Importance
The issue of war trauma is important because it can have lasting health impacts. Many Southeast Asian refugees living in the United States have experienced violence and war. The trauma that they live with affects their health mentally and physically. The effects of war trauma and of being refugees can also create barriers to seeking help.
Mental Health
A study of Cambodian refugees living in the U.S. showed that many of them had symptoms of PTSD and depression two decades after their exposure to war trauma.3 Another study of Cambodians refugees in the U.S. showed that those with PTSD and depression experienced a greater number of war traumas than those without PTSD and depression. There is also some evidence that refugees with PTSD and depression may find it more stressful to resettle and acculturate to the U.S.4 Getting accustomed to living in another country can be difficult for anyone. However, it may be especially difficult for refugees since they are forced to relocate and may not speak the language, understand the customs, or have the necessary resources.
Physical Health
In addition to mental health concerns, there may also be a number of physical health problems associated with war trauma and refugee camps. For Southeast Asian refugees, these problems include tuberculosis, hepatitis B, malnutrition, vitamin deficiencies, anemia, and parasites such as hookworm.5 Cervical cancer is also a significant problem for Vietnamese, Laotian, and Cambodian American women.6 Many of the physical health problems that affect Southeast Asian refugees may be related to physical hardship or torture in labor camps, poor healthcare in refugee camps, and physical manifestations of psychological trauma.7 Other factors include lack of food, lack of clean water, and exposure to unsanitary conditions in camps.
Barriers to Seeking Help
Southeast Asian refugees living in the U.S. face many barriers to seeking help. These barriers include low English proficiency, low education, low income or poverty, lack of awareness of services, lack of health insurance, lack of transportation, and preference for traditional medicine. For example, compared to other races and other Asian ethnic groups, Southeast Asian Americans are less likely to have completed high school, less likely to have college or advanced degrees, and less likely to be proficient in English.8 Compared to whites, Southeast Asians are more likely to be uninsured, less likely to get insurance through their jobs, and more likely to be covered by Medicaid. In addition, traditional beliefs and practices such as those held by Hmong may be barriers to health care because they can contradict with Western medical practices.9 Unfortunately, even if refugees do seek treatment in the U.S. , their specific needs associated with war trauma may not be addressed because providers have little training and experience treating these issues.10
Resources
- Asian and Pacific Islander American Health Forum: Fact Sheet: Cambodians: http://www.apiahf.org/resources/pdf/Cambodian%20Health%20Brief.pdf
- Asian and Pacific Islander American Health Forum: Fact Sheet: Hmong: http://www.apiahf.org/resources/pdf/Hmong%20Health%20Brief.pdf
- Asian and Pacific Islander American Health Forum: Fact Sheet: Vietnamese: http://www.apiahf.org/resources/pdf/Vietnamese%20Health%20Brief.pdf
- EthnoMed: http://ethnomed.org/
- National Asian American Pacific Islander Mental Health Association: http://www.naapimha.org/index.html
- National Institute of Mental Health : http://www.nimh.nih.gov/
- PTSD Alliance : http://www.ptsdalliance.org
- Southeast Asia Resource Action Center : http://www.searac.org/
- University of California , Irvine : Libraries: Southeast Asian Archive: http://www.lib.uci.edu/libraries/collections/sea/sasian.html
- Wildflowers Institute: Community Sites: http://www.wildflowers.org/community/index.shtml
References
1. Centers for Disease Control and Prevention. (2005). Coping With a Traumatic Event. Retrieved from http://www.bt.cdc.gov/masstrauma/copingpub.asp.
2. U.S. Committee for Refugees and Immigrants. Terms and Definitions. Retrieved from http://www.refugees.org/article.aspx?id=1089.
3. Marshall GN. Schell TL. Elliott MN. Berthold SM. Chun CA. (2005). Mental health of Cambodian refugees 2 decades after resettlement in the United States . JAMA. 294(5):571-579.
4. Blair RG. (2000). Risk factors associated with PTSD and major depression among Cambodian refugees in Utah . Health & Social Work. 25(1):23-30.
5. Ackerman LK. (1997). Health problems of refugees . Journal of the American Board of Family Practice. 10(5):337-348.
6. National Asian Women's Health Organization. (2000). A Profile: Cervical Cancer and Asian American Women. Retrieved from http://www.nawho.org/pubs/NAWHOCC.pdf.
7. Uba L. Chung RC. (1991). The relationship between trauma and financial and physical well-being among Cambodians in the United States . Journal of General Psychology. 118(3):215-225.
8. Asian Nation (2006). Socioeconomic Statistics and Demographics. Retrieved from http://www.asian-nation.org/demographics.shtml.
9. Asian and Pacific Islander American Health Forum. (2003). Fact Sheet: Hmong. Retrieved from http://www.apiahf.org/resources/pdf/Hmong%20Health%20Brief.pdf.
10. Asian and Pacific Islander American Health Forum. (2003). Fact Sheet: Cambodians. Retrieved from http://www.apiahf.org/resources/pdf/Cambodian%20Health%20Brief.pdf.