Shondelle M. Wilson-Frederick, Ph.D.; Juanita J. Chinn, Ph.D.; 

Lacreisha N. Ejike-King, Ph.D., M.S. and Rashida R. Dorsey, Ph.D., M.P.H.

Background

Non-Hispanic Black females (hereafter referred to as Black 

females) in the United States experience vastly different 

morbidity and mortality profiles relative to other racial and ethnic 

U.S. populations [1]. Indeed, Black females experience the 

highest rates of hypertension and obesity compared to other racial

or sex groups [2]. However, analyses often do not examine the 

impact of nativity on these observed health outcomes. To better 

understand the underlying factors that contribute to the disparate 

health outcomes in Black females in the United States, it is 

important to examine both U.S. born and foreign-born Black 

females.

Blacks in the United States are a diverse population that includes 

Caribbean, African, South and Central American immigrants as 

well as U.S.-born Blacks [3]. However analyses typically report 

on measures of health and well-being among Blacks without 

examining nativity or length of time in the United States. 

We present estimates using data from the National Health 

Interview Survey (NHIS 2002-2012) conducted by the Centers for 

Disease Control and Prevention (CDC), National Center for 

Health Statistics (NCHS) [4]. Data were collected prior to the 

establishment of the Health Insurance Marketplace and the 

expansion of Medicaid eligibility under the Affordable Care Act. 

Our analysis only includes adult Black females (ages 18 to 64 

years) who lived in the United States and self-identified as nonHispanic Black. We examine demographic and health 

characteristics among 23,210 non-elderly Black females by 

nativity and length of time in the United States: U.S.-born (91 

percent), foreign-born with less than 10 years in the United States 

(3 percent) and foreign-born with 10 years or more in the United 

States (6 percent). U.S.-born includes anyone who was born in 

one of the 50 United States, the District of Columbia, or U.S. 

territories. The foreign-born population includes anyone who was 

not born in the United States or a U.S. territory.

Keywords

disaggregated data, health disparities, Black race group, immigrant health, women’s health, social 

determinants of health

Highlights

Among Black females, 80% of U.S. 

born, 78% of foreign-born who 

lived in the United States for 10 

years or more, and 63% of foreignborn who lived in the United States 

for less than 10 years had health 

insurance coverage.

Nearly two out of five foreign-born

females who lived in the United 

States for less than 10 years had a 

usual place for preventive care.

Across all categories of nativity and 

years in the United States, a 

majority of Black females had never 

smoked.

Foreign-born Black females who

lived in the United States for 10 

years or more (33%) had the lowest 

percentage of obesity.

Forty percent of U.S.-born Black 

females (highest among three 

groups of Black females) had been 

diagnosed with hypertension.

Data from the CDC/NCHS NHIS 2002-

2012 based on household interviews 

of a sample of 23,210 civilian noninstitutionalized Black females (ages 

18 to 64 years).
What is the age composition of Black females (ages 18 to 64 years) in the United 

States?

Figure 1. Age composition of adult Black females, by nativity and years in the United States (NHIS 2002-

2012)

NOTE: Analysis only includes Black females who self-identified as non-Hispanic Black. Data are based on 

household interviews of a sample of the civilian non-institutionalized population. The average age of U.S.-born Black 

adult females was 39 years. The average age of foreign-born Black females who lived in the United States for less 

than 10 years was 33 years. The average age of foreign-born Black females who lived in the United States for 10 

years or more was 42 years. Due to rounding, sum of bars for each category of nativity and years in the United 

States may not equal 100 percent. 

Chi-square test was used to test for statistically significant difference in age composition across categories of nativity 

and years in the United States, p<0.001

18 to 24 years:

Twenty-seven percent of foreign-born Black females who lived in the United States for less than 10 years 

were between the ages of 18 to 24 years. Eighteen percent of U.S.-born Black females were between the 

ages of 18 to 24 years. Eight percent of foreign-born Black females who lived in the United States for 10 

years or more were between the ages of 18 to 24 years.

