent Liberian immigrants hold low socio-economic statuses. Some came to this country illiterate or with gaps in their education. This has created a cultural-educational gap amongst newly arrived Liberian immigrants. Many young Liberian immigrants struggle with educational and socialization issues. Studies have been conducted on the acculturation experiences of youths from Europe, Asia, and South and Central America. Yet to date, very little research has been done on the lives of African youth, especially those who emigrated from Liberia after the civil war. Their voices have been missing from the literature. This qualitative study provides narratives of four Liberian immigrant youths, between the ages of 18 and 22 years old, who formerly attended schools in Liberia, have lived in the U.S. less than ten years, and have attended at least three years of high school in the United States. Each youth was interviewed regarding their school, home, and community acculturation experiences. Excerpts of their interviews allow the reader to hear the participants' stories in their own words. Findings of the research from emergent themes indicate that the Liberian immigrant youths had many commonalities in their acculturation experiences such as: accent ridicule, bullying by peers, fights between African Americans and Liberian immigrants, and lack of appreciation for African cultures. The participants also struggled with ethnic identity issues, limited finances, and unjust educational and social systems in the United States. All four Liberian immigrants experienced some type of external and internal conflicts. A relationship was found between the possession of resiliency traits and the Liberian immigrant youths' abilities to handle conflicts and successfully acculturate to the United States. Two participants possessed strong resiliency characteristics such as autonomy, problem solving abilities, abilities to forgive, a sense of purpose and future, and creativity. They had favorable acculturation experiences, successfully graduating from high school. Two other participants lacked resiliency traits and had less favorable acculturation experiences. They succumbed to external and internal conflicts and dropped out of high school.

West African immigrants appear to carry a heavier burden of hypertensive heart disease than the native-born African Americans in the United States. In this study, I used the socioecological model theory as a guide to examine the association between perceived stress, length of stay in United States, smoking status, housing conditions, and the risk of hypertensive heart disease among West African immigrants, ages 18 - 54 years in DeKalb County, Georgia. In this quantitative, cross-sectional design, self-reported data were collected from a sample of West African immigrant (N=107) in the DeKalb County of Georgia, using a demographic data/screening sheet and the Perceived Stress Scale. Multivariate logistic regression analysis was used to determine the association between hypertensive heart disease and perceived stress, smoking status, length of stay in the United States, and housing condition, having adjusted for the modifying variables age and education. Results indicated that length of stay in the United States [p =.019, Phi =.331], housing condition [p=.156, R2 =.019], smoking status [p=.050, R2 =.036] and experienced perceived stress experienced [p=.312, R2=.010] are associated with risk of developing hypertensive heart disease. There was a statistically significant association between age [p=.002] and the development of hypertensive heart disease. The result of this study can contribute to positive social change by helping public health agencies to target some of the identified risk factors for hypertensive heart disease in foreign born African American population so as to mitigate the adverse health outcomes associated with hypertensive heart disease.

This project explores the 'maternal migration effect'. Following migration to a high-income country with a low maternal mortality rate, we assume that some immigrant women’s reliance upon maternal practices that respond to a low-income, high-mortality context can adversely affect care-seeking and utilization of treatment facilities. At highest risk in the United Kingdom and Sweden are those from Africa's Horn, particularly Somali women who have experienced diasporic migration. By applying constructivist qualitative methods as proxies for medical anthropology, we propose a framework for identifying socio-cultural factors, and then we explore how these can influence the western facility-based maternity care encounter. Study 1 proposes a conceptual framework to understand why sub-Saharan African immigrants might experience adverse childbirth outcomes in western settings. Analysis was guided by 'naturalistic inquiry method' to explore delay-causing socio-cultural factors to optimal maternity treatment. Delays can result from (a) broken trust underlying women’s late-booking or refusal of treatment interventions, and care provider frustration; (b) over-reliance on poorly-functioning interpreter services that deny women’s access to medical expertise; and (c) mutual broken trust and miscommunication, and limited development of guidelines for treatment avoidance. Limited coherence exists in the perspectives between women and providers about caesarean section and other interventions, refusal of treatment, and coping strategies following adverse birth outcomes. Care providers' held misconceptions about women’s preferences for gender- and ethnic-congruence. Women preferred competent care. Congruent language was identified as the key ingredient for optimal culture-sensitive care. Study 2 applied 'grounded dimensional analysis' and 'functional narrative analysis' to explore pre-migration socio-cultural factors that influence Somali parents' childbearing in Sweden. Women’s delayed care-seeking continues, despite that childbearing is still perceived as life-threatening. Decision-making is shared between the couple. Men more than women trust care providers to fill gaps in their knowledge. The postpartum period showed that fathers play an important role. "Aftercare" concerns include unarticulated sexual aversion combined with loss of traditional kin support. Women's autonomy is enhanced but greater necessity exists for intimate partner communication and reliance upon professional care services. Medical anthropology can provide a complementary instrument for developing qualitative evidence-based strategies that target prevention of adverse childbirth outcomes in European countries.

