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The Unusually Poor Physical Health Status of Cambodian Refugees Two Decades After Resettlement

Journal of Immigrant and Minority Health volume 13, pages 876–882 (2011)Cite this article

Abstract

To better document the health status of Cambodian refugees, the physical health functioning, disability, and general health status of Cambodian refugees was compared to that of non-refugee Asian immigrants with similar demographic characteristics. Data were collected between October 2003 and February 2005, from 490 face-to-face interviews conducted with a stratified probability sample of households from the Cambodian community in Long Beach, California. Data on the health status of the general adult population (n = 56,270) was taken from the California Health Interview Survey, a telephone interview of a representative sample California residents. Cambodian refugees reported exceedingly poor health when compared to both the general population to the Asian participants. This disparity was only slightly reduced when Cambodian refugees were compared to the subsample of Asian immigrants who were matched on gender, age, income, and urbanicity. Although Cambodians refugees are older and poorer than the general population, their poor health cannot be fully attributed to these risk factors. Research is needed to guide health policy and practices aimed at eliminating this health disparity.

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References

  1. Barnes JS, Bennett CE, Bureau USC. The Asian population, 2000: US Dept. of Commerce, Economics and Statistics Administration, US Census Bureau. 2002.

  2. Sue DW, Sue D. Counseling the culturally diverse: theory and practice. 4th ed. New York: John Wiley & Sons; 2003.

    Google Scholar 

  3. Ghosh C. Healthy people 2010 and Asian Americans/Pacific Islanders: defining a baseline of information. Am J Public Health. 2003;93(12):2093–8.

    PubMed  Article  Google Scholar 

  4. Barnes M, Adams PF, Powell-Griner E. Health characteristics of the Asian adult population, United States, 2004–2006: US Dept. of Health & Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. 2008.

  5. Frisbie WP, Cho Y, Hummer RA. Immigration and the health of Asian and Pacific Islander adults in the United States. Am J Epidemiol. 2001;153(4):372–80.

    PubMed  Article  CAS  Google Scholar 

  6. Min PG. Asian Americans: contemporary trends and issues. Thousand Oaks, CA: Pine Forge Press; 2006.

    Google Scholar 

  7. Gorman BK, Read JG. Gender disparities in adult health: an examination of three measures of morbidity. J Health Soc Behav. 2006;47(2):95–110.

    PubMed  Article  Google Scholar 

  8. Kiuila O, Mieszkowski P. The effects of income, education and age on health. Health Econ. 2007;16:781–98.

    PubMed  Article  Google Scholar 

  9. Rahman O, Strauss J, Gertler P, Ashley D, Fox K. Gender differences in adult health: an international comparison. Gerontologist. 1994;34(4):463–9.

    PubMed  Article  CAS  Google Scholar 

  10. Singer A, Wilson J. From ‘There’ to ‘Here’: refugee resettlement in metropolitan America. Washington, DC: Brookings Institution; 2006.

    Google Scholar 

  11. Verbrugge LM, Wingard DL. Sex differentials in health and mortality. Women Health. 1987;12(2):103–45.

    PubMed  Article  CAS  Google Scholar 

  12. Koch-Weser S, Liang SL, Grigg-Saito DC. Self-reported health among Cambodians in Lowell, Massachusetts. J Health Care Poor Underserved. 2006;17(Suppl 2):133–45.

    PubMed  Google Scholar 

  13. Marshall GN, Schell TL, Elliott MN, Berthold SM, Chun C-A. Mental health of Cambodian refugees 2 decades after resettlement in the United States. JAMA. 2005;294(5):571–9.

    PubMed  Article  CAS  Google Scholar 

  14. Buvinic M, Gupta GR. Female-headed households and female-maintained families: are they worth targeting to reduce poverty in developing countries? Econ Dev Cult Change. 1997;45(2):259–80.

    Article  Google Scholar 

  15. Ellis R. Help for single-parent refugee families. Refugees Magazine. The UN Refugee Agency, Issue 95. 1994. http://www.unhcr.org/cgi-bin/texis/vtx/search?page=search&docid=3b53f4494&query=help%20for%20single-parent%20refugee%20families.

