>> WELCOME BACK. WE'RE GOING TO GET STARTED. PLEASE TAKE YOUR SEATS.. THANK YOU. I'M GOING TO HAVE A 90 SECOND THANK YOU FROM DR. STEVEN HIRSCHFIELD THEN PROCEED WITH THE FINAL AGENT CA. >> GOOD MORNING. THIS IS DR. STEVEN SIRSCHFELD FROM THE EUNICE KENNEDY SHRIVER NATIONAL CHUTE OF HIELD HEALTH AND HUMAN DEVELOPMENT. I WANT TO THANK EVERYONE FOR ASSEMBLING AN INTERESTING INFORMATIVE CONFERENCE. THOUGH THE CONFERENCE STILL HAS MANY HOURS TO GO, ALREADY A FEW THINGS TO GUIDE THE DATA ACQUISITIONS FOR THE NATIONAL CHILDREN'S STUDY HAVE EMERGED. THOUGH WE ARE INTERESTED IN HUMAN NETWORKS AB THEIR FINE DIEP MIX, HOW PEOPLE COMMUNE -- DYNAMICS AND HOW PEOPLE COMMUNICATE AND WHAT INFLUENCES THE DECISIONS AN OUTCOMES WE NEED TO CAPTURE KEY EVENTS FOR THE PARENTS OF THE CHILDREN BORN ATTORNEY THE NATIONAL CHILDREN'S STUDY. IF A MIGRATION OCCURRED, WHEN IT OCCURRED, WHERE IT ORIGINATED, AND IF THERE WAS A SEPARATION OF FAMILY MEMBERS. AS WE REFLECT WHAT WE HAVE LEARNED DURING TWO DAYS WE WANT TO CONTINUE TO ENGAGE THOSE OF YOU WHO CONTRIBUTED TO THE DISCUSSION AND OTHERS WHO MAY CONTRIBUTE IN THE FUTURE. THE NATIONAL CHILDREN'S STUDY WILL PRODUCE AN UNPRECEDENTED DATA RESOURCE THAT BELONGS TO ALL OF US SO WE SHOULD PLAN OUR DATA COLLECTION TO ENSURE THAT AS MANY PEOPLE ARE SERVED AND CAN BENEFIT AS RESOURCES ALLOW. FEEL ENCOURAGED TO CONTACT US AT THE EMAIL ADDRESS ON THE SLIDE, CONTACT NCS@MAIL.NIH.GOV AND FOLLOW US ON OUR PUBLIC WEBSITE, WWW.NATIONALCHILDRENSSTUDY.GOV. THANK YOU. >> SO NEXT ON THE AGENDA WE WILL HAVE DR. LAYRY IS A AVILES-SANTA FROM THE NATIONAL HEART LUNG AND BLOOD INSTITUTE HERE AT THE NATIONAL INSTITUTES OF HEALTH, AND SHE'S ACTUALLY GOING TO SHARE WITH US INFORMATION ON A PARTICIPATION OF IMMIGRANTS IN RESEARCH STUDY AND JUST WITH A LITTLE BACKGROUND, SHE IS THE PROJECT DIRECTOR FOR THE HISPANIC COMMUNITY HEALTH STUDY OF LATINOS AND HER MAIN RESEARCH INTERESTS INCLUDE PREVENTION OF CARDIOVASCULAR DISEASE, IN LATINOS WITH TYPE 2 DIABETES. MORE EXTENSIVE BIO IS DEFINITELY AVAILABLE IN THE FOLDER, SO WE CAN WELCOME DR. AVILES-SANTA. [APPLAUSE] >> THANK YOU. AND THANK YOU FOR THE INVITATION. I HAVE CERTAINLY ENJOYED ALL THE PRESENTATIONS AND I THINK THIS TOPIC IN GENERAL IS ABSOLUTELY RELEVANT. I HOPE THAT THE PRESENTATION THAT I'M GOING TO FACILITATE TODAY IS GOING TO BE HELPFUL TO THE NATIONAL CHILDREN'S STUDY AND ALSO TO MOTIVATE YOU TO DEVELOP OTHER QUESTIONS. >> CAN YOU HEAR ME NOW? SO I AM THE OFFICER FOR THE HISPANIC COMMUNITY HEALTH STUDY, STUDY OF LATINOS AND I AM HERE PRESENTING ON BEHALF OF THE STEERING COMMITTEE WHICH IS LISTED IN THE SLIDE AND WANT TO -- THANK YOU FOR COMING. ALSO THE HISPANIC COMMUNITY HEALTH STUDY IS NOT ONLY FUNNED BY NHLBI BUT CO-FUNDED BY OTHER SIX INSTITUTES WITHIN THE NIH. I WANT TO SHOW YOU A SERIES OF PICTURES AND WHY THE HISPANIC COMMUNITY HEALTH STUDY IS NECESSARY AND WAS NECESSARY. SO AS YOU CAN SEE SOME OF YOU MAYBE FAMILIAR OR MAY KNOW WHAT ALL THESE ITEMS ARE. [LAUGHTER] AS YOU SEE, HISPANIC IS AN UMBRELLA TERM. IT WANTS TO REALLY TALK ABOUT A GROUP THAT IS HIGHLY HETEROGENEOUS THAT HAS MULTIPLE NATIONALITIES, COUNTRIES OF ORIGIN, AND ALSO CULTURES WITHIN THE CULTURE, THE MAIN CULTURE. AND WAYS TO EXPRESS THEMSELVES NOT ONLY IN CUISINE OR PARIS OR IN REALLY JOHN OR CULTURE TRADITIONS BUT ALSO HOW WE ADAPT OR ADOPT TO OTHER COUNTRIES, CONCEPTS OF HEALTH AND DISEASE, ET CETERA, ET CETERA. JUST BRIEFLY, I KNOW THAT WE ARE RUNNING OUT OF TIME, THE HISPANIC COMMUNITY HEALTH STUDY WAS INITIATED AS A CONSULT WITH EXTERNAL EXPERTS ABOUT THE NEED IN RESEARCH ON HISPANIC HEALTH. AFTER CONSULTATION AN RFP WAS RELEASED, IT WAS PURSUING THE REQUEST OF PROPOSALS TO RECRUIT 4,000 PARTICIPANTS, TOTAL SAMPLE SIZE WAS GOING TO BE 16,000. AND EVALUATE PREVALENCE OF RISK FACTORS AN PREVALENCE OF MULTIPLE CHRONIC CONDITIONS IN HISPANICS OF DIFFERENCE ORIGINS. WE ALSO WANTED TO SEE A STRONG INTERACTION WITH THE LOCAL COMMUNITY AND PLAN TO DEVELOP THE CAREER OF YOUNG OR HISPANIC INVESTIGATORS. THE PROPOSALS WERE RECEIVED AND EVALUATED BY AN EXTERNAL PANEL AND FOUR PROPOSALS FOR FEEL CENTERS AND ONE FOR A COORDINATING CENTER WERE AWARDED IN 2006. THE PRIMARY GOAL OF THE HISPANIC COMMUNITY HEALTH STUDY WE ALSO SAW IS TO IDENTIFY THE PREVALENCE PULMONARY RISK FOR DISEASE AND OTHER CONDITIONS IN HISPANIC GROUPS. THIS IS A POSTER WE USE SHOWING DIVERSITY OF FACES FACES COLOR, HAIR TEXTURE OF HISPANIC COMMUNITIES. IN ADDITION WE WANTED TO KNOW PREVALENCE OF FACTORS THAT WOULD BE EITHER PROTECTIVE OR HARMFUL IN THE DEVELOPMENT OF THIS CONDITION. WE ALSO WANTED TO COLLECT INFORMATION MANY ON ALL CAUSE MORTALITY AND INCIDENCE OF CARDIO VASCUALREADY AND PULMONARY CONDITIONS. THIS PRODUCT IS NOT ONLY CROSS SECTIONAL, IT'S ALSO LONGITUDINAL. THE FEEL CENTERS ARE LOCATED -- THE TOTAL SAMPLE SIZE IS 16,000 OR THAT WAS A GOAL, 16,000 PARTICIPANTS, THE SAMPLE DESIGN WHICH IS EXPLAINED IN ONE OF THE ARTICLES THAT WAS IN YOUR FOLDER, IS COMMUNITY BASED RANDOM SAMPLING, SO PARTICIPANTS WOULD NOT COME FROM A CLINIC, THEY WOULDN'T BE REFERRED BY FRIENDS, THEY WANTED THE SAMP TOLL REPRESENT THE LOCAL COMMUNITY. THE AGE RANGE IS 18-74 AND WE WANT AD MAJORITY 45 TO 74 AND IN EVERY FIELD SENOR THE TARGET SAMPLE WOULD BE 4,000 HISPANIC WHO SELF-IDENTIFIED HISPANIC WITH ANY OF THE HISPANIC GROUPS LISTED THERE. THE FIELD SENTERS ARE LOCATED IN SAN DIEGO AND THAT WAS A SLIP THERE. THAT'S A COORDINATING CENTER IN NORTH CAROLINA. A FIELD SENOR IN MIAMI, THE BRONX AND A SENOR IN CHICAGO. WELL, THE RECRUITMENT WAS DESIGNED TO START IN MARCH OF 2008 AND FINISH IN JUNE 2011. WE PASS THE GOAL SO WE RECRUITED OVER 16,000 PARTICIPANTS ACROSS FIELD CENTERS. THAT'S SHOWING THAT CENTERS RECRUIT OVER 4,000 EACH WAY. IN TERMS OF VARIABLES DISCUSSED THE LAST TWO DAYS PEOPLE SELF-IDENTIFY WITH ANY GROUP, WE DIDN'T GIVE THE LABEL. IT WAS SELF-DETERMINED BUT WE ALSO ASK THEM THE COUNTRY OF BIRTH, NOT ONLY OF THE PARTICIPANTS BUT ALSO THE PARENTS AND ALSO THE TWO SETS OF GRANDPARENTS. AND WE ARE ALSO CHECKING MORE SPECIFIC DATA ON THE PLACE OF BIRTH, THE TOWN T STATE, THE PROVINCE, ET CETERA. WE CHECKED DATA ON YEARS LIVING IN THE U.S. AND HISTORY WHETHER THEY LIVED IN ANOTHER COUNTRY BEFORE MOVING TO THE U.S.. IF THERE WAS A BRIDGE COUNTRY OR SOMETHING LIKE THAT. OKAY. THIS IS THE DISTRIBUTION OF ORIGINS OR BACKGROUND IN THE COHORT. 