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Culturally Competent Health Care for the Hmong

Selected and compiled by Jacquelyn Coughlan, M.S., M.L.S.

Adler, S. R. (1991). Sudden unexpected nocturnal death syndrome among Hmong immigrants: Examining the role of the "nightmare." Journal of American Folklore, 104(411), 54-71.
Adler, S. R. (1994). Ethnomedical pathogenesis and Hmong immigrants' sudden nocturnal deaths. Culture, Medicine and Psychiatry, 18(1), 23-59.
Adler, S. R. (1995). Refugee stress and folk belief: Hmong sudden deaths. Social Science & Medicine, 40(12), 1623-1629.
Allen, M., Matthew, S., & Boland, M.J.O. (2004). Working with immigrant and refugee populations: Issues and Hmong case study. Library Trends, 53(2), 301-328.
Asia and Pacific Islander American Health Forum. (2006). Hmong in the United States. Retrieved June 3, 2008, from
Barnes, L. L., & Plotnikiff, G. A. (2001). Fadiman and beyond- The dangers of extrapolation. Bioethics Forum, 17(1), 7-12.
Barrett, B., Shadick, K., et al. (1998). Hmong/medicine interactions: Improving cross-cultural health care. Family Medicine, 30(3), 179-184.

Ben-David, A., & Good, I. J. (1998). Ethiopians and the Hmongs: A comparative study in cultural narrative from a family therapy perspective. Journal of Family Psychotherapy, 9(1), 31-45.


Bliatout, B. (1988). Hmong attitudes towards surgery: How it affects patient prognosis. Migration World, 16(1), 25-28.


Bliatout, B. T. (1986). Guidelines for mental health professionals to help Hmong clients seek traditional healing treatment. In G. L. Hendricks, B. T. Downing, & A. S. Deinard (Eds.), The Hmong in transition (pp. 349-364). New York: Center for Migration Studies of New York.


BRYCS - Bridging Refugee Youth & Children's Services. (2004). Background on Potential Health Issues for Hmong Refugees from Wat Tham Krabok. Retrieved June 3, 2008 from


Capps, L. L. (1994). Change and continuity in the medical culture of the Hmong in Kansas City. Medical Anthropology Quarterly, 8(2), 161-177.

Capps, L. L. (1999). Fright illness in Hmong children. Pediatric Nursing, 25(4), 378-383, 393-394.
Cerhan, J. U. (1990). The Hmong in the United States: An overview for mental health professionals. Journal of Counseling & Development, 69(1), 88-91.
Cha, D. (2003). Hmong American concepts of health, healing, and conventional medicine. New York: Routledge.
Cheon-Klessig, Y., Camilleri, D., et al. (1988). Folk medicine in the health practice of Hmong refugees. Western Journal of Nursing Research, 10(5), 647-660.

Children's Hospitals and Clinics of Minnesota. (2002). Hmong Culture and Medical Traditions. Retrieved June 3, 2008, from @xcp/@web/@integrativemed/documents/policyreferenceprocedure/web009310.asp


Coben, J. R. (2002). Building a bridge: Lessons learned from family mediation training for the Hmong community of Minnesota. Family Court Review, 40(3), 338-349.


Culhane-Pera K. A., Her C., & Her, B. (2007). "We are out of balance here": a Hmong cultural model of diabetes. Journal of Immigrant and Minority Health / Center for Minority Public Health. 9(3), 179-90.


Culhane-Pera, K. A., & Vawter, D. E. (1998). A study of healthcare professionals' perspectives about a cross-cultural ethical conflict involving a Hmong patient and her family. Journal of Clinical Ethics, 9(2), 179-190.


Culhane-Pera, K. A., Naftali, E. D., Jacobson, C., & Xiong, Z. B. (2002). Cultural feeding practices and child-raising philosophy contribute to iron-deficiency anemia in refugee Hmong children. Ethnicity & Disease, 12(2), 199-205.


