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PubMed1991

Elevated blood pressure among Southeast Asian refugee children in Minnesota.

The blood pressures and body sizes of children aged 10-15 years in the Minneapolis and St. Paul, Minnesota, public schools were measured during 1986 and 1987. The sample consisted of 1,680 Southeast Asian refugees--including 219 Cambodians, 1,086 Hmong, 149 Lao, and 226 Vietnamese--and 3,424 blacks and 11,336 whites. Mean systolic blood pressure in Hmong boys was higher than that in black boys and white boys. Mean systolic blood pressures of Hmong, Lao, and Vietnamese girls were lower than those of black girls and white girls. The mean diastolic blood pressures of Hmong boys and of Cambodian and Hmong girls were greater than those of blacks and whites of the same sexes. Southeast Asian children were shorter and weighed less than black children and white children. Body size may confound associations between ethnic groups and blood pressures and may obscure the problem of hypertension among the smaller Southeast Asian children. Southeast Asian boys had greater mean systolic blood pressures than did black and white boys across all weight strata; a similar contrast among girls did not reveal this difference. The risk of hypertension, defined by US National Heart, Lung, and Blood Institute guidelines, was assessed in multiple logistic regression analyses that controlled for differences in weight, height, age, and pulse rate. The odds ratios for hypertension, relative to blacks and whites of the same sexes, were 2.69 (95% confidence interval (CI) 1.85-3.65) in Hmong boys, 2.89 (95% CI 1.35-6.21) in Lao boys, 2.10 (95% CI 1.03-4.28) in Cambodian girls, and 1.49 (95% CI 1.00-2.20) in Hmong girls. Hypertension and subsequent cardiovascular disease may emerge as a significant problem among Southeast Asian refugees in the United States.

Adolescent↗

PubMed1989

Fertility, menstrual characteristics, and contraceptive practices among white, black, and Southeast Asian refugee adolescents.

This study compares fertility and menstrual characteristics and contraceptive practices of white, black, and Southeast Asian refugee adolescents participating in the Minneapolis Health Department's Maternal and Infant Care Program between 1980 and 1982. Mean ages were similar among all racial groups; however, half the Hmong adolescents had a live birth as compared to less than 25% of the other racial groups. More than 75% of the Hmong and other Southeast Asian adolescents were married as compared to 11% of the whites and 8% of the blacks. Menarche was significantly later (2 years) for Hmong and other Southeast Asians, and the interval between menarche and first pregnancy was significantly shorter for the Hmong. While more than half of the whites and blacks previously used contraception, 14% of the Hmong and 29% of the other Southeast Asians had used contraception. Oral contraceptives were the most frequently used method for whites, blacks, and Southeast Asians; the Hmong were equally likely to choose oral contraceptives or barrier methods. The Hmong were less likely to choose contraception postpartum than were the other groups.

Adolescent↗

PubMedDate not supplied

Growth patterns of first-generation Southeast Asian Americans from birth to 5 years of age.

OBJECTIVE: The objective of this study was to compare patterns of growth (height, weight, occipitofrontal circumference) of Hmong, Lao, and white children conceived and born in the United States. METHODS: The study design involved a retrospective review of longitudinal cohorts from clinic records. Participants included 146 white, 112 Hmong, and 49 Lao children on whom data were collected from birth to 5 years of age. All were patients of a community clinic in a poor urban neighborhood. The study included children whose mothers conceived and received all prenatal care in the United States and gave birth in Minnesota during a 10-year period. Measurements on family characteristics, height, weight, and occipitofrontal circumference were obtained. RESULTS: The white children generally approximate the medians of national (National Center for Health Statistics [NCHS]) reference data. Lao children (especially boys) are found to be short and proportionately light relative to reference data. Hmong children are found to be short relative to reference data but are disproportionately heavier, so that weight-for-height is considerably higher than reference data. In Hmong girls, mean weight-for-height z scores increase from -0.5 z at birth to 1.26 z at 5 years, an average increase of 0.31 z per year. CONCLUSIONS: Lao and Hmong children conceived and born in the United States continue to have short stature (10th to 25th percentile). Hmong children have evidence of early overweight that is distinctive when compared with Lao and white counterparts.

