Systemic discrimination versus cultural behavioral norms

From The Immigrant Health Advantage: An Examination of African-Origin Black Immigrants in the United States by Justin Vinneau Palarino.  From the Abstract:

The immigrant health advantage suggests that, despite significant socioeconomic disadvantage, immigrant populations report better-than-expected health relative to U.S.-born counterparts. This phenomenon has been repeatedly shown in Hispanic-origin immigrant population with little focus on other racial/ethnic groups. In this study, the immigrant health advantage is examined as it pertains to overweight, obesity, hypertension, and diabetes in African-origin black immigrants (n = 2748) relative to U.S.-born non-Hispanic blacks (n = 71,320). Additionally, to investigate within-immigrant heterogeneity in health deterioration associated with duration in the United States, the health of African-origin black immigrants is compared to non-Hispanic white and Mexican–American immigrants. Analyses are conducted on adults aged 18–85 + (n = 570,675) from the 2000–2018 National Health Interview Survey using binomial logistic regressions. Findings support the notion of an immigrant health advantage and suggest that, relative to U.S.-born blacks, African-origin black immigrants are at lower odds for obesity, hypertension, and diabetes, regardless of duration in the United States. Further, when compared to non-Hispanic white and Mexican–American immigrants, African-origin black immigrants display similar probabilities of reporting overweight, obesity, and diabetes across four duration categories. These findings suggest that, despite potentially experiencing high rates of discriminatory and/or racist behaviors, African-origin black immigrants’ health does not deteriorate differently than this sample of non-black immigrant counterparts. The findings presented here provide further insight into the health of African-origin blacks immigrants, a rapidly growing proportion of both the U.S.-black and foreign-born population.

I have long argued that differences in group outcomes in the US are primarily due to culture and class associated behaviors and are not due primarily to systemic bias as is usually argued.  In other words, outcomes are due to behaviors (shaped by culture and class) and not due to racism per se.  These findings seem consistent with that conclusion.

Obesity, hypertension, and diabetes are disproportionately prevalent among African-American blacks and it is usually argued that these conditions are due to inadequate healthcare provision to African-American blacks.  

Black immigrants suffer significant socioeconomic disadvantage but are in better health when they arrive compared to African-American blacks.  Indeed, in terms of obesity, hypertension, and diabetes, black immigrants match the profile of whites and hispanics.

More interestingly, black immigrant susceptibility to obesity, hypertension, and diabetes does not increase the longer they are in the US.  If blacks were suffering systemic racial discrimination in a fashion that is usually argued, then black immigrants ought to suffer the same consequences as American born blacks.  That they do not suggests the importance of culture and behaviors over imagined systemic discrimination.