17

23

45

15

18

23

44

15

27

35 34

4

8

19

61

13

0

10

20

30

40

50

60

70

18 to 24 years 25 to 34 years 35 to 54 years 55 to 64 years

Percent

Age categories

Total

U.S.-born

Foreign-born, less than 10 years in the United States

Foreign-born, 10 years or more in the United States

Page 2
25 to 34 years:

Thirty-five percent of foreign-born Black females who lived in the United States for less than 10 years 

were between the ages of 25 to 34 years. Twenty-three percent of U.S.-born Black females were between 

the ages of 25 to 34 years. Nineteen percent of foreign-born Black females who lived in the United States 

for 10 years or more were between the ages of 25 to 34 years. 

35 to 54 years:

The majority (61 percent) of foreign-born Black females who lived in the United States for 10 years or 

more were between the ages of 35 to 54 years. Forty-four percent of U.S.-born Black females were

between the ages of 35 to 54 years. Thirty-four percent of foreign-born Black females who lived in the 

United States for less than 10 years were between the ages of 35 to 54 years. 

55 to 64 years:

Fifteen percent of U.S.-born Black females were between the ages of 55 to 64 years. Thirteen percent of 

foreign-born Black females who lived in the United States for 10 years or more were between the ages of 

55 to 64 years. Only 4 percent of foreign-born Black females who lived in the United States for less than 

10 years were between the ages of 55 to 64 years. 

Page 3
What percentage of Black females (ages 18 to 64 years) in the United States are 

married?

Figure 2. Age-adjusted percentage of adult Black females who are married, by nativity and years in the 

United States (NHIS 2002-2012)

NOTE: Analysis only includes Black females who self-identified as non-Hispanic Black. Data are based on 

household interviews of a sample of the civilian non-institutionalized population. All prevalence estimates were ageadjusted to the 2000 U.S. population standard. The non-married category (not shown) includes adult Black females 

who were never married, separated, widowed, and divorced.

Chi-square test was used to test for statistically significant difference in marriage across categories of nativity and

years in the United States, p<0.001

Overall, less than half of non-elderly Black females were married. Forty-seven percent of foreign-born 

Black females who lived in the United States for 10 years or more were married. Similarly, 45 percent of 

the foreign-born Black females who lived in the United States for less than 10 years were married. U.S.-

born Black females (36 percent) represented the lowest percentage of Black females who were married. 

37

36

45

47

0

5

10

15

20

25

30

35

40

45

50

Married

Percent

Married

Total

U.S.-born

Foreign-born, less than 10 years in the United States

Foreign-born, 10 years or more in the United States

Page 4
What is the educational attainment among Black females (ages 18 to 64 years) in 

the United States?

Figure 3. Age-adjusted educational attainment among adult Black females, by nativity and years in the 

United States (NHIS 2002-2012)

NOTE: Analysis only includes Black females who self-identified as non-Hispanic Black. Data are based on 

household interviews of a sample of the civilian non-institutionalized population. GED is a certificate of general 

education development. Due to rounding, sum of bars for each category of nativity and years in the United States 

may not equal 100 percent. All prevalence estimates were age-adjusted to the 2000 U.S. population standard. 

Chi-square test was used to test for statistically significant difference in educational attainment across categories of 

nativity and years in the United States, p=0.001

Less than high school:

Foreign-born Black females who lived in the United States for less than 10 years (27 percent) represented

the highest percentage of Black females with less than a high school level of education. Seventeen 

percent of U.S.-born Black females and only 13 percent of foreign-born Black females who lived in the 

United States for 10 years or more had less than a high school level of education. 

High school/ GED:

Thirty percent of U.S.-born Black females reported high school/GED as their highest level of educational 

attainment. Twenty-seven percent of foreign-born Black females who lived in the United States for 10 

years or more and 23 percent of foreign-born Black females who lived in the United States for less than 

10 years reported high school/GED completion as their highest level of educational attainment.

17

30

53

17

30

53

27

23

50

13

27

60

0

10

20

30

40

50

60

70

Less than high school High school/GED Some college or greater

Percent

Educational attainment

Total

U.S.-born

Foreign-born, less than 10 years in the United States

Foreign-born, 10 years or more in the United States

Page 5
Some college or greater:

Sixty percent of foreign-born Black females who lived in the United States for 10 years or more 

completed some college or greater. Fifty-three percent of non-elderly U.S.-born Black females and 50 

percent of foreign-born Black females who lived in the United States for less than 10 years completed 

some college or greater.

Page 6
What is the distribution of income to poverty ratios among Black females (ages 

18 to 64 years) in the United States?

