Systematic Review: Health Promotion and Disease Prevention Among Hmong Adults in the USA

Abstract

Although disparities in the burden of disease and illness experienced across major racial and ethnic groups in the USA is well known, little is known about subgroups, including the Hmong population. This review sought to determine the current state of health disparities related to health promotion and disease prevention among Hmong adults from 1975 to 2015. Seventy-one descriptive (qualitative, mixed methods, and quantitative) studies were reviewed. Most focused on two areas: (1) health status (mainly breast and cervical cancers) and (2) health-related behaviors. This literature review confirms the existence of health disparities related to health promotion and disease prevention in the Hmong adult population. Effective intervention relies on identifying these disparities. A possible explanation for these disparities is the lack of health data collected on subgroup populations, which include the Hmong adult population. More research and more comprehensive health policies at the organizational level are needed to allow data to be collected on subgroup populations in order to better understand the social determinants that place the Hmong people at risk.

Review of Hmong-Related Health Problems: A Quick Guide for Healthcare Providers

“…Additionally, 23.2% of the Hmong have lower than a high school diploma compared to 12% of the general population, and 76.8% have higher than a high school diploma compared to 88% among the general population [7]. Also, 87% of Hmong in the US speak English less than very well, compared to 60% of the Asian American population in general [1].…”

“…Thus, "determinants of health," such as income and education, may vary considerably between and among each of these subgroups and could result in significant differences in health outcomes. Little is known as to whether there are differences between the umbrella groups and any of the subgroups and within the subgroups themselves [1].…”

“…Particularly, two studies in California have shown a large discrepancy related to such health-seeking behaviors. One study reported that over 97% of the Hmong patients deferred treatment for nasopharyngeal cancer as compared to 25.6% of their Asian/Pacific Islander counterparts [1,16]. The second study documented that only 3% of the Hmong patients diagnosed with hepatocellular carcinoma received treatment in the form of local surgical treatment, resection, or liver transplantation when compared to 22% of Asian Americans who sought surgical treatment [1,15].…”

“…The Hmong are an Asian ethnic group originally from southern China that later migrated to the northern regions of Laos, Vietnam, and Thailand. Since the 1970s, large numbers of Hmong have come to the United States (US) as refugees with their last major resettlement happening in 2006 [ 1 - 2 ]. The aim of this review is to provide healthcare workers with a concise guide that should provide clarity regarding most of the Hmong-related health issues and their cultural beliefs that affect their management in order to enhance their care.…”

Hmong Older Adults’ Perceptions of Insider and Outsider Researchers

“…The Hmong believe illness has either spiritual or physical causes (Lor, Xiong, Park, Schwei, & Jacobs, 2016). They do not have an understanding of preventive medicine or of chronic disease, resulting in low screening rates and later stages of diagnoses and high cancer mortality rates (Lor, 2017).…”