  16. Go CG, Le TN. Gender differences in Cambodian delinquency: the role of ethnic identity, parental discipline, and peer delinquency. Crime Delinq. 2005;51(2):220.

    Article  Google Scholar 

  17. Brislin RW. Back-translation for cross-cultural research. J Cross Cult Psychol. 1970;1(3):185.

    Article  Google Scholar 

  18. Ponce NA, Lavarreda SA, Yen W, Brown ER, Disogra C, Satter DE. The California health interview survey 2001: translation of a major survey for California’s multiethnic population. Public Health Rep. 2004;119(4):388–96.

    PubMed  Article  Google Scholar 

  19. California HIS. CHIS 2001 methodology series: report 1—sample design. Los Angeles, CA: UCLA Center for Health Policy Research; 2002.

    Google Scholar 

  20. California HIS. CHIS 2001 methodology series: report 2—data collection methods. Los Angeles, CA: UCLA Center for Health Policy Research; 2002.

    Google Scholar 

  21. California HIS. CHIS 2001 methodology series: report 3—data processing procedures. Los Angeles, CA: UCLA Center for Health Policy Research; 2002.

    Google Scholar 

  22. California HIS. CHIS 2001 methodology series: report 4—response rates. Los Angeles, CA: UCLA Center for Health Policy Research; 2002.

    Google Scholar 

  23. California HIS. CHIS 2001 methodology series: report 5—weighting and variance estimation. Los Angeles, CA: UCLA Center for Health Policy Research; 2002.

    Google Scholar 

  24. California HIS. Technical paper no. 1—the CHIS 2001 sample: response rate and representativeness. Los Angeles, CA: UCLA Center for Health Policy Research; 2003.

    Google Scholar 

  25. Prevention CfDCa. Behavioral risk factor surveillance system summary data quality report. In: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 2001.

  26. Ware J Jr, Kosinski M, Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33.

    PubMed  Article  Google Scholar 

  27. Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, et al. Cross-validation of item selection and scoring for the SF-12 health survey in nine countries: results from the IQOLA project. International quality of life assessment. J Clin Epidemiol. 1998;51(11):1171–8.

    PubMed  Article  CAS  Google Scholar 

  28. Salyers M, Bosworth HB, Swanson JW, Lamb-Pagone J, Osher FC. Reliability and validity of the SF-12 health survey among people with severe mental illness. Med Care. 2000;38(11):1141–50.

    PubMed  Article  CAS  Google Scholar 

  29. Aaronson NK, Acquadro C, Alonso J, Apolone G, Bucquet D, Bullinger M, et al. International quality of life assessment (IQOLA) project. Qual Life Res. 1992;1(5):349–51.

    PubMed  Article  CAS  Google Scholar 

  30. Hoffmann C, McFarland BH, Kinzie JD, Bresler L, Rakhlin D, Wolf S, et al. Psychometric properties of a Russian version of the SF-12 health survey in a refugee population. Compr Psychiatry. 2005;46(5):390–7.

    PubMed  Article  Google Scholar 

  31. Jenkinson C, Layte R, Jenkinson D, Lawrence K, Petersen S, Paice C, et al. A shorter form health survey: can the SF-12 replicate results from the SF-36 in longitudinal studies? J Public Health. 1997;19:179–86.

    CAS  Google Scholar 

  32. Leplège A, Ecosse E, Verdier A, Perneger TV. The French SF-36 health survey translation, cultural adaptation and preliminary psychometric evaluation. J Clin Epidemiol. 1998;51(11):1013–23.

    PubMed  Article  Google Scholar 

  33. Adams KM, Gardiner LD, Assefi N. Healthcare challenges from the developing world: post-immigration refugee medicine. BMJ. 2004;328(7455):1548–52.

    PubMed  Article  Google Scholar 

  34. Stewart AL, Ware JE, editors. Measuring functioning and well-being: the medical outcomes study approach. Durham, NC: Duke University Press; 1992.

  35. Mossey JM, Shapiro E. Self-rated health: a predictor of mortality among the elderly. Am J Public Health. 1982;72(8):800–8.

    PubMed  Article  CAS  Google Scholar 

  36. McGee DL, Liao Y, Cao G, Cooper RS. Self-reported health status and mortality in a multiethnic US cohort. Am J Epidemiol. 1999;149(1):41–6.

