Hmong Healthcare Disparities

Hmong Wisconsinites History

The Hmong people are an ethnic group with a unique culture who originally lived in China for over 4,000 years. Starting in the 1800s some left China for Vietnam, Laos, Thailand, and Burma. The Hmong people from Laos and Vietnam were trained by American forces to fight the northern Vietnamese and then they had to immigrate to Thailand after the war was over. During the '70s and the early ’80s, there was a large influx of Hmong refugees to Wisconsin (PBS). Many of the smaller towns in Wisconsin started Asian refugee settlement programs, with the encouragement of religious leaders and the government. According to the Wisconsin Department of Health Services, 38% of the Asian population in Wisconsin is Hmong (Department of Health Services).

Background

This map shows the estimated number of residents in each county in Wisconsin according to the U.S. Sensus Bureau's 2019 American Community Survey. Credit to PBS Wisconsin

A map of southeast Asia showing the four countries were most of the Hmong population is from. Credit to Chippewa Valley Museum.

Grade Level: 7-8th

1. What countries does the map show?

2. What do you notice about the geography?

3. Predict how the geography might impact culture in the region?

1. What do you notice first about this map?

2. Identify 2 areas of Wisconsin with a large Hmong presence

3. Evaluate why they are not spread out evenly across the state.

1988 NYT Article

Hmong Religion

In the U.S, almost 70% of the Hmong still practice traditional, animist ancestor worship and Shamanism, whereas the other 30% have converted to Christianity (Circle of Life).

Animist is the beleif in the spirit world that there is an interconnectedness of all living things. Animist belive that the human body is the host for a number of souls.

"The Hmong believe that diseases are caused by a departed ancestral spirit or the souls of those who have suffered an illness. The latter explains why certain Hmong believe that illness results from the separation of body and soul, which may or may not be related to the act of offending an ancestor, rather than a biological process. Moreover, the wish of the soul to leave the body it occupies is another concept related to the disease process according to the Hmong culture. As a result of these conceptions, the Hmong believe that western medicine is not the best treatment option for the illnesses, and they can instead be treated by a traditional healer called the shaman. The shaman is responsible for duties similar to that of a psychologist, a doctor, and a minister"

Religion

Map of Shamanic healing centers in Wisconsin. Credit to Google Maps

Wang Pao Yang, a Hmong shaman, shows a large metal ring in his right hand and rings on his fingers which he uses during spiritual healing ceremonies for people who are very sick, September 2, 2009, at his Fresno, California home. Credit to Getty Images

1. What places does the map show

2. Who do you think is the clientelle of these centers.

3. Speculate why these centers are where they are on the map? How are they important for Hmong culture?

1. What does Wang Pao Yang do for a living?

2. Evaluate the location where Yang is operating.

3. Compare and Contrast Yang to a typical western doctor.

Healthcare disparities

Health Disparity

-Current health data shows that Hmong Americans are more at risk for infection-related cancers like nasopharyngeal carcinoma, gastric cancer, hepatic cancer, and cervical cancer.

-Due to poor access to healthcare Hmong Americans are more likely to discover and treat their illnesses at an advanced stages.

-In Wisconsin, Thao et al. showed that the prevalence of diabetes among the Hmong was 11.3% compared to 6% in the non-Hispanic white population.

A chart from the 2010 U.S. Census on the percentage of each racial/ethnic group living in poverty in the United States. Credit to Semantic Scholar

Source: 1990 & 2000 Censuses of Population and Housing; 2006-2010 American Community Survey, U.S. Census Bureau

1. Which groups have the least and greatest percentage of poverty?

2. How do you think the chart relates to healthcare?

3. Why do you think Hmong are more impoverished than Asian Americans as a whole?

1. How has educational attainment changed overtime?

2. How might educational attainment impact access and trust in Western medicine?

3. Was there anything about this graph that suprised you?

The Spirit Catches You and You Fall Down

The Spirit Catches You and You Fall Down is a book about a hmong girl who had seizures and the family brought her to the hospital to get treatment. They believed in a little bit of medicine and a little bit of spiritual healing but were skeptical of too much medicine limiting the spiritual healing. The doctors took a while to accurately diagnose the child because of the language barrier. They classified it as neurological disorder and gave them medication. The doctors dismissed the families relgious beliefs toward medicine. The family was unhappy with the side effects of the medication and stopped using it on their child. The chld was taken from the family and placed in a foster home where her condition go worse until

she was brain dead.

1. Analyze what is happening in the photo?

2. What does this photo tells us about this healthcare setting?

3. Predict what you think the relationship between the hospital and the guy is.

1. What does this video tell us about gender and age roles in Hmong community?

2. How does wealth and resources effect the treatment of the woman? Would this situation developed differently if the patient was from an impoverished family?

3. This Grey's Anatomy episode was filmed in 2005 in English for an U.S. audience, what do you think this clip was trying to tell the viewers?

Healthcare and the Hmong community

Collaboration

1. What did the hospital do to try to collaborate with the Hmong community?

2. Compare and contrast this video to the Grey's Anatomy clip.

3. Rate the hospital's actions to lowering healthcare disparties for Hmong people. (On a scale of 1 to 10). Explain your rating.