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.

Thesis advisor: Thanh V. Tran / Diabetes management is a major part of treatment but many ethnic/racial minorities with type 2 diabetes do not make the needed adjustment. A key component of healthcare access is health acculturation, defined as a level of success in navigating the mainstream healthcare system. The overall goal of this study is to develop a measure of health acculturation and examine its relationship with diabetes management across several ethnic minority groups in the US. The first purpose is to investigate the relationship between health acculturation and type 2 diabetes management behaviors in a sample of foreign-born Vietnamese, Chinese, Korean and Latino adults. The second purpose is to assess ethnic differences by testing the interaction between health acculturation and ethnicity on diabetes management behaviors. Merged dataset from CHIS 2009 and 2011-2 were used for analysis. Multiple and logistic regression analysis revealed that those with high health acculturation skills performed more diabetes management than their counterparts. Latinos performed better than all Asian subgroups on most diabetes management behaviors regardless of the level of health acculturation. The study has implications for social workers and healthcare providers working with ethnic and minority populations. The results suggest that the health acculturation measure would be a good screening tool to identify immigrant populations who will most benefit from health intervention within the culture of western medicine. In addition, the results help to identify specific skills and tools needed by social workers and healthcare providers to better serve these populations. / Thesis (PhD) — Boston College, 2015. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Thesis (Ph. D.)--University of Missouri--Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 228-243). Also available on the Internet.