Making culture visible: an examination of birthplace and health status.

Culture shapes beliefs about health and illness. It provides the context by which an individual evaluates his or her symptoms to decide whether he or she is healthy or ill. We have largely ignored the impact of culture on the health status of U.S.- and foreign-born Black women. We have operationalized the term Black or African American in a way that obscures cultural differences among women of African descent living in the United States. While we know that people of African descent living in the United States are composed of many different ethnic backgrounds (e.g., persons from the Caribbean and African countries), we have not systematically examined these differences using national data. In this study I examine the relationship between culture and health status using the U.S. Department of Health and Human Services 1991 National Health Interview Survey (NHIS). Significant differences were found between U.S.- and foreign-born Black women. Foreign-born Black women reported more favorable health status than U.S.-born Black women. Measures of socioeconomic status and social support accounted for many differences between the two groups. These findings suggest that culture may play a role in the evaluation of health status. Therefore, U.S.- and foreign-born Black women appear to use different criteria when assessing their health status.