A prominent New York Haitian physician has corroborated studies of immigrants showing a decline in their health status with longer duration of residency in the United States.
"Studies show that Caribbean blacks are less likely to rate their health as fair or poor than U.S.-born blacks," Dr. Carla Boutin-Foster, an associate professor of medicine and public health at Weil Cornell Medical College in New York, told the second annual Caribbean Health Summit at SUNY Downstate Medical Center and University Hospital Center of Brooklyn.
"However, this changes around more than four years in the U.S.," she added in delivering the keynote address at the summit, organized by the Brooklyn-based APC Community Services, in collaboration with the Brooklyn Health Disparities Center, Cicatelli Associates Inc, SUNY Downstate Medical Center and Kings County Hospital Center, among others.
Boutin-Foster attributed the health decline among Caribbean nationals to, among other things, the adoption of a "sedentary lifestyle," unhealthy diets, loss of major sources of social support, and "greater stress to acculturate with fewer resources."
She said while new Caribbean immigrants have lower rates of obesity, this "advantage is lost over time with greater duration of residence," stating that the proportion of obesity increases with more years in the U.S., starting at four years.
In New York City, Boutin-Foster said immigrants from Jamaica and Barbados have the highest body mass index (BMI), a number calculated from a person's weight and height.
Researchers say BMI is a "fairly reliable indicator" of how much fat a person is carrying around. It is used as a screening tool to identify possible weight problems for adults.
Boutin-Foster also said that in a study conducted at Downstate Medical Center, high rates of invasive cervical cancer were found in Haitian women because of low rates of screening.
Among Caribbean men, she said high rates of prostate cancer have been documented, pointing to one study conducted in Tobago, Trinidad's sister isle, which found the rate of prostate cancer to be four times higher than in the U.S. for men ages 50 to 79. She also said high rates of prostate cancer have been found in Jamaican men.
Boutin-Foster said the prevalence of mental illness among Caribbean immigrants might vary with reason for migration. Seeking political refuge and exposure to violence or natural disasters could lead to post traumatic stress disorder (PTSD).
The physician said depression "may present with greater physical symptoms and less presentation as mood changes."
She called for programs to help Caribbean immigrants to not only obtain insurance, but also to use it in "meaningful ways."
Boutin-Foster pointed to a large cohort of Caribbean women by investigators from the Arthur Ashe Institute for Urban Health that found that higher levels of health information knowledge did not correlate with subsequent health behaviors, such as smoking or getting mammographies.
In addition to knowledge, she urged that communities have "practical tools" for developing healthy behaviours.
"Language discordance may be a barrier to meaningful access to health care and navigating the health care system," she said, stating that two-thirds of Caribbean-born residents speak a foreign language: Dominican Republic and Cuba (Spanish), and Haiti and Martinique (French/Creole).
