African descent populations are experiencing a disproportionate burden of type 2 diabetes. In New York City, almost one third of the Black population are foreign-born Afro-Caribbeans and two thirds are African American. We compared type 2 diabetes risk profiles and disease burden among foreign-born Afro-Caribbean and US-born African American New Yorkers by estimating: a) Prevalence of type 2 diabetes; b) Type 2 diabetes risk profile by ethnicity and c) Odds of type 2 diabetes. Using the 2013/14 New York City Health and Nutrition Examination Survey probability sample weighted to the New York City population, we analyzed data for Afro-Caribbean (n=81) and African American (n=118) participants. Type 2 diabetes was defined as prior diagnosis; or HbA1c≥6.5%; or fasting glucose ≥126mg/dL. Logistic regression estimated odds of type 2 diabetes by BMI category, waist circumference (cm), and physical activity; adjusting for age, sex, education, income, and marital status. Among Afro-Caribbeans (Age (Mean ±SE) 49±2years, BMI 29.2 ±0.7kg/m
2
) and African Americans (Age 46±2years, BMI 30.3 ±0.9kg/m
2
) type 2 diabetes prevalence was 31% (25 of 81) and 21% (25 of 118) respectively. Compared to African Americans with type 2 diabetes, Afro-Caribbeans with type 2 diabetes had lower mean BMI (29.9 ±0.8kg/m
2
vs. 34.6 ±1.78kg/m
2
,
P
=0.01), and lower waist circumference (102 ±2cm vs. 114 ±3cm,
P
=0.0015). Afro-Caribbeans with type 2 diabetes were more likely to be overweight (57.2% vs. 13.5%) rather than obese (33.2% vs. 74.7%), yet less likely to meet HP2010 physical activity goals (23.6% vs 35.3%). Overall type 2 diabetes odds were no different between groups. In the total population odds were 5% higher for each cm waist circumference [aOR=1.05 (95% CI 1.01-1.10),
P
=0.0194]. Compared to the youngest age group, ages 20-49y, type 2 diabetes odds were higher among ages 50-59y [aOR=7.12 (95% CI 2.29-22.14)], and ages 60+ [aOR=5.04 (95% CI 1.65-15.39),
P
=0.0482]. In stratified logistic regression analyses among Afro-Caribbean New Yorkers, odds were 18% greater per cm waist circumference [aOR=1.18 (95% CI 1.03-1.35),
P
=0.0194]. For Afro-Caribbeans, low physical activity was associated with seven times greater odds of type 2 diabetes [aOR=7.03 (95% CI 1.19-41.53),
P
=0.0314]. Compared to African Americans, Afro-Caribbeans with type 2 diabetes are more likely to have lower waist circumference and be overweight rather than obese despite reporting less physical activity. Further examination of the relationship between BMI, waist circumference and visceral vs. subcutaneous adipose tissue may elucidate important intraethnic differences in diabetes risk. To enhance detection of diabetes among Afro-Caribbeans and African Americans in New York City, screening criteria should consider unique diabetes phenotypes.
Characteristics of a Church-placed Physical Activity Program Associated with Physical Activity Uptake in Church-going African Americans in New York City