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PubMed1996

The effects of welfare status on psychological distress among Southeast Asian refugees.

It has been established in the general population that there is a relationship between welfare status and psychological well-being. There are few studies, however, which investigate the effects of welfare dependency on Southeast Asian refugees, a population that is highly dependent on welfare. This study examined the relationship between welfare status and psychological well-being among Vietnamese, Cambodian, Laotian, and Hmong refugees. The study compared three welfare groups: those who have never been on welfare, those who were once dependent on welfare and are no longer on welfare, and those who are still welfare-dependent. The results supported three hypotheses: a) a high percentage of all four refugee groups were still dependent on welfare even after being in the United States for an average of 5 to 6 years, b) a significant relationship was found between welfare dependency and psychological distress, and c) dependence on welfare had long-term effects for all four groups. An interesting finding that emerged for the Vietnamese, Cambodians, and Laotians was that individuals who were once on welfare but who are no longer receiving welfare benefits are at similar risk as their counterparts who are currently on welfare of developing psychological distress. The findings therefore showed that for this population, if individuals had been touched by welfare at any period in their lives, they were at risk of developing psychological distress. There was an unexpected different finding for the Hmong; individuals who were no longer on welfare were more at risk than those who continued to receive or never had received welfare. Reasons for the intergroup differences and why refugees tended to stay on welfare longer than the general population were explored, along with a discussion about the implications of the findings for refugee policy.

Adolescent↗
PubMedDate not supplied

A survey of vaccinations of immigrants and refugees in San Diego County, California.

PURPOSE: This report summarizes a vaccination coverage survey of 65 immigrant and refugee families in San Diego County. It included gathering information from 19 community and government organizations on the immunization system, and on families' barriers impeding immunization. METHODS: The "rapid appraisal" exploratory method flexibly used several research methods, such as informant interviews and door-to-door surveys, changing methods as new questions were uncovered. The researcher went alone, or with organizations' staffs, to interview families, record their vaccination records, and give them forms telling which vaccine doses they lacked. PRINCIPAL FINDINGS: The 4:3:1 (4 DTP, 3 polio, 1 MMR) vaccination series completion rate among children while they were aged 19-35 months old ranged from 33% in those born in 1984-1985, to 60% in those born in 1996-1997. The hepatitis B vaccine completion coverage rate among children in the 1984-1993 birth cohorts was 73%. The hepatitis B vaccine completion coverage rate among Hmong, Vietnamese, and Chinese adolescents ranged from 86%-100%, and among the Kurdish was 85%, Somali 73%, Lao 43% and Cambodian adolescents 35%. CONCLUSIONS: The hepatitis B vaccine completion coverage rate was higher among Hmong, Vietnamese, and Chinese adolescents probably because they lived near clinics and schools providing the vaccine to many, and among the Kurdish and Somali because they received many doses in refugee programs. The families experienced immunization barriers involving transportation, languages, little knowledge of immunizations, and missed opportunities. Two populations have cultural barriers: numerous European-Americans believe in anti-vaccine ideas; and many East Africans have little knowledge of the English language and the American system. RECOMMENDATIONS: Health personnel should continue using current methods to promote immunizations. Community organizations' staffs should consistently check vaccination records, and health officials should do more trainings for those staffs. The National Task Force on Hepatitis B Immunization, Focus on Asians and Pacific Islanders should broaden its work from Asians and Pacific Islanders, to other nationalities with intermediate or high hepatitis B endemicity.

Adolescent↗
PubMed2001

Using a transcultural, patient based approach to improve patient outcome in a pediatric ESRD patient.

In this case, the medical team learned about the Hmong cultural beliefs and collaborated with the family to design a plan of care that included their nonwestern medical practices. Improved health care for the child resulted from a partnership between the Hmong community, extended family members, cross-cultural nursing staff, and the nephrology team. This experience amended existing protocols for managing diverse populations and because of its success, the pediatric nephrology team was awarded the UCSD Healthcare Diversity Award in 1998.

Adaptation, Psychological↗
PubMed1987

The Fresno County Refugee Health Volunteer Project: a case study in cross-cultural health care delivery.

