Uncovering the health effects of the Great Migration | News

Cecilia Vu, PhD ’22, uses her quantitative skills to explore the health of African Americans who left the South during the 20th century April 6, 2022 – Cecilia Vu says she got hooked on public health when she realized how powerful data could be in shining a light on peoples’ […]

Cecilia Vu, PhD ’22, uses her quantitative skills to explore the health of African Americans who left the South during the 20th century

April 6, 2022 – Cecilia Vu says she got hooked on public health when she realized how powerful data could be in shining a light on peoples’ experiences.

The realization came about a decade ago. At the time, Vu was an undergraduate at Boston University and working as a research assistant for the BU School of Social Work’s Hyeouk Hahm, who studies mental health among Asian Americans, especially women and younger adults. Her research, focused on issues such as the challenges of straddling two cultures and dealing with generational tensions, struck a chord with Vu, the daughter of Vietnamese immigrants. For example, she recalled feeling “embarrassed and apologetic” during a trip to Vietnam because she wasn’t fluent in the language. “The things we were studying were all things that I was experiencing myself,” she said.

“I was fascinated with the data part of the research—the idea that, through data, you could tell stories about people was mind-blowing to me. At the time, I hadn’t known you could use data in that way,” said Vu. “That got me hooked completely for life on public health.”

Vu is now on track to earn a PhD in population health sciences with a concentration in epidemiology in May from Harvard T.H. Chan School of Public Health. And she’s been using the quantitative skills she learned at the School to research the Great Migration—the migration of millions of African Americans from the South to the urban Northeast, Midwest, and West from 1910 through 1970—and its impact on birth outcomes and mental health among those who migrated. Vu looked at racial factors that could have impacted health among the migrators, such as residential segregation and experiences of everyday discrimination.

‘An eye-opening experience’

Vu, a Milton, Massachusetts native who majored in American Studies at BU, flirted with the possibility of working in global health. She had internships with both the International AIDS Society in Geneva and the U.S. Agency for International Development in Washington, D.C. But she kept thinking about the work she’d done with Hahm on Asian Americans’ experiences. She eventually decided to return to BU for an MPH, where she focused on social epidemiology—looking at how societal conditions such as economic inequality, lack of access to education, and racist policies can affect health.

After earning her degree, Vu worked as an epidemiologist for the Massachusetts Department of Public Health. She evaluated reproductive health programs, calling it “an eye-opening experience.” She saw how, year after year, certain towns and communities had the highest rates of asthma, teen pregnancies, or early deaths. “I learned from my colleagues to look at these trends with a racial justice lens—to see how racially unjust policies like redlining, which can determine who can live in a particular community, can then influence the socioeconomic environment, poverty, the level of resources in that community,” she said.

After four years, Vu decided it was time to learn more. “I wanted to really understand how I could quantify the relationship between the history of racial injustice and public health, to really show that the policies and histories of particular communities have resulted in poor health outcomes,” she said. “I knew Harvard Chan School was the right place to go for that, because they have such a strong social epidemiology program.”

A lightbulb moment

Vu landed on the research topic for her dissertation somewhat serendipitously. The topic of the Great Migration’s impact on cities came up in one of her classes. She realized she knew very little about it, even though it was one of the largest internal migrations in U.S. history, an exodus propelled by African Americans seeking better economic conditions and an escape from the prevalent racial segregation and discrimination in the South. Vu decided to read Isabel Wilkerson’s book, “The Warmth of Other Suns,” which tells the story of the migration through data, records, and personal stories. “It was magical and compelling,” she recalled.

Soon, in another class, the topic of the Great Migration came up again—this time, in a paper by a fellow PhD student, Ellora Derenoncourt, who is now an assistant professor of economics at Princeton University. Derenoncourt’s paper detailed how some of the destination cities of those who migrated, such as Detroit and Pittsburgh, wound up being places with some of the most limited economic opportunities for African Americans.

That’s when a lightbulb moment hit. “I remember thinking, ‘That relates to the book I just read’,” Vu recalled. “Then it occurred to me, after doing a brief literature review, how little we know about the Great Migration in terms of public health. I was curious: Did Black Americans who migrated do better than those who stayed in the South? No one was really writing about this, so I decided to.”

Unexpected findings

Previous research had shown an increased risk of both adult and infant mortality among the African Americans who migrated out of the South. Vu probed further, examining the links between migration and low birth weight, as well as the connection between migration and mental health disorders. She assumed that those who migrated would have fared better in terms of health, given the fact that moving would have likely afforded them greater economic and educational opportunities. But that’s not what she found. “Moving out of the South did not improve health,” she said.

For instance, she found that the children of migrators had higher odds of mental health disorders compared to the children of those who stayed in the South. And they were more likely to report perceived discrimination. “Because of the well-known link between discrimination and mental health, I speculate that exposure to racial discrimination may have elevated the rates of lifetime mental health disorders among children of migrators,” Vu said. “That discrimination makes me think that this might apply to their parents as well.”

She added, “My findings make me question racism and discrimination in the South vs. the North, both in the past and the present. During the Great Migration, one of the motivations to migrate was the desire to leave legalized racial segregation under Jim Crow and the threat of racial violence. But racial discrimination in the North was also widespread at the time—through residential segregation and hiring and wage discrimination, for example. I think this also applies today as well.”

Vu hopes to continue studying racial inequities and public health. She already has a job lined up as a data science research fellow at BU’s Center for Antiracist Research. “I’m super excited,” she said. “It will allow me to use the rich quantitative skills I’ve gained at Harvard Chan School for racial equity work. The data training has been exceptional, and I’m just glad I get to keep practicing it going forward.”

– Karen Feldscher

photo: Kent Dayton

Uncovering the health effects of the Great Migration

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