Figure 4. Age-adjusted ratio of income to poverty among adult Black females, by nativity and years in the 

United States (NHIS 2002-2012)

NOTE: Analysis only includes Black females who self-identified as non-Hispanic Black. Data are based on 

household interviews of a sample of the civilian non-institutionalized population. Due to rounding, sum of bars for 

each category of nativity and years in the United States may not equal 100 percent. An income to poverty ratio 

represents a detailed indicator of poverty status. The ratio was created by the NCHS utilizing published information 

from the U.S. Census Bureau regarding poverty thresholds [5]. A ratio of the previous calendar year’s income value 

reported by respondents to the poverty threshold for the same year was constructed, based on the family’s overall 

size as well as the number of children (aged 17 and under) present in the family. All prevalence estimates were ageadjusted to the 2000 U.S. population standard. “Ratios below 1.00 indicate that the income for the respective 

family or unrelated individual is below the official definition of poverty, while a ratio of 1.00 or greater 

indicates income above the poverty level. A ratio of 1.25, for example, indicates that income was 125 

percent above the appropriate poverty threshold” [6].

Chi-square test was used to test for statistically significant difference in ratio of income to poverty across categories 

of nativity and years in the United States, p<0.001

26

52

22

27

52

21

27

56

17 16

54

29

0

10

20

30

40

50

60

Less than 1.00 1.00 to 3.99 4.00 or greater

Percent

Ratio of income to poverty 

Total

U.S.-born

Foreign-born, less than 10 years in the United States

Foreign-born, 10 years or more in the United States

Page 7
Income to poverty ratio of less than 1.00:

Twenty-seven percent of both U.S.-born Black females and foreign-born Black females who lived in the 

United States for less than 10 years had an income to poverty ratio of less than 1.00. Sixteen percent of 

foreign-born Black females who lived in the United States 10 years or more had an income to poverty 

ratio of less than 1.00.

Income to poverty ratio of 1.00 to 3.99:

Fifty-six percent of foreign-born Black females who lived in the United States for less than 10 years, 54

percent of foreign-born Black females who lived in the United States for 10 years or more, and 52 percent 

of U.S.-born Black females had an income to poverty ratio of 1.00 to 3.99.

Income to poverty ratio of 4.00 or greater:

Twenty-nine percent of foreign-born Black females who lived in the United States for 10 years or more

had the highest percentage of Black females with an income to poverty ratio of 4.00 or greater. Twentyone percent of U.S.-born Black females and 17 percent of foreign-born Black females who lived in the 

United States for less than 10 years had an income to poverty ratio of 4.00 or greater.

Page 7

Page 8
What percentage of Black females (ages 18 to 64 years) in the United States have 

health insurance coverage?

Figure 5. Age-adjusted health insurance coverage among adult Black females, by nativity and years in 

the United States (NHIS 2002-2012)

NOTE: Analysis only includes Black females who self-identified as non-Hispanic Black. Data are based on 

household interviews of a sample of the civilian non-institutionalized population. Black females were considered

insured if they had any private health insurance, government- or state-sponsored health insurance plans. All 

prevalence estimates were age-adjusted to the 2000 U.S. population standard.

Chi-square test was used to test for statistically significant difference in health insurance coverage status across 

categories of nativity and years in the United States, p<0.001

Nearly 4 out of 5 non-elderly Black females had health insurance coverage (79 percent). Eighty percent 

of U.S.-born Black females and 78 percent foreign-born Black females who lived in the United States for 

10 years or more had health insurance coverage. Sixty-three percent of foreign-born Black females who 

lived in the United States for less than 10 years had health insurance coverage.

79 80

63

78

0

10

20

30

40

50

60

70

80

90

Insured

Percent

Health insurance coverage

Total

U.S.-born

Foreign-born, less than 10 years in the United States

Foreign-born, 10 years or more in the United States

Page 9
What percentage of Black females (ages 18 to 64 years) in the United States 

report having a usual place for preventive care?

