Prevalence of functional limitations among foreign and US-born Black older adults: 2010–2016 National Health Interview Surveys

Objective: To determine whether the prevalence of functional limitations in United States (US) born differs from that of foreign-born Black older adults. Design: We performed a cross-sectional analysis of data from 14,438 US-born and 1583 foreign-born Black older adults (≥50 years) in the 2010–2016 National Health Interview Surveys (NHIS). Functional limitations were defined by upper and lower extremity limitations, and global functional limitations. Generalized linear modeling using a Poisson distribution and logarithmic link function was used to compare the predicted probabilities of functional limitations in both groups. Results: The mean age (SE) of US-born Blacks was 63.56 (0.12) years and foreign-born Blacks was 62.06 (0.32). The majority (92%) of foreign-born Blacks had resided in the US for ≥10 years. US-born older adults were more likely to have upper (46% vs. 29%, p <.001) and lower (61% vs. 40%, p <.001) extremity limitations than foreign-born Blacks. The prevalence of lower extremity limitations was 22% less in foreign-born Blacks compared to US-born Blacks after adjusting for sociodemographic and health profiles (Prevalence Ratio [PR]: 0.78, 95% CI:0.73–0.84). The adjusted prevalence of upper extremity limitations in foreign-born Blacks was 27% (PR: 0.73, 95% CI: [0.68–0.79]), compared to US-born Black older adults. And that of global functional limitations was 22% less (PR: 0.78, 95% CI [0.73–0.83]) in foreign-born compared to US-born Blacks. Conclusion: Compared to their US-born counterparts, foreign-born Black older adults had a markedly lower prevalence of upper and lower extremity functional limitations. Future comparative studies should examine reasons for this apparent health advantage among foreign-born adults to inform social and medical interventions to prevent functional decline in Black older adults in the US.