39% ARE SELF-IDENTIFIED MEXICAN OR MEXICAN AMERICAN. 17% PUERTO RICAN. 14 RAZ CUBAN, .5% CENTRAL AMERICAN. AND AMONG THEM THE THREE MOST COMMON ARE NICARAGUA, HONDURAN AND GUATEMALAN. 95% DOMINICAN, 6.5% SOUTH AMERICAN AND THE TOP 3 ARE COLUMBIAEN, PROVIAN AND EQUADORIAN. THE OTHER IS HISPANIC AND THAT MEANS THEY IDENTIFY WITH ONE -- MORE THAN ONE OF THE GROUPS OR THEY WERE A MIX HISPANIC WITH ASIAN AND OTHER ANCESTRIES. THIS IS A DISTRIBUTION ACCORDING TO FIELD CENTER WITH A MAJORITY OF MEXICAN, MEXICAN AMERICANS IN SAN DIEGO AND CHICAGO, MAJORITY OF PER PUERTO RICAN IN THE BRONX BUT A SIGNIFICANT DOMINICAN POPULATION IN THE BRONX AND MAJORITY OF CUBAN BUT SUBSTANTIAL CENTRAL AMERICAN POPULATION IN MIAMI. WE ARE TALKING MIGRATION AND WHETHER PUERTO RICANS ARE MIGRANT OR CITIZENS SO THE MEANING OF MIGRATION OR BEING BORN OUTSIDE THE U.S. IS DIFFERENT ACCORDING TO THE STUDY AND FOR THE PURPOSE OF THIS SLIDE BORN OUTSIDE THE U.S. MEANS BORN OUTSIDE THE U.S. AND ITS TERRITORIES. 79% OF THE SAMPLE WERE BORN OUTSIDE THE U.S. AND IT'S -- 20% WERE BORN IN THE US. IF YOU ADDED, IF WE CONSIDER PUERTO RICAN BORN OUTSIDE OF THE U.S. THEN DEAF NUTTILY OVER 90% WOULD BE BORN OUTSIDE THE US. THE MAJORITY HAVE LIVED IN THE U.S. OVER 15 YEARS. BY FAR THE PREFERRED LANGUAGE NOT ONLY AT HOME OR FOR DAILY ACTIVITIES BUT ALSO TO ANSWER THE INTERVIEW WAS SPANISH. AND THIS IS SHOWING A -- ONE OF THE BIOLOGICAL MEASUREMENTS, BMI IN THE COHORT. IN TERMS OF AAGE OF EMPLOYMENT WE BROKE IT DOWN 18-44, 45 AND OLDER, AND YOU SEE THE RATES OF EMPLOYMENT AND UNEMPLOYMENT THAT ALTHOUGH THERE ARE -- THE MAJORITY ARE EMPLOYED, THERE IS A SIGNIFICANT PROPORTION WHO ARE UNEM EMPLOYED IN BOTH AGE GROUPS. IN TERMS OF EDUCATION, YOU CAN SEE THAT HAVING LESS THAN HIGH SCHOOL, HAVING COMPLETED 12 GRADES OR BEYOND 12 GRADES IS ALMOST FLAT ACROSS GROUPS OR ACROSS A COHORT, I SHOULD SAY. THIS IS TAKING INTO CONSIDERATION EDUCATION OUTSIDE OF THE U.S. AS WELL. SO WE COUNTED THE YEARS OR THE EQUIVALENT TO EDUCATION IN THE US. IN TERMS OF ANNUAL INCOME OVER 60 POARS OF THE COHORT ARE EARNING ANNUAL INCOME OF 60 -- I'M SORRY, $40,000 PER YEAR. THIS IS BROKEN DOWN ACCORDING TO AGE GROUP AND YOU STILL SEE THAT OVER 60% ACCORDING TO AGE GROUP ARE EARNING LESS THAN $40,000 PER YEAR. IN TERMS OF BEING COVERED BY ANYSOR OF HEALTH INSURANCE IN THE GROUP OF 18-44, WE SEE THAT THERE ARE DIFFERENCES MAINLY TRIGGERED FROM THIS SLIDE ON THE LOCAL HEALTH SYSTEM, THAT'S ONE OF THE FACTORS TOO THIS NEEDS TO BE TAKEN INTO CONSIDERATION THAT THE U.S. DOESN'T ONLY HAVE ONE HEALTH SYSTEM, WE HAVE MULTIPLE HEALTH SYSTEMS. SO PEOPLE IN NEW YORK ARE COVERED WHEREAS PEOPLE IN MIAMI ARE HIGHLY INSURED OR NOT SHOORED. -- INSURED. A SIMILAR TREND IS SEEN IN PEOPLE 45-74. HAVING THESE -- OR SHARING WITH YOU THE PROFILE OF THE COHORT TAKING INTO CONSIDERATION THESE ARE FOUR FIELD CENTERS DIVERSE HISPANIC GROUP, HOW DO WE GET THERE? HOW DO WE RECRUIT THE SAMPLE, NOT EVEN THAT, WE PASS THE GOAL, THAT'S THE PURPOSE OF MY PRESENTATION HERE, TO SHARE THE WITH YOU THE STRATEGIES HOW WE DID IT, NOT ONLY HOW WE RECREWED THE PARTICIPANTS BUT HOW WE ARE RETAINING THEM FOR THE ANNUAL FOLLOW-UP. I'M GOING TO SHOW YOU A FEW PICTURESCH THIS IS THE GROUP FROM SAN DIEGO. , THE GROUP FROM CHICAGO, THE GROUP FROM MIAMI, THE GROUP FROM BRONX, THIS IS THE COORDINATING CENTER. SO WHAT DO YOU SEE? THE PICTURE VERSUS IN COMMON? OTHER WOMEN, DIVERSE, AND A LOT OF PEOPLE. A LOT OF PEOPLE. EXACTLY. FOR THIS TYPE OF EPIDEMIOLOGICAL STUDY, YOU NEED TO REALLY RECRUIT A SAMPLE THAT REPRESENT AS COMMUNITY. YOU NEED TO DO A LOT OF LEG WORK. SO YOU NEED PEOPLE. YOU NEED TO FIGURE OUT HOW TO CREATE THE SHIFTS AND WHEN TO DO THE RECRUITMENT, THE HOME VISITS, ET CETERA. SO YOU HAVE ALSO TO WORK ON LOGISTICS. YOU HAVE TO CONSIDER THE AGE, THE EXPERIENCE STAFF HAVE IN TERMS OF INTERACTING WITH PEOPLE AND HOW MUCH THEY KNOW ABOUT THEIR OWN CULTURE TAN OTHER CULTURES AND COMMUNITY AND SURROUNDINGS. WHEN IT IS SAFE TO GO OUT AND DO RECRUITMENT. WHAT DAYS OF THE WEEK ARE BETTER. AND WHEN ACTIVITIES ARE HAPPENING IN THE COMMUNITY THAT SHOULD BE AVOIDED. ET CETERA, ET CETERA. ALSO THEY NEED TO BE TRAINED AND CERTIFIED IN THE RECRUITMENT, SKILLS, AND NOT ONLY RECRUITMENT IN THE ENTIRE PROCEDURES THAT THE STUDY IS COVERING. IN OUR CASE LANGUAGE AND CULTURAL PROFICIENCY ARE NECESSARY IN ORDER TO INTERACT WITH HISPANICS OF DIFFERENT ORIGINS. NOT ONLY STAFF NEEDS TO BE PREPARED TO DO THIS, WE ALSO NEED GOOD RELATIONSHIPS WITH THE COMMUNITY. AND ESTABLISH PARTNERSHIPS AN GOALS THAT WILL BENEFIT BOTH OF US. WE NEED TO KNOW THE STRUCTURE OF THE COMMUNITY, WHAT RESOURCES ARE THERE AND WHAT INSIGHT AND COLLABORATION THE COMMUNITY ORGANIZATIONS CAN OFFER AND WILL OFFER TO HELP YOU WITH THE PROJECT. I SHOW YOU THE POSTER BECAUSE THIS WAS WORK OF THE COMMUNITY BOARD IN THE STUDY. YOU ALSO NEED PUBLICITY, YOU NEED TO TACKLE EVERY MEDIA POSSIBLE ESPECIALLY RAID YOA. BUT TV IS ALSO POWERFUL IN THE COMMUNITY. LOCAL NEWSPAPERS AND WE ALSO RECRUITED A COMMUNITY VIDEO. I HAVE 3. THE VIDEO WE LEF AT HOME FOR THE PARTICIPANTS TO VIEW AFTER THE RECRUITERS WENT. SO THEY COULD GET MORE INFORMATION OR REVIEW INFORMATION THAT THEY HAVE SHARED WITH THEM. ONE FIELD CENTER POSTED THE VIDEO ON YOUTUBE. IF PARTICIPANTS ARE NOT HOME LOOK AT PART TIMER, LOOK AT DIFFERENT TIMES OF THE DAY. WE ALSO HAD WEEKLY PHONE CALLS WITH THE RECRUITMENT TEAM AND WE BRAINSTORMED EVERY WEEK SOLVING PROBLEMS, LOOKING FOR SOLUTIONS. VERY IMPORTANT, THIS HAS BEEN COVERED TREMENDOUSLY IN THE LAST TWO DAYS. ALL FACTORS THAT INFLUENCE PARTICIPATION ESPECIALLY IN A STUDY SPONSORED BY THE FEDERAL GOVERNMENT. THE FIRST FACTOR WAS SELF-IDENTITY. THAT IS THAT DETERMINED AND WHEN WE PRESENT THE PROJECT AT THE HISPANIC IMMUNITY HEALTH STUDY, HOW HISPANICS REACT TO THE TERM HISPANIC. BECAUSE IT'S NOT THE SAME CONNOTATION HERE IN THE U.S. AS IN COUNTRIES O ORIGIN. TO GIVE YOU AN L ILLUSTRATION OF ALL THE TERMS WE IDENTIFY WITH, BECAUSE WE IDENTIFY DIRECTLY WITH OUR ROOTS, WITH OUR ORIGIN. BUT NOT NECESSARILY WITH A MAIN TERM, WE IDENTIFY WITH (INAUDIBLE) BUT NOT NECESSARILY CALL MYSELF HIS PA IN THIS CASE BUT MY HERITAGE IS LATINO EMERICANA. ARE YOU ALL RIGHT? LEGAL STATUS VARIES. WE DID NOT ASK LEGAL STATUS IN THE PROJECT. WE WRESTLED WITH THE ISSUE AND GOT FEEDBACK FROM THE COMMUNITY BOARD AVOIDING IT FOR