Understanding physical function in older African immigrants: the roles of acculturation and racial discrimination

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Abstract Physical function is an important public health concern in older African immigrants because poor physical function leads to worse health outcomes, affects quality of life and is costly to the health system. Physical function difficulties are prevalent in older adults; 33-40% of community dwelling older adults report at least one difficulty. African immigrants are one of the fastest growing immigrant groups and nearly 20% of them are older than 55 years. To prevent future disability and improve quality of life for this population, there is a need to understand the experience of physical function difficulty in older African immigrants. Acculturation and racial discrimination are associated with poorer physical function in other racial/ethnic immigrant groups and native born Blacks. Older African immigrants experience acculturation and high rates of racial discrimination; however, it is not known if these affect physical function in African immigrants. Guided by Berry’s acculturation theory and the Disablement process model, the purpose of the proposed study is to understand older African immigrants’ experiences of living with physical function difficulties; in particular the roles of acculturation and racial discrimination. A mixed methods design will be used to get an in-depth understanding of these concepts and relationships in this population. Older African immigrants (≥55years) will be recruited through community based organizations that serve African immigrants in the Baltimore- Washington Metropolitan area. We will utilize the 20 item Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF20) to assess participants’ difficulties in performing daily tasks such as bending, carrying groceries and bathing. Use of the PROMIS PF20 measure in this population will enable us to compare participants’ physical function results to the general population, since scores using this scale are normed the general population. The specific aims of this study are 1) Examine the relationship between acculturation and physical function difficulties in older African immigrants. 2) Determine the relationship between racial discrimination and physical function difficulties in older African immigrants. 3) Describe the physical function of older African immigrants and explore whether acculturation and racial discrimination affect physical function difficulties. This study aligns with the National Institute on Aging’s objective to understand the differences and health inequities experienced by older minority populations. Findings from this study can contribute to the development of culturally tailored interventions to decrease physical function difficulties in older African immigrants, towards the goal of decreasing inequities in the burden of physical function difficulties in foreign born Blacks.