Beginning in 1979, Fresno County received a 2nd dramatic influx of Southeast Asian refugees. There are now approximately 20,000 of these refugees, including the largest population of Hmong in the US. This community includes about 2000 Cambodian, 14,000 Hmong, and 4000 Lowland Lao. Altogether, Southeast Asian refugees comprise nearly 10% of the population of Fresno. These demographics provide the backdrop for significant problems in health care service delivery. Some barriers include: 1) stress, loss, dislocation, poverty, illness, and unemployment that are part of the refugee experience; 2) language differences; 3) cultural isolation; and 4) cultural beliefs and practices whose spiritual, wholistic, and natural forms of care often run contrary to the West's scientific, specialized, and technological treatment modalities. The Health Department began to recognize some difficulties related to health services for refugees and developed a strategy to combat these. This strategy was named the Refugee Health Volunteer Project and its goal was to enable individuals, families, and community groups to better meet their own health care needs. Goals were to be met by 1st creating a community-based health promotion network to 1) identify health needs, 2) communicate health information, 3) train community health volunteers, and 4) build a greater capacity for self-care that would last beyond the end of the program. The program's goal would also be met by overcoming the access problems with the service system by 1) communicating community-identified needs, 2) identifying specific barriers in the service system, 3) initiating broad participation among service providers in designing more accessible approaches to service delivery, and 4) improving coordination between service providers. Significant progress has been made in a very short time. The Project demonstrates that a fairly common, bureaucratic organization can be responsive to extremely unique community needs. The project is demonstrating the effectiveness of a network approach as a model for service delivery to ethnic communities experiencing language and cultural barriers to health care. The project staff have served as a catalyst for initiatives which are creating ways in which the broader health delivery system can be more accessible to refugee clients. What is emerging is an approach to health empowerment that builds on the strengths, skills, knowledge, and experience of community people and those organizations which support their efforts.

Americas↗
PubMed2006

[Analysis of polymorphisms in Y-DNA haplotypes and mtDNA haplogroups in Yao ethnic group from Guizho].

The frequencies of Y-chromosome haplotypes consisting of 12 single nucleotide polymorphisms (SNP) and mitochondrial DNA (mtDNA) haplotypes consisting of 9 SNPs were investigated using PCR-RFLP in 97 Yaos from Guizhou to study the patrilineal and matrilineal genetic structure and the origin of Yao Ethnic Group from Guizhou. Results showed that all 97 samples were classified into 4 Y-DNA haplotypes (H7, H8, H9 and H11). The major haplotype H7 of Hmong-Mien Population was highly prevalent (92.4%) in Yaos from Guizhou. Eight mtDNA haplotypes were identified through mtDNA analysis and all the haplotypes could be classified into 5 haplogroups (B4, B5, D4, D5 and N*) that were defined previously. The frequency of a 9-bp deletion in the human mtDNA Co II/tRNALys intergenic region was 58.2% in the 97 samples. These data suggest that the patrilineal genetic structure of Yao ethnic group from Guizhou was simple and Yaos from Guizhou had the typical genetic character of the Hmong-Mien Population and some admixture with other populations. The matrilineal genetic structure of Yaos from Guizhou was relatively complex and the 9-bp deletion was a characteristic genetic marker of the matrilineal genetic structure of Yaos from Guizhou.

Asian People↗
PubMed1989

Food habits and dietary change of Southeast Asian refugee families living in the United States.

Food habits and changes in food consumption patterns were assessed among 60 Southeast Asian refugee families (Cambodian and Hmong) living in the United States. With the use of a structured interview schedule, in-home interviews were conducted by a Hmong or a Cambodian bilingual staff person with the adult having primary responsibility for family meal preparation. Results indicated that while food buying practices have changed drastically in the U.S., Southeast Asian refugee families have maintained strong ties to their native foods and traditional diets. In the U.S., as in Southeast Asia, rice remains the staple food in their diet. High status foods in Cambodia and Laos, such as fruits, meats, and soft drinks, remain highly preferred foods in the U.S. and are consumed frequently. Although most adults prefer eating their native foods, their children prefer both American and native foods. Thirty percent of the adolescents in the home had major responsibility for evening meal preparation.

