Greater Hypertension Risk among Foreign-born Adults: Examining the Roles of Language, Nativity, and Neighborhood Deprivation in an Ethnoracially Diverse U.S. Sample.

Disparities in hypertension prevalence and management persist, particularly among ethnoracial individuals in the US. Yet, the extent to which nativity, acculturation, and neighborhood deprivation contribute to these disparities remains inadequately understood. Existing research yields mixed findings on how these factors intersect to influence hypertension risk. This study investigates disparities in hypertension risk by examining the influence of nativity, language, and neighborhood deprivation on blood pressure levels in a diverse clinical sample of US- and foreign-born patients from multiple countries of origin. Data were derived from a South Florida Nurse-Led Community Health Center (NLCHC). The sample consisted of 520 adults who received care between 2014 and 2018. The majority of participants were female (68.30%), born outside of the US (66.15%), and nearly half reported English as the primary language spoken at home (46.54%). A large proportion of the sample identified as ethnoracial, with approximately 42.1% having identified as Black and nearly 40% identifying as Hispanic (37.9%). Descriptive and regression analyses were used to achieve the study objectives. Increased age and body mass index (BMI) predicted elevated diastolic and systolic blood pressure (DBP and SBP; p < .001). Foreign-born individuals and those who spoke English and Creole as their primary language had higher SBP and DBP than their US-born and Spanish-speaking counterparts (p < .01). Neighborhood deprivation did not predict BP. Our findings support the need to explore heterogeneity in HTN risk among immigrant subgroups, challenging the immigrant health paradox and informing culturally tailored community-level interventions.