Date of Award
Spring 2026
Document Type
Open Access Dissertation
Department
Public Health
First Advisor
Lucy Annang Ingram
Second Advisor
Rachel Davis
Abstract
Background: Nigerians are among the largest immigrant groups in the United States and continue to grow across generations. However, little is known about their collective health status. As a distinct community within American society, it is necessary to examine their health profiles as well as cultural practices that might impact them. Doing so will help strengthen population health by ensuring that public health intervention efforts consider the needs of diverse communities and broadly promote health equity. Bearing this in mind, this study examined sociocultural factors influencing health decision-making among 2nd generation Nigerian Americans. It also explores cultural factors impacting 2nd generation Nigerian Americans’ engagement with the American healthcare system and their reflections on such encounters. Findings from this research study will contribute to the literature on immigrant health and inform a more nuanced research agenda that aims to understand the specificities of determinants of health as they relate to diverse cultural identities.
Methods: Twenty-six qualitative interviews were conducted with 2nd generation Nigerian Americans who lived within 35 miles of Dallas, TX. Participants were recruited using a quota sampling strategy and age ranged between 18 and 34 years. Recordings were transcribed and analyzed using thematic analysis via NVivo 14.
Results: Four themes emerged reflecting sociocultural factors influencing heath decisions: (1) Family Influence; (2) Food Exposure; (3) Experience with Traditional Remedies; and (4) Religion. Most participants demonstrated awareness and evaluation of traditional Nigerian cultural practices. Some balanced preservation of beneficial traditions with adoption of U.S.-emphasized preventive behaviors based on improved health knowledge, perceived benefit, access to viable alternatives, and comfort. Additionally, multiple cultural factors were reported as influencers of health-seeking behaviors. Most behaviors were learned early, and for some, sustained into adulthood. Participants age 30 and older reported more consistent ties to health behaviors aligned with American health standards. As it relates to healthcare engagement, many participants described their experiences within the healthcare system as typical encounters. Meanwhile, others expressed that their encounters often required them to become more assertive, as a response to their needs being overlooked or minimized.
Conclusion: This research establishes the centrality of culture to health practices among 2nd generation Nigerian Americans. The results indicate that health promotion efforts targeting 2nd generation Nigerians should look beyond individual-level intervention approaches and incorporate family-centered approaches, as family influence is crucial to health decision making. It also highlights the need for additional research to understand the factors associated with the continuation of learned health practices and the health implication of such behaviors. Lastly, the persistence of health inequality reported herein demonstrated a need among healthcare institutions to invest in bias-awareness training, culturally responsive communication, and institutional accountability.
Rights
© 2026, Antonika Kiwonda Kadiri
Recommended Citation
Kadiri, A. K.(2026). Examining the Sociocultural Factors That Influence 2nd Generation Nigerian Americans’ Responses to Their Physical Health Concerns and Their Engagement With The U.S. Healthcare System. (Doctoral dissertation). Retrieved from https://scholarcommons.sc.edu/etd/8829