Asian↗

PubMed1994

Determinants of infant feeding choices among southeast Asian immigrants in northern California.

OBJECTIVE: This study documents obstacles to successful lactation among Southeast Asian women. DESIGN: We assessed the infant feeding practices of 65 Hmong and 57 Vietnamese women. The women were recruited and interviewed at clinics of the Special Supplemental Food Program for Women, Infants, and Children (WIC) and neighborhoods in northern California. Analysis included logistic regression and odds ratios. RESULTS: Only 5 of the Hmong women and 3 of the Vietnamese women in our initial sample breast-fed their youngest child. Primary reasons for formula-feeding included convenience, the intent to return to work or school (although few did so), desire to allow others to feed, and the expectation of insufficient milk. In addition, most perceived that formula-feeding was more popular in the United States, and 19 of the Vietnamese women believed formula-feeding was healthier than breast-feeding. Variables positively related to breast-feeding included the number of times the mother was enrolled in WIC (for Hmong women) and the number of children previously breast-fed (for both groups). Breast-feeding was negatively related to the total number of children (for Hmong women), maternal age (for Vietnamese women), and receiving formula at the time of discharge from the hospital (for both groups). APPLICATIONS/CONCLUSIONS: Promotion of breast-feeding among Southeast Asian women should focus on increasing the number of women who initiate breast-feeding, addressing attitudes regarding the popularity and convenience of formula-feeding, and discouraging hospital practices that may impede breast-feeding.

Adult↗

PubMedDate not supplied

Fish consumption advisories and outreach programs for Southeast Asian immigrants.

Southeast Asian immigrants and refugees, in particular the Hmong people of Laos, have settled in large numbers in metropolitan areas of Minnesota. These communities, accustomed to hunting and fishing for food in Laos, now fish in some of the most contaminated waters of Minnesota. Fishing and fish-preparation customs of their homeland emphasize using all fish caught and discarding very little waste. These practices result in a potentially high exposure to PCBs and mercury. Educational outreach efforts to inform this population of the potential health hazards from consuming the fish are hindered by language and cultural barriers. While most Hmong anglers welcome information about contaminants and fishing, the typical press releases and mailings that convey fish advisory information to the public do not reach this community. The Minnesota Department of Health and the Minnesota Department of Natural Resources collaborated to determine the health messages and communication methods that would best meet the needs of these communities. Using the results of interviews and a behavioral survey, the Minnesota Department of Health has tailored fish consumption advisories to meet the unique needs of Southeast Asian anglers. Over the past four years, educational programs involving specialized advisories, translations, signs, a Hmong language video, and workshops have been used to inform Hmong anglers and other Southeast Asians about fish contaminants.

Asia, Southeastern↗

PubMed1999

Faculty and student cross-cultural learning through teaching health promotion in the community.

Cross-cultural learning for nursing students and faculty increased through a collaborative venture of teaching health promotion classes in a Hmong community. Through the learning process, nursing students and faculty learned about Hmong culture, and Hmong participants learned about health. The purpose of this article is to describe the process and evaluation of health promotion classes in a Hmong community.

Community Health Nursing↗

PubMed1999

[Knowledge about AIDS and risk behaviors among hill tribes in northern Thailand].

