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African-born immigrants make up one of the fastest-growing group of immigrants in the United States; however, they are largely invisible in the literature on immigrant health. Very little is known about the effect of acculturation on their health perceptions and behaviors and the subsequent effects on their health outcomes. We review the literature on the effects of acculturation on health perceptions, health behavior, and health outcomes among African immigrants in the United States. Using PubMed, PsycINFO databases, and sociological abstracts, we examined studies that explored the influence of acculturation, specifically proxy measures of acculturation on African immigrant health in the United States. Following our inclusion criteria, 29 articles were retained in the review. The majority of the studies were quantitative and conducted among Somali immigrants. Our findings indicate that duration of residency in the United States and English language proficiency were the most frequently used proxy measures for acculturation when studying the health perceptions, health behaviors, and health outcomes of African immigrants. We conclude by highlighting the need to move beyond proxy measures for acculturation to explore other protective and contextual factors such as culture and religion and their influence on the health of African immigrants in the United States.
Keywords: African, Acculturation, Immigrants, Culture, Health
INTRODUCTION
Acculturation, a process that occurs "when groups of different cultural backgrounds and their individual members engage each other," is said to influence health out-comes and patterns of health care service utilization among certain groups of immigrants in the United States (i.e., Asian-Americans, Hispanic immigrants) (Berry, 2008; Estrada, Trevino, and Ray, 1990; Gordon-Larsen et al., 2003; Lara et al., 2005; Lee, Sobal, and Frongillo Jr., 2000; Salant and Lauderdale, 2003). African-born immigrants who are largely invisible in the vast literature on immigrant health in the United States (US), have doubled in size from 881,300 in 2000 to 1.6 million in 2010 (Ndukwe, Williams, and Sheppard, 2013), yet it is not well understood whether acculturation has an effect on their health perceptions, health outcomes, or patterns of health care utilization. Evidence suggests that being born in another country versus being born in the US influences one's use of health care services and health outcomes (Mullins et al., 2010; Wafula and Snipes, 2013). African immigrants are usually lumped into...