Barriers to Cancer Screening in Hmong Americans: The Influence of Health Care Accessibility, Culture, and Cancer Literacy

Abstract

Hmong Americans face high cancer mortality rates even in comparison to their Asian American counterparts, and report low utilization of cancer screenings. To date, no study has been conducted on the cultural barriers this population faces in undergoing cancer screenings. A systematic review of the literature was conducted to examine the existing knowledge regarding the barriers to cancer screening for Hmong Americans. Potential barriers were identified from this examination to include: health access factors (type of health insurance, ethnicity of provider, low English proficiency, and years spent in the U.S.); cultural factors (belief in the spiritual etiology of diseases, patriarchal values, modesty, and mistrust of the western medical system); and cancer literacy factors (cancer and prevention illiteracy). Based on this review, potential cultural and ethnic group-specific prevention strategies and cancer health policies are discussed to address these barriers and enhance screening behavior among the Hmong.

Inequalities and Barriers to the Use of Health Care among Cancer Patients in the Pacific: A Systematic Review

“…This is dangerous as herbal medicines are often untested and may not necessarily be of benefit to the patient [28]. Other researchers such as Hee Yun Lee, who studied culture as a barrier to cancer services, found that the only way to target culture oriented populations was to redesign the service with the target of culture in mind [29]. An additionally important aspect of this is native language, as the Pacific is home to a wide variety of unique languages.…”

Engaging in Culturally Informed Nursing Care With Hmong Children and Their Families

“…Illnesses are ascribed to natural and spiritual causes. A natural illness, such as a headache, is viewed as a result of the disharmony between yin and yang, or hot and cold (Lee & Vang, 2010). Treatment for natural illnesses may consist of bringing a balance to the body through herbal medicine, acupuncture, spoon rubbing, coining or cupping.…”

“…Spoon rubbing is a process where patients' bodies are repeatedly scraped with a silver spoon. Coining is lightly scraping the skin with a hot coin to cast away evil spirits (Lee & Vang, 2010). Cupping is creating a vacuum on the skin to draw out tension, fever, or pain.…”

“…The Hmong may be wary of a health care provider's intentions (Lee & Vang, 2010). Hmong Americans' distrust of the medical system can stem from unfamiliarity with the healthcare system, negative experiences individuals in the Hmong community have had, and general skepticism of systems in the U.S. due to the betrayal of the Hmong after the Vietnam War (Lee & Vang, 2010).…”

“…Hmong Americans' distrust of the medical system can stem from unfamiliarity with the healthcare system, negative experiences individuals in the Hmong community have had, and general skepticism of systems in the U.S. due to the betrayal of the Hmong after the Vietnam War (Lee & Vang, 2010). Distrust can lead to delays in seeking health care and poorer health outcomes.…”