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West African immigrants appear to carry a heavier burden of hypertensive heart disease than the native-born African Americans in the United States. In this study, I used the socioecological model theory as a guide to examine the association between perceived stress, length of stay in United States, smoking status, housing conditions, and the risk of hypertensive heart disease among West African immigrants, ages 18 â?? 54 years in DeKalb County, Georgia. In this quantitative, cross-sectional design, self-reported data were collected from a sample of West African immigrant (N=107) in the DeKalb County of Georgia, using a demographic data/screening sheet and the Perceived Stress Scale. Multivariate logistic regression analysis was used to determine the association between hypertensive heart disease and perceived stress, smoking status, length of stay in the United States, and housing condition, having adjusted for the modifying variables age and education. Results indicated that length of stay in the United States [p =.019, Phi =.331], housing condition [p=.156, R2 =.019], smoking status [p=.050, R2 =.036] and experienced perceived stress experienced [p=.312, R2=.010] are associated with risk of developing hypertensive heart disease. There was a statistically significant association between age [p=.002] and the development of hypertensive heart disease. The result of this study can contribute to positive social change by helping public health agencies to target some of the identified risk factors for hypertensive heart disease in foreign born African American population so as to mitigate the adverse health outcomes associated with hypertensive heart disease.