Two hundred eighty-one Hmong, 240 Mien, and 210 Lahu hill tribe people (ages between 17-39) in northern Thailand were interviewed from March to May 1996 about their knowledge, beliefs, attitudes regarding AIDS, STDs and condoms, and sexual behavior, to guide future tribal AIDS education and care programs. Premarital sex for both men and women and extramarital sex for men seems to be still culturally permissive and wide-spread among the Hmong and Mien people. The Lahu reported lower cultural acceptance, but this group had higher levels of premarital and extramarital sex than the other two groups, excepting extramarital sex for Hmong men. Many men among the three groups knew about condoms, but they do not like to wear condoms because, "it is not natural." Lahu people had the least education, were the least literate, and had the least family income. In addition, Lahu had the lowest level of knowledge of AIDS and STDs and they seem to have the most risky behaviors among the three groups. On the other hand, although Mien people had the highest education, were the most literate, had the most family income, and had the highest level of knowledge of AIDS and STDs, they seem to have high risk sexual behavior, also. There were increasing numbers of hill tribe people migrating to the cities and becoming involved to a greater degree in seasonal or permanent wage labor, including the commercial sex industry among Lahu and Mien groups. Hmong seem to have the lowest number of workers migrating to the cities. The results indicate the need to inform and educate tribal people about AIDS in a socio-cultural specific context.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Religiosity and Psychosocial Adjustment Among 100 Homng Refugees.

PURPOSE OF THE PAPER. The purpose of this paper is to study the relationship between religiosity and psychosocial adjustment in a group of Asian refugees from Laos. SUMMARY OF METHODS UTILIZED. Subjects consisted of 100 adult Hmong refugees from Laos who had relocated one decade earlier to Minnesota. At the time of the interview, about 80% remained in Minnesota; the remainder were interviewed in their respective communities. Five measures of religiosity were operationalized: Religious Belief (animism versus monotheism); recent Religious Practice (present/absent in previous monthrpar;; Religious Conversion lpar;present/absent in the U.S.rpar;; having a Home Altar (present/absent today); and having a shamanistic Trance Ritual (present/absent in the last five years). These five indices of religiosity were then compared against four general areas of psychosocial adaptation as follows: demographic characteristics lpar;5 itemsrpar;; sociocultural indices of adaptation lpar;5 items, including 2 scales) health care seeking over the previous five years (6 items); and psychiatric signs and symptoms (4 psychiatric scales). SUMMARY OF METHODS UTILIZED. Methods of data collection were as follows: (1) questionnaire-based interviewing by Hmong research assistants to provide data on religion affiliation, belief and practice; demographic information; psychosocial function; cultural affiliations and behaviors; and health care seeking; (2rpar; a psychiatric interview by the senior author followed by completion of two psychosocial scales (Axis 4 Psychosocial Stressors and Axis 5 Psychosocial Function using DSM-III criteriarpar; and several psychiatric rating scales lpar;Hamilton Anxiety Scale, Hamilton Depression Scale, Brief Psychiatric Rating Scale, and Global Assessment Scalerpar;. PRINCIPAL FINDINGS. Religious Pracitice in the last month was highly associated with several measures of psychosocial adaptation. Conversely, any Trance Ritual in the last five years was associated with increased anxiety and health care seeking. Religious Belief (animism versus monotheism) and having a Home Altar were associated with the other cultural factors, but not with psychosocial, heatlh and mental health measures. CONCLUSIONS. Aspects of religiosity among Hmong refugees were related to psychosocial adaptation in diverse ways, with some factors associated with better adaptation, some factors associated with maladaptation, and some factors related to other cultural dimensions but not psychosocial adaptation. KEY WORDS. Hmong; psychosocial adjustment.

Journal Article↗

PubMed2003

[Origin of Hakka and Hakkanese: a genetics analysis].