Culhane-Pera, K. A., Peterson, K. A., Crain, A. L., et al. (2005). Group visits for Hmong adults with type 2 diabetes mellitus: A pre-post analysis. Journal of Health Care for the Poor and Underserved, 16(2), 315-327.

Culhane-Pera, K. A., Wawter, D. E., Phua Xiong, Babbitt, B., & Solberg, M. M. (Eds.) (2003). Healing by Heart, Clinical and Ethical Case Stories of Hmong Families and Western Providers. Nashville, TN: Vanderbilt University Press.
Danner, C.C., et al. (2007). Running from the demon: Culturally specific group therapy for depressed Hmong women in a family medicine residency clinic. Women & Therapy: A Feminist Quarterly, 30(1/2), 151-176.
Deinard, A., & Dunnigan, T. (1987). Hmong health care--reflections on a six-year experience. International Migration Review, 21(3), 857-865.
Dettmer, K. & Meschke, L.L. (2002). Hmong adolescent mothers: Their chosen path and undetermined future. Paper presented at The 64th Annual Conference of the National Council on Family Relations, Houston, TX.

Devlin, H., Roberts, M., Okaya, A., & Xiong, Y. M. (2006). Our lives were healthier before: Focus groups with African American, American Indian, Hispanic/Latino, and Hmong people with diabetes. Health Promotion Practice, 7(1), 47-55.

Downing, B. T. (1986). Language issues. In G. L. Hendricks, B. T. Downing & A. S. Deinard (Eds.), The Hmong in transition (pp. 187-193). New York: Center for Migration Studies of New York.
Duffy, J., Harmon, R., Ranard, D.A., Thao, B., & Yamk, K. (2004). The Hmong: An introduction to their history and culture. (60 pages). Retrieved March 24, 2009 from
Dunnigan, T., et al (1993). The problem of metaphorical nonequivalence in cross-cultural survey research: Comparing the mental health statuses of Hmong refugee and general population adolescents. Journal of Cross-Cultural Psychology, 24(3), 344-365.
Edinburgh, L., Saewyc, E., Thao, T., & Levitt, C. (2006). Sexual exploitation of very young Hmong girls. Journal of Adolescent Health, 39(1), 111-118.
Edwards, L. E., Rautio, C. J., & Hakanson, E. Y. (1987). Pregnancy in Hmong refugee women. Minnesota Medicine, 70(11), 633-637.
Fadiman, A. (1998). The spirit catches you and you fall down: A Hmong child, her American doctors, and the collision of two cultures. New York: Noonday Press.
Falk, C. (1992). Hmong funeral in Australia in 1992. Retrieved June 3, 2008, from

Falk, C. (1996). Upon meeting the ancestors: The Hmong funeral ritual in Asia and Australia. Hmong Studies Journal, 1(1), 1-11.


Falk, C. (2004). Hmong instructions to the dead: What the mouth organ Qeej says. Asian Folklore Studies, 63(1), 1-29.

Faller, H. S. (1985). Perinatal needs of immigrant Hmong women: Surveys of women and health care providers. Public Health Reports, 100(3), 340-343.
Finck, J. (1984). Southeast Asian refugees of Rhode Island: Cross-cultural issues in medical care: Concerns about blood drawing, medications, surgery, and autopsies are discussed. Rhode Island Medical Journal, 67, 319-321.
Foo, L. (2002). Hmong women in the US: Changing a patriarchal culture. In Asian American Women Issues, Concerns and Responsive Human and Civil Rights Advocacy, (pp. 145-161). New York, NY: Ford Foundation. Retrieved May 6, 2009 from
Food and Nutrition Information Center. (2005). Ethnic and Cultural Resources. Retrieved June 3, 2008, from
Fox, P. G., Cowell, J. M., et al. (1995). Effects of family disruption on Southeast Asian refugee women. International Nursing Review, 42(1), 27-30.