NOW. WE WANTED TO ESTABLISH THE PROJECT AND GAIN TRUST OF THE COMMUNITY. THIS IS SOMETHING THAT WE COULD CONSIDER LATER BUT IN THIS PHASE OF THE STUDY WE DIDN'T CHECK THAT INFORMATION. THERE WERE PARTICIPANTS WHO WERE CONCERNED ABOUT LAW ENFORCEMENT AND HOW CONFIDENTIAL THE INFORMATION PROVIDED IN THE PROAPOLOGETIC WAS. THAT WAS ASSURED IN THE CONSENT FORM, THAT WAS ASSURED DURING OUR INTERACTIONS WITH THEM. AND CONFIDENTIALITY AS WELL, ANOTHER PORTION OF THE CONSENT FORM. WHEN WE APPROACH THE COMMUNITIES IN THE FIELD, HAVING A STUDY SPECIFICALLY FOR HISPANICS WAS SEEN AS POSITIVE BY ASSORTMENT AND NEGATIVE BY SOME. POSITIVE FINALLY REPRESENTED RESEARCH, NEGATIVE. WHY ARE YOU TARGETING US? OR OTHER GROUPS IN COMMUNITY. STUDY HISPANICS AND WHY NOT IN MY GROUP? SO THOSE THINGS WE HAD TO DEAL WITH AND HELP RECRUITERS ANSWER QUESTIONS PROVIDING DATA, STUDYING THE DATA AVAILABLE SO THEY COULD PROVIDE A VERY GOOD DIPLOMATIC ANSWER. IN THE COMMUNITIES IT IS TRUE THERE ARE MULTIPLE SCAMS OUT THERE. AND GOING TO THE HOUSE TO INTERVIEW AND PRESENT A PROJECT, MANY OF THEM RESPONDERS SAW IT AS POTENTIAL SCAM AND DIDN'T WANT TO PARTICIPATE MED SCARE SCAMS, HAPPENING IN MIAMI AND NEW YORK. ONE RESEARCH ON EXPERIMENT TAITION, ARE YOU GOING TO TAKE TISSUE FROM ME? ESPECIALLY PEOPLE WHO HAVE HAD OR HAVE LEARNED OF A BAD EXPERIENCE IN RESEARCH WITH THE FEDERAL GOVERNMENT. WE COLLECTED DNA AND SPEND TIME EXPLAINING WHAT DNA WAS FOR, WHAT GENETICS RESEARCH IS FOR AND ASSURANCES OF WHAT WE ARE NOT GOING TO DO WITH IT. THE CONCEPT OF HEALTH AND DISEASE -- I AM OUT OF TIME. PEOPLE MAY SEE HEALTH AND DISEASE IN A DIFFERENT WAY, HEALTH PRACTICE, BELIEFS THAT MAY INTERFERE WITH THEIR PARTICIPATION, NO NECESSARILY EPIDEMIOLOGICAL STUDIES BUT ALSO IN CLINICAL TRIALS. THE BENEFITS VERSUS RISKS THAT YOU NEED TO EXPLAIN TO THE PARTICIPANTS AND WHY THE NEED OF A STUDY LIKE THIS IN ORDER TO LEARN MORE AB HISPANIC HEALTH IN GENERAL. INTERACTING WITH HEALTHCARE PROVIDERS, SOME LOCAL PHYSICIANS UNFORTUNATELY TOLD PARTICIPANTS NOT TO COME TO THIS STUDY. THEY THOUGHT IT WAS PART OF A SCAM OR THEY THOUGHT THAT THE PARTICIPANTS WERE GOING TO BE TRANSFERRED TO ANOTHER TYPE OF CARE. SO WE DEVELOPED ALSO A LETTER FOR PHYSICIANS. ROLE OF REIMBURSEMENT VERSUS INCENTIVE. WE REIMBURSED FOR TRANSPORTATION AND OTHER EXPENSES THAT WERE INCURRED DURING PARTICIPATION, WE DIDN'T USE REIMBURSEMENT TO ATRACK PEOPLE, THAT WOULD HAVE BEEN COERCION. WE WERE CAREFUL AT DOING THAT. IN TERMS OF RETENTION, QUICKLY, WE HAVE A VERY GOOD RETENTION, OVER 85%, MEDIATED BY THE TRUST THAT WAS CREATED AND BY CONTINUITY. WE RETAIN STAFF THAT CONTINUE INTERACTING WITH THE PARTICIPANTS. WE ALSO WE CHECK TWOD OR MORE PERSON WHOSE DON'T LIVE WITH THEM IN CASE WE CANNOT TRACK THEM THE FOLLOWING YEAR. WE HAVE NEWS LETTERS WE SEND HOLIDAY CARDS, BIRTHDAY CARDS, WE HAVE FAMILY DAY ACTIVITIES AND MANY STUDIES, PARTICIPANTS THAT COME BACK AND PARTICIPATE. WE ALSO -- LATINOS USE CELL PHONES A LOT OR PHONE CARDS. SO WE NEED TO INCLUDE THE MOBILE PHONE IN A WAY TO COMMUNICATE WITH THEM. WE HAVE NOT COLLECTED EMAIL BUT THAT'S A WAY, AND WE HAVE A PARTICIPANT WEBSITE AND ONE OF THE FIELD CENTERS POSTED THE VIDEO ON -- CREATED A FACEBOOK PAGE. FOR RETENTION AND FOLLOW-UP IS CONTINUALLY BRAINSTORMING REINVENTION, RE-EVALUATION AND FEEDBACK. SUMMARY TAKE CONTEXT INTO CONSIDERATION AS HOW THE POTENTIAL PARTICIPANTS ARE GOING TO RESPOND. AND HOW TO RETAIN THEM. DON'T ASSUME YOU KNOW EVERYTHING CONTINUOUSLY STUDY, LEARN AB DIFFERENT CULTURE, HISTORY AND CONSULT WITH THE EXPERTS. IN TERMS OF STAFF TAKE INTO CONSIDERATION THE NUMBER, THE QUALIFICATION AND THE TRAINING AND USE MULTIPLE APPROACHES, NOT SCWHRUS ONE AT A TIME. THIS IS A DIVERSE COMMUNITY THAT APPLIES TO ASIAN COMMUNITY, AFRICAN COMMUNITIES AS WELL. WE NEED TO USE MULTIPLE APPROACHES. IN ORDER TO ATTAIN RECRUITMENT GOALSCH HEARSAY THE END OF MY PRESENTATION. SO THANK YOU FOR STAYING HERE. [APPLAUSE] >> YOU WERE ABLE TO RECRUIT TARGET SAMPLE SIZE BUT HOW MANY PEOPLE ACTUALLY REFUSED WHEN YOU APPROACHED THEM. >> IT TOOK SCREENING OVER I BELIEVE 100,000 HOUSEHOLDS TO GET 16,000 PERSONS. SO THAT TELLS YOU MORE OR LESS THE FRACTION OR THE PROPORTION OF THE AMOUNT OF WORK THAT NEEDS TO BE DONE. >> ALL THOSE HOUSEHOLDS HISPANIC S? >> BASED ON THE CENSUS TRACK WE HOPE THAT TO BE THE CASE BUT WHEN WE WENT THERE NOT ALL WERE. >> THANK YOU, LARISSA. I WOULD LIKE TO INTRODUCE DR. RICHARD ALBA, DISTINGUISHED PROFESSOR OF SOCIOLOGY AT THE GRAD GRADUATE CENTER AT UNIVERSITY OF NEW YORK. TEACHING FOCUS IS ON ETHNIC AND RACIAL CHANGE FOR IMMIGRANTS AN CHILDREN IN THE U.S. AND IN EUROPE. HE HAS WRITTEN MANY BOOKS AN MOST RECENTLY BLOWING THE COLOR LINE T NEW CHANCE FOR MORE INTEGRATED AMERICA. HE SHARE WITH US TODAY AN ULTIMATE CHALLENGE BEFORE US, THAT IS HOW DO WE INTEGRATE CHILDREN OF IMMIGRANTS IN AN EVER EVOLVING ECONOMY AND DI RERS SOCIETY. LET US WELCOME DR. RICHARD ALBA. [APPLAUSE] >> THANK YOU VERY MUCH, MARIA, MARIA WAS A STUDENT IN ONE OF MY CLASSES WHEN I WAS TEACHING AT SUNNI, ALBANY. IT'S VERY NICE TO KNOW THAT ONE LEAVE AS POSITIVE IMPRESSION ON AT LEAST A FEW. I'M GOING TO TAKE A VERY DIFFERENT PERSPECTIVE ON THE MATTERS OF INTEREST TO US. SO I'M INTERESTED IN SOME SENSES WHY THE STUDY MATTERS. WHY ARE THE CHILDREN OF IMMIGRANTS SO IMPORTANT TO THE FUTURE OF THE UNITED STATES AND I'M GOING TO LOOK MORE BROADLY AND SPEAK ABOUT THE FUTURE OF WESTERN EUROPEAN SOCIETIES AS WELL. AND I'M GOING TO BEGIN WITH WHAT IS CLEARLY AN ENORMOUS TRANSITION OF ENORMOUS CONSEQUENCE THAT'S GOING TO TAKE PLACE OVER THE NEXT 25 YEARS. IN NORTH AMERICA AND IN WESTERN EUROPE. THEN PURSUE ISSUES OF CHALLENGES INVOLVED, AND ALSO THE OPPORTUNITIES INVOLVED. SO THERE'S REALLY I THINK A KIND OF AT THE BEGINNING OF A HISTORIC MOMENT WHERE THE ACTIVE POPULATION THROUGHOUT WESTERN SOCIETIES IS ABOUT TO CHANGE IN A VERY DRAMATIC WAY. THIS IS NOT THE RESULT OF THE YOUNG PEOPLE WHO ARE COMING OF AGE, THAT'S A VERY IMPORTANT COMPONENT BUT IT'S ALSO A FUNCTION OF PEOPLE EXITING FROM THE ACTIVE YEARS, EXITING FROM THE LABOR FORCE AND WE KNOW IN THE UNITED STATES THERE IS A BABY BOOM BUT THERE WERE BABY BOOMS EVERYWHERE IN THE WEST SO OVER THE NEXT 25 YEARS, THESE PEOPLE WHO ARE HEAVILY NATIVE, HEAVILY MEMBERS OF THE MAJORITY POPULATION, WHO ARE RELATIVELY HIGHLY EDUCATED COMPARED TO THOSE WHO