Adolescent↗
PubMed1986

Birth weight, Apgar scores, labor and delivery complications and prenatal characteristics of Southeast Asian adolescents and older mothers.

The study population included 337 adolescents and 876 mothers who delivered live-born, singleton infants in the Maternity and Infant Care Program at the Minneapolis Health Department between 1980-1982. Whites and blacks on the average experienced menarche 1-2 years earlier than the Southeast Asians although age of first pregnancy was 2 years later for the Southeast Asians. In spite of the significantly later ages of entry into prenatal care, lower weight gains, and hematocrits among the Southeast Asians, compared to the white and black populations, overall height-weight status on admission compared favorably with whites and blacks. The virtual absence of alcohol and tobacco consumption among the Southeast Asians may in fact contribute to the generally favorable Apgar scores, length of gestation, and birth weights. The high frequencies of alcohol and tobacco consumption among white adolescents during pregnancy suggest the need for more intervention to discourage smoking in this population. Further, the potential adoption of these substances needs to be discouraged among the Southeast Asian adolescents. While 2-4% of the whites, blacks and Hmong adolescents experienced eclampsia, 1% of the older Hmong mothers and none of the other Southeast Asians experienced eclampsia. The most frequent complication for all groups was perineal laceration.

Adolescent↗
PubMed1982

Health status of refugees from Vietnam, Laos, and Cambodia.

More than 0.5 million refugees from Southeast Asia have immigrated to the United States. We undertook a prospective evaluation of 709 refugees within two months of their resettlement in San Diego. The sample included 164 Vietnamese, 356 Cambodians, 139 Laotians, and 50 Hmong. The prevalence of abnormalities was high: intestinal parasites, 61%; positive tuberculin test (PPD) results 55%; anemia, 37%; hepatitis B antigenemia, 14%; and abnormal VDRL test results, 12%. Except for hepatitis, significant differences were noted among the Vietnamese, Cambodian, Laotian, and Hmong subjects on each of these health status indicators. The refugee population should not be considered a homogeneous group of Indochinese, particularly by those responsible for their health care.

Adolescent↗
PubMed2006

On cross-cultural conflict and pediatric intervention.

A critical examination of Richard Miller's position in his recent Children, Ethics, and Modern Medicine on how to handle pediatric interventions in cases of cross-cultural conflict between parents and doctors with respect to treating young children. Particular emphasis is placed on Miller's interpretation of and arguments about a Hmong case extensively researched by Anne Fadiman in her The Spirit Catches You and You Fall Down. The conclusion drawn is that Miller's position requires further nuance and development, and some recommendations are made toward that end.

Anthropology, Cultural↗
PubMed1997

Prevalence of antibodies to hepatitis A, C, and E viruses in different ethnic groups in French Guiana.

In order to determine the prevalence of antibodies to hepatitis A, C, and E viruses (HAV, HCV, and HEV) in the various ethnic groups and areas of French Guiana, sera (996 for HCV and HEV, 941 for HAV) were tested for antibodies to these viruses using ELISAs. Differences in HAV seroprevalence were found for different age groups, with a large increase in people aged 20-30 years in comparison with those under 20. After logistic analysis, significant differences were found between places of residence; the prevalence of anti-HAV was higher along the Maroni and Oyapock rivers than in the littoral area. The ethnic differences that were observed were generally due to differences in residence. Of all sera, 5.3% were positive for anti-HCV in preliminary tests, but only 1.5% remained positive after confirmation. Brazilians were significantly more frequently infected by HCV than other ethnic groups (4.7%). Sixty-four sera (6.4%) had antibodies to HEV, and differences were found between ethnic groups. Persons of ethnic groups who had emigrated recently to French Guiana had significantly higher seroprevalence rates: 14.6% for Chinese and Hmongs [odds ratio (OR), 4.4; 95% confidence interval (CI), 1.8-10.7], 13.5% for Brazilians (OR, 4.1; CI, 1.8-9.4), and 10.6% for Haitians (OR, 3.1; CI, 1.1-8.7).