Figure 6. Age-adjusted percentage of adult Black females who have a usual place for preventive care, by 

nativity and years in the United States (NHIS 2002-2012)

NOTE: Analysis only includes Black females who self-identified as non-Hispanic Black. Data are based on 

household interviews of a sample of the civilian non-institutionalized population. All prevalence estimates were ageadjusted to the 2000 U.S. population standard. Non-elderly Black females were classified as having a usual place for 

preventive care if they reported going to a: 1) clinic or health center; 2) doctor’s office or HMO; 3) hospital outpatient 

department; 4) some other place; or 5) doesn’t go to one place most often. Individuals who reported not obtaining 

preventive care anywhere or going to the emergency room for preventive care were classified as not having a usual 

place for preventive care.

Chi-square test was used to test for statistically significant difference in having a usual place for preventive care

across categories of nativity and years in the United States, p=0.010

Fifty-nine percent of foreign-born Black females who lived in the United States for 10 years or more and 

55 percent of U.S.-born Black females had a usual place for preventive care. However, 36 percent of 

foreign-born Black females who lived in the United States for less than 10 years had a usual place for 

preventive care.

55 55

36

59

0

10

20

30

40

50

60

70

Had a usual place for preventive care

Percent

Usual place for preventive care

Total

U.S.-born

Foreign-born, less than 10 years in the United States

Foreign-born, 10 years or more in the United States

Page 10
When do Black females (ages 18 to 64 years) in the United States report last 

seeing a dentist?

Figure 7. Age-adjusted last dental visit among adult Black females, by nativity and years in the United 

States (NHIS 2002-2012)

NOTE: Analysis only includes Black females who self-identified as non-Hispanic Black. Data are based on 

household interviews of a sample of the civilian non-institutionalized population. Due to rounding, sum of bars for 

each category of nativity and years in the United States may not equal 100 percent. All prevalence estimates were 

age-adjusted to the 2000 U.S. population standard. 

Chi-square test was used to test for statistically significant difference in last dental visit across categories of nativity 

and years in the United States, p<0.001

Never:

A very low percentage of Black females reported never visiting a dentist. Six percent of foreign-born 

Black females who lived in the United States for less than 10 years, 2 percent of foreign-born Black 

females who lived in the United States for 10 years or more, and 1 percent of the U.S.-born Black females 

reported they had never visited a dentist.

More than 1 year ago: 

Forty-two percent of U.S.-born Black females, 41 percent of foreign-born Black females who lived in the 

United States for less than 10 years, and 36 percent of foreign-born Black females who lived in the United 

States for 10 years or more had a dental visit more than 1 year ago.

1

42

22

36

1

42

22

35

6

41

15

37

2

36

22

41

0

5

10

15

20

25

30

35

40

45

Never More than 1 year ago More than 6 months, but not

more than 1 year ago

6 months or less

Percent

Last dental visit

Total

U.S.-born

Foreign-born, less than 10 years in the United States

Foreign-born, 10 years or more in the United States

Page 11
More than 6 months, but not more than 1 year ago: 

Twenty-two percent of U.S.-born Black females, 22 percent of foreign-born Black females who lived in 

the United States for 10 years or more, and 15 percent of foreign-born Black females who lived in the 

United States for less than 10 years had a dental visit more than 6 months, but not more than 1 year ago.

6 months or less:

Forty-one percent of foreign-born Black females who lived in the United States for 10 years or more, 37 

percent of foreign-born Black females who lived in the United States for less than 10 years, and 35 

percent of U.S.-born Black females reported having a dental visit in the past 6 months or less.

Page 12
What percentage of Black females (ages 18 to 64 years) in the United States had a 

flu shot in the past 12 months?

Figure 8. Age-adjusted flu shot receipt in the past 12 months among adult Black females, by nativity and 

years in the United States (NHIS 2002-2012)

NOTE: Analysis only includes Black females who self-identified as non-Hispanic Black. Data are based on 

household interviews of a sample of the civilian non-institutionalized population. All prevalence estimates were ageadjusted to the 2000 U.S. population standard. It is recommended that everyone aged 6 months and older obtain an 

annual flu vaccination with rare exception [7].

Chi-square test used to determine that differences in having a flu shot in the past 12 months are not 

significant across categories of nativity and years in the United States, p=0.540

Only 25 percent of Black females had obtained a flu shot in the past 12 months. Similar percentages of

U.S.-born Black females (25 percent), foreign-born Black females who lived in the United States less than 

10 years (24 percent), and foreign-born Black females who lived in the United States for 10 years or more 

(23 percent) had a flu shot in the past 12 months.