PRECEDED THEM, THESE WERE THE FIRST COHORTS TO EXPERIENCE MASS HIGHER EDUCATION, WELL PLACED IN THE LABOR MARKET, THEY'RE LEAVING THE LABOR MARKET, LEADING THE ACTIVE YEARS IN MORE DIVERSE COHORTS GOING TO BE COMING UP TO REPLACE THEM. IN THE UNITED STATES, ONE IS ESTIMATED FROM DATA THAT'S THE ONE FOR 2009 ONE IS A PROJECTION BY THE U.S. CENSUS BUREAU. I GREATLY SIMPLIFIED THE RACIAL DIVISIONS INTO THE MAJORITY POPULATION OF NON-HISPANIC WHITES AND EVERYTHING ELSE. YOU CAN SEE IN THE 2009 POPULATION PERIOD THE BABY BOOM IS CONCENTRATED ROUGHLY IN THE AGES OF 45 TO 64. IN 2009 OVER THE NEXT 25 YEARS, ALL THOSE PEOPLE BELIEVE THE LABOR FORCE. AND YOU CAN SEE THAT IN ABSOLUTE NUMBERS THERE WILL NOT BE THE SAME SIZE OF MAJORITY POPULATION REPLACING THEM. YOU'RE NOT TALKING PROPORTIONS BUT ABSOLUTE NUMBERS. CURRENTLY IF YOU LOOK AT THE 2009 POPULATION PYRAMID YOU CAN SEE WE'RE IN THE MIDST OF AN CHILDREN OF THE BYE-BYE BOOM LARGELY BORN WHO ARE NOW IN THE AGES OF 15 TO 29. OVER THE NEXT TEN YEARS THEY ENTER THE ACTIVE AGES AND COHORTS COMING BEHIND THEM WILL ALSO HAVE SMALLER NUMBERS OF THE MAJORITY GROUP THAN EVER BEFORE. OBVIOUSLY THE NUMBERS OF MINORITY POP LAILINGSES ARE INCREASE -- POPULATION ARE INCREASING TO THE POINT WHERE YOUNG CHILDREN IS ROUGHLY A 50 DIVISION. SO WE'RE FACING REALLY A DEMOGRAPHIC CONTEXT THAT IS QUITE DIFFERENT FROM WHAT WE HAVE EXPERIENCED CERTAINLY IN THE LATE 20th CENTURY. IT'S NOT SO DIFFERENT ELSEWHERE. IN SOME WAYS MORE EXTREME. 2009, IT'S A POPULATION PYRAMID, THERE WAS A BABY BOOM IN GERMANY, IT LASTED A LONGER PERIOD OF TIME IN GERMANY. UNDERSTANDABLE BECAUSE OF DESTRUCTION OF WAR, CASUALTIES EXPERIENCED BY MEN, ET CETERA. IT EXTENDS ROUGHLY A 30-YEAR PERIOD. BUT IN CONTRAST TO THE U.S. IN NORTHERN EUROPE THE ENTIRE CHILD AN YOUNG PERSON'S COHORTS ARE SHRUNKEN COMPARED TO THESE BABY BOOMS. THEY ARE ALSO MORE DIVERSE. SO YOU CAN SEE THAT WHEN WE LOOK AT THE CHILD POPULATION, ROUGHLY 30% OF THIS SMALL GROUP OF CHILDREN COMES FROM IMMIGRANT ORIGIN. SO THIS PROBLEM IS GOING TO BE THROUGHOUT THE WESTERN WORLD, QUICKLY SOME FIGURES FROM OTHER COUNTRIES, NETHERLANDS, ROUGHLY A QUARTER OF YOUNG PEOPLE ARE IMMIGRANT ORIGIN, FRANCE AN GREAT BRITAIN ABOUT A 6TH. IN SPAIN WHERE IMMIGRATION IS A RECENT PHENOMENON, NONETHELESS HIGH PROPORTION, 25% ROUGHLY, OF BIRTHS ARE TO ONE OR TWO IMMIGRANT PARENTS. OF COURSE, NOT ALL IMMIGRATIONS ARE THE SAME. WE HAVEN'T TALKED I THINK ENOUGH ABOUT THE DIVERSITY OF IMMIGRATION. AND IN A VERY CRUDE WAY WE COULD SAY THAT IMMIGRATIONS TEND TO BE BIMODAL. THERE ARE RELATIVELY HIGH STATUS GROUPS, IMMIGRANTS WHO BRING HIGH LEVELS OF HUMAN CAPITAL WHOSE CHILDREN TEND TO DO WELL IN WESTERN SCHOOL, NOT ONLY IN THE UNITED STATES BUT ALSO IN GREAT BRITAIN. THERE ARE MANY LOW STATUS IMMIGRANTS, LOW LEVELS OF HUMAN CAPITAL, LOW WAGE LABOR SEEKING IN THE IMMIGRANT GENERATION, AND OFTEN ARE ETHNORACIALLY STIGMATIZED IN SOME WAY. IN EUROPE THIS IS BECAUSE THEY COME FROM FORMER COLONIES, IN THE U.S. THIS IS PRIMARILY BECAUSE THEY'RE SEEN NON-WHITE. AS THEIR CHILDREN TEND TO FACE GREATER DIFFICULTIES IN SCHOOLS. WELL, IN MANY COUNTRIES THE CHILDREN OF WHAT I CALL LOW STATUS IMMIGRATIONS ARE CUT QUITE CONSEQUENTIAL FOR THE CHILD POPULATION SO TWO-THIRDS OF THE IMMIGRANT ORIGIN CHILDREN IN THE NETHERLANDS COME FROM -- THEY CALL IT NON-WESTERN ORIGIN, THESE ARE PRIMARILY CHILDREN OF PARENTS FROM FORMER COL ?IS -- COLONIES MOROCCO GUEST WORKER IN THE POST PERIOD. IN THE WEST 60% OF IMMIGRANT ORIGIN CHILDREN HAVE LATIN AMERICAN OR CARIBBEAN ORIGIN WHICH MEANS IN THE MAIN THEY ARE CHILDREN OF LOW STATUS IMMIGRANT FAMILIES. HALF IMMIGRANT ORIGIN CHILDREN IN FRANCE HAVE AFRICAN BACKGROUNDS, THESE ARE JUST MEANT TO BE ILLUSTRATIVE OBVIOUSLY RATHER THAN EXHAUSTIVE. SO THE CHALLENGE IS GOING TO BE TO INTEGRATE THE CHILDREN OF IMMIGRANT ORIGIN, LOW STATUS IMMIGRANT ORIGINS AN INTEGRATION HAS A SPECIFIC MEANING, IT MEANS WE ARE RAISING CHILDREN WHO FUNCTION IN THE LABOR MARKET, IN TOPOLOGY, OTHER IMPORTANT SOCIETAL DOMAINS IN WAYS SIMILAR TO THE MAJORITY ADULTS WHO ARE GOING TO BE IN SMALLER NUMBERS. IN THE FUTURE N ALL THESE SOCIETIES, IT'S FAIR STATEMENT SEEMS TO ME WITHOUT INTEGRATION ALL THESE SOCIETIES WILL BE AT RISK OF DECLINE IN ECONOMIC SOCIAL AN CULTURAL WAYS CERTAINLY IN A GLOBALIZING WORLD. WHAT DO WE KNOW ABOUT INTEGRATION? SCHOOL SYSTEMS ARE ONE OF THE VERY IMPORTANT INSTITUTIONS THAT HELP INTEGRATE CHILDREN OF IMMIGRANTS. MY MOUTH TENDS TO GET DRY WHEN I TALK. TWO MAIN DIMENSIONS WE CAN EVALUATE HOW WELL SCHOOLS ARE PERFORMING, THERE ARE INTERNATIONAL STUDIES OF SCHOOL TAUGHT SKILLS, LITERACY, MATHEMATICS AND SO FORTH, THE PROGRAM FOR INTERNATIONAL STUDENT ASSESSMENT, IT'S NOT NAMED AFTER THE ITALIAN CITY NO MATTER WHAT YOU MIGHT THINK IS ONE WAY, AND BUT IT'S ALSO IMPORTANT TO LOOK AT CREDENTIALS. IT'S SOMEWHAT MORE DIFFICULT TO MEASURE CREDENTIALS BECAUSE THE DATA SETS ARE OFTEN NOT SO COMPARABLE. BUT THEY'RE CRITICAL BECAUSE THOSE ARE IN FACT THE THINGS THAT QUALIFY PEOPLE FOR THEIR POSITION IN THE LABOR MARKET. THERE'S NOT NECESSARILY ESPECIALLY WHEN WE TALK ABOUT THE CHILDREN OF IMMIGRANTS. WHO MAY LACK THE SCHOOL RELEVANT CAPITAL IN THEIR FAMILIES AN MAYBE SLOWER THEREFORE TO SHOW THEIR TALENTS WITHIN A SCHOOL SYSTEM, IT'S IMPORTANT TO LOOK AT CREDENTIALS AND NOT EVALUATE THEIR POSITION ON THE BASIS OF SCHOOL TAUGHT SKILLS. WHEN WE LOOK ACROSS SOCIETIES, THIS IS PART OF A LARGE NSF PRO SPECT, MY (INDISCERNIBLE) PROJECT BECAUSE THERE'S SO MANY PEOPLE INVOLVED. THERE ARE FAIRLY CONSISTENT DIFFERENCES WE SEE BETWEEN MAINSTREAM -- THE STUDENTS COMING FROM MAINSTREAM FAMILIES AND THOSE COMING FROM LOW STATUS IMMIGRANTS. I WANT TO POINT OUT HERE THAT DESPITE THE CONFIDENCE MANY AMERICAN VERSUS IN OUR ABILITY TO INTEGRATE THE CHILDREN OF IMMIGRANTS BECAUSE OF OUR HISTORY AS AN IMMIGRATION SOCIETY IN FACT THE U.S. DOESN'T COME OW OUT THAT WELL IN THESE COMPARISONS. IT COMES OUT AT THE LOW END OF THE RANGE. THESE ARE P PIZZA READING SCORES, THE STUDY IS DONE AT AGE 15. CHILDREN ARE TESTED IN LITERACY AND MATHEMATICS AND OFTEN IN OTHER SPECIAL MODULE AREA. I HAVE COMBINED SEVERAL YEARS OF THE STUDY WHICH IS ARE DONE TRIANNUALLY. NOTICE THE SECOND GENERATION HERE, THE CHILDREN OF IMMIGRANTS ARE LIMITED TO CHILDREN GROWING UP IN FAMILIES WHERE THEIR PARENTS HAVE LESS THAN A SECONDARY SCHOOL