title: Diabetes among US- and foreign-born blacks in the USA.
abstract: OBJECTIVE
  Little is known about diabetes status among US blacks by nativity. This study aims to measure differences in diabetes among US blacks by region of birth and examines potential explanations for subgroup differences.
  
  
  METHODS
  Data from 47,751 blacks aged 25-74 pooled from the 2000-2013 waves of the National Health Interview Survey were analyzed. Logistic regression models predicted self-reported diabetes. The roles of education, income, body mass index (BMI), smoking, and duration of US residence were explored.
  
  
  RESULTS
  Compared to the US-born, foreign-born blacks had significantly lower reported diabetes prevalence (8.94% vs. 11.84%) and diabetes odds ratio [OR: 0.75; 95% confidence interval (CI): 0.62, 0.89], adjusting for socio-demographic characteristics. Further inclusion of education, income, household size, and smoking did not appreciably change the OR (0.77; 95% CI: 0.61, 0.86). Including an adjustment for BMI entirely eliminated the foreign-born advantage (OR 0.93; 95% CI: 0.78, 1.11). The foreign-born from the Caribbean/Americas had similar diabetes odds compared to the African-born. Among the foreign-born, an increased duration of US residence was associated with a higher diabetes odds, but these associations did not reach statistical significance (p > 0.05).
  
  
  CONCLUSIONS
  The healthy immigrant advantage extended to diabetes among US blacks, a finding that is explained by lower levels of overweight/obesity among the foreign-born compared to the US-born. Nonetheless, more than 71.4% of the foreign-born were overweight or obese. Understanding the mechanisms through which exposure to the US environment leads to higher obesity and diabetes risk may aid prevention efforts for the rapidly growing foreign-born black subpopulation.
authors.affiliation: a Nutrition and Health Sciences , Emory University , Atlanta , GA , USA.
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Ford
authors.affiliation: a Nutrition and Health Sciences , Emory University , Atlanta , GA , USA.|b Hubert Department of Global Health , Emory University , Atlanta , GA , USA.
authors.forename: K M Venkat
authors.initials: KM
authors.lastname: Narayan
authors.affiliation: b Hubert Department of Global Health , Emory University , Atlanta , GA , USA.
authors.forename: Neil K
authors.initials: NK
authors.lastname: Mehta
mesh_terms: D000328:Adult; D000349:Africa / Q000208:ethnology; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D017691:Caribbean Region / Q000208:ethnology; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000208:ethnology*; D054242:Emigrants and Immigrants; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity; D014481:United States / Q000453:epidemiology; D001741:Black or African American
keywords: African Americans/blacks; diabetes; immigration; obesity