Understanding African Immigrant Health in the United States: An Exploratory Study of the Nigerian Immigrant Healthcare Experience

Abstract

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.