Black migrants represent a small but growing share of recent migration flows from foreign countries to the United States. Among black migrants, Sub-Saharan Africans are an important and rapidly growing share of the total foreign-born US black population. Yet, we know relatively little about their health and well-being in the United States and even less about their families and communities in Sub-Saharan Africa. The goal of this pilot project is to lay the foundation for a grant application to the National Institute of Aging to better understand the impact of migration from Africa on the health and wellbeing of the migrants as well as their families in the United States and Africa. The research will provide important evidence on the impact of migration to the United States on family members left behind in Africa, many of whom are elderly and rely on remittances from those who have left. The research will be conducted in the United States and Ghana.
Specifically, the project will:
1. Conduct analyses of Ghanaian and US Census data to identify a research design to efficiently sample migrants from Ghana to the U.S. in a longitudinal design;
2. Test field protocols for sampling of those individuals and their families living in the U.S. and in Ghana and following those who move across the border; and
3. Develop and test survey instruments and biomarker measurement protocols for a study of health and well-being of migrants in the United States, their family and community members in Ghana in comparison with a those who do not migrate.
Sampling, tracing and interviewing migrants and their families across international borders is far from straightforward. It is, however, critically important for providing scientific evidence of the impact of migration at the population level. This pilot will rigorously evaluate different sampling and recruitment strategies to assure the success of the application for a large-scale study to be submitted to the NIA and elsewhere.
We have selected Ghana for this project because, first, among Sub-Saharan Africans, Ghanaians represent the third largest group in the U.S. and, second, we have begun building a collaborative team with first-rate population and health scientists at several different institutes in the University of Ghana. The longer-term goal is to build a collaborative network of comparable research activities on international migration in several African countries.
The proposed project will enhance our understanding of adult health and birth outcomes among black immigrants in the United States by region and country of birth. Black immigrants constitute a small but growing share of recent immigration flows. The vast majority of Blacks come to the United States from the Caribbean and from Africa. By 2005-2010, foreign-born Blacks made up just over eight percent of the U.S. Black population up from less than one percent in 1960. We have identified two widely used US data sources that will permit the analysis of Black immigrant health outcomes by region and /or country of birth in the United States. These include the 2000-2010 waves of the National Health Interview Survey and vital statistics birth record data. The vital statistics data will be used to examine birth outcomes by region and country of birth and the NHIS will be used to examine adult health outcomes by region and/or country of birth sample size permitting. To assess the role of migrant selectivity we compare health outcomes of Black immigrants to those in their countries or regions of origin utilizing data from the Demographic and Health Surveys and the WHO/SAGE Wave 1 data from Ghana. These analyses will be used to inform study design and data collection in immigrant sending communities in Ghana and among Ghanaian immigrants in the United States.
This study will extend previous analyses of trends in socioeconomic inequality in all cause and cause-specific mortality by age and sex in the United States by investigating whether these trends have been similar among whites and African Americans and by relating these findings to trends in the distribution of risk factors, such as obesity and smoking. The data come from Kitagawa and Hauser study for 1960, and the National Longitudinal Mortality Study (NLMS) and the National Health Interview Survey (1987-1994) linkage to the National Death Index for later decades. The Slope Index of Inequality (SII) is used to examine both absolute and relative differentials in inequality, as well as the percentage contribution of various cause-of-death groups to absolute inequality. The SII provides an estimate of how much change in death rates is associated with increased educational attainment. The second measure we employ is the Index of Dissimilarity, which is widely used in the social sciences as a summary measure of the difference between two distributions. In our case the two distributions to be compared are the distributions of deaths (all or cause-specific) and population at risk of dying by educational attainment. The same method will be adapted whenever possible to examine risk factor distributions by educational attainment over time. The results of these analyses will help determine whether the documented increase in socioeconomic inequalities in mortality between 1960 and the 1980s has continued into the 1990s. The cause-specific investigations together with the analyses of trends in mortality risk factors by SES will point to areas where public health interventions might be most effective. The results will also provide input into further studies designed to illuminate the processes that link SES to health and mortality.
Socioeconomic status is considered by many to be a fundamental cause of disease and death. In this paper, we document educational and income inequalities in all-cause and cause-specific mortality at ages 35-64 in Finland and the United States, two countries with different health care systems, income distributions, and social welfare programs for the working-age population. We found that education is an independent determinant of premature mortality for men and women in both countries after adjustment for age, household size, family income, marital status, and labor force participation. Educational inequalities in mortality in both places were most pronounced for causes of death that were linked to health behaviors, risk-taking behaviors, and stress. These educational inequalities were largest for Finnish men, for whom the association between education and mortality was linear. For Finnish women and for American men and women educational thresholds mattered more than each additional year of schooling. The association between family income and mortality was curvilinear in both countries. The degree of curvature was more pronounced in the United States than in Finland when family-income effects were adjusted only for age and household size. When we also controlled for education, labor force participation, and marital status the income effects were strongly attenuated and the difference in curvature between countries was no longer statistically significant. That increases in family income were more important for reducing mortality at the lower end of the income distribution in both countries suggests that there are diminishing returns to family income, and poverty is detrimental to health. The findings suggest that effects of an individual's socioeconomic position on mortality, whether measured by education or family income, are to a large extent independent of how society is organized.
The purpose of this study is to investigate the effects of early life socioeconomic status, place of birth, and household structure on cause-specific mortality and familial clustering of cause-specific mortality in Finland during the latter half of the twentieth century. We base the analyses on a 10% sample of households drawn from the 1950 Finnish Census of Population with the follow-up of household members in subsequent censuses and death records beginning in 1970 through 2005. The proposed project is a first in a series of anticipated longitudinal analyses of individuals and families over a 50 year period. The results of the proposed project will contribute to the accumulating evidence on the associations of early life conditions on adult mortality and familial clustering of mortality. The Finnish data constitute a unique register based data set that does not rely on individual recall of early life conditions, educational attainment, occupations, and other life course trajectories
The purpose of this study is to investigate race/ethnic differences in disability in the United States with an emphasis on immigrant populations and their U.S. born counterparts. The study utilizes the 5% PUMS sample from the 2000 Census of Population; the 2000 Census included a new set of questions on disability. The Census provides the most comprehensive information on race/ethnicity available in US data sources and the size of the 5% sample makes the Census the only data source that permits detailed analyses of health status among smaller race/ethnic subgroups in the United States. These data will be used to investigate race/ethnic differences in disability by age, place of birth, and length of stay in the United Sates, with and without controls for other individual and household-level characteristics. The results of the proposed analyses will advance our understanding of variations in health status among native-born and foreign-born Hispanics, NH-Whites, African-origin populations, and Asian Americans, including subpopulations within these broad race/ethnic groups.