An Observational Study of Sub-Saharan African Immigrants in California

Little is known about the health needs and status of Sub-Saharan African (SSA) immigrants in the U.S. To address this, the California Health Interview Survey (CHIS) began collecting disaggregated Black data in 2021 to better understand the health profiles of SSA immigrants. This cross-sectional study utilizes the 2021-2022 CHIS two-year public use dataset for adults aged 18 and over to examine the demographics, economic well-being, health status, healthcare access, health insurance access, health behaviors, and other social determinants of health of SSA immigrants in California. Descriptive analyses were used to summarize the demographic and health characteristics of SSA immigrants. We found a balanced gender distribution showing females slightly outnumbering males, with most identifying as heterosexual and residing in urban areas. SSA immigrants are generally well-educated, with 57% holding college degrees, and 66% employed full-time. However, 16% live below the poverty line, and 16% experience food insecurity, surpassing national averages. Health status indicates 16% report fair to poor health, with prevalent chronic conditions like asthma and diabetes. Despite 96% having health insurance, 18% delay necessary healthcare. Social determinants highlight high adverse childhood experiences and systemic discrimination, though resilience is evident through positive childhood experiences. These findings highlight the need for targeted interventions to address the unique challenges faced by SSA immigrants, enhancing their access to resources and support systems to improve overall health and well-being.