NEW YORK, CMC – A prominent Haitian physician here 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 US-born blacks,” Dr. Carla Boutin-Foster, an Associate Professor of Medicine and Associate Professor of 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 US,” 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.
Dr. 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 obese increases with greater years in the US, starting at four years.
In New York City, Dr. Boutin-Foster said immigrants from Jamaica and Barbados have highest Body Mass Index (BMI), a number calculated from a person’s weight and height.
Researchers say BMI is a “fairly reliable indicator” of body fatness for most people. It is used as a screening tool to identify possible weight problems for adults.
However, researchers warn that BMI is not a diagnostic tool. For example, a person may have a high BMI; but, to determine if excess weight is a health risk, a healthcare provider would need to perform further assessments, researchers say.
These assessments might include skin-fold thickness measurements, evaluations of diet, physical activity, family history, and other appropriate health screenings.
Dr. 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 was four times higher than the US, ages 50-79.
She also said high rates of prostate cancer have also been found in Jamaican men.
Dr. Boutin-Foster said prevalence of mental illness among Caribbean immigrants may vary with reason for migration, stating that seeking political refuge, exposure to violence and natural disasters may lead to Post Traumatic Stress Disorder (PTSD).
The physician said depression “may present with greater physical symptoms and less presentation as mood changes.”
She has therefore called for programmes to help Caribbean immigrants not only to obtain insurance but to use it in “meaningful ways.”
Dr. 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 mammography.
In addition to knowledge, urged that communities have “practical tools” for making healthy behaviors.
“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).
Dr. Janice Emanuel-Bunn, the Guyanese-born President of APC Community Services, a non-profit community organization, said the conference, which attracted leading medical and health providers in the Caribbean community, achieved its goals in addressing health disparities in the Caribbean and other minority communities, regarding auto-immune diseases and sleep disorder, and identifying strategies to reducing the disparities.
She also said the summit also educated health care providers about the cultural competency in health care delivery and motivated health care professionals to “shift the paradigm from sickness care to wellness care and engaged Caribbean patients in prevention.”
“In the wrap-up session, I challenged attendees to do be active in the political process, to foster changes in health policies, to advocate for our communities, to educate residents, to provide opportunities for social and economic development, to form a Caribbean Health Disparities Taskforce, and to be engaged consistently,” Dr. Emanuel-Bunn, who is also a professor at the University of Phoenix’s School of Advanced Studies Doctoral Program in Arizona, told the Caribbean Media Corporation (CMC).
