Abstract Body: Background: While it is known that adverse social determinants of health (SDOH) disproportionately affect Black persons in the United States (US), it is increasingly recognized that this group is heterogeneous. Nevertheless, there is limited research characterizing differences in SDOH across distinct Black heritage groups, specifically, those that report African American, African, and Afro Caribbean heritage. Greater understanding of these differences is critical for the development of effective interventions to address adverse SDOH.
Objective: To characterize differences in SDOH across three Black ethnic groups using screening data from two community-based trials.
Methods: The GoFresh Trials are two randomized controlled trials investigating the effects of the Dietary Approaches to Stop Hypertension (DASH) eating pattern on blood pressure after 12 weeks in adults with and without treated hypertension living in Boston. SDOH characteristics in GoFresh were assessed in the following categories: demographics characteristics (including car and home ownership, income, educational levels), social needs (via the AHC Health-Related Social Needs Scale), perceived stress levels (via the PSS-4 instrument), and discrimination (via the Krieger Discrimination Scale). We used age- and sex- adjusted models to compare SDOH across the three ethnic heritage groups.
Results: Of 1,600 screened participants; 72% were female. The mean age (±SD) was 45 years (±16). Persons identifying as African American were 4.65 times more likely to report discrimination at school and 0.2 times less likely to face discrimination when receiving services compared to Africans. Africans were 0.39 (0.18, 0.78) and 0.57(0.35, 0.95) less likely to have a PCP compared to African Americans and Afro Caribbeans respectively. There were no differences in food security and income levels among the three groups.
Conclusion: Persons identifying as African American are more likely to report experiences of discrimination at schools compared to African and Caribbean persons. Discrimination affects the different Black ethnic heritage groups to varying degrees. These differences in SDOH highlight the importance of awareness of these differences as they have implications to provision of care.