25 25

24 23

0

5

10

15

20

25

30

Had a flu shot in past 12 months

Percent

Flu shot in past 12 months

Total

U.S.-born

Foreign-born, less than 10 years in the United States

Foreign-born, 10 years or more in the United States

Page 13
What is the smoking status among Black females (ages 18 to 64 years) in the 

United States?

Figure 9. Age-adjusted smoking status among adult Black females, by nativity and years in the United 

States (NHIS 2002-2012)

NOTE: Analysis only includes Black females who self-identified as non-Hispanic Black. Data are based on 

household interviews of a sample of the civilian non-institutionalized population. Due to rounding, sum of bars for 

each category of nativity and years in the United States may not equal 100 percent. All prevalence estimates were 

age-adjusted to the 2000 U.S. population standard.

Chi-square test was used to test for statistically significant difference in smoking status across categories of nativity 

and years in the United States, p<0.001

Never smoker:

The vast majority of non-elderly Black females were never smokers (70 percent). The highest percentage

of never smokers was observed among foreign-born Black females who lived in the United States for less 

than 10 years (97 percent) followed by foreign-born Black females who lived in the United States for 10 

years or more (91 percent). Sixty-eight percent of U.S.-born Black females were never smokers.

70

12

18

68

13

20

97

2 1

91

4 5

0

10

20

30

40

50

60

70

80

90

100

Never smoker Former smoker Current smoker

Percent

Smoking status

Total

U.S.-born

Foreign-born, less than 10 years in the United States

Foreign-born, 10 years or more in the United States

Page 14
Former smoker:

A very low percentage of non-elderly Black females were former smokers. Thirteen percent of U.S.-born 

Black females, 4 percent of foreign-born Black females who lived in the United States for 10 years or 

more, and 2 percent of foreign-born Black females who lived in the United States for less than 10 years 

were former smokers.

Current smoker:

U.S.-born Black females represented the highest percentage of current smokers (20 percent). A lower 

percentage of foreign-born Black females who lived in the United States for 10 years or more (5 percent) 

and foreign-born Black females who lived in the United States less than 10 years (1 percent) were current 

smokers.

Page 15
What is the weight status among Black females (ages 18 to 64 years) in the United 

States?

Figure 10. Age-adjusted weight status among adult Black females, by nativity and years in the United 

States (NHIS 2002-2012)

NOTE: Analysis only includes Black females who self-identified as non-Hispanic Black. Data are based on 

household interviews of a sample of the civilian non-institutionalized population. Body mass index (BMI, kg/m2) was 

used as a health indicator of weight. Individuals classified as underweight, BMI less than 18 kg/m2, are not shown. 

Individuals with a BMI between 18.5 kg/m2 to 24.9 kg/m2 were classified as healthy weight; 25.0 kg/m2 to 29.9 kg/m2

were classified as overweight; and those with a BMI of 30 kg/m2 and above were classified as obese [8]. Due to 

rounding, sum of bars for each category of nativity and years in the United States may not equal 100 percent. All

prevalence estimates were age-adjusted to the 2000 U.S. population standard.

Chi-square test was used to test for statistically significant difference in weight status across categories of nativity and

years in the United States, p<0.001

Healthy weight:

Thirty-four percent of foreign-born Black females who lived in the United States for 10 years or more and

32 percent of foreign-born females who lived in the United States for less than 10 years had a healthy 

weight. Twenty-five percent of U.S.-born Black females had a healthy weight. 

Overweight:

Thirty-four percent of foreign-born Black females who lived in the United States for 10 years or more 

were classified as overweight. Thirty-one percent of foreign-born Black females who lived in the United 

States for less than 10 years and 28 percent of U.S.-born Black females were classified as overweight.

26

28

46

25

28

47

32 31

37

34 34

33

0

5

10

15

20

25

30

35

40

45

50

Healthy weight Overweight Obese

Percent

Weight status

Total

U.S.-born

Foreign-born, less than 10 years in the United States

Foreign-born, 10 years or more in the United States

Page 16
Obese:

U.S.-born Black females (47 percent) exhibited the highest percentage of obesity. Thirty-seven percent of 

foreign-born Black females who lived in the United States for less than 10 years and 33 percent of 

foreign-born Black females who lived in the United States for 10 years or more were classified as obese.

Page 17
What is the prevalence of diagnosed hypertension among Black females (ages 18

to 64 years) in the United States?

