Health outcomes in a foreign land

According to Dr. Bernard Kwabi-Addo and in his book, 'Health Outcomes in a Foreign Land – A Role for Epigenomic and Environmental Interactions (Springer 2017)', there has been a high incidence and mortality rates for cardiovascular diseases, diabetes, chronic liver disease, kidney disease and cancer among the African diaspora in Western European and North American countries.

The picture is different when compared to Africans on the African continent or Europeans and Americans in their respective host countries. In 'Health Outcomes in a Foreign Land', Dr. Kwabi-Addo uses multiple lenses to analyze the complex causes of health disparities among Africans (or other minorities) in the diaspora.

The book discusses the biological (genetic and epigenetic) factors and non-biological (environmental and social) factors in its effort at explaining the health disparities. TheAfricanDream.net talked with the book's author to learn more about it.

Dr. Kwabi-Addo, himself an immigrant originally from Ghana says "the process of migration from one’s native country to a different country affects every aspect of the lives of Africans, especially their health with the over-riding theme of disparity and disadvantage."

The environment and communities in which people are born and live, grow, work and age affect their health outcomes. The Doctor further explains that "these circumstances are further shaped by the distribution of wealth, power, and resources at the global, national, and local levels, which can themselves be influenced by government policies."

Research has shown that the African diaspora is disproportionately affected by premature births or low birth weight infants and such early life course is directly linked to future health outcomes. Thus, the 9 months gestation period, and what the growing fetus gets exposed to such as insufficient nutrition, pollutions, drugs, infections, and hormones have important implications for the health of the individual.

"In this new book...", Dr. Kwabi-Addo says, "I try to throw more light on the existing evidence of multi-generational consequences of adverse health for the African diaspora that directly ties in with low socioeconomic status, racial segregation, discrimination, incarceration rates, fatherlessness, unemployment, and other negativities that come to play."

Behavioral and lifestyle choices such as poor diet, lack of physical activity, tobacco and alcohol consumption obviously also take an adverse tole on one's health.

However, some of these choices are themselves influenced by the heavy marketing of unhealthy foods and lack of fresh fruits and vegetables in low-income neighborhoods as well as the heavy marketing of alcohol and cigarettes especially targeting the youth. These are a commonplace feature in low-income neighborhoods as detailed in the book.

Individuals of the African diaspora with limited education or low socio-economic status and racial minorities are disproportionately affected by low health literacy. This creates a lack of the ability to obtain, process and to understand basic health information and services needed to make appropriate health decisions.

"On the other hand, educational investment in formal schooling and graduate degree, as well as on-the-job training, has positive health outcomes. Biological factors such as mutations (genetic variations) are linked to cardiovascular diseases, hypertension, kidney disease and cancer disparities including a host of other health conditions. The culture of the African may also influence their health, thus diet, use of alternative medicines and spirituality can impact health outcomes." -- Dr. Kwabi-Addo.

African-born immigrants are amongst the fastest growing migrant groups in the USA; mostly from West Africa (Nigeria and Ghana) and Eastern Africa (Ethiopia and Kenya). More than half of the African immigrants arrived recently. Thus there has been limited research on African immigrant health, a reason for which they tend to be categorized as African-American or Black in health statistics.

As a result, the need to advance the research in this underrepresented population and avoid lumping African immigrants with other groups under the broad category as “African” is dire if we are to identify diseases that disproportionately affect this population including HIV/AIDs, strokes, and liver cancer. Dr. Kwabi-Addo gives an instance: "many African immigrants have limited knowledge about cancer or preventative measures such as screening and this is in part compounded by barriers and challenges including lack of insurance and access to primary care physicians."

"We face a mammoth challenge in health disparities with no simple solutions. Reduction of health disparities must be approached from different angles, many of which I have outlined in my book as part of efforts to improve healthcare knowledge, access to preventative measures and navigating the healthcare system as an African living in the Diaspora" Dr. Kwabi-Addo tells TheAfricanDream.net

Bernard Kwabi-Addo, Ph.D., is an associate professor of Biochemistry and Molecular Biology and the Principal Investigator of the Prostate Cancer Research Laboratory at Howard University in Washington, D.C., in the United States. He is also an adjunct associate professor of Oncology at Johns Hopkins Medical School in Baltimore, Maryland. This 324-page book, which is his second, is published by Springer International Publishing and available online at www.springer.com/us/book/9783319558646.'Cancer Causes and Controversies: Understanding Risk Reduction and Prevention' is his first publication jointly authored with Tia Laura Lindstrom.