Hakka is a distinctive Han Chinese population in Southern China speaking Hakkanese. The origin of Hakka has been controversial. In this report, we analyzed Y chromosomal markers in 148 Hakka males. Principle component analysis of Y-SNP haplotype distribution shows Hakka is clusteed strongly with the Han in Northern China, and is also close to She, a Hmong-Mien-speaking population, while the general Southern Han is fairly close to Daic populations. Admixture analysis revealed that the relative genetic contribution 80.2% (Han), 13% (She) and 6.8% (Kam) in Hakka. The network of Y-STR haplotype of M7 individuals in all concerned populations suggested two possible origins of Hmong-Mien contribution in Hakka: One is from Hubei and the other is from Canton. The Kam contribution in Hakka is likely from Kan-Yue, the ancient aborigine of Kiangsi (Jiangxi). The frequency of 9bp-deletion in Region V of mitochondrial DNA of Hakka is 19.7%, which is quite close to She but far from Han. We therefore concluded that genetically the majority of Hakka gene pool shall come from North Han with She contributing the most among all non-Han groups. Regarding the Hmong-Mien character of Hakkanese, the genetic structure of Hakka shows their core may be Kim-man, the ancient Hmong-Mien. We hypothesized that a great number of Han people from North China join this population in succession. Southern Chinese dialects, such as Hakkanese may also be those languages of Southern aborigines at first, and turn to extant appearance under the continuance effect of Northern Chinese.

China↗

PubMed1984

[High prevalence of antiHTLV-1 antibodies in the Boni, an ethnic group of African origin isolated in French Guiana since the 18th century].

Antibodies to HTLV-1 (ELISA test using disrupted virus) were studied in different ethnic groups in French Guiana, including 135 blood donors from Cayenne, 97 Boni Blacks and 57 Wayana Indians from Maripasoula area, and 57 Hmong from Cacao village. We observed significant differences between Boni Blacks and Wayana Indians, having respectively 10.3% versus 0% of high antibody titers. The Hmong, recent refugees from Kampuchea, exhibited an intermediate level (3.5%) of infection. These results favour an African origin of HTLV-1 and raise, for the Hmong, the question of an infection acquired in Guiana.

Adolescent↗

PubMed1997

Predictors of hostility in a group of relocated refugees.

The objective of this research was to determine whether early postmigration demographic and psychosocial factors associated with cultural marginality would predict hostility one decade after flight and relocation. In this longitudinal study, participants, who had spent 1 year in a refugee comp, were studied at 1.5, 3.5, and 9 years postrelocation in the United States (i.e., Times 1, 2, and 3). Earlier data were compared with hostility at 9 years. Participants were interviewed primarily in their homes, although a few were interviewed elsewhere at their request (i.e., community center, University of Minnesota clinical offices). The 102 Hmong participants in this study, originally from Laos, comprised the first group of Hmong refugees, aged 15 to 72 years old (M = 31.0, SD = 13.1), to be relocated from Thailand to Minnesota by the Immigration and Naturalization Service in 1976. Hmong research assistants collected these data using a questionnaire format at 1.5, 3.5, and 9 years postrelocation. Hostility was measured using the Hostility subscale of the 90-item Symptom Checklist (SCL-90). Female gender, animistic belief, absence of a leadership role, and high scores on the SCL-Hostility predicted higher SCL-Hostility scores. Increased hostility was associated with greater financial, marital, and mental-emotional problems. This study suggests that demographic factors associated with marginality and loss of control predict hostility in a group of refugee immigrants. Losses and stressors from a decade earlier in Asia did not predict hostility.

Acculturation↗

PubMed2006

Views on smoking cessation methods in ethnic minority communities: a qualitative investigation.

OBJECTIVE: The purpose of this qualitative analysis is to increase our understanding of minority smokers' experiences and beliefs about guideline-recommended smoking cessation treatments. METHODS: We conducted sixteen focus groups (N=95) among current and former smokers from four ethnic minority communities in Minneapolis/St. Paul in 2005. Focus groups were conducted separately for American Indians, Vietnamese, Hmong and African Americans. RESULTS: Participants reported little experience with counseling and views on seeking help from physicians were mixed. African American and American Indian participants expressed feelings of mistrust and negative experiences with doctors. Hmong and Vietnamese smokers viewed doctors positively but did not regard them as an important resource to help with quitting, and especially for Vietnamese, the cultural value of mental control and self-determination was seen as most important to quit smoking. Across all the groups, pharmacotherapy was rarely utilized and participants had low knowledge and poor understanding of the benefits of pharmacotherapy. CONCLUSIONS: Personal beliefs, views toward doctors, and lack of knowledge are important determinants of the use of tobacco treatments among ethnic minority smokers. In order to increase minority smokers' utilization of evidence-based tobacco cessation treatments, effective strategies are needed to deliver accurate information about treatment from trusted sources.