Figure 11. Age-adjusted diagnosed hypertension among adult Black females, by nativity and years in the 

United States (NHIS 2002-2012)

NOTE: Analysis only includes Black females who self-identified as non-Hispanic Black. Data are based on 

household interviews of a sample of the civilian non-institutionalized population. To be classified with diagnosed 

hypertension, non-elderly Black females reported being told by a doctor or other health professional that they had 

hypertension on two or more different visits. All prevalence estimates were age-adjusted to the 2000 U.S. population

standard.

Chi-square test was used to test for statistically significant difference in diagnosed hypertension across categories of 

nativity and years in the United States, p<0.001

A sizeable percentage of U.S.-born Black females (40 percent) had been diagnosed with hypertension by 

a doctor or other health professional. In contrast, 27 percent of foreign-born Black females who lived in 

the United States for less than 10 years and 27 percent of foreign-born Black females who lived in the 

United States for 10 years or more had been diagnosed with hypertension by a doctor or other health 

professional.

38

40

27 27

0

5

10

15

20

25

30

35

40

45

Diagnosed with hypertension

Percent

Diagnosed hypertension

Total

U.S.-born

Foreign-born, less than 10 years in the United States

Foreign-born, 10 years or more in the United States

Page 18
Summary

This data brief provides a profile of demographic and health 

characteristics from a diverse sample of 23,210 non-elderly Black 

females in the United States (NHIS 2002-2012). Three out of five 

foreign-born Black females who lived in the United States for 10 years 

or more had completed some college or greater. Nearly 80 percent of 

non-elderly Black females had health insurance coverage. Only 36 

percent of foreign-born Black females who lived in the United States for 

less than 10 years had a usual place for preventive care. Thirty-four 

percent of foreign-born Black females who lived in the United States for 

10 years or more had a healthy weight. However, 40 percent of U.S.-

born Black females, compared to 27 percent of their foreign-born 

counterparts, had been diagnosed with hypertension. These findings 

demonstrate the importance of examining health data by nativity and 

length of time in the United States among Black females to illuminate 

ways to increase health awareness, bolster health care access, and 

further develop effective programs and policies to reduce health 

disparities among this diverse population in the United States.

Conclusion 

This brief highlights the heterogeneity of demographic and health characteristics for non-elderly U.S.-

born and foreign-born Black females. On many measures detailed in this data brief, significant 

differences were observed among U.S.-born Black females, foreign-born Black females who lived in the

United States for less than 10 years, and foreign-born Black females who lived in the United States for 10 

years or more. These observations suggest that disaggregating data by nativity and length of time in the 

United States better illustrates the differences in demographic and health characteristics of the U.S.-born 

and foreign-born Black populations. Examining the nativity of the Black population in the United States 

will help public health officials identify challenges and shape public health responses to disparities in 

health and health care.

Thirty years ago, the U.S. Department of Health and Human Services (HHS) issued The Report on the 

Secretary’s Task Force on Black and Minority Health (also known as the Heckler Report). This

groundbreaking report documented health disparities among minorities, estimated to be responsible for as 

many as 60,000 excess deaths each year. Margaret Heckler, the HHS Secretary who formed the Task 

Force, called the disparities detailed in the report: “an affront both to our ideals and to the ongoing genius 

of American medicine.” 

Ensuring all Americans have access to quality, affordable health care is an important step in addressing 

health disparities that have persisted since the 1985 Heckler Report. While millions have obtained health 

insurance since the passage of the Affordable Care Act, fully understanding the health and health care 

challenges facing minorities in the United States is also essential. By acknowledging the growing 

percentage of Black immigrants living in the United States [9, 10] and adjusting our approach to studying 

health indicators and social determinants of health, the nation’s public health leaders and policy makers 

will be better positioned to reduce disparities that persist in these communities.

The Office of Minority 

Health at the U.S. 

Department of Health 

and Human Services 

is dedicated to 

improving the health of 

racial and ethnic 

minority populations 

through the 

development of health 

policies and programs 

that help eliminate 

health disparities.

Page 19
Definitions [4]

Adult non-Hispanic Blacks

Based on non-elderly females who self-identified as non-Hispanic Black or African American.

Diagnosed hypertension

To be classified with diagnosed hypertension, non-elderly Black females reported being told by a doctor 

or other health professional that they had hypertension on two or more different visits.