PRECRENGS. IN AN ATTEMPT TO IDENTIFY CHILDREN IN LOW STATUS IMMIGRANT FAMILIES, I'M NOT COMPARING TO NATIVES WHOSE PARENTS HAVE SIMILAR STATUS BECAUSE THERE ARE FEW OF THOSE. THEY ALSO I ARGUE ARE NOT COMMENSURATE IN Ay- VARIETY OF WAYS WITH THE CHILDREN COMING FROM IMMIGRANT FAMILIES BUT THERE ARE BIG GAPS. THE U.S. GAP IS NOT EXCEPTIONAL, THE ONE IN GERMANY IS GREATER THAN THAT IN THE U.S. BUT YOU CAN SEE THAT A NUMBER OF COUNTRIES HAVE SMALLER GAPS THAN THE U.S. LIKE FRANCE, GREAT BRITAIN AND NETHERLANDS. WE LOOK ALSO CREDENTIALS SELECTED MEXICAN AMERICANS AS A GROUP TO COMPARE AGAINST THE MAINSTREAM AND YOU CAN SEE THAT THE CREDENTIALS DIFFERENCES IN THE U.S. ARE LARGE, NOT NECESSARILY LARGER THAN ALL OTHER COUNTRIES, NETHERLANDS AND THE DUTCH STUDY WAS DONE IN THE CITY OF AMSTERDAM, THAT'S WHY THE RATES OF UNIVERSITY DEGREES ARE SO HIGH BECAUSE AS A UNIVERSITY TOWN. YOU CAN SEE THE DISPROPORTION IN THE NETHERLANDS IS SAME ORDER AS DISPROPORTION AT THE UPPER AND LOWER ENDS, DROP-OUTS, AND UNIVERSITY DEGREES, IS IN THE UNITED STATES. IN GREAT BRITAIN A POPULATION THAT HAS WITH PAKISTANIS AND BANGLADESHIs, THE LOW STATUS IMMIGRANT POPULATION IN GREAT BRITAIN, WHEN IT COMES TO UNIVERSITY DEGREES THEY SEEM TO NOW HAVE CAUGHT UP. THIS IS RECENT THEY HAVE CAUGHT UP WITH THE MAJORITY POPULATION. SO WE'RE NOT DOING WONDERFULLY WHEN WE LOOK AT EDUCATIONAL DATA. I'M GOING TO TALK BRIEFLY AB THE OPPORTUNITY. I DID SAY THERE WAS A CHALLENGE AND ALSO AN OPPORTUNITY. AND I THINK THE KEY HERE IS THAT SITUATIONS WHERE THERE IS A POTENTIAL FOR NON-ZERO SUM MOBILITY, OFFER AGAIN THE POSSIBILITY INDIVIDUALS FROM MINORITY ORIGINS CAN MOVE UP WITHOUT APPEARING TO THREATEN THE ADVANTAGED POSITION OF MAJORITY POPULATIONS. THAT CAN GIVE RISE TO ETHNORACIAL FLUIDITY. SO THE EXODUS OF BABY BOOM FROM THE LABOR MARKET IN THE U.S. AN ELSEWHERE RAISES THE POSSIBILITY THAT THERE WILL BE SIGNIFICANT NON-ZERO SUM MOBILITY FOR THE NEXT QUARTER OF A CENTURY. IN THE US. I'LL JUST POINT OUT, THE ANALOGY WITH THE PERIOD OF MASS ASSIMILATION THAT OCCURRED FOR THE SOUTHERN AND EASTERN -- THE DECEDENTS OF SOUTHERN AND EASTERN EUROPEAN IMMIGRANTS, IN THE 25 YEARS FOLLOWING THE END OF WORLD WAR II. ENORMOUS NUMBER OF THINGS HAPPENED IN THAT PERIOD THAT I THINK ARE STILL NOT TERRIBLY WELL UNDERSTOOD. BUT SOME GROUPS, FOR EXAMPLE, ERADICATED WHAT HAD BEEN LARGE EDUCATION GAPS WITH THE MAINSTREAM. THE SOUTHERN ITALIANS ARE AN EXAMPLE OF THIS. RATES OF MARRIAGE ACROSS ETHNIC AN RELIGIOUS LINES INCREASED GREATLY FOR SOME GROUPS LIKE THE JEWS, AND THE ITALIANS. AND I THINK MAYBE SOMETHING WE FORGOT IS THAT THE BOUNDARIES SHIFTED IN A WAY THAT TOOK IN REALLY JOHNS THAT HAD BEEN PREVIOUSLY DEFINED AS OUTSIDER REALLY JOHNS. I THINK THIS BELIES A SIMPLISTIC UNDERSTANDING OF WHAT ASSIMILATION IS. ASSIMILATION IS OFTEN PRESENTED AS A OBLITERATION OF PREVIOUS IDENTITIES AND PREVIOUS CULTURAL BACKGROUNDS. BUT IN FACT USING CATHOLIC -- JEWS AN CATHOLICS DID NOT BECOME PROTESTANTS, THEY KID NOT TAKE ON THE DID NOT TAKE ON THE MAINSTREAM RELIGIOUS IDENTITY BUT THEY BECAME DEFINED AS PART OF A BROADER MAINSTREAM. SO THIS WAS, I'LL WITHOUT GOING INTO THE THEORY IN DEPTH, THIS WAS IN FACT IN A PERIOD OF EXPANSIVENESS IN THE EDUCATION SYSTEM AN ECONOMY. SO IT DID CREATE ROOM FOR THE CHILDREN AND GRANDCHILDREN OF IMMIGRANTS TO MOVE UP WITHOUT APPEARING TO CHANGE THE POSITION OF WHITE PROTESTANTS. I DON'T MEAN TO SAY IT'S GOING TO RUN SO SMOOTHLY AND IT WILL BE EXACTLY LIKE IT WAS IN THE PAST BECAUSE OF COURSE THERE ARE IMPORTANT DIFFERENCES BETWEEN TODAY AN THN THEN. WE ARE IN A PERIOD OF GREATER INEQUALITY THAN TRUE IN THE POST WORLD WAR II PERIOD. THIS IS VIEWED BY ECONOMIC HISTORIANS AS A PERIOD OF GREAT COMPRESSION, IN FACT WE WERE AT A HISTORICAL NAIDER OF ECONOMIC INEQUALITY AND ALSO THE EDUCATIONAL SYSTEM I WOULD ARGUE HAS CHANGED IN SIGNIFICANT WAYS BETWEEN NOW AND WHEN THE PRIOR GROUPS WERE INCORPORATED. AS SEAN REERDEN HAS SHOWN, THERE'S GREATER NEIGHBORHOOD INEQUALITY THOUSAND AND GREATER INEQUALITY AMONG SCHOOLS THAN BEFORE AS A RESULT OF THE GROWING ECONOMIC INEQUALITY IN OUR SOCIETY. THERE'S ALSO A DEMONSTRATED DECLINE IN THE ACADEMIC SKILLS AND ABILITIES OF TEACHERS IN THE '50s AN '60s TEACHERS WERE HIGHLY SELECTED IN THE SENSE MOST WOMEN WHO WENT TO COLLEGE HAD TEACHING AS AN ASPIRATION AND NOW TEACHERS TEND TO BE SELECTED FROM THE BOTTOM QUARTILE OF ACADEMIC ABILITIES IN COLLEGE. NEVERTHELESS, I WANT TO ARGUE ON A MILDLY POSITIVE NOTE THERE IS THE PROS SPECK FOR REAL CHANGE. I'M GOING THE TAKE WALL STREET. THIS ISN'T QUITE THE TOP 1% AS YOU'LL SEE WHEN WE GET TO EARNINGS BUT IT IS PROBABLY THE TOP FOUR OR FIVE PERCENT. SO HERE IS AN INDUSTRY WHICH PAYS EXTREMELY WELL. WHICH CARRIES ACTUALLY GREAT ECONOMIC SIGNIFICANCE AS WE LEARNED FOR OUR SOCIETY IT'S RESPONSIBLE FOR 8% OF THE U.S. GDP. AND UNDERGOING SOMETHING OF A DEMOGRAPHIC TREND. HISTORICALLY IT RECRUITED PREDOMINANTLY FROM COLLEGE AGE WHITE MEN, WE ANALYZED DATA FROM THE 2000 CENSUS AND ALSO FROM THE 2005 '09 ACS. CORE WORKERS WERE DEFINED AS PEOPLE WHO WORK IN THE SECURITIES INDUSTRY, SPECIFIC INDUSTRY IN THE CENSUS WHO HAVE PROFESSIONAL MANAGERIAL OKAY PAIX PAIGS OR ONE OR TWO SALES OCCUPATIONS WHERE COLLEGE EDUCATED WALL STREET WORKERS ARE HIGHLY REPRESENTED. YOU CAN SEE AS WE LOOK FROM OLD TORE YOUNGER COHORTS BUT ALSO LOOKING FROM ONE CENSUS TO ANOTHER, THE PROPORTION OF WHITE MEN IS CHANGENING A IRFALY SIGNIFICANT MANNER, IT GOES FROM TWO THIRDS AMONG OLEST WORKERS IN 2000 TO UNDER HALF AMONG YOUNGEST WORKERS IN 2005, '09, DESPITE WHAT SHOULD BE HAPPENING, IT'S NOT WOMEN SO MUCH WHO ARE TAKING UP THE SLACK, IT IS MINORITIES WHO INCLUDE EMPLOYMENT OBVIOUSLY, SO ASIANS HAVE BECOME A LARGER PART OF THE WALL STREET WORK FORCE, ALMOST 5% IN THE OLDEST GROUP FAR LEFT AND YOU CAN SEE AMONG THE YOUNGEST, THE MOST RECENT DATATA IN THE YOUNGEST GROUP, THERE ARE ABOUT 20%. BUT LATINOS, ALSO INCREASED THEIR REPRESENTATION GOING FROM 3% TO 8%. IMMIGRANTS ARE AN IMPORTANT PART OF THIS STORY, ESPECIALLY OUTSIDE THE WHITE POPULATION. SO YOU CAN SEE THAT AMONG BLACKS AND LATINO, ABOUT ON THE FAR RIGHT, YOU CAN SEE ABOUT A THIRD BLACK AN LATINO CORE WORKERS ON WALL STREET WERE FOREIGN BORN AND THREE QUARTERS OF ASIAN WORKERS REASON WALL STREET WERE FOREIGN-BORN. IF WE CAN IDENTIFY THE SECOND GENERATION, THE CHILDREN