Gerdner, L. A., Xiong, S. V., & Cha, D. (2006). Chronic confusion and memory impairment in Hmong elders: Honoring differing cultural beliefs in America. Journal of Gerontological Nursing, 32(3), 23-31.

Goodkind J. R. (2005). Effectiveness of a community-based advocacy and learning program for Hmong refugees. American Journal of Community Psychology. 36(3-4), 387-408.

Goodkind, J. R. (2006). Promoting Hmong refugees' well-being through mutual learning: Valuing knowledge, culture, and experience. American Journal of Community Psychology, 37(1), 77-93.

Haddad, A., & Brown, K. (1994). Ethics in action: What would you do? RN, 57(7), 19-21.
Hayes, C. L., & Kalish, R. A. K. (1994). Death-related experiences and funerary practices of the Hmong refugee in the United States. In L. A. DeSpalder & A. L. Strickland (Eds.), The path ahead: Readings in death and dying (pp. 75-79). Mountain View, CA: Mayfield.
Hein, J. (2006). Ethnic origins: The adaptation of Cambodian and Hmong refugees in four American cities. New York: Russell Sage Foundation Publications.
Heinz, C. B. (n.d.). Asian Shamanism (Emphasizing Laos and Hmong Shamanism). Retrieved June 3, 2008, from

Helsel, D. G., & Mochel, M. (2002). Afterbirths in the afterlife: Cultural meaning of placental disposal in Hmong American community. Journal of Transcultural Nursing, 13(4), 282-286.


Helsel, D. G., Mochel, M., & Bauer, R. (2004). Shamans in a Hmong American community. Journal of Alternative and Complementary Medicine, 10(6), 933-938.

Helsel, D. G., Mochel, M., & Bauer, R. (2005). Chronic illness and Hmong Shamans. Journal of Transcultural Nursing, 16(2), 150-154.

Helsel, D., Petitti, D. B., et al. (1992). Pregnancy among the Hmong: Birth weight, age and parity. American Journal of Public Health, 82(10), 1361-1363.

Hendricks, G. L., Downing, B. T., Deinard, A. S. (Eds.). (1985). The Hmong in transition. Staten Island, N. Y.: Center for Migration Studies of New York.
Henry, R. R. (1999). Measles, Hmong, and metaphor: Culture change and illness management under conditions of immigration. Medical Anthropology Quarterly, 13(1), 32-51.
Her, C., & Culhane-Pera, K. A. (2004). Culturally responsive care for Hmong patients: Collaboration is a key treatment component. Postgraduate Medicine, 116(6), 39-42, 45-46.
Hickman, J.R. (2007). "Is it the spirit or the body?": Syncretism of health beliefs among Hmong immigrants to Alaska. National Association for the Practice of Anthropology Bulletin, 27(1), 176-195.
Hmong Cultural Center. (2003). Hmong Resource Center Library.  Retrieved June 3, 2008, from

Hmong Health. (2007). Hmong customs and health beliefs. Retrieved June 3, 2008, from

Hmong National Development, Inc. (2008). Welcome to the official HND website. Retrieved October 15, 2008 from
Hmong National Development, Inc. - HND & the Hmong Cultural Resource Center. (2004). Hmong 2000 census publication: Data and analysis. (75 pages). Retrieved October 15, 2008 from
Hmong Studies Journal. (n.d.). An Internet journal on the Hmong. Retrieved June 3, 2008, from
Ikeda, J. P. (1999). Hmong American food practices, customs, and holidays. Chicago: American Dietetic Association.
Ikeda, J. P., Ceja, D. R., Glass, R. S., Harwood, J. O., Lucke, K. A., & Sutherland, J. M. (1991). Food habits of the Hmong living in central California. Journal of Nutrition Education, 23(4), 168-175.
Jambunathan, J. (1995). Hmong cultural practices and beliefs: The postpartum period. Clinical Nursing Research, 4(3), 335-345.
Jambunathan, J., & Stewart, S. (1995). Hmong women in Wisconsin: What are their concerns in pregnancy and childbirth? Birth: Issues in Perinatal Care and Education, 22(4), 204-210.
Jambunathan, J., & Stewart, S. (1997). Hmong women: Postpartum family support and life satisfaction. Journal of Family Nursing, 3(2), 149-166.