Adolescent↗
PubMed2005

Seizing the moment: California's opportunity to prevent nutrition-related health disparities in low-income Asian American population.

Asian Americans and Pacific Islanders (AAPI) have the fastest growing rate of overweight and obese children. Aggressive programs are urgently needed to prevent unhealthy acculturation-related changes in diet and physical activity and to promote the healthier aspects of traditional lifestyle habits. We conducted focus groups and key informant interviews to explore knowledge, attitudes, dietary practices, and physical activity levels among three low-income Asian American ethnic groups, Chinese, Vietnamese, and Hmong, in California. Content analysis was used to identify similarities and differences among the groups. Several common health beliefs clearly emerged. Participants noted the importance of fresh (not frozen) fruit and vegetable consumption and physical activity for general health. The concept of good health included having a harmonious family, balance, and mental and emotional stability. All groups also expressed the general belief that specific foods have hot or cold properties and are part of the Yin/Yang belief system common to Asian cultures. The lure of fast food, children's adoption of American eating habits, and long work hours were identified as barriers to a healthy, more traditional lifestyle. A California campaign for Asian Americans using multilevel strategies is recommended to counter the alarming rise of obesity among AAPI youth. Strategies directed to individual, community, and policy levels should emphasize maintenance of healthy traditional diets, informed selection of mainstream U.S. foods, and promotion of active lifestyles to prevent an impending burden from cancer and nutrition-related chronic diseases in AAPI populations.

Asian↗
PubMed1992

Prevalence of herpesvirus, human T-lymphotropic virus type 1, and treponemal infections in Southeast Asian refugees.

Sera obtained for treponemal serology (VDRL) from 193 Southeast Asian refugees representing five ethnic groups seen in a primary care clinic were examined for antibodies to human T-lymphotropic virus type 1 (HTLV-1), human herpes-virus-6 (HHV-6), Epstein-Barr virus (EBV), and cytomegalovirus (CMV). The seroprevalence was highest for EBV (99%), followed in decreasing order by CMV (95%), HHV-6 (26%), and HTLV-1 (0.6%). The VDRL was positive in 15% of patients. The highest seroprevalence to HHV-6 was noted in the Chinese (33%) and the lowest in the Laotian hilltribes, the Mien and Hmong (14%). Antibody to HHV-6 was most prevalent among patients under 20 and those between 60 and 69 years of age. Differences were not found among ethnic groups in the seroprevalence of HTLV-1, EBV, or CMV.

Adult↗
PubMed1988

Folk medicine in Laos: a comparison between two ethnic groups.

Folk healing was studied in two ethnic groups of Laos during the period 1965-75. Hmong, mostly illiterate and animistic, lived in highly autonomous villages within an atomistic society, occupying remote and sparsely populated mountains. Lao, mostly literate and Buddhist, lived in lowland towns and villages within a hierarchical and integrated society, occupying the densely populated Mekong flood plain. Folk healing systems of both groups demonstrated similarities regarding folk syndromes and folk modalities. Differences included more complex theories about illness, greater number of folk practitioner types and greater differentiation of the shaman role (i.e. into separate priest and healer roles) in the more complex Lao society.

Cross-Cultural Comparison↗
PubMed1991

Infant mortality among ethnic immigrant groups.

The numerically large and growing Indochinese refugee population has been little studied with respect to infant health. It is a population that is young, is experiencing high fertility, late onset of prenatal care, and is characterized by low socioeconomic status. Thus, it presents a high risk profile with respect to infant mortality. Using linked birth and infant death records for the San Diego metropolitan area for the period 1978-85 infant mortality rates (IMRs) were calculated for Indochinese refugee groups from Vietnam, Laos and Cambodia in comparison with other ethnic groups. We found, surprisingly, that Indochinese refugees as a group had an IMR below that for non-Hispanic Whites and substantially below that for Blacks. In general, IMRs for Indochinese refugees were similar to those for other Asian groups. These findings held even after controlling for birth weight and onset of prenatal care. The timing and causes of death suggest areas in which the IMR could drop to even lower levels with improved community outreach programs, especially among refugee groups from Laos (Hmong and Lao) who exhibited the unusual pattern of higher post-early neonatal than early neonatal mortality.

