Abstract
Mental health problems among Southeast Asian refugees have been documented. However, longer term health consequences of mass
violence as re-settled refugees age are less well described. This study investigated relationships among trauma symptoms,
self-reported health outcomes, and barriers to healthcare among Cambodian and Vietnamese persons in Connecticut. An internet
phone directory was used to generate a list of names that was compared to 2000 census data to estimate the proportion of the
population in each group. From these lists, 190 telephone listings were selected at random. Interviewers telephoned selected
listings to screen for eligible participants and obtain an appointment for interview. Surveys were administered through face-to-face
interviews during home visits conducted in Khmer or Vietnamese. The Harvard Trauma Questionnaire assessed trauma symptoms.
Questions regarding the presence of physician diagnosed heart disease, hypertension, diabetes, and chronic pain were adapted
as written from the Health Interview Survey. Healthcare access and occurrence were measured with questions regarding cost
and access, patient-provider understanding, and interpretive services. Hierarchical modeling was used to account for respondent
nesting within family. Analyses controlled for age, sex, and country of origin. Individuals who reported greater trauma symptoms
were more likely to report heart disease by a factor of 1.82, hypertension by a factor of 1.41, and total count of diseases
by a factor of 1.22, as well as lower levels of subjective health. Greater trauma symptoms were also associated with greater
lack of understanding, cost and access problems, and the need for an interpreter. Although the majority of Southeast Asian
immigrants came to the United States as refugees approximately 20–30 years ago, there continues to be high levels of trauma
symptoms among this population which are associated with increased risk for disease and decreased access to healthcare services.
violence as re-settled refugees age are less well described. This study investigated relationships among trauma symptoms,
self-reported health outcomes, and barriers to healthcare among Cambodian and Vietnamese persons in Connecticut. An internet
phone directory was used to generate a list of names that was compared to 2000 census data to estimate the proportion of the
population in each group. From these lists, 190 telephone listings were selected at random. Interviewers telephoned selected
listings to screen for eligible participants and obtain an appointment for interview. Surveys were administered through face-to-face
interviews during home visits conducted in Khmer or Vietnamese. The Harvard Trauma Questionnaire assessed trauma symptoms.
Questions regarding the presence of physician diagnosed heart disease, hypertension, diabetes, and chronic pain were adapted
as written from the Health Interview Survey. Healthcare access and occurrence were measured with questions regarding cost
and access, patient-provider understanding, and interpretive services. Hierarchical modeling was used to account for respondent
nesting within family. Analyses controlled for age, sex, and country of origin. Individuals who reported greater trauma symptoms
were more likely to report heart disease by a factor of 1.82, hypertension by a factor of 1.41, and total count of diseases
by a factor of 1.22, as well as lower levels of subjective health. Greater trauma symptoms were also associated with greater
lack of understanding, cost and access problems, and the need for an interpreter. Although the majority of Southeast Asian
immigrants came to the United States as refugees approximately 20–30 years ago, there continues to be high levels of trauma
symptoms among this population which are associated with increased risk for disease and decreased access to healthcare services.
- Content Type Journal Article
- Category Original Paper
- Pages 1-8
- DOI 10.1007/s10903-012-9715-2
- Authors
- Julie Wagner, University of Connecticut Health Center, MC3910, 263 Farmington Ave., Farmington, CT 06030, USA
- Georgine Burke, Connecticut Children’s Medical Center, Hartford, CT, USA
- Theanvy Kuoch, Khmer Health Advocates, West Hartford, CT, USA
- Mary Scully, Khmer Health Advocates, West Hartford, CT, USA
- Stephen Armeli, Farleigh Dickinson University, Teaneck, NJ, USA
- Thiruchandurai V. Rajan, University of Connecticut Health Center, MC3910, 263 Farmington Ave., Farmington, CT 06030, USA
- Journal Journal of Immigrant and Minority Health
- Online ISSN 1557-1920
- Print ISSN 1557-1912