Jintrawet, U., & Harrigan, R. C. (2003). Beliefs of mothers in Asian countries and among Hmong in the United States about the causes, treatments, and outcomes of acute illnesses: An integrated review of the literature. Issues in Comprehensive Pediatric Nursing, 26(2), 77-88.

Johnson, S. K. (2002). Hmong health beliefs and experiences in the Western health care system. Journal of Transcultural Nursing, 13(2), 126-132.
Kahler, L. R., Sobota, C. M., et al. (1996). Pregnant women at risk: An evaluation of the health status of refugee women in Buffalo, New York. Health Care for Women International, 17(1), 15-23.
Kaiser, T.L. (2003). Achieving shared meaning in cross-cultural dialogue: Understanding a Hmong family's response to marital violence. Journal of Ethnic & Cultural Diversity in Social Work, 12(3), 29-54.

Kasemsup, R., & Reicks, M. (2006). The relationship between maternal child-feeding practices and overweight in Hmong preschool children. Ethnicity & Disease, 16(1), 187-193.

Keown-Bomar, J. (2004). Kinship networks among Hmong-American refugees. New York: LFB Scholarly Publishing. 
Kern Resource Center. (2006). Hmong for health care workers. (70 pages). Retrieved June 3, 2008 from
Kroll, J., Linde, P., et al. (1990). Medication compliance, antidepressant blood levels, and side effects in Southeast Asian patients. Journal of Clinical Psychopharmacology, 10(4), 279-283.

La Du, E. B. (1985). Childbirth care for Hmong families. MCN: The American Journal of Maternal/Child Nursing, 10(6), 382-385.


Lee, P. A. (1986, Spring). Traditional medicine: Dilemmas in nursing practice. Nursing Administration Quarterly, 10(3), 14-20.

Lee, P. S. (1986). Health beliefs of pregnant and postpartum Hmong women. Western Journal of Nursing Research, 8(1), 83-93.
Lee, S.E. (2006). Hmong women issues: Identity and mental health. (136 pages). Retrieved October 29, 2008 from

Levenick, M. (2001). Hmong and prenatal care. Journal of Cultural Diversity, 8(1), 26-29.

Levine, M., Anderson, L., McCullough, N, et al. (2004). Hmong birthing. Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) Lifelines, 8(2), 147-149.
Liamputtong, P. (2000). Hmong women and reproduction. Westport, CT: Bergin and Garvey.
Liamputtong, P. (2002). Infant feeding practices: The case of Hmong women in Australia. Health Care for Women International, 23(1), 33-48.
Liamputtong, P. (2003). Abortion--it is for some women only! Hmong women's perceptions of abortion. Health Care Women International, 24(3), 230-241.
Liamputtong, P. (2007). Baby, souls, name, and health: Traditional and changed rituals for a newborn infant among Hmong immigrant mothers in Australia. In Liamputtong, P., Childrearing and infant care issues: A cross-cultural perspective (pp. 201-220). Hauppauge, NY: Nova Publishers.
Liamputtong, P., & Manderson, L. (1996). Maternity and reproductive health in Asian societies. Australia: Harwood Academic.

Lipson, J. G., Dibble, S. L., et al. (1996). Culture & nursing care: A pocket guide. San Francisco: UCSF Nursing Press.


Ly, C. (2001). The conflict between law and culture: The case of the Hmong in America. Wisconsin Law Review, 2, 471-499.