OF IMMIGRANTS WE CAN DO FOR ADULTS IN CENSUS DATA, THERE WOULD BE A LARGER IMPACT OF RECENT IMGRATION ON THESE CHANGES. BUT (INDISCERNIBLE) SHOWS THAT'S ALSO TRUE HERE. BECAUSE IF WE LOOK AT RUE MIEWN RATION AN EARNINGS ON WALL STREET ARE WITHOUT QUESTION A METRIC BY WHICH PERCEIVED VALUE IS REPRESENTED, IF THIS IS TRUE ANYWHERE, IT'S GOING TO BE TRUE ON WALL STREET. ALMOST ALL THESE CATEGORIES ARE PRETTY WELL PAID YOU CAN SEE WHITE MEN CONTINUE TO MONOPOLIZE THE ECONOMIC AWARDS IN THIS INDUSTRY EVEN AS NUMBERS SHRINK. THAT'S PARTICULARLY TRUE IN THE MIDDLE AGE RANGE, THERE ARE WORKERS IN 30s AN EARLY 40s ON PEOPLE WHO ARE HIGHLY PRODUCTIVE, NO DOUBT, AND HAVEN'T RETIRED WITH THEIR $10 MILLION AND YOU CAN SEE THAT WHY MEN ARE EARNING AB TWICE AS MUCH, AS MOST OTHER CATEGORIES OF WORKERS. SO WE HAVE A PARADOX OF WORK FORCE THAT IS UNDERGOING SIGNIFICANT ETHNORACIAL CHANGE BUT YET WHERE THE WHITE MEN MANAGED TO MAINTAIN THEIR HOLD ON THE LION'S SHARE OF REWARDS. SO THAT IN MANY WAYS IS THE PARADOX WE FACE AS A SOCIETY. WE ARE UNDERGOING ENORMOUS CHANGE OVER THE NEXT 25 YEARS. I THINK YOU CAN ARGUE WALL STREET IF IT'S UNABLE TO LOOK FOR TALENT AND LEADERSHIP OUTSIDE THESE DECLINING POOL OF COLLEGE EDUCATED WHITE MEN, IS GOING TO FAIL TO MAINTAIN ITS POSITION WITHIN A WORLD FINANCIAL ECONOMY AND LIKEWISE I THINK IF WE ARE UNABLE TO SUCCESSFULLY INTEGRATE THE CHILDREN OF IMMIGRANTS WE WILL FACE VERY SEVERE PROBLEMS IN THE FUTURE AS A SOCIETY. SO I'LL END ON THAT NOTE. THANK YOU VERY MUCH. [APPLAUSE] HAPPY TO TAKE QUESTIONS OR COMMENTS. CHARLIE OF COURSE. (OFF MIC) TALK WHITE, BLACK, LATINO ASIAN AS THOUGH THEY WERE SEPARATE COMMUNITIES. LOOKING AT YOUR CRYSTAL BALL, WHAT IS THE LIKELIHOOD OF BLENDED POPULATION ACROSS THESE GROUPS PARTICULARLY MAYBE AMERICAN SOCIETY VERSUS YIEWMP? >> CERTAINLY THE CASE YOU'RE PROMPTING ME TO SPECULATE HERE. AS WE WERE TALKING YESTERDAY FOR THE IMMIGRANT ORIGIN POPULATIONS, I WOULD SAY IN THE QUITE DISTINCT COMPARED TO THE AFRICAN AMERICAN POPULATION, THERE ARE HIGH RATES OF INTERMARRIAGE, AMONG THE U.S. BORN,AND THESE ARE INTERMARRIAGES CHIEFLY WITH WHITE, PEOPLE WITH EUROPEAN BACKGROUND. THAT AS WE KNOW FROM RESEARCH OF JENNIFER LEE AND FRANK BEAN, THE CHILDREN OF THESE INTERMARRIAGE INTERMARRIAGES, PART HISPANIC, PART ASIAN DON'T FEEL SEPARATION FROM MAINSTREAM SOCIETY. WE KNOW THE RATE OF INTERMARRIAGE IS INCREASING IN A SENSE AS THE POPULATION OF U.S. BORN IS INCREASING AMONG THESE GROUPS SO YOU'RE RIGHT. THE POPULATION OF MIXED ORIGIN IS GOING TO BE INCREASINGLY CONSEQUENTIAL AND WILL BE INCREASINGLY DIFFERENTIATED FROM THOSE CHILDREN HAVE GROWN UP IN HISPANIC FAMILIES, MAINLY HISPANIC NEIGHBORHOODS OR ASIAN FAMILIES, DISPROPORTIONATELY ASIAN NEIGHBORHOODS, IT'S SOMETHING THAT I THINK IS HARD TO CAPTURE WITH THE CURRENT SCHEME OF ETHNORACIAL DATA THAT WE HAVE, FOR EXAMPLE, IN THE CENSUS QUESTIONS, YOU CANNOT EASILY IDENTIFY WHEN PEOPLE ARE PART HISPANIC AND PAR EUROPEAN IN BACKGROUND. THESE ARE PEOPLE WITH DIFFERENT CHARACTERISTICS FROM THE PEOPLE WHO REPORT THEMSELVES AS PRIMARILY HISPANIC. IT IS A WAY THE BOUNDARIES WILL SHIFT A BIT. AND THE WHITE POPULATION ACTUALLY MIGHT BE A BIT UNDERSTATED IN THESE PROJECTIONS. BECAUSE IT WILL BE TO SOME EXTENT AUGMENTED BY CHILDREN OF THESE INTERMARRIAGES BUT WE DONE KNOW EXACTLY HOW MUCH IT IS AUGMENTED TO WHAT EXTENT PEOPLE WILL CHOOSE WHITE OR EUROPEAN IDENTITIES OVER OTHER IDENTITIES. IT'S AN IMPORTANT QUESTION TO TRY TO TACKLE. YES. RICHARD. (OFF MIC) >> OR ASIANS THAT'S TRUE. I DON'T THINK THAT'S TRUE FOR HISPANICS. (OFF MIC) >> IT'S ALSO A QUESTION OF WHICH PARENT IS THE PRIMARY TRANSMITTER OF A KIND OF PUBLIC IDENTITY. SO WHEN YOU HAVE MARRIAGES THAT ARE PRIMARILY BETWEEN UROAMERICAN MEN AND ASIAN WOMEN, IT MEANS THAT MANY OF THE MIXED ASIAN WHITE CHILDREN NOT CARRYING ASIAN NAMES. AND I THINK THAT'S CONSEQUENCABLE FOR HOW PEOPLE ARE PUBLICLY IDENTIFIED. AS YOU MAY KNOW, I'M SURE YOU DO KNOW THIS, THERE'S ATTENTION TO THE APPLYING STUDENTS APPLYING TO ELITE COLLEGES OF ASIAN -- OF MIXED ASIAN BACKGROUNDS WHO WILL ARE NOT REPORTED THEMSELVES AS ASIAN ON THE ADMISSIONS FORMS BECAUSE THEY BELIEVE THEIR CHANCES WILL BE BETTER IF THEY ARE PART OF THE WHITE POOL. OBVIOUSLY THESE MOST HEEZLY DONE WHEN YOU HAVE A NON-ASIAN SURNAME. THANK YOU. THANK YOU VERY MUCH. [APPLAUSE] >> DR. BACHRACH WILL BE OUR LAST SPEAKER SUMMARIZING THE ENTIRE TWO DAY EVENT. SHE ASKED ME TO HAVE -- OKAY. -- LET ME INTRODUCE HER, DR. BACHRACH WITH IS A DEMOGRAPHER BY TRAINING AND IS VISITING SCHOLAR AT THE SOCIAL SCIENCE RESEARCH INSTITUTE AT DUKE UNIVERSITY AND RESEARCH PROFESSOR AT THE MARYLAND POPULATION RESEARCH CENTER IN THE COLLEGE OF BEHAVIORAL AND SOCIAL SCIENCES, UNIVERSITY OF MARYLAND. HER CURRENT RESEARCH INTEREST FOCUSES ON INTE GRITION AN CULTURE THEORY AND SOCIAL DEMOGRAPHY. I WILL LIKE TO INTRODUCE DR. CHRISTINE BACHRACH. [APPLAUSE] >> THANK YOU, EVERYBODY. WHAT A CHALLENGE. A CHALLENGE FOR ME AND A CHALLENGE FOR THE NATIONAL CHILDREN'S STUDY. N CLRKSS HAS A TOUGH JOB, -- NCS HAS SUCH A TOUGH JOB, SUCH AN AMAZING STUDY THAT EVERYONE THAT LEARNS ABOUT IT CAN IMAGINE A THOUSAND WAYS TO STRENGTHEN THEIR SCIENCE IF ONLY THE STUDY WOULD CHECK THESE FEW MEASURES. THE STUDY HAS BEEN VERY OPEN TO RECEIVING ADVICE EVER SINCE ITS INCEPTION IN THE LATE 1990s, BELIEVE IT OR NOT. AND THAT ADVICE HAS BEEN ROLLING IN EVER SINCE. SO THEY HAVE THE L CA LENG OF TAKING THIS IN AND BALANCING IT OUT AN FIGURING OUT WHAT IT IS THAT IS ABSOLUTELY ESSENTIAL TO INCLUDE IN THE STUDY AND WHAT NOT. IN LIGHT OF THAT INCREDIBLE CHALLENGE, I REALLY WOULD LIKE TO COMPLIMENT NOT ONLY OUR MANY DISTINGUISHED SPEAKERS TODAY AND YESTERDAY, BUT ALSO DR. LOPEZ CLASS AND THE NATIONAL CHILDREN' STUDY FOR HAVING THE FOR SIGHT TO CONVENE THE CONFERENCE AND BRINGING TOGETHER AN EXCELLENT MIX OF PEOPLE, BOTH PEOPLE WHO ARE DEEPLY CONVERSENT WITH NATIONAL LEVEL DATA ON IMMIGRANT CHILDREN AND PEOPLE WHO ARE -- WHOSE RESEARCH AND EXPERIENCE GIVES QUALITATIVE INSIGHT INTO THE FAMILIES THAT NCS WILL BE STUDYINGCH THESE AREN'T MUTUALLY EXCLUSIVE OF COURSE. BUT HAVING BOTH PERSPECTIVES PRESENT HAS GREATLY ENRICHED THE CONFERENCE. HAVING THIS CONVERSATION NOW AS THE NCS IS MOVING FROM VANGUARD AND PILOT PHASE IS INTO ITS FINAL PLANNING FOR THE MAIN PROJECT, IT'S JUST RIGHT. SO THANK YOU, MARIA, AND EVERYONE FROM