Cardiovascular Health Trajectories of Afro-Caribbean Immigrants in the United States: A Systematic Literature Review on Immigrant Advantage, Generational Change, and Structural Influences (2019-2025).

Afro-Caribbean immigrants are a growing subgroup among the immigrant population in the United States. Yet their cardiovascular health trajectories are unexplored. Although some studies on immigration health have demonstrated a persistent immigrant health advantage, others indicate an evident decline over time and across generations. This study aims to synthesize the influencing factors linked to worsened cardiovascular outcomes for Afro-Caribbean immigrants migrating to the United States from their country of origin. This systematic review addresses the following research question: How do the length of U.S. residence, generational status, and key demographic and structural determinants influence cardiovascular health outcomes among Afro-Caribbean immigrants in the United States? Searches were performed in PubMed, Taylor & Francis, ProQuest, JSTOR, and SpringerLINK, yielding a total of 174 records from keyword searches published between 2019 and 2025. Studies were included in the final review if they focused on Caribbean-origin Black immigrants living in the United States, examined cardiovascular or cardiometabolic health outcomes between 2019 and 2025, and were peer-reviewed empirical articles published in English. Studies on non-Caribbean populations, non-empirical designs, or those without a cardiovascular focus were excluded. Findings highlight the influence of acculturation, generational status, and structural determinants on cardiovascular outcomes. Overall, evidence suggests the immigrant health advantage weakens over time, emphasizing the need for longitudinal, intergenerational equity-centered research to inform culturally responsive interventions.