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Volume 2: No. 2, April 2005
SPECIAL TOPICS
ORIGINAL RESEARCH: FEATURED
ABSTRACT FROM THE 19TH NATIONAL CONFERENCE ON CHRONIC DISEASE
PREVENTION AND CONTROL
Race, Ethnicity, and Linguistic Isolation as Determinants
of Participation in Public Health Surveillance Surveys
Michael Link, Ali Mokdad, Herbert Stackhouse, Nicole Flowers
Suggested citation for this article: Link M, Mokdad A,
Stackhouse H, Flowers N. Race, ethnicity, and linguistic isolation as
determinants of participation in public health surveillance
surveys [abstract]. Prev Chronic Dis [serial online]
2005 Apr [date cited]. Available from: URL: http://www.cdc.gov/pcd/issues/2005/
apr/04_0142c.htm.
PEER REVIEWED
Track: Methods and Surveillance
Public health officials and researchers require valid and
reliable public health surveillance data to plan, implement, and
evaluate programs designed to eliminate health disparities among
racial and ethnic minority populations. Monitoring chronic
disease and behavioral risk factors among such populations,
however, has proven challenging. This research is designed to
assess disparities among minority populations in participation
levels in public health surveillance efforts and to test
alternative methods for reducing these disparities.
We analyzed data from the 2003 Behavioral Risk Factor
Surveillance System (BRFSS), which is a monthly,
random-digit–dialed telephone survey of the
noninstutionalized adult (aged 18 years and older) population in the
United States. County-level data from the 2003 BRFSS and 2000
U.S. Census are modeled using ordinary least squares regression to examine the
effects of race, ethnicity, and linguistic isolation on six
measures of survey participation (e.g., resolution, screening,
cooperation, refusal, refusal conversion, response
rates).
The study finds that even after adjusting for other factors such as
socioeconomic conditions, average commute time, use of call screening
technology, and level of data collection effort (other factors thought to be
related to survey response), areas with higher percentages of African Americans
(regression coefficient, −0.14, P < .001), Hispanics (regression
coefficient, −0.57, P < .001), and those who do not
speak English — particularly those speaking only Asian (regression
coefficient, −1.67, P <
.001) or Indo-European (regression coefficient, −2.73, P < .001) languages — were significantly
less likely than whites to participate in the public health surveillance.
In response to
this finding, the BRFSS is investigating two alternatives for
reaching these underrepresented groups: 1) use of alternative
survey modes; in particular, providing translated hard-copy
versions of the BRFSS by mail, and 2) use of specialized language
line translation services to offer real-time translation of the
BRFSS into languages beyond English and Spanish.
The collection of valid and reliable data for public health
surveillance in the United States is becoming challenging.
Current methods increasingly underrepresent racial, ethnic, and
linguistically isolated groups. As a result, the health problems
and needs of these groups may be significantly underreported. The
development of successful public health interventions and
programs capable of reducing health disparities requires that
monitoring systems be developed that are capable of tracking the
public health of all groups.
Corresponding Author: Michael W. Link, PhD, Senior
Survey Methodologist, Centers for Disease Control and Prevention,
National Center for Chronic Disease Prevention and Health
Promotion, Division of Adult and Community Health, 4770 Buford
Hwy NE, Mail Stop K-66, Atlanta, GA 30341-3717. Telephone:
770-488-5444. E-mail: MLink@cdc.gov.
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