THE NCS. THE OTHER PERSON I WANT TO THANK IS YVONNE MADDOX WHO SPEN AN ENORMOUS AMOUNT OF TIME WITH US. WE SHOULD TAKE THAT AS A REAL TRIBUTE TO THE IMPORTANCE OF THIS TOPIC. THANK YOU. I SEE MY ROLE AS SUMMING UP AS FAST AS I CAN WHAT WE HAVE DONE. I HAVE A FEW NEXT STEPS TO SUGGEST, I HAVE ASKED THE TIMER TO BE SET FOR 15 MINUTES. IT WAS, OKAY. I'M AT 12 ALREADY. OH, SHOOT. OKAY. I MAY GO OVER 15 MINUTE BUS I REALLY WANT US TO HAVE A LITTLE BIT OF TIME FOR AUDIENCE DISCUSSION AFTERWARDS. SO TO THE RIGHT. OKAY. SO I SAW THIS AS THE CENTRAL QUESTION THIS CONFERENCE WAS ASKING, STUDY OF HEALTH DIFFERENCES AND TRAJECTORY AMERICANS CHILDREN NEED TO DO TO ENSURE AMERICAN CHILDREN ARE ADEQUATELY -- IMMIGRANT CHILDREN ARE ADEQUATELY REPRESENTED. AND CAPTURE THE ESSENTIAL DETERMINANTS OF THE HEALTH TRAJECTORIES OF IMMIGRANT CHILDREN. I'M SORRY, I LIKE THIS PIECE FROM JENNIE VAN HOOX AB STRACT UNIQUE MIGRATION INCORPORATION EXPERIENCE, THESE ARE STRONGLY RELATED TO HEALTH AND MORTALITY. THIS GROUP WILL ALMOST CERTAINLY DRIVE I WOULD ADD NOT ONLY RACIAL AN ETHNIC HEALTH DISPARITIES IN THE FUTURE, BUT WILL HAVE A MAJOR IMPACT ON THE OVERALL PICTURE OF HEALTH OF U.S. CHILDREN. WE HAVE BEEN TALKING 25% OF CHILDREN UNDER AGE 8 HAS ONE FORM, THIS IS A DYNAMIC THING. SIX YEARS AGO AT NICHD WE HAD A CONFERENCE CALLED ONE AND FIVE. ABOUT 1 IN FIVE OF AMERICAN CHILDREN WERE CHILDREN OF IMMIGRANTS, NOW IT'S ONE IN FOUR BY 2030 IT WILL BE 1 IN 3. AND AMONG THE YOUNGEST CHILDREN THAT NC SLRKS BRING TYPE THE STUDY, THE PERCENTAGE IS HIGHER. WHY IS THIS IMPORTANT? BECAUSE CHILDREN O IMMIGRANTS HAVE DIFFERENT HEALTH TRAJECTORIES THAN NATIVE BORN PARENTS. SOME INDICATORS OF PHYSICAL HEALTH, OBESITY, COGNITIVE AND EMOTIONAL DEVELOPMENT IN MOST STUDIES. BUT WHAT HEALTH ADVANTAGES THERE ARE UNRAVEL OVER TIME GENERATION. EQUALLY IMPORTANT THESE DIFFERENCES FROM NOT MONOLITHIC, THAT'S EMPHASIZED OVER AND OVER AGAIN, THEY VARY OVER TIME, GENERATION, COUNTRY OF ORIGIN, RACE ETHNICITY AND LEGAL STATUS. THE FIRST THING I WANT TO PUT ON THE TABLE HAS COME OUT A NUMBER OF TIMES IN THE CONFERENCE THAT NCS HAS TO TACK SERIOUSLY. TO TALK ALL NECESSARY STEPS AN DEVELOP TO ENSURE THEY ARE FULLY REPRESENTED IN THE NCS REGARDLESS OF PARENTAL LEGAL TA STATUS. THAT'S A TALL CHALLENGE GIVEN WHAT WITH WE HEARD FROM JENNIE VAN HOOK, ABOUT 25% BEING MISSED IN THE AMERICAN COMMUNITY SAMPLE. WE HEARD SUGGESTIONS FROM DR. AVILES-SANTA HOW TO APPROACH THIS, PROBABILITY SAMPLING FOR THE STUDY IS ABSOLUTELY FOUNDATIONAL TO ANY CLAIM ABOUT REPRESENTATION SOME MENTIONED OVERSAMPLING, WHETHER OR NOT THAT'S SOMETHING THE NCS COULD THINK AB. GIVEN THE CHALLENGES USING BIRTH RECORDS AS BEATS FOR SOME PART OF THE SAMPLE IS SOMETHING THE NCS SHOULD CONSIDER. ISSUES OF HOW TO ENGAGE PEOPLE IN THE STUDY COMMUNITY ENGAGEMENT, VERY IMPORTANT TARGETED STRATEGIES FOR NOT ONLY RECRUITING BUT RETAINING SAMPLED ELIGIBLES MOVERS BECAUSE IMMIGRANTS ARE HIGHLY MOBILE. STRONG PROTECTION OF CONFIDENTIALITY IS VERY IMPORTANT AND IMREGREGS FROM THE STUDY. MOVING -- IMMIGRATION FROM THE STUDY. MOVING FROM THAT QUESTION TO THE MORE COMPLEX ISSUE FIGURING OUT WHAT THE NATIONAL CHILDREN'S STUDY NEEDS TO DO IN ORDER NOT ONLY TO REPRESENT IMMIGRANT CHILDREN BUT GATHER INFORMATION TO UNDERSTAND HEALTH TRAJECTORIES. YOU CAN'T -- EQUATION PREDICTING HEALTH MAINSTREAM POPULATION, IT DOESN'T WORK. THERE ARE MANY FACTOR, NO SINGLE IMMIGRANT EFFECT AND THERE ARE MANY FACTORS THAT INFLUENCE HEALTH AND DEVELOPMENT AMONG IMMIGRANT CHILDREN THAT AREN'T CLOSE TO BEING ON THE TABLE FOR KIDS BORN TO NATIVE PARENTS. SO THIS MEANS THAT THE NCS HAS TO CAPTURE AT LEAST THE MOST IMPORTANT ASPECTS UNIQUE TO IMMIGRANT FAMILIES AND CONSIDER VARIABLES THAT MAYBE VITAL FOR THE PRODUCTION OF GOOD HEALTH IN IMMIGRANT AND MINORITY FAMILIES BUT MAY HAVE MUCH LESS IMPORTANT MAINSTREAM FAMILIES. I ATTEMPTED TO PULL TOGETHER A SYNTHESIS OF WHAT WE HAVE HEARD OVER THE LAST FEW DAYS. IT'S IMPERFECT. I'M OKAY. SO BRIEFLY I HAVE SELECTION AFFECTING BOTH CHARACTERISTICS OF> I LEFT FIVE MINUTES. I'M SORRY. >> DISCUSSION. >> THANK YOU FOR THE GREAT SUMMARY. YOU BROUGHT UP THE POINT ABOUT RECEIVING CONTEXT AND HOW THE MAJORITY ARE RECEIVING IMMIGRANTS, THAT MADE ME THINK ONE OF THE THINGS WE HAVE NOT TALKED ABOUT THAT IS CRITICALLY IMPORTANT GIVEN THAT'S STILL THE MAJORITY OF THESE CHILDREN SURVEYED WILL BE FROM THE MAINSTREAM MAJORITY WHITE POPULATION IS THAT WE ALSO NEED TO GET PARENTS AND CHILDREN'S RACIAL AND ETHNIC ATTITUDES FROM ALL THE CHILDREN, ALL THE PARENTS BECAUSE IT'S EQUALLY IMPORTANT TO LOOK AT HOW THE WHITE COMMUNITY IS GOING TO BE RESPONDING TO THE RACIAL DIVERSITY THAT'S GOING TO INCREASE OVER THE COURSE OF THE CHILD'S DEVELOPMENT. THAT IS NOT SOMETHING WE HAVE TALKED ABOUT YET IT WILL BE CRITICAL AS WE MOVE FORWARD IN THE STUDY. >> PASS ALONG, NEXT. LET'S HAVE THE AUDIENCE HAVE A CHANCE TO -- >> AS A RETIRED INS POLICY STATISTICS PERSON, I WANT TO POINT OUT IMMIGRATION STATUS IS QUITE COMPLEX AND THERE SEASON A BRIGHT LINE BETWEEN LEGAL AND ILLEGAL. THERE ARE INTERMEDIATE STATUSES. THAT PERSON CAN BE IN TRANSITION FROM ONE TO THE OTHER. AND YOU NEED TO KEEP THAT IN MIND WHEN THINKING HOW STATUS AFFECTS THE OTHER THING ABOUT IMMIGRATION STATUS IS IT CHANGES OVER TIME. SO THE LONGITUDINAL ASPECT OF THE STUDY NEEDS TO TAKE THAT IN MIND. AND UNTIL A PERSON IS ABLE TO SAY THEY'RE A NATURALIZED CITIZEN TO CONSIDER IMMIGRATION STATUS IS FLUID, BUT SEE THE ESTIMATES HOW MANY PEOPLE ARE CONSIDERED ILLEGAL AT ANY POINT IN TIME. WEB ANY TIME BETWEEN 1 AND 2 MILLION FOLKS AT ANY TIME ARE ACTUALLY PROBABLY NOT DEPORTABLE BECAUSE THEY'RE IN TRANSITION FROM SEMILEGAL TO LEVEL STATUS OR MORE PERMANENT STATUS. DON'T OVERSIMPLIFY IMMIGRATION STATUS. >> THANK YOU. >> MY NAME IS SYLVIA SALAZAR WITH THE NATIONAL CANCER INSTITUTECH I WANT TO ASK ABOUT THE CONTEXT OF WHAT'S HAPPENING IN THE MEDIA RIGHT NOW AND HOW UNDOCUMENTED COMMUNITIES ARE BEING PERCEIVED. THAT'S REALLY HAVEN'T AN IMPACT THE WORK I'M DOING AT THE NATIONAL CANCER INSTITUTE IT DOES HAVE IMPACT ON WHETHER OR NOT PEOPLE DO PARTICIPATE IN SOME OF THE RESEARCH THAT WE'RE DOING. s SPECIAL PLI WHEN WE ASK IMMIGRATION STATUS. RIGHT NOW WITH WHAT'S HAPPENING WITH THE CHILDREN THAT ARE BEING DETAINED AS A RESULT OF THEIR PARENTS BEING DEPORTED, THAT'S HAVING IMPACT AT THE COMMUNITY LEVEL. PUTTING