This research attempts to explore how African immigrant teachers in South African schools reconstructed their professional identities. In this study African immigrant teachers are those teachers who have undergone teacher professional training in an African country other than South Africa. The study was qualitative in nature and utilized narrative inquiry and the case study approach. Data-gathering techniques included a mix of semi-structured interviews, observations, focus group interviews, field notes and a researcher’s journal (multiple variable sampling of five different South African public schools- one African immigrant teacher per school; school principals and focus group interviews of learners who were students of the immigrant teachers). Data analysis made use of grounded theory and content analysis. Findings from the study were fourfold: First, African immigrant teachers in South African schools cultivated good relationships with colleagues and administrators in order to reconstruct their professional identities. Second, they developed special traits such as perseverance and resilience. Third, access to opportunities, resources and materials in their schools were useful. Fourth, immediate employment on arrival in South Africa was available. Apart from factors that promoted the reconstruction of African immigrant teachers’ professional identities, there are also factors that opposed the reconstruction of their professional identities, namely their immigration status, their employment status and the attitudes of indigenous learners towards them. The new knowledge that was generated indicated that African immigrant teachers in South African schools are considered desirable and indispensable partners by employers, colleagues, administrators and learners. This is in contrast to the general perception in the literature that immigrant teachers are mere work seekers; opportunists and desperate individuals who are not an asset to the host country. / Dissertation (MEd)--University of Pretoria, 2012. / Humanities Education / MEd / Unrestricted

Indiana University-Purdue University Indianapolis (IUPUI) / In the United States, there is very little knowledge about the health of African immigrants. Although their population exceeds 2 million and still on the rise exponentially, a big gap exists regarding knowledge about health care access and outcomes for this population. Before relocating to the US, many African immigrants face health-threatening conditions, including civil wars and poverty, which are exacerbated by the lack of understanding and attention to their health care needs in the US. Methods: To examine the health care experiences of African immigrants in the US, two distinct studies were conducted. A scoping review examined literature between 1980 and 2016 using four databases, to identify knowledge-gaps concerning African immigrant in the US. A qualitative study comprising 33 semi-structured (one-on-one) interviews and 4 focus groups was conducted using Nigerian immigrant participants in Indianapolis, to assess how discrimination affects their health care experiences and quality of care, and the factors their influence their health care meanings, respectively. Results: For the scoping review, 14 articles were included. All the studies were focused on barriers to the health care access of African immigrants in the US. Along with religion and culture, lack of culturally-competent healthcare and distrust of the US health system, were identified as the major barriers. Both the one-on-one interviews and focus groups revealed provider attitudes, through implicit and open biases, were a key contributing factor to the participants’ health care meanings and healthcare utilization. Additionally, results showed an important intersectionality within the healthcare experiences of the participants, as a result of their perception as “black,” along with African Americans and other physically-related groups. Conclusion: African immigrants in the US grapple with the critical process of reconciling their original identities with their emerging realities, including negative provider attitudes and discrimination, and lack of identify in the US health system. This study highlights the importance of understanding African immigrant health in the US, through the examination of the role of the African framework of understanding of their health in their approaches to healthcare and well-being. / 2021-03-06

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<p>The study examines the participation of African immigrants in the South African labour force with the central question revolving around whether the immigrants create jobs through the establishment of their own businesses or take jobs from the locals. Analytical frame work used in this study includes descriptive statistics, chi-square test for association and standardized residuals, two-way analysis of variance and logistic regression. Demographic, locational and socio-economic characteristics were studied using descriptive and inferential statistical analysis. Two-factor analysis of variance was used to examine the differences on average in the African immigrants&rsquo / participation in the labour force, while logistic regression was used to investigate the effect of some demographic characteristics on employment and work status.</p>

<p>The study examines the participation of African immigrants in the South African labour force with the central question revolving around whether the immigrants create jobs through the establishment of their own businesses or take jobs from the locals. Analytical frame work used in this study includes descriptive statistics, chi-square test for association and standardized residuals, two-way analysis of variance and logistic regression. Demographic, locational and socio-economic characteristics were studied using descriptive and inferential statistical analysis. Two-factor analysis of variance was used to examine the differences on average in the African immigrants&rsquo / participation in the labour force, while logistic regression was used to investigate the effect of some demographic characteristics on employment and work status.</p>

Magister Philosophiae - MPhil / The study examines the participation of African immigrants in the South African labour force with the central question revolving around whether the immigrants create jobs through the establishment of their own businesses or take jobs from the locals. Analytical frame work used in this study includes descriptive statistics, chi-square test for association and standardized residuals, two-way analysis of variance and logistic regression. Demographic, locational and socio-economic characteristics were studied using descriptive and inferential statistical analysis. Two-factor analysis of variance was used to examine the differences on average in the African immigrants; participation in the labour force, while logistic regression was used to investigate the effect of some demographic characteristics on employment and work status. / South Africa