The Scientific World Journal / 2013 / Article / Tab 1

Research Article

Immigrant Health Inequalities in the United States: Use of Eight Major National Data Systems

Table 1

National data systems for studying immigrant health in the United States.

Data systemData collection and design Government or sponsoring agencyImmigration variablesPeriod of data availabilityNumber of records or sample sizeSubnational analysisAdvantagesDisadvantages

National Vital Statistics System (NVSS)Period data; temporal; death and birth registration; complete count administrative dataNational Center for Health Statistics, Centers for Disease Control and Prevention (CDC)Decedent’s nativity/immigrant status; maternal nativity status derived from place-of-birth variable1900 through 20112.5 million deaths and 4.0 million births annuallyRegions, census divisions, states, counties, and metropolitan and nonmetropolitan areas Large number of vital records; race/ethnicity detail; geographic detail; long-term time trend; various health, mortality, and birth outcome measuresNo data on several key immigration-related variables, for example, duration of US residence, naturalization, and English-language proficiency

National Linked Birth and Infant Death FilesLongitudinal; cohort; complete count administrative recordsNational Center for Health Statistics, Centers for Disease Control and Prevention (CDC)Mother’s nativity/immigrant status1985 to 200930,000 to 40,000 infant deaths are linked to a cohort of more than 4 million births each yearRegions, census divisions, states, and counties Large population size; ethnic detail; extensive infant mortality analysis by age, cause of death, and medical risks No data on duration of US residence, naturalization, language, or legal status

National Longitudinal Mortality Study (NLMS)Longitudinal; census and CPS records linked prospectively to deaths by cause of death and cancer incidence recordsNational Institutes of Health, US Census Bureau and National Center for Health Statistics, CDCNativity/Immigrant status; country/region of birth1973 to 20082.7 million CPS records at baseline and 341,343 deaths during the 23-year mortality followupState-level analysis possible for selected cohortsLarge sample size; self-reported race/ethnic detail; longitudinal; mortality by cause of deathOnly a subset of the dataset is available as public-use file

National Notifiable Disease Surveillance System (NNDSS)Surveillance conducted by health practitioners and laboratories at local, state, and national levels. State epidemiologists report cases of notifiable diseases to CDC, which tabulates and publishes these data on a weekly and annual basisOffice of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC)It varies by specific disease or surveillance subsystem. For example, the Tuberculosis Surveillance System collects country of birth, year of arrival to the US, and country of birth for primary guardian(s), among others. For other notifiable diseases, no immigration variables are collected1912 to presentIt varies by disease and over time; for example, from 1 case of anthrax disease to 1.4 million Chlamydia  trachomatis infections reported in 2011Regions, states, and countiesNational system; race/ethnicity detail; geographic detail; long-term time trend; various health outcome measuresUnderreporting, state differences in surveillance approaches, changes in disease definitions, changes in the list of notifiable diseases over time and by state, and missing information

National Survey of Children’s Health (NSCH)Cross-sectional; sample survey; telephone surveyHealth Resources and Services Administration (HRSA) and National Center for Health Statistics, CDCParents’ and children’s nativity/immigrant status; duration of residence in the US; English language proficiency2003-2004, 2007-2008, and 2011-2012Approximately 102,353 children under age 18 in 2003-2004, 91,642 in 2007-2008, and 95,677 children in 2011-2012Regions, census divisions, and statesLarge sample size; state-specific analyses; large number of health and behavioral indicatorsAll data based on parental reports; ethnic detail not available on the public-use file

National Health Interview Survey (NHIS)Cross-sectional; temporal; sample survey; in-person interview dataNational Center for Health Statistics, Centers for Disease Control and Prevention CDCChildren’s and adults’ nativity/immigrant status; duration of residence in the US; naturalization status; English language proficiency 1957 to 2012;
immigrant status first became available in the 1976
survey
Approximately 100,000 children and adults annuallyFour broad census regions only (northeast, midwest, south, and west)Large sample size; race/ethnicity detail; long-term time trend; extensive sociodemographic, behavioral, health, and morbidity indicatorsNo geographic detail; data on most Asian subgroups suppressed on public-use file; no language variables; no information on immigrants’ legal or refugee status

National Health
and Nutrition Examination Survey (NHANES)
Cross-sectional; temporal; sample survey; in-person interview dataNational Center for Health Statistics, Centers for Disease Control and Prevention CDCChildren’s and adults’ nativity/immigrant status; duration of residence in the US 1976 to 2010; periodic survey from 1976 to 1998; and continuous survey since 1999Approximately 10,000 children and adults in each waveNoneClinical examination data; medical and lab test results; measured height and weight Small sample size; limited ethnic detail; no geographic detail; no language variables; no immigrants’ legal or refugee status variable

American Community Survey, Public Use Microdata
Sample (ACS)
Cross-sectional; sample survey; in-person interviewUS Census BureauNativity/immigrant status; parents’ nativity status; detailed country-of-birth information; duration of residence in the US; naturalization status; English language ability; languages spoken at homeFrom 2000 to 2011 More than 3 million records in the annual sampleRegions, census divisions, states, and counties (on summary files)Large sample size; extensive race/ethnicity detail; detailed country-of-birth information; language; naturalization status; duration of US residenceNo health variables other than disability and health insurance coverage