Educational attainment

Education was categorized as less than high school; high school graduate, including certificate of general 

education development (GED); and some college or greater.

Health insurance coverage

Non-elderly Black females were considered insured if they had any private health insurance, governmentor state-sponsored health insurance plans.

Income to poverty ratio

Observations missing on income were not included in the analysis of income to poverty ratios. The 

income to poverty ratio was created by the NCHS utilizing published information from the U.S. Census 

Bureau regarding poverty thresholds [5]. A ratio of the previous calendar year’s income value reported by 

respondents to the poverty threshold for the same year was constructed, based on the family’s overall size 

as well as the number of children (aged 17 and under) present in the family [4]. “Ratios below 1.00 

indicate that the income for the respective family or unrelated individual is below the official definition of 

poverty, while a ratio of 1.00 or greater indicates income above the poverty level. A ratio of 1.25, for 

example, indicates that income was 125 percent above the appropriate poverty threshold” [6]. 

Marital Status

Non-elderly Black females who were not married included those reported to be widowed, divorced, 

separated, or never married. 

Nativity and Years in the United States

Nativity refers to place of birth and was based on a geographical place of birth recode provided by the 

NCHS/NHIS. For this study, two places of birth were analyzed: U.S.-born and foreign-born. The U.S.-

born population includes anyone born in one of the 50 United States, the District of Columbia or a U.S. 

territory. The foreign-born population includes anyone who was not born in the United States or a U.S. 

territory. Years in the United States refers to the respondent’s answer to “Years that {respondent} has 

been in the U.S.” This question was asked of all respondents that were not born in the United States.

Smoking status

Those who reported smoking fewer than 100 cigarettes in their lifetime were classified as never smokers. 

Former smokers reported smoking 100 cigarettes or more in their lifetime and did not currently smoke 

every day or on occasion. Current smokers were classified as having smoked 100 cigarettes in their 

lifetime and currently smoking every day or on occasion.

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Weight status

Weight status was based on body mass index (BMI, kg/m2

). BMI classifications were based on cut-points 

established by the World Health Organization, using self-reported height and weight [8]. Individuals 

classified as underweight, BMI less than 18.5 kg/m2

, are not shown. Individuals with a BMI between 

18.5 kg/m2 to 24.9 kg/m2 were considered a healthy weight; 25.0 kg/m2 to 29.9 kg/m2 were considered 

overweight; and individuals with BMI of 30 kg/m2

and above were considered obese.

Usual place for preventive care

Non-elderly Black females were classified as having a usual place for preventive care if they reported 

going to a: 1) clinic or health center; 2) doctor’s office or HMO; 3) hospital outpatient department; 4) 

some other place; or 5) doesn’t go to one place most often. Non-elderly Black females who reported not 

obtaining preventive care anywhere or going to the emergency room for preventive care were classified as 

not have a usual place for preventive care.

Data Sources and Methods

Analyses in this data brief were based on National Health Interview Surveys (NHIS) collected from 2002-

2012. Sampling weights were used to produce national estimates that were representative of the civilian 

non-institutionalized U.S. population. Our analysis was restricted to non-Hispanic and Black/AfricanAmerican females between the ages 18 to 64 years who specified their nativity or length of time in the 

United States. This resulted in a final sample of 23,210 non-elderly Black females. 

Chi-square tests were used to assess differences for demographic and health characteristics by nativity 

and years in the United States. All estimates shown meet the NCHS standard of having less than or equal 

to 30% relative standard error. Point estimates in all figures are accompanied by 95% confidence 

intervals. Statistical analyses were conducted using STATA 13 [11] to account for the complex sample 

design of the NHIS. Data were analyzed using sample weights to account for differential probabilities of 

sample selection, non-response, and sample non-coverage. All prevalence estimates were agestandardized to the 2000 U.S. population [12]. 

The authors intentionally did not use the terms “African-American” or “Black/African-American”. The 

authors highlight the diversity of the Black population, particularly by nativity and length of time in the 

United States. The term “African-American” does not capture the geographical diversity of the Black 

population, and the Black foreign-born population, specifically.

Limitations

Because we used a nationally representative sample of non-elderly Black females from the 

CDC/NCHS/NHIS, all variables included in this analysis were self-reported and subject to recall bias. 