Black or African American↗

PubMed1989

Delusions of fatal contagion among refugee patients.

Delusions of fatal contagion were encountered in about 10% of refugee psychiatric patients from Southeast Asia belonging to one ethnic group, the Hmong. Psychotic depression was the most common diagnosis among the Hmong patients with delusions of contagion, whereas paranoid and schizophrenic diagnoses predominate in patients with similar delusions from other refugee groups. Some cases also occurred as a shared delusional disorder. Associated findings included isolation from the community, intrafamilial conflict, failure to acculturate, and sexual frustration or conflict. Most patients responded to tricyclic medication, later supplemented in about half of the cases with a neuroleptic. This syndrome, which does not appear to have been described previously, should be considered in cases of somatizing refugees who present repeatedly to medical facilities.

Adolescent↗

PubMed2002

Prevalence of hepatitis B and C virus infection in rural ethnic populations of Northern Thailand.

BACKGROUND: In Thailand, the population is composed of multiethnic stocks. However, many epidemiological studies on HBV and HCV have focused on blood donors with Thai and/or Chinese ethnic background. Available information on HBV and HCV infections among ethnic minorities in Thailand is limited. OBJECTIVE: So as to contribute to the local public health planning, we have conducted an ethno-epidemiological survey for the HBV and HCV infections among several minorities in a multiethnic center, Northern Thailand. STUDY DESIGN: A total of 658 individuals from seven ethnic groups, Lahu, Lisu, Shan, Red Karen, White Karen, Hmong and Akha, living in northern Thailand were studied for the prevalence of HBV and HCV infections by the use of particle agglutination tests. RESULTS: An overall prevalence of HBs-Ag, anti-HBs and anti-HCV in the seven groups was 10.3, 33.0 and 3.8%, respectively. The positivity rate of HBV and HCV infection in each tribe ranged 4.7% (Akha)-22.6% (Lahu) and 2.0% (Hmong and Akha)-8.1% (Shan), respectively. Sexual difference in the prevalence of HBV was not observed, whereas the prevalence of HCV was significantly higher in the males (P<0.05). The prevalence of HBV was significantly different (P<0.005) by the groups but that of HCV was not. CONCLUSIONS: The prevalence of HBV and HCV infection in Thai ethnic minorities was investigated. We demonstrated that HBV was a more common infectious agent found in this populations than HCV. The prevalence of HBV infection was different by tribe but not by sex. In contrast, the prevalence of HCV infection was not different by tribe but by sex (males were infected more than females). The present study showed that HBV and HCV infection are widely spread in rural ethnic populations of northern Thailand. Thus, a nation wide but community-base epidemiological survey is required for the public health planning to control their related serious diseases.

Adolescent↗

PubMed2002

What does "being American" mean? A comparison of Asian American and European American young adults.

Two studies found that the meaning of "being American" differs for Asian Americans and European Americans. In Study 1, Hmong and European American undergraduates described what "being American" meant to them. In Study 2, Chinese American and European American undergraduates described what "American culture" meant to them. Responses were coded for references to cultural exposure, customs/traditional behavior, ethnic diversity, political ideology, and patriotism. Across both studies, Asian Americans referred to American customs and traditional behavior more than European Americans. European Americans referred to patriotism more than Hmong (in Study 1) and to ethnic diversity more than Chinese Americans (in Study 2). The authors suggest that these differences reflect the distinct statuses, concerns, and experiences of Asian Americans and European Americans.

