Variations in health and health behaviors by nativity among pregnant black women in Philadelphia

Objectives. We compared health behaviors and health outcomes among USborn, African-born, and Caribbean-born pregnant Black women and examined whether sociodemographic and psychosocial characteristics explained differences among these population subgroups. Methods. We analyzed data from a prospective cohort study conducted in Philadelphia, Pennsylvania, with a series of nested logistic regression models predicting tobacco, alcohol, and marijuana use and measures of physical and mental health. Results. Foreign-born Black women were significantly less likely to engage in substance use and had better self-rated physical and mental health than did native-born Black women. These findings were largely unchanged by adjustment for sociodemographic and psychosocial characteristics. The foreign-born advantage varied by place of birth: It was somewhat stronger for African-born women than for Caribbean-born women. Conclusions. Further studies are needed to gain a better understanding of the role of immigrant selectivity and other characteristics that contribute to more favorable health behaviors and health outcomes among foreign-born Blacks than among native-born Blacks in the United States.