Ma, S. (2005). Hmong refugee's death fugue. Hmong Studies Journal, 6, 1-36. Retrieved February 3, 2009 from
Macdonald, D. & Reznik, V. (2001). Using a transcultural, patient based approach to improve patient outcome in a pediatric ESRD patient. Nephrology Nursing Journal, 28(4), 444, 450.

McInnis, K. (1991). Ethnic-sensitive work with Hmong refugee children. Child Welfare, 70(5), 571-580.

Meredith, W. H., & Rowe, G. P. (1986). Changes in Hmong refugee marital attitudes in America. In Hendricks, G. L., Downing, B. T., &A. S. Deinard (Eds.), The Hmong in transition (pp. 121-134). Staten Island, N. Y.: Center for Migration Studies of New York.
Meyers, C. (1992). Hmong children and their families: Consideration of cultural influences in assessment. The American Journal of Occupational Therapy, 46(8), 737-744.
Miyares, I. M. (1998). The Hmong refugee experience in the United States: Crossing the River. New York: Garland.
Ngo, B. (2002). Contesting "culture": The perspectives of Hmong American female students on early marriage. Anthropology and Education Quarterly, 33(2), 163-188.
Nutall, P., & Flores, F. (1997). Hmong healing practices used for common childhood illnesses. Pediatric Nursing, 23(3), 247-251.
Nyce, J. M., & Hollinshead, W. H. (1984). Southeast Asian refugees of Rhode Island: Reproductive beliefs and practices among the Hmong. Rhode Island Medical Journal, 67(8), 361-366.
Olson, M.C. (1999). "The heart still beat, but the brain doesn't answer". Perception and experience of old-age dementia in the Milwaukee Hmong community. Theoretical Medical Bioethics, 20(1), 85-95.
Parker, M., & Kiatoukaysy, L. N. (1999). Culturally responsive health care: The example of the Hmong in America. Journal of the American Academy of Nurse Practitioners, 11(12), 511-518.
Paulson, R. R., Duvall, K. L., et al. (1984). Splenomegaly in Hmong refugees. Archives of Internal Medicine, 144(2), 257-260.

Pfeifer, M. E. (n.d.). Hmong Courtship and Marriage Practices. Retrieved June 3, 2008,  from


Pfeifer, M. E. (n.d.). Health and medical issues affecting the Hmong. Retrieved June 3, 2008, from


Pinzon-Perez, H. (2006). Health issues for the Hmong population in the U.S.: Implications for health educators. International Electronic Journal of Health Education, 9, 122-133. Retrieved June 3, 2008, from


Pinzon-Perez, H., Moua, N., & Perez, M. A. (2005). Understanding satisfaction with shamanic practices among the Hmong in rural California. The International Electronic Journal of Health Education, 8, 18-23. Retrieved June 3, 2008 from


Plotnikoff, G. A., Numerich, C., Wu, C., Yang, D., & Phua, X. (2002). Hmong shamanism: Animist spiritual healing in Minnesota. Minnesota Medicine, 85(6), 29-34.

Plumb, A. L. (2003). Nursing resources: Refuges for refugees and their caregivers dealing with the complex health issues faced by this population. American Journal of Nursing, 103(12), 98-99.
Powell, G. J., & Yamamoto, J. (Eds.). (1997). Transcultural child development: Psychological assessment and treatment. New York: Wiley.
Rairdan, B., & Higgs, A. R. (1992). When your patient is a Hmong refugee. American Journal of Nursing, 92(3), 52-55.

Reznik, V., Cooper, T., MacDonald, D., Benador, N., & Lemire, J. (2001). Hais cuaj txub kaum txub--to speak of all things: A Hmong cross-cultural case study. Journal of Immigrant Health, 3(1), 23-30.