Adult↗

PubMed2003

Asian American and Pacific Islander seafood consumption -- a community-based study in King County, Washington.

This paper describes and quantifies seafood consumption rates, and acquisition and preparation habits of 202 first- and second-generation Asian American and Pacific Islanders (AAPI) from 10 ethnic groups (Cambodian, Chinese, Filipino, Hmong, Japanese, Korean, Laotian, Mien, Samoan, and Vietnamese) in King County, Washington in 1997. Participants were all seafood consumers. Average and median seafood consumption rates were 117.2 and 89 g/day, respectively, based on the average body weight (62 kg) of participants. Shellfish comprised 45.9% and "all finfish" 43.3% of all seafood consumed. Consumption rates varied significantly between ethnic groups with Vietnamese (2.63 g/kg/day) and Japanese (2.18 g/kg/day) having the highest average consumption rates, and Mien (0.58 g/kg/day) and Hmong (0.59 g/kg/day) the lowest. The most frequently consumed finfish and invertebrates were salmon (93% of respondents), tuna (86%), shrimp (98%), crab (96%), and squid (82%). Fish fillets were eaten with the skin 55%, and the head, bones, eggs, and/or other organs 20% of the time. Crabmeat including the hepatopancreas (accumulates lipophilic chemicals such as organochlorine compounds) was consumed 43% of the time. This paper was a product of a Community-University Partnership. Community guidance in study design and data collection was essential for successful participation by the AAPI Community. Data reported here not only will provide risk assessors with AAPI-specific seafood consumption rates but with insights into cultural consumption/acquisition habits that may alter risk assessment assumptions for the AAPI Community.

Asian↗

PubMed2005

Injection prevalence and risks among male ethnic minority drug users in Northern Thailand.

Thailand's rate of HIV due to drug use is increasing, and nearly one-half of clients at a drug treatment centre in the north are from marginalized ethnic minority groups. We describe and compare socio-demographics, drug use, and sexual practices across ethnic minority people presenting for treatment at the Northern Drug Treatment Center, Mae Rim, Thailand. A prevalence study was conducted between February 1999 and January 2000. Trained interviewers administered a baseline questionnaire to 1,865 people admitted to the Northern Drug Dependence Treatment Center. Ethnic minority (Karen, Akha, Hmong, Lisu, and Lahu) males were included in this analysis (n = 629). Between 7% and 28% of each minority group had ever injected drugs (p = 0.002). Ninety-five per cent of men ever injecting had used heroin. Younger age, speaking Thai language, having a job with higher contact with Thais, and prior drug detoxification were significantly associated with injection in multivariate analysis, while Hmong and Lisu ethnicity were protective. Using occupation and language as proxies, contact with Thais and concomitant acculturation may be a risk for injection among this population. The inadvertent consequences of acculturation as it relates to injection and HIV risk must be addressed.

Adult↗

PubMed1983

Refugees who do and do not seek psychiatric care. An analysis of premigratory and postmigratory characteristics.

Social psychiatric research can provide information about the role of interpersonal and societal factors in the genesis of psychiatric disorder. This discipline relies heavily on "experiments in nature" which expose a large number of people to a potentially pathological social stimulus. It also depends in large part upon the study of nonpatients to serve as a comparative group for patients. Both conditions are met in this study of Hmong refugees from Indochina. While the population and the event are esoteric to some extent, their experiences of sudden sociocultural change, geographic migration, role discontinuity, identity crisis, and massive loss are common experiences among many psychiatric patients, regardless of their origin. Thus this study contributes to our understanding regarding the social genesis of psychiatric disorder. This prospective study of refugees to the United States was undertaken among the Hmong population in Minnesota (N = 97) during 1977. Subsequently 17 of this group became psychiatric patients over a 12-month period. Premigration and postmigration factors associated with patient status are described. Hypotheses are offered regarding those postmigration experiences or social strategies which favored or prevented psychiatric status.

Adaptation, Psychological↗