Health Impact of Racial Discrimination in African Immigrants: An Integrative Review

Background and Purpose: Racial discrimination is considered a social determinant of health. Discrimination toward immigrants including African immigrants has steadily increased in the United States. Racial discrimination may put African immigrants at increased risk for negative mental and physical health consequences. The purpose of this review is to evaluate the available evidence on African immigrants exposed to racial discrimination.

Methods: This integrative review appraised published studies (2012-2023) addressing mental and physical health outcomes of African immigrants. Articles were identified using structured search terms in several databases (APA PsycINFO, CINAHL, PubMed, Web of Science). Methodological quality was assessed using the Johns Hopkins Nursing Evidence-Based Practice model. Findings are reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: Sixteen studies met inclusion criteria. Study designs included cross-sectional (n= 14) and qualitative (n= 2). The most common measure to assess racial discrimination was the Everyday Discrimination Scale. Existing literature indicates that racial discrimination has significant negative effects on health outcomes. A majority of the studies (14/16, 87.5%) identified mental health (depression, anxiety, and posttraumatic stress) and substance use (cannabis and alcohol) as negative health outcomes. The physical health outcomes were less consistently reported (2/16, 12.5%) and included increased risk of cardiovascular disease and overall poor physical functioning.

Conclusions and Implications: Racial discrimination was associated with both mental and physical health consequences in African immigrants. To date, the majority of the literature has focused on mental health. Less is known about the effects of racial discrimination on physical health outcomes in African immigrants. Given that racial discrimination is on the rise for African immigrants and research is limited in this immigrant population, more work is needed to elucidate the relationship of racial discrimination and physical health outcomes. Further, elucidating potential mechanisms for any observed relationships will be critical for targeting interventions to address health disparities.