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The Hmong Population and Healthcare

The Hmong-speaking population of the United States represents a much smaller population as a percentage compared to other Asian-American cultures. The 2000 U.S. Census states that there are about 200,000 to 250,000 people of full or partial Hmong ancestry living in the United States. Most Hmong-Americans live in California, Minnesota and Wisconsin, with the Minneapolis/St. Paul metro area featuring a very high concentration of Hmong immigrants. When working with this group in your healthcare organization, it helps to keep the following in mind about the Hmong immigrant population’s culture and language.

The Hmong language is made up of many dialects spoken by the Hmong people of parts of China, northern Vietnam, Thailand and Laos. The two most common dialects of Hmong are White Hmong (Hmong Der) and Green/Blue Mong (Mong Leng). White Hmong is spoken by the majority of Hmong immigrants in the United States. Green/Blue Mong is mutually intelligible with White Hmong, but differs in certain aspects. Some have compared the two dialects’ differences to those between American and British English. Hmong is a tonal language and was an oral language until it began to be written by missionaries in 1952. New words are being constantly borrowed from Thai, Vietnamese and Lao.

Many Hmong immigrants arrived in the U.S. after having fled political persecution after the Vietnam War. Many tend to suffer from poverty which has implications on their assimilation. As of the 1990 census, 60 percent are said to live in poverty with a mean national income of $14,327. However, it’s important to remember that not all Hmong are the same, especially because some Hmong were born in the United States and there has gradually been an increase in the number of Hmong who are college educated. Various degrees of acculturation exist, as with many other cultural groups within the U.S.

Generally, when working with Hmong populations, it’s best to explain medical processes and procedures very clearly and think through the proper sequence of an explanation, either written or verbal. It’s best to use simple words and be aware of information overload. Be conscious of other cultural differences, such as: in the Hmong culture, yes does not always mean yes to the content of the question. It often means that they’re saying “yes, I understand you asked me a question”. No is considered disrespectful, so sometimes it’s best to avoid yes or no questions. This can be very important when writing or speaking about health-specific information.

There are other cultural differences to be aware of when working with Hmong populations. Hmong immigrants believe that the soul resides in the head, so touching a person’s head without permission is disrespectful. Before removing jewelry or amulets from a patient, seek the permission and understanding of the patient, oldest male family member or spiritual leader.

Some health providers might find it helpful to learn more about the Hmong understanding of Western medicine by reading the nonfiction book The Spirit Catches You and You Fall Down, by Anne Fadiman. The title describes the meaning in Hmong of the concept of epilepsy. The book details the cultural conflict that arose between a Hmong girl’s immigrant parents and Western medical staff who saw her condition as medically dangerous, while her parents saw the girl’s seizures as a divine gift.

When your organization provides material in Hmong, it can provide much needed patient education and explain the U.S. health system to this community.


	viaLanguage Translation Articles The Hmong Population and Healthcare The Hmong-speaking population of the United States represents a much smaller population as a percentage compared to other Asian-American cultures. The 2000 U.S. Census states that there are about 200,000 to 250,000 people of full or partial Hmong ancestry living in the United States. Most Hmong-Americans live in California, Minnesota and Wisconsin, with the Minneapolis/St. Paul metro area featuring a very high concentration of Hmong immigrants. When working with this group in your healthcare organization, it helps to keep the following in mind about the Hmong immigrant population’s culture and language. The Hmong language is made up of many dialects spoken by the Hmong people of parts of China, northern Vietnam, Thailand and Laos. The two most common dialects of Hmong are White Hmong (Hmong Der) and Green/Blue Mong (Mong Leng). White Hmong is spoken by the majority of Hmong immigrants in the United States. Green/Blue Mong is mutually intelligible with White Hmong, but differs in certain aspects. Some have compared the two dialects’ differences to those between American and British English. Hmong is a tonal language and was an oral language until it began to be written by missionaries in 1952. New words are being constantly borrowed from Thai, Vietnamese and Lao. Many Hmong immigrants arrived in the U.S. after having fled political persecution after the Vietnam War. Many tend to suffer from poverty which has implications on their assimilation. As of the 1990 census, 60 percent are said to live in poverty with a mean national income of $14,327. However, it’s important to remember that not all Hmong are the same, especially because some Hmong were born in the United States and there has gradually been an increase in the number of Hmong who are college educated. Various degrees of acculturation exist, as with many other cultural groups within the U.S. Generally, when working with Hmong populations, it’s best to explain medical processes and procedures very clearly and think through the proper sequence of an explanation, either written or verbal. It’s best to use simple words and be aware of information overload. Be conscious of other cultural differences, such as: in the Hmong culture, yes does not always mean yes to the content of the question. It often means that they’re saying “yes, I understand you asked me a question”. No is considered disrespectful, so sometimes it’s best to avoid yes or no questions. This can be very important when writing or speaking about health-specific information. There are other cultural differences to be aware of when working with Hmong populations. Hmong immigrants believe that the soul resides in the head, so touching a person’s head without permission is disrespectful. Before removing jewelry or amulets from a patient, seek the permission and understanding of the patient, oldest male family member or spiritual leader. Some health providers might find it helpful to learn more about the Hmong understanding of Western medicine by reading the nonfiction book The Spirit Catches You and You Fall Down, by Anne Fadiman. The title describes the meaning in Hmong of the concept of epilepsy. The book details the cultural conflict that arose between a Hmong girl’s immigrant parents and Western medical staff who saw her condition as medically dangerous, while her parents saw the girl’s seizures as a divine gift. When your organization provides material in Hmong, it can provide much needed patient education and explain the U.S. health system to this community.