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«Editors Rose Maria Li, M.B.A., Ph.D. Peggy McCardle, Ph.D., M.P.H. Rebecca L. Clark, Ph.D. Kevin Kinsella, M.A. Daniel Berch, Ph.D. National ...»

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Diverse Voices

The Inclusion of Language-Minority

Populations in National Studies:

Challenges and Opportunities


Rose Maria Li, M.B.A., Ph.D.

Peggy McCardle, Ph.D., M.P.H.

Rebecca L. Clark, Ph.D.

Kevin Kinsella, M.A.

Daniel Berch, Ph.D.

National Institute on Aging

National Institute of Child Health and Human Development

National Center on Minority Health and Health Disparities

August 2001

Diverse Voices

The Inclusion of Language-Minority

Populations in National Studies:

Challenges and Opportunities Editors Rose Maria Li, M.B.A., Ph.D.

Peggy McCardle, Ph.D., M.P.H.

Rebecca L. Clark, Ph.D.

Kevin Kinsella, M.A.

Daniel Berch, Ph.D.

National Institute on Aging National Institute of Child Health and Human Development National Center on Minority Health and Health Disparities August 2001 Li RM, McCardle P, Clark RL, Kinsella K, and Berch D, eds.

Diverse Voices—Inclusion of Language-Minority Populations in National Studies: Challenges and Opportunities.

National Institute on Aging and National Institute of Child Health and Human Development.

Bethesda, MD: 2001.

Acknowledgments The planning for this meeting began in 1999 when I was affiliated with the Demographic and Behavioral Sciences Branch (DBSB), National Institute of Child Health and Human Devel- opment (NICHD). When I joined the Behavioral and Social Research Program, National Institute on Aging (NIA) in 2000, I was able to continue working on this activity with the support and encouragement of the Associate Director, Richard Suzman. Fortunately, around the same time, Peggy McCardle, a linguist by training, joined the Child Development and Behavior Branch at NICHD. Peggy was willing and interested in taking the lead for NICHD in planning the meeting, and her rigorous thinking and managerial abilities soon became appar- ent. We were also fortunate to get reinforcements. Dan Berch joined NIA in the spring of 2000 and pulled together the session on technological innovation and linguis- tic logistics. We also recruited Rebecca Clark from DBSB shortly after she joined NICHD in early 2000. Her strong background in immigration research and her prior tenure at the Urban Institute helped us fill in many of the remaining holes in the agenda. We also benefited by earlier brainstorming sessions with Christine Bachrach, Chief of DBSB at NICHD, and Natasha Cabrera, a psychologist at NICHD. The final meeting agenda was truly strengthened as a result of this multidisciplinary collaboration and input.

Many people contributed time and expertise to the meeting and the writing of this meeting report. We appreciate the cooperation and assistance of all the meeting participants who provided valuable and stimulating comments. Nathan Stinson, Deputy Assistant Secretary for Minority Health, Department of Health and Human Services, and Yvonne Maddox, Acting Deputy Director of NIH and the Deputy Director for NICHD, graciously agreed to serve as keynote speakers. Their remarks underscored the relevance and timeliness of the topic in multiple arenas, from data collection to health care delivery. We are grateful to John Ruffin, Director of the NIH Office of Research on Minority Health since its founding in 1990, and now the Director of the NIH National Center on Minority Health and Health Disparities, for authorizing the funds that provided the catalyst for transforming the idea for this meeting into a reality. We want to give special thanks to April Burton at NICHD who helped with the logistics for the meeting, and coordinated with the folks at IQ Solutions to make the meeting a success.

iii We are also grateful to Raynard Kington, the Director of the NIH Office of Behavioral and Social Science Research, for his support and assistance in underwriting the publication costs of this report. The final version of this report could not have been completed without the help of multiple reviewers. We thank Robert Santos and James McNally for their careful reading of an earlier draft of this report, and Gillian Stevens who responded to multiple questions that arose throughout the process. We are particularly indebted to Kevin Kinsella who applied not only his superb editing skills but also his broad knowledge of Census data to help us ready the report for publication.

We are most appreciative of the expert assistance provided by Wan He and Gladys Martinez in reviewing the Chinese and Spanish translations of the Executive Summary.

We also want to thank Andrew Galen, an NIA summer intern, who did an excellent job helping to coordinate the many details involved in bringing this report to publication.

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iv Diverse Voices

The Inclusion of Language-Minority Populations in National Studies:

Challenges and Opportunities Contents Executive Summary


Describing the Language-Minority Population

Extant Demographic Data on U.S. Linguistic Diversity

Levels of English Proficiency

Geographic Distribution of Language-Minority Populations

Challenges for Including Language-Minority Populations in Surveys

Difficulties in Assessing Language Usage

The Multiplicity of Languages

Additional Factors Contributing to Underrepresentation in National Studies

Sampling, Measuring and Interviewing Language-Minority Populations

Sampling Procedures

Survey Instrument Issues

Interviewer Expertise

Problems of Within-Group Heterogeneity

Strategies for Exerting Quality Control Over Translation and Interview Practices............. 18

Technological Innovation and Linguistic Logistics


Barriers to Inclusion

Enabling Inclusion


Appendix A. Recent and Current-Practice Examples

B. Inclusion of Language-Minority Populations in National Studies: Challenges, Opportunities, and Past Practices—July 27–28, 2000 Meeting Agenda

C. Biographical Sketches of Presenters

D. Workshop Participants

Executive Summary In August 2000, President Clinton issued an Executive Order requiring all federally assisted programs to provide access for persons with limited English proficiency. This order highlighted the need to consider language issues in the design and execution of federal, state and local service programs. Concurrently, it stimulated awareness of the need for scientifically reliable data on the prevalence of English proficiency and the steps needed to overcome existing barriers to collecting such information.