Rice, C. D. (2003, April 7). Hmong publications. Hmong homepage - music, movies, and books. Retrieved June 3, 2008, from


Rice, P. L. (1995). Pog laus, tsis coj khaub ncaws lawm: The meaning of menopause in Hmong women. Journal of Reproductive and Infant Psychology, 13(2), 79-92. Retrieved October 22, 2004, Reprinted at


Rice, P. L. (1997). Giving birth in a new house: Childbirth traditions and the experience of motherhood among Hmong women from Laos. Asian Studies Review, 20(3), 133-148.


Rice, P. L. (1998). Childhood health and illness: Cultural beliefs and practices among the Hmong in Victoria. Australian Journal of Primary Health-Interchange, 4(4), 44-59.

Rice, P. L. (1999). Infant weaning practices among Hmong women in Melbourne. Australian Journal of Primary Health-Interchange, 5(2), 27-37.

Rice, P. L. (1999). When the baby falls! The cultural construction of miscarriage among Hmong women in Australia. Women & Health, 30(1), 85-103.


Rice, P. L. (1999). What women say about their childbirth experiences: The case of Hmong women in Australia. Journal of Reproductive and Infant Psychology, 17(3), 237-254.


Rice, P. L. (2000). Nyo dua hli--30 days confinement: Traditions and changed childbearing beliefs and practices among Hmong women in Australia. Midwifery, 16(1), 22-34.


Rice, P. L. (2000). Death in birth: The cultural construction of stillbirth, neonatal death and maternal death among Hmong women in Australia. Omega: Journal of Death and Dying, 41(1), 39-57.


Rice, P. L. (2000). Baby, souls, name and health: Traditional customs for a newborn infant among the Hmong in Melbourne. Early Human Development, 57(3), 189-203.


Rice, P. L., Ly, B., & Lumley, J. (1994). Childbirth and soul loss: The case of a Hmong woman. The Medical Journal of Australia, 160(9), 577-578.

Richman, D., & Dixon, S. (1985). Comparative study of Cambodian, Hmong, and Caucasian infant and maternal perinatal profiles. Journal of Nurse-Midwifery, 30(6), 313-319.
Schriever, S. H. (1990). Comparison of beliefs and practices of ethnic Viet and Lao Hmong concerning illness, healing, death and mourning: Implications for Hospice care with refugees in Canada. Journal of Palliative Care, 6(1), 42-49.
Shadick, K. M. (1993). Development of a transcultural health education program for the Hmong. Clinical Nurse Specialist, 7(2), 48-53.
Small, S. A., Tiwari, G., & Huser, M. (2006). The cultural education of academic evaluators: Lessons from a univeristy-Hmong community partnership. American Journal of Community Psychology, 37(3-4), 357-364.
Smith, L. S. (1997). Critical thinking, health policy, and the Hmong culture group, Part II. Journal of Cultural Diversity, 4(2), 59-67.
Sperstad, R. A., & Werner, J. S. (2005). Coming to the cultural "in-between": Nursing insights from a Hmong birth case study. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 34(6), 682-688.
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Spring, M.A. (1989). Ethnopharmacologic analysis of medicinal plants used by Laotian Hmong refugees in Minnesota. Journal of Ethnopharmacology, 26(1), 65-91.
Stewart, S., & Jambunathan, J. (1996). Hmong women and postpartum depression. Health Care for Women International, 17(4), 319-330.
Su, J., Lee, R.M., & Vang, S. (2005). Intergenerational family conflict and coping among Hmong American college students. Journal of Counseling Psychology, 52(4), 482-489.

Tapp, N. (1988). The reformation of culture: Hmong refugees from Laos. Journal of Refugee Studies, 1(1), 20-37.


Tatman, A. W. (2004). Hmong history, culture, and acculturation: Implications for counseling the Hmong. Journal of Multicultural Counseling and Development, 32(4), 222-233.

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Young, C., Camilleri, D. D., McElmurry, B. J., & Ohlson, V. M. (1988). Folk medicine in the health of Hmong refugees. Western Journal of Nursing Research, 10(5), 647-660.

©Jacquelyn Coughlan, May 2009 ( citations)