Foreign-born Black adults show lower stroke risk than Americans

For Black individuals in the United States, being born in another country was associated with a lower risk of stroke, according to a study published July 15, 2026, in Neurology^®, the medical journal of the American Academy of Neurology.

"In the United States, people who identify as Black have a higher rate of stroke compared to other groups, and are often treated as single category of people, which can hide variations related to birthplace and immigration status," said study author Alejandro Vargas, MD, MS, of Rush University Medical Center in Chicago and a Fellow of the American Academy of Neurology. "Our study looked at stroke survivors, their place of birth and when they immigrated and found lower risks of stroke for people born outside of the U.S."

The study included 64,717 adults who identified as Black in a national survey. Of participants, 88% were born in the U.S., 8% were born in the Caribbean, South and Central America, and 4% were born in Africa.

Researchers determined which participants had a stroke by reviewing responses on the survey to the question "Have you ever been told by a doctor or health professional that you have had a stroke?"

A total of 2,549 people reported having a stroke. The prevalence of stroke was 4.3% for those born in the U.S., 1.5% for those born in the Caribbean, South and Central America and 0.8% for those born in Africa.

Compared to stroke survivors born in other countries, those born in the U.S. were younger, less likely to have a college education and had higher rates of smoking and obesity.

After adjusting for factors such as age, smoking status and income, researchers found that people born in the Caribbean, South and Central America had 53% lower odds of stroke than those born in the U.S. and people born in Africa had 57% lower odds of stroke. People who had immigrated within 15 years of the survey had 73% lower odds of stroke.

"Among Black individuals with stroke, those born in the Caribbean, South and Central America and Africa were less likely to have had a stroke compared to those born in the United States, regardless of region of birth, time spent in the U.S. or time since migration," said Vargas. "Our study suggests a healthy immigrant effect in which recent immigrants are healthier than the general population. This may be due to differences in stroke risk factors such as high blood pressure or stress. Grouping all racial and ethnic populations together can hide important health trends and hinder efforts to create targeted interventions."

A limitation of the study was that the number of people born in other countries was small compared to the number born in the United States.