A report by Fresno State’s Central Valley Health Policy Institute indicates young Hmong adults use less primary care and have less-timely prenatal care than other groups and that the biggest barrier to appropriate use is experiencing disrespect from health care providers.

“Understanding Traditional Hmong Health and Prenatal Care Beliefs, Practices, Utilization and Need” provides new evidence of the need for culturally competent care in the Fresno, Stockton and Merced, where live the region’s greatest concentrations of Hmong.

The results also point to the need for the health care and Hmong communities to work together to bridge the cultural gaps that prevent Hmong mothers and fathers and their children from utilizing available health care in the San Joaquin Valley.

The report was issued Wednesday, Nov. 9. It offers the first local primary data on Hmong health care utilization collected from a sample of 74 men (18-45 years old) and 99 women (18-36).  The age groups were selected to reflect women of child-bearing age and the fathers of chose children.

Among the findings contributing to a deep mistrust of the Western health care system:

  • An estimated 90 percent of respondents reported no language assistance was offered, while nearly half were dissatisfied with the overall Western health care experiences
  • About 90 percent said the health care provider’s office staff was not respectful, while nearly 80 percent said doctors were disrespectful of Hmong patients.
  • About 60 percent reported disconnect between Western and Hmong medicine.
  • Lack of insurance and other economic barriers were also linked to health care use.

The study was conducted by the Central Valley Health Policy Institute in collaboration with the Hmong Health Collaborative, with funding from The California Endowment and California Wellness Foundation.

“Lack of respect by Western health care staff and lack of trust in the Western health care system were stronger predictors as barriers to health care access than cultural practices and self identifications,” said Dr. Marlene Bengiamin, senior research associate and lead author of the report.

“Better understanding of traditional Hmong health care practices may enable health educators to relate more sensitively to Hmong clients,” Bengiamin added. “Likewise, educating the Hmong community about the Western healthcare system may make them feel more empowered to use the system.”

Susan Vang, coordinator of the Hmong Health Collaborative said, “As in many immigrant and refugee populations, cultural barriers and language access within health care settings are fundamental issues affecting the health and well-being of the Hmong community.”

The report findings, Vang added, should be seen as “an encouraging platform for cross-cultural sharing and action planning among health care providers, social service agencies and the Hmong community itself.”

Health Policy Institute director and report coauthor Dr. John Capitman said, “These findings present a challenge for both health care providers and Hmong-serving organizations. They need to learn how to communicate cultural respect and create service experiences that are not so unpleasant as to be barriers to seeking subsequent care.”

He added, “These findings challenge Hmong community organizations to work with their clients developing strategies for ensuring more positive and informative Western medicine experiences.”

The Rev. Dr. Sharon Stanley, executive director of Fresno Interdenominational Refugee Ministries Inc said the project “helps highlight the particular health care gaps that Hmong experience in prenatal care. This is unique community research and education, which supplies rare-to-find data specific to our Hmong neighbors and their needs.”

Xi Chang, coauthor of the report and a young leader in the Hmong community, said, “Rarely do we have the opportunity to conduct research into Hmong health care, practices and beliefs. However, this focus on the Central Valley Hmong community really highlights some of the most important health care gaps and misunderstandings we see today in Southeast Asians and refugees.”

Dr. Ghia Xiong, a registered psychologist who teaches and conducts training on working with Hmong clients, said, “In the Hmong culture respect plays an incredible role in their everyday life. It is vital to being in harmony with oneself and with others and the environment. Also, it is a key to opening the minds and hearts of the Hmong people.”

With health care of such importance, he said, “without respect, it is detrimental to any relationship and outcomes. It is why everything in the Hmong culture is built on respect. This research supports how important respect is in the Hmong culture.”

The Central Valley Health Policy Institute, founded in 2002 to engage residents and decision makers on regional health policy issues, is housed under the Central California Center for Health and Human Services within Fresno State’s College of Health and Human Services.

For more information about the Institute and/or report, contact Bengiamin at 559.228.2167 or marleneb@csufresno.edu.

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