Although studies reveal that immigrants and ethnic minorities are among those at greatest risk for poor health outcomes, little research exists on rural immigrants who experience a disproportionate burden of poverty and economic hardship.
Evan Choi, associate professor of child, youth and family studies, is using restricted-access versions of U.S. Census Bureau data to examine rural, low-income immigrant families and their health-related behaviors — and how they relate to their children’s health and developmental outcomes.
Choi’s research merges census data with the U.S. Center for Disease Control’s National Health Interview Survey to explore both factors at individual, family and community levels. Findings will help streamline census data collection programs, and will pave the way for future health education programs designed for low-income, rural immigrant families.
The combined data show that economic resources are key factors in determining children’s health and behavioral outcomes. For example, children of immigrant families living in high-poverty census tracts were found to have more health and behavioral problems. Also, when immigrant families face health care access and affordability issues, their children’s development is worse than those without such issues.
Thanks to census data access, Choi was able to explore factors outside the home environment. For example, he examined neighborhood characteristics, including socioeconomic status, race and ethnic composition, and community resources such as schools, hospitals, doctors and green space.
“I believe the implications I can make from this study are more valid, because we’re looking at the whole country, and not just limiting data to Nebraska or California or other specific regions,” said Choi, a CYFS research affiliate. “This study provides a better cross-section of the population.”
The National Health Interview Survey is an annual longitudinal survey that captures health information on more than 12,000 families each year. Choi pooled NHIS data from 2013 through 2015 with census information to better understand neighborhood characteristics. Using five data sets, he examined poverty and unemployment rates, minority population compositions, community resources, “food deserts” — urban areas where buying affordable, high-quality food is difficult — and other factors. Data was accumulated for more than 38,000 families — 9,000 of which were immigrant families.
I believe the implications I can make from this study are more valid, because we’re looking at the whole country, and not just limiting data to Nebraska or California or other specific regions.”
Evan Choi, associate professor of child, youth and family studies
Because his research relied on restricted census data, Choi underwent a rigorous background check and was required to submit an additional research proposal to the Census Bureau and the National Center for Health Statistics, outlining which data he planned to access. His proposal review and security approval process took about 10 months.
“It was very time-consuming, but worth it,” he said.
While he awaited approval, Choi examined publicly available data sets, using the information to construct his theoretical and conceptual models. Once he was granted Census Bureau Special Sworn Status, he was allowed access to the Central Plains Federal Statistical Research Data Center, located in the Whittier Building on the University of Nebraska–Lincoln campus.
The CPRDC’s secure computing facility houses restricted-access data sets collected by the Census Bureau and other federal agencies to bolster research that expands basic knowledge and provides benefits to the federal statistical system.
During his visits to the CPRDC, Choi was not allowed to bring a cellphone, camera, computer or any other recording device. He could not take notes, which meant he typically accessed and reviewed data, then left the center to quickly jot down information before he forgot.
Choi notes that rural immigrant families represent one of Nebraska’s largest emerging populations. Using this study’s baseline data, he plans to seek additional grant funding to design, develop and evaluate a high-impact, culturally sensitive health education program for the state’s low-income, rural immigrant families.
“I think we can better target high-poverty rural areas specifically,” he said.
The project is funded by the Central Plains Federal Statistical Research Data Center and housed at CYFS. Graduate Research Assistant Jinyoung Lee also was part of the research team.