CHILDREN IF PAYMENT. HOW DOES THAT AFFECT PEOPLE'S ABILITY TO PARTICIPATE IN THE STUDY TO ESTABLISH THAT TRUST, IT'S REALLY IMPORTANT. >> >> THIS WAS A GREAT COMMENT. YOU GOT ME SO EXCITED I DELETED THE SLIDE. YOU KNOW I MET TO MENTION THING SOMETHING (INDISCERNIBLE) MENTIONED LAST NIGHT. HABITS OF ILLEGALITY AND THIS CULTURE AROUND PIR SEPTION OF IMMIGRANTS CREATED IN THIS COUNTRY, YOU HAVE TO HAVE A VERY IMPORTANT IMPACT ON KIDS' DEVELOPMENT. AND I'M WONDERING WHETHER MAYBE A SUPPLEMENTAL STUDY COULD DO SOME WORK ON IMAGES AROUND IMMIGRANT FAMILIES, IMMIGRANTS IN THE MEDIA. THAT MIGHT BE A NICE EDITION. REBECCA. (OFF MIC) >> ONE COMMENT THAT PIGGY BACKS TO MAKE SURE THIS STUDY THAT LANGUAGE IS CAREFULLY USED IN TERMS OF HOW THE PARTICIPANTS ARE ADDRESSED SO TO NOT USE LANGUAGE SUCH AS ILLEGAL ALIENS AND THAT WILL HELP I THINK FOR RETENTION AS WELL AS IN THE WRITTEN MATERIALS AS WELL AS PEOPLE NOT MENTION, THAT WOULD HELP >> I GREW UP UNDOCUMENTED, WE DIDN'T GET OUR GREEN CARDS UNTIL I WAS 18. I HAVE TO TELL YOU THE WORD ILLEGAL, THE WORD UNDOCUMENTED, AND ON A PERSONAL LEVEL IT MAKES YOU FEEL LESS THAN A PERSON, AND IN THE COMMUNITY, I HAVE SEEN PEOPLE WHO THE PARENTS ARE UNDOCUMENTED BUT THE CHILD IS CITIZEN AND THEY WON'T EVEN TALK ABOUT IT, THE CHILD WON'T KNOW, WHAT THAT DOES TO A PERSON, TO A CHILD WHO FEELS LIKE THEY'RE NOT EVEN A HUMAN BEING, THEY'RE ILLEGAL ALIENS, WHEN YOU GET THE CARD WHEN YOU BECOME A RES DIDN'T, IT'S WEIRD. AND IT DOES HAVE AN IMPACT I THINK ON SELF-ESTEEM AND ALSO ON STRESS CAUSED BY THE SITUATION OVERALL. SO I THINK SAYING UNDOCUMENTED INSTEAD OF ILLEGAL OR ALIEN OR ANY OF THAT, YOU HAVE TO APPROACH IT IN A WAY THAT'S DELICATE. IN SPANISH THERE'S PARTICULAR WAYS TO SAY IT AS WELL. SO YOU HAVE TO APPROACH THAT IN A CERTAIN WAY. IT'S THE WAY IT GOES. THERE'S A SONG IN SPANISH MEXICAN SONG HOW SUPERMAN IS AN ILLEGAL, HOW SUPERMAB IS AN ALIEN THAT CAME FROM ANOTHER WORLD AN SETTLED HERE. SO YOU HEAR IT ON THE RADIO SOMETIMES, IT'S FUNNY BUT IT'S MAKING FUN OF THAT FEELING AND THAT STIGMA THAT IS YOU'RE ILLEGAL, SUPERMAN IS ALSO ILLEGAL. >> YEAH. YEAH. THAT'S GREAT. VERY GOOD SUGGESTION. THANK YOU. >> WE HAVE HEARD A NUMBER OF COMMENTS ABOUT STRESS AS A INTERVENING MECHANISM FOR THE IMPACT OF LEGAL STATUS ON CHILDREN'S HEALTH. BUT WE HAVEN'T REALLY TALKED ABOUT MEASURES OF STRESS, BUT SEEMS LIKE A POINT WORTH MAKING THAT SOME KINDS OF MEASURES OF PARENTAL STRESS, CHILD STRESS, FAMILY STRESS, OUGHT TO BE INCLUDED IN THE STUDY, THEY DON'T NEED TO BE IMMIGRANTS-SPECIFIC BECAUSE STRESS IS A GENERAL PHENOMENON THAT MAYBE PRESENT IN LOW INCOME FAMILIES, SO ON AS WELL BUT SEEMS LIKE I DON'T KNOW IF THERE ARE PLANS TO MEASURE STRESS AT THE FAMILY LEVEL BUT SEEMS IMPORTANT. >> I KNOW IT WAS DISCUSSED A LOT BUT I DON'T KNOW WHAT -- IT IS, OKAY. YVONNE IS NODDING. (OFF MIC) >> DEVELOPED TO ALSO CAPTURE ISSUES OF STRESS RELATED TO ACCULTURATION PROCESS. FOR EXAMPLE, INTERGENERATIONAL CONFLICT. THAT DOESN'T NECESSARILY HAPPEN IN ALL FAMILIES. INTERGENERATIONAL CONFLICT HAPPENS BUT IT'S SO MUCH BETWEEN THE YOUNG AND THE OLE. BUT MUCH MORE WHEN YOUTH ACULTUREATE SO MUCH MORE. (INAUDIBLE) AND THAT'S ONE ASPECT IF YOU USE A REGULAR STRESS WHICH SHOULD BE USED. A REGULAR STRESS INSTRUMENT YOU WOULD MISS. >> I WANT TO START BY SAIG THIS IS BEEN A FASCINATING SYMPOSIUM. I LIVE IN MICHIGAN IN WAYNE COUNTY WHERE WE HAVE A LARGE ARAIB AMERICAN POPULATION AND WE HAVEN'T ADDRESSED THAT IMMIGRANT POPULATION AND THE STIGMA AND MARGINALIZATION THAT HAPPENS SPECIFICALLY BE THE EVANS OVER THE LAST TEN YEARS BUT WE ALSO WANT TO LOOK AT THAT STIGMA AND MARGINALIZATION AND HOW IT IMPACTS HEALTH SEEKING BEHAVIOR BECAUSE EVEN THOUGH THE NATIONAL CHILDREN'S STUDY IS OBSERVATIONAL STUDY, PEOPLE WHO ARE SEEKING HEALTHCARE AND IN A MARGINALIZED GROUP ARE GOING TO HAVE DIFFERENCE BEHAVIORS THAN THOSE WHO ARE NOT MARGALIZED. >> THANKS, GOOD. I'MSOR OF OUT OF ROOM ON THE PAGE AND WE'RE OVER FIVE MINUTES OVER, SHOULD WE -- SHALL I TAKE -- TURN IT BACK TO THE -- TO OUR LEADERS AND -- LEAVE THAT UP THERE. [APPLAUSE] >> THIS HAS BEEN A VERY INFORMATIVE AND ENERGETIC EVENT THE LAST TWO DAYS, WE CERTAINLY GATERRED A LOT OF INFORMATION FROM OUR SPEAKERS AND OUR DISCUSSANTS. I WOULD LIKE THE AGAIN THANK DR. CHRISTINE FOR PROVIDING A VERY NICE OVERVIEW AND SUMMARY OF CAP CAPTURING THE KEY LIE HIEGS OVER -- HIGHLIGHTS OVER THE LAST TO TWO DAYS. THANK YOU AGAIN, DR. BACHRACH. I WOULD LIKE TO BEGIN BY THANKING DR. MAD DOCK WHO ENCOURAGE IT IS MOVE FORWARD WITH THE SYMPOSIUM AND ALSO LIKE TO THANK OUR TASK FORCE WHICH CONSISTS OF A NUMBER OF NIH STAFF INCLUDING DR. GINA JAMES, ERIC LORENZA, PART OF THE NCS STAFF AND OTHER MEMBERS NOT NIH STAFF, I DON'T KNOW IF THEY'RE STILL HERE, (INDISCERNIBLE), STEVEN GOLDBERG AND ULGA PRICE, THEY HELP WITH THE -- MAKING RECOMMENDATIONS ON THE SPEAKERS AND MOVING FORWARD INVITING MANY SPEAKERS THAT ARE HERE TODAY. AGAIN, THANK YOU VERY MUCH FOR YOUR ATTENTIVENESS AND WE LOOK FORWARD TO MOVING THIS FORWARD TO ANOTHER LEVEL BECAUSE I THINK THIS IS THE BEGINNING OF INNOVATIVE ENTRY INTO IMMIGRATION AN IMMIGRATION STATUS. HAVE A WONDERFUL DAY AND A NICE WEEKEND. THANK YOU AGAIN. [APPLAUSE] >> MARIA, THANK YOU VERY MUCH. I THINK WE ALL NEED TO GIVE MARIA A REAL ROUNDING SOUND OF APPLAUSE. [APPLAUSE] SHE THANKED ME FOR ENCOURAGING HER BUT SHE CAME FORWARD. AND REALLY IT WAS A CHALLENGE FOR HER TO BE THINKING ABOUT SOMETHING LIKE THIS. MARIA IS RELATIVELY NEW TO THE PROGRAM OFFICE AND SHE HAD THE COURAGE TO RECOGNIZE THIS IS SOMETHING WE NEEDED TO PUT OUT THERE IN A WAY THAT WOULD BE VISIBLE BUT WOULD GET THE TYPE OF SCIENTIFIC RIGOROUS DISCUSSION AS WE'VE GOT B THROUGH THIS TWO DAY MEETING SO WE THANK YOU, MARIA AND WE DO THANK ALL OF YOU FOR COMING. MARIA IS ALREADY SAID THERE WILL BE SOME FOLLOW-UP ON THIS, WE HAVE A LOT TO DIGEST AND TO THINK ABOUT, A TERRIFIC JOB SUMMARIZING THE POINTS OF MEETING, CHRISTINE DID AND DID IT IN A THOUGHTFUL HIGH-QUALITY WAY. WE WILL BE GETTING BACK TO Y'ALL. THERE WILL BE SOME RECORD OF THIS MEETING IN TERMS OF A DOCUMENTED PUBLICATION THANK YOU VERY MUCH AND HAVE A HAPPY HOLIDAY SEASON. [APPLAUSE] >> I WOULD BE REMISS IF I DON'T THANK (INDISCERNIBLE) DARCY SMITH WHO MADE SURE THE SPEAKERS WERE ACCOMMODATED AND LOOKED OVER ALL THE LOGISTICS, A SPECIAL HAND OF APPLAUSE. [APPLAUSE]