The assessment of immigration status in health research

This report examines methodological issues relating to immigrant health, definition of immigrant, the assessment of immigrant status, and sampling strategies with immigrant populations.

A literature review was conducted for the period 1977-98, utilizing various computer data bases to identify relevant studies. A total of 179 separate U.S.-based studies were reviewed. Twenty-two sample instruments and two revised versions of instruments for the assessment of immigration status were evaluated.

In general, research relating to immigrants and their health has not attended to methodological issues inherent in such investigations. Instruments utilized to assess immigration status differ across studies, making cross-study comparisons difficult. Few studies have relied on probability sampling. Almost no data are available on field performance of instruments developed to assess immigration status.

Development of an appropriate instrument requires consideration of the definition of immigrant to be used, the level of respondent knowledge to be presumed, the political and social climate that exists at the time of the survey administration, the populations and geographic locales with which the instrument will be utilized, the complexity of the instrument, and methods of the instrument administration. In view of the paucity of data pertaining to the field performance of instruments used to assess immigration status, any instrument considered for use must be field tested and revised appropriately before incorporation into a national survey. The appropriateness of any particular sampling strategy should be evaluated in the context of the field testing.