Исследование выявило «эффект здорового иммигранта»: у чернокожих американцев риск инсульта ниже, если они родились за границей

A study published in Neurology identified a healthy immigrant effect on stroke risk among patients who identify as Black. Individuals who identify as Black are often homogenized as 1 group in the United States health care system. In general, Black adults in the US have a higher incidence of stroke. To assess the nuanced variation in stroke prevalence among Black individuals based on region of birth, investigators analyzed data from the National Health Interview Survey (NHIS). Adults (N=64,717) aged 25 to 74 years between 2000 and 2018 who identified as Black were evaluated for self-reported stroke on the basis of region of birth. Data were weighted for a population of 12,983,173. The individuals were born in the US (88.3%); Caribbean, South America, or Central America (CSCA; 8.0%); and Africa (3.7%). Individuals born in the US had a higher rate of obesity and smoking, and those born in Africa had a higher rate of having a college education than those born in other regions. Homogenizing racial and ethnic groups without including differential characteristics of the immigrant journey to the United States may mask important differences and limit the success of public health efforts and targeted interventions. The prevalence of stroke was highest among individuals born in the US (4.3%), followed by those from CSCA (1.5%) and Africa (0.8%). The individuals from the US with a history of stroke were younger, more likely to have obesity and to smoke, and less likely to have a college education than other stroke survivors. After stratifying the patients by nativity and age and adjusting for sociodemographic and clinical covariates, individuals from CSCA (adjusted odds ratio [aOR], 0.23; 95% CI, 0.08-0.63; P =.01) or Africa (aOR, 0.29; 95% CI, 0.10-0.85; P =.02) aged 25 to 44 years, individuals from CSCA aged 45 to 64 years (aOR, 0.49; 95% CI, 0.34-0.71; P <.01), and individuals from CSCA aged 65 to 74 years (aOR, 0.56; 95% CI, 0.39-0.81; P =.01) were less likely to have a history of stroke than individuals born in the US from the same age group. After stratifying the patients by nativity and time spent in the US and adjusting for sociodemographic and clinical covariates, odds of stroke were decreased among those born outside the US with fewer than 15 years (aOR, 0.27; 95% CI, 0.15-0.47; P <.01) or at least 15 years (aOR, 0.53; 95% CI, 0.42-0.68; P <.01) spent in the US than those born in the US. Study limitations include the reliance on self-reported location of origin and history of stroke, the small sample sizes for foreign-born subgroups, potential language barriers, and the exploratory nature of the time-since-migration analysis. The study investigators concluded, “Homogenizing racial and ethnic groups without including differential characteristics of the immigrant journey to the United States may mask important differences and limit the success of public health efforts and targeted interventions.” This article originally appeared on The Cardiology Advisor