Birth Weight↗
PubMed1977

Narcotic addiction in two Asian cultures: a comparison and analysis.

Our current knowledge regarding the effects of open access to narcotic drugs is limited. This study was undertaken to clarify issues regarding availability of these drugs. Two ethnic groups in Laos were compared: the Hmong (or Meo), a tribal group with access to opium in their homes; and the Lao, a peasant people with more limited access, usually in opium dens. Of 15 demographic and clinical variables studied, 10 showed significant differences between the two cultures. Eight of these 10 could be readily accounted for by differences in drug availability. Only two differences could be ascribed to socio-ecologic factors not related to drug availability. Similarities between the two groups appeared due to (1) pharmacologic effects of narcotic addiction and (2) low social opprobrium toward addiction in both cultures. In this study, open availability of narcotic drugs appeared to favor the following: a greater proportion of female addicts; younger age of opiate usage and addiction; use of the more intoxicating route of administration; earlier onset of problems related to addiction; and shorter duration of addiction before seeking treatment.

Adult↗
PubMed2006

Tympanometry of a diverse group of preschool aged children.

OBJECTIVE: Ethnicity has been previously described as a risk factor for middle ear disease. Little data exist on the presence of middle ear disease based on tympanometry screening comparing Asian children and children of other races. METHODS: Two hundred and seventy children aged 3-5 were screened with tympanometry at six Head Start sites in St. Paul, Minnesota during the months of September and October of 2004. Gender, age, and race/ethnicity was recorded and entered into a database, along with values for canal volume, static admittance, peak pressure, and tympanometric width. RESULTS: Criteria for abnormal tympanometry were based on American Speech-Language Hearing Association (ASHA) recommendations for a failed tympanogram for 1-5 year olds (admittance <0.3 mmho or width >200 daPa). There were no statistically significant differences in failure rates between males and females. There were, however, more failures for Asian (predominantly Hmong) children compared to children of other races/ethnicities after adjusting for age and gender differences (OR=6.39, CI 3.65-11.2, p<0.001) and for children <4-years-old compared to children 4-5-years-old after adjusting for race and gender differences (OR=1.99, CI 1.03-3.84, p<0.05). CONCLUSIONS: Asian children were more than six times as likely to fail tympanometry as children of other races/ethnicities. The explanation for this difference is likely to be multifactorial, and further research is needed to characterize this difference.

Acoustic Impedance Tests↗
PubMed2003

Thai mothers and children and the home observation for measurement of the environment (home inventory): pilot study.

The HOME Inventory is a measure of home stimulation available to children. The purposes of the study were to: (a) examine the psychometric properties of a Thai-translated HOME (Infant/Toddler), (b) compare Thai mean HOME scores with three groups (Hmong, Eskimo, HOME normative sample in the state of Washington) reported in the literature. A convenience sample from Mahasarakham public health centers in northeastern Thailand was assessed using 36 dyads of mothers and toddlers, 13-35 months. The internal consistency was 0.81 for the total scale; F-tests of the HOME total scale and subscale means showed significant differences between Thai and three other groups. Scheffe tests which showed Thai means on three subscales (Maternal Involvement, Responsivity, Restriction) were not significantly different from the Washington sample, but were significantly lower on three subscales (Play, Organization, Stimulation). Further study is needed on the use of home assessment instruments by nurses and others working in multicultural settings.

Child↗
PubMed1989

Somatization among refugees: an epidemiologic study.

Somatization has been widely reported among refugee psychiatric patients since World War II, and some psychological theorists have viewed somatization as an alternative to depression. These and other theories were tested in a population survey of 97 Hmong refugees who had lived in the U.S. for several years. Four different measures of somatization were employed, including a 12-item self-rating scale, a single-item global rating based on the total interview, and somatic subscales of the two Hamilton interview-rating scales. These data demonstrate that somatization accompanies certain demographic characteristics that are associated with failure to acculturate. Somatization in this non-patient, refugee population was associated with treatment seeking and self-identified "medical problems" and with psychiatric symptoms and disorders, but not with objective evidence of medical disorder.

Acculturation↗