Banner by Alisa Zhang

Stewing Over The (Un)Healthy Immigrant Effect

By Daara Akinpelu

Having been hundreds of miles from home for months, I remember the first bite of rice and Nigerian stew I had during my first school break as a new college student last year.

Pure bliss.

And oil.

But mostly bliss. After all, it was technically healthier food.

Now in what world is more oil better for your health? Fair question. In a survey of young adult offspring of African immigrants regarding healthy eating and activity, many agreed that although West African recipes often used way too much oil, they were much healthier than typical American cuisine. This is because, despite the high-fat content, native foods use large amounts of fresh vegetables and meats and little to no processed substances. As a result, cultural experiences have led many first- and second-generation immigrants to view the American diet as much unhealthier compared to African cuisine, as the former has more processed products, saturated fats, and sugars.

The United States is home to a flavorful mix of the dishes, customs, and beliefs of many other countries, and their influences are only growing larger and more diverse. A study estimates that 82% of the population increase between 2005 and 2050 will be because of immigrants and their descendants, with African immigrants contributing around 50 million to this increase and further diversifying the Great American Melting Pot.

But unfortunately, something not so tasty is cooking up here and has been for the past couple of decades: The “Healthy Immigrant Effect.” This is ‌the premise that the more time spent away from the country of origin in another host country, the worse the health of the individual will be. Could this be due to the disappearance of a more nutrient-rich diet upon arrival in the new country?

Given the African diet, this hypothesis seems plausible. Some say that “West Africans have some of the healthiest diets in the world.” The food pyramid is built on fruits, such as plantains, guava, mangoes, and melon; tubers such as cassava, yams, and yuca; nuts and seeds such as cashews, coconuts, peanuts, and groundnuts; herbs and spices such as annatto, bay leaf, cinnamon, cilantro, cloves, ginger, and nutmeg; and a large variety of fresh seafood, poultry, eggs, and meat. 

Africans incorporate many of these “superfoods,” distinctly nutrient-dense produce and proteins, into their daily meals and snacks, and often couple them with dark, leafy greens in several dishes (such as my mom’s most-craved efo riro or egusi stew). Cleveland Clinic’s Registered Dietitian Beth Czerwony notes that “superfoods,” such as collard greens, kale, mustard greens, spinach, and ginger are sources of sustenance that offer more health benefits than what is on a nutrition facts label. Thus, appropriately, Africans, who uniquely feature these natural ingredients (and many more) in almost all of their major dishes, have reason to scorn the contrasting American cuisine as distasteful and unhealthy.

But the much-criticized American diet is actually growing in popularity among African countries and worldwide. Studies are showing that due to the effects of globalization, in much of the world, eating habits are declining in quality. In an interview with Dr. James Boafo of Kwame Nkrumah University of Science and Technology, Ghana, the lecturer emphasized that there is a great increase in fast food consumption in the Gold Coast country. Other Western African countries have seen this increase as well.

Therefore, better nutritional intake, one of the proposed causes of the Healthy Immigrant Effect, is actually dissipating, as health conditions associated with consuming large amounts of processed foods are emerging with earlier onsets for African immigrants, taking a toll on their physical well-being before they even leave their homeland. 

Chronic diseases involving blood glucose and heart health, if present before their arrival to the U.S., are exasperated; and if absent, are quickly manifesting in their already deteriorated health. Considering the lack of cultural competency by healthcare staff and the influence of religious/cultural beliefs on how African immigrants live in the States, the immigrant is not reaping the total benefits of the American health system.

In public health expert Dr. Omenka’s scoping review on understanding the healthcare experiences and needs of African immigrants in the United States, a recurring theme was established: cultural influences (traditional beliefs, spirituality, stigma, language barriers, etc.) and the failures of the U.S. health system (cultural incompetence, high costs, biased/hostile providers) result in the breakdown of the patient-physician relationships that enable holistic, effective, and efficient medical treatments.

For instance, some Africans believe that taking medicine is an act of distrust in their religion and the healing power of a divine entity. Even if they were open to medication and other treatment, they cannot put their faith in the physician, as some healthcare providers are not welcoming of their dialect or are confused about their diet due to a lack of knowledge of African foods. Rightfully so, many fear being falsely perceived as carrying disease simply because they showed up to a clinic visit in traditional dress. 

For so long, data concerning these issues have remained largely undiscussed and unquantified. There is a lack of concrete research findings concerning many aspects of African-immigrant health, as this demographic is commonly considered under the broad category of “black individuals,” especially in health care. 

Yet recent information still shows the Great American Melting Pot is bubbling over, staining the health of immigrant populations before they even become key ingredients in the mix. 

And that is far less tasty than my mom’s Nigerian stew.

(Special thanks to Dr. Abimbola Fapohunda and Librarian Helena Von Ville for their time, expertise, and academic input on this article)