Chapters 13 and 14

In Chapter 13, we got a glimpse into what it was like for Lia to be transferred back to MCMC.  This chapter seemed to be filled with miscommunications and missed opportunities for cultural competency to make for a better experience for both the hospital and the Lees.  For instance, to the Hmong, it’s an extreme faux pas to say someone is going to die because that’s

seen as more of a threat than a fact.  Because of this, the Lees felt like the doctors were not trying to help Lia.  Then, Nao Kao decided to try and take Lia home, without her being discharged. Both sides were frustrated to say the least but Lia ended up at home and she seemed to at least get a little better when she got home.


In Chapter 14, we learned about an important distinction between Hmong immigrant and other European immigrants that’s incredibly important to understanding their experiences and actions.  Unlike other immigrants, they didn’t come here to become Americans to chase the American Dream and become Americans. Rather, they are both refugees and came to America to keep their Hmong culture which was being persecuted in China.  In other words, they don’t want to assimilate, but rather be left alone to live their lives as they’d like. The United States also definitely mishandled their resettlement. For instance, not only did the US not do enough to facilitate the transition, but the language that the media used about them only made it worse.  Not only was the language used about them racist, people definitely didn’t go out of their way to make them feel welcome- people even used violence. According to one survey, unsurprisingly so, the Hmong actually fared the worst regarding their mental health.


These chapters fit perfectly with chapter 11 and its discussion of the advantages and disadvantages of acculturation and assimilation.  The chapters on culture and health both allude to just how much research has yet to be completed on these topics, and how different the results could be regarding different ethnic groups.  Although acculturation does lead to a better trust of doctors, it also has negative health benefits, as we can see with the Hmong.


This week’s chapters left me with a couple of questions.  Right now immigration is certainly a hot a topic. How can a country best help immigrants adjust to being in their country?  How will the United States healthcare system adjust to our changing demographics?

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