Objective: Healthcare is an indispensable commodity, but not all race/ethnic groups in the United States (US) have equal access. Studies on African immigrants and access to healthcare in the US are almost non-existent. However, black African immigrants, uncharacteristically, face significant access constraints. Contributing to this is the fact that many researchers do not distinguish the healthcare needs of African immigrants from that of native born African Americans. Research on Blacks has only focused on African Americans who represent a single segment of an increasing black population in the US. African Americans, indeed, have one of the worst accesses to healthcare constraints and health outcomes. But the case of African immigrants who differ culturally from native born Americans and even native born African Americans is potentially quite different. We explored the association between “race” and “region of birth” and access to healthcare for African-born Blacks in the U.S.

Methods: We analyzed data from the 2002 – 2011 National Health Interview Survey of a nationally representative sample of adults (N = 455,472). After using multiple logistic regressions to assess differences in access to healthcare, we further applied the Fairlie decomposition technique to assess the contribution of each factor to the access to health care disparity. The likelihood of having a usual place for care and having seen a doctor over the past year was examined, controlling for gender, age, race/ethnicity, insurance status, health status as well as income and education.

Results: Age, gender, educational level, health insurance coverage, poverty level, and self-reported health status accounted for having a “usual place for care” and being able to see or talked to general doctor over the past year. Black African immigrants are younger, have more education, more likely to be employed, and more likely than African Americans to be above the federal poverty level. However, Black African immigrants, compared to African Americans have significant access barriers to healthcare in the United States.

Conclusion: Both African Americans and Black African immigrants face barriers to healthcare in the US. However, Black African immigrants as a segment of the population face greater access constraints. Public policies, particularly in Medicaid, have contributed to this disparity. Thus, efforts at improving the health and access to care among African Americans or Black African immigrants in the United States should be based on public insurance and subsidy policies that address this population. The generalized nature of health policies towards these groups has not advanced their health and access to healthcare.