Individuals in the United States who do not speak English well (referred to as language-minority individuals) represent a major challenge for health and social service agencies, educators, policy planners, and researchers. Although only about 3 percent of the U.S. population aged 5 and over speak English poorly or not at all, the proportion varies substantially by age, nativity, education, and other factors.

Demographers and other social scientists usually use large-scale household surveys, based on probability sampling, to collect data that accurately represent the characteristics of the U.S. population as a whole. Most surveys limit their interviewing to English or English and Spanish, and respondents must have a relatively high level of proficiency in that language.

If, as expected, the proportion of language-minority individuals in the population increases over time, the representativeness of national samples is increasingly compromised. Indeed, population research based on what are purportedly nationally representative surveys very often will overlook those immigrants likely to be the most vulnerable. Since lack of language ability is often a barrier to accessing health care and other social services, the inability to speak English well may contribute to disparities in health outcomes.

In view of strong national commitments to (1) improving the inclusion of minorities in clinical trials; (2) reducing health disparities among subpopulations;

and (3) developing cultural competence in health service delivery, researchers and policy makers should give added attention to language as a potential barrier excluding people from national surveys, as well as from access to health care and social services.

To help find ways for survey research to capture the increasing linguistic diversity of the United States and hence be truly nationally representative, this report focused on current barriers to inclusion as well as ways to enable inclusion.

1 Barriers to Inclusion A recurring theme throughout this report is that cost is the most significant barrier to inclu-ding language-minority populations in national studies. Four necessary but expensive tasks were identified: (1) sampling to get sufficient numbers of subjects who do not speak English well;

(2) translating or developing survey instruments (including the concomitant costs of vetting the translation, conducting focus groups, and/or piloting surveys); (3) recruiting, hiring, and training bilingual interviewers; and (4) contacting and interviewing subjects who live in rural or geographically diverse locations.

The geographic distribution of minority language populations may be a significant barrier to their inclusion in national studies. Language-minority individuals are often difficult to include in studies either because they are clustered in small, possibly remote areas, or because they are not concentrated in any particular area. Cost-effective sampling strategies based on geographic location therefore often cannot be used.

Language change over time is a barrier to inclusion of language-minority groups in research. The version of language spoken by recent immigrants often differs significantly from that of individuals who immigrated several years ago. And, among long-term immigrants, those who live in isolated communities develop different dialects from those who routinely interact with English speakers.

Lack of coherence with other research goals presents a barrier. Addressing specific language groups may not be well-integrated into a project’s major research focus, and may therefore seem an ad hoc, add-on component that does not fit well with the overall research goals and design.

Use of community members as translators/interpreters may be a barrier.

While the use of local translators and interpreters can sometimes improve survey coverage, their use also may be a barrier with regard to issues of confidentiality or culturally sensitive topics that respondents are uncomfortable with or reluctant to openly discuss with someone from their own community. Similarly, someone from the local community (either the current community or the community of origin of an immigrant) may invoke the class structure of the culture of origin, which can interfere with the goals of the research.

Enabling Inclusion The challenges of including language-minority populations in national surveys and studies are not new, and many underutilized resources are already at hand. In addition, there are new technologies and potential solutions on the horizon. It is possible to decrease cost through innovative sampling approaches, rather than screening the general population.

For example, researchers can identify subjects through pre-existing lists based on administrative records (e.g., birth registries, INS records, Medicare records). Other strategies include using telephone interviews to conduct preliminary screenings, and cumulating data from repeated surveys in order to increase sample sizes.

2 Instrument translation should incorporate and expand on several important practices.

Translation should be done by professional bilingual translators, and the translations should be vetted (judged as to linguistic and cultural appropriateness) by monolingual speakers of the target language. Translated or parallel instruments should undergo cognitive testing to determine that they test/query the same concepts. Researchers should allow translation into Anglicized dialects. The retention/inclusion of English terms in the translated instrument is important when a concept does not exist in the target language and culture. Translations should also be tested in focus groups of monolingual speakers from or typical of the target research group, and should be piloted whenever possible.

Researchers should build in time for translations when designing and planning studies. The English version of an instrument should be completed before beginning its translation, and there must be time to translate, evaluate, and test the translated version prior to the initiation of actual data collection in either language. Alternatively, researchers could develop (or contract development of ) a parallel, culturally appropriate instrument simultaneously with the English language instrument, or lagged behind the English version but overlapping in timing.

The rapidly expanding sophistication of machine technology can reduce the amount of time required for professional translators by allowing them to refine and correct translations rather than shoulder the entire translation burden. Although not applicable in all cases, some research should benefit from using one or more of the three major types of machine translation currently in use—knowledge-based, corpus-based, and human-in-the-loop.

In order to complement and inform future activities, researchers should ensure that they make optimal use of existing knowledge by building on the work of others

and collaborating across disciplines. Researchers should:

Gather and share the experience of international organizations that already © have multilingual survey experience (e.g., United Nations, Organisation for Economic Co-operation and Development, World Bank, Demographic Health Surveys, World Health Organization).

–  –  –

of colleagues for potential use in machine translation memory databases.

Use existing survey instruments as a starting point whenever feasible.

© For example, a survey from another country, already written in the language of that country, might require refinements to accommodate cultural adaptations that have taken place since a group emigrated, but could provide a basis to build on.

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(Diverse voices make sweet music;

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