Also, the NHIS only collects data on non-institutionalized persons; thus, our findings are not 

generalizable to incarcerated populations, military personnel, or adults in nursing homes or other longterm care facilities.

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References

1. Williams, D.R. The health of men: structured inequalities and opportunities. Am J Public Health, 

2003. 93(5): p. 724-31.

2. U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. 

National Center for Health Statistics. Health, United States, 2013: With Special Feature on 

Prescription Drugs. National Center for Health Statistics, Editor. 2014: . Hyattsville, MD.

3. Grieco, E.M. Race and Hispanic Origin of the Foreign-Born Population in the United States: 2007, 

in American Community Survey Reports. U.S. Census Bureau, Editor. 2010.

4. U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. Data 

File Documentation, National Health Interview Survey, 2012 (machine readable data file and 

documentation). National Center for Health Statistics-Centers for Disease Control and Prevention, 

Editor. 2013: Hyattsville, Maryland.

5. U.S. Census Bureau. Poverty thresholds. 2015; Available from: 

http://www.census.gov/hhes/www/poverty/data/threshld/index.html.

6. U.S. Census Bureau. Current Population Survey: Definitions and explanations. Available from: 

http://www.census.gov/population/www/cps/cpsdef.html.

7. U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. 

Vaccination: Who Should Do It, Who Should Not and Who Should Take Precautions. 2015; Available 

from: http://www.cdc.gov/flu/protect/whoshouldvax.htm.

8. U.S. Department of Health and Human Services and U.S. Department of Agriculture (USDA). 

Dietary guidelines for Americans, 2005. 2005, US Government Printing Office: Washington.

9. Gambino, C.P., E.N. Trevelyan, and J.T. Fitzwater. The Foreign-Born Population From Africa: 

2008–2012, in American Community Survey Briefs. U.S. Census Bureau, Editor. 2014.

10. Anderson, M. A Rising Share of the U.S. Black Population Is Foreign Born; 9 Percent Are 

Immigrants; and While Most Are from the Caribbean, Africans Drive Recent Growth. Pew Research 

Center, Editor. 2015: Washington, D.C.

11. StataCorp. Stata statistical software: Release 13 [Computer software]. 2014: College Station, TX.

12. Klein, R. and C. Schoenborn. Age adjustment using the 2000 projected U.S. population., in Healthy 

People Statistical Notes. 2001, National Center for Health Statistics: Hyattsville, Maryland.
About the Authors

Shondelle M. Wilson-Frederick is with the Office of Minority Health (OMH) at the U.S. Department of 

Health and Human Services (HHS). Lacreisha N. Ejike-King was formerly with the HHS OMH. Rashida 

R. Dorsey is with the Office of the Assistant Secretary for Planning and Evaluation at the U.S. 

Department of Health and Human Services. At the time this brief was developed, Dr. Dorsey served as 

the Director of the Division of Policy and Data at OMH. Juanita J. Chinn is the OMH Health Disparities 

Fellow at the National Center for Health Statistics (NCHS).

Suggested citation

Wilson-Frederick SM, Chinn JJ, Ejike-King LN, and Dorsey RR. Demographic and Health 

Characteristics among a Diverse Group of Adult Black Females in the United States: 2002-2012. OMH 

Data Brief No. 4. Rockville, MD: Office of Minority Health. 2015.

Acknowledgement

The authors would like to acknowledge Roland J. Thorpe, Jr., Ph.D., Assistant Professor, Department of 

Health, Behavior, and Society; Director, Program for Research on Men’s Health, Hopkins Center for 

Health Disparities Solutions of the John Hopkins Bloomberg School of Public Health, and member of the 

U.S. Department of Health and Human Services Advisory Committee on Minority Health, for his 

thorough review of this data brief.

Copyright information

All material appearing in this report is in the public domain and may be reproduced or copied without 

permission; citation as to source, however, is appreciated.

Office of Minority Health 

J. Nadine Gracia, M.D., M.S.C.E., Deputy Assistant Secretary for Minority Health and Director, Office of 

Minority Health, U.S. Department of Health and Human Services

1101 Wootton Parkway, Suite 600

Rockville, MD 20852

Phone: 240-453-2882 | Fax: 240-453-2883 

Email: info@minorityhealth.hhs.gov | www.minorityhealth.hhs.gov

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