    PubMed  CAS  Google Scholar 

  37. Stewart AL, Hays RD, Ware JE Jr. The MOS short-form general health survey. Reliability and validity in a patient population. Med Care. 1988;26(7):724–35.

    PubMed  Article  CAS  Google Scholar 

  38. California HIS. CHIS 2001 methodology series: revised CHIS 2001 weights. Los Angeles, CA: UCLA Center for Health Policy Research; 2005.

    Google Scholar 

  39. Amodeo M, Peou S, Grigg-Saito D, Berke H, Pin-Riebe S, Jones LK. Providing culturally specific substance abuse services in refugee and immigrant communities: lessons from a Cambodian treatment and demonstration project. J Soc Work Pract Addict. 2004;4(3):23–46.

    Article  Google Scholar 

  40. Grigg-Saito D, Och S, Liang S, Toof R, Silka L. Building on the strengths of a Cambodian refugee community through community-based outreach. Health Promot Pract. 2008;9(4):415.

    PubMed  Article  Google Scholar 

  41. Rummel RJ. Death by government. New Brunswick, NJ: Transaction Publishers; 1994.

    Google Scholar 

  42. Mollica RF, McInnes K, Sarajlic N, Lavelle J, Sarajlic I, Massagli MP. Disability associated with psychiatric comorbidity and health status in Bosnian refugees living in Croatia. JAMA. 1999;282(5):433–9.

    PubMed  Article  CAS  Google Scholar 

  43. Palinkas LA, Pickwell SM. Acculturation as a risk factor for chronic disease among Cambodian refugees in the United States. Soc Sci Med. 1995;40(12):1643–53.

    PubMed  Article  CAS  Google Scholar 

  44. Uba L, Chung RC. The relationship between trauma and financial and physical well-being among Cambodians in the United States. J Gen Psychol. 1991;118(3):215–25.

    PubMed  Article  CAS  Google Scholar 

  45. Weinstein HM, Sarnoff RH, Gladstone E, Lipson JG. Physical and psychological health issues of resettled refugees in the United States. J Refug Stud. 2000;13(3):303.

    Article  Google Scholar 

  46. Gerritsen AA, Bramsen I, Deville W, van Willigen LH, Hovens JE, van der Ploeg HM. Physical and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands. Soc Psychiatry Psychiatr Epidemiol. 2006;41(1):18–26.

    PubMed  Article  Google Scholar 

  47. Kinzie JD, Riley C, McFarland B, Hayes M, Boehnlein J, Leung P, et al. High prevalence rates of diabetes and hypertension among refugee psychiatric patients. J Nerv Ment Dis. 2008;196(2):108–12.

    PubMed  Article  Google Scholar 

  48. Pickwell SM. Health of Cambodian refugees. J Immigr Health. 1999;1(1):49–52.

    PubMed  Article  CAS  Google Scholar 

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Acknowledgments

We thank the RAND Survey Research team: Judy Perlman, MA, Can Du, MA, and Crystal Kollross, MS, for their assistance with data collection. We gratefully acknowledge the contribution of our interviewers and community advisors to the success of this research. This research was supported by grants R01MH059555, R01AA13818, and R01MH082069. We are also indebted to the research participants without whom this study would not have been possible.

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Authors and Affiliations

  1. RAND Corporation, 1776 Main Street, P.O. BOX 2138, Santa Monica, California, 90407, USA

    Eunice C. Wong, Grant N. Marshall, Terry L. Schell, Marc N. Elliott & Katrin Hambarsoomians

  2. University of California Los Angeles (UCLA), Center for Health Policy Research, Los Angeles, California, USA

    Susan H. Babey

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  1. Eunice C. Wong
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  2. Grant N. Marshall
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  3. Terry L. Schell
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  4. Marc N. Elliott
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Correspondence to Eunice C. Wong.

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Wong, E.C., Marshall, G.N., Schell, T.L. et al. The Unusually Poor Physical Health Status of Cambodian Refugees Two Decades After Resettlement. J Immigrant Minority Health 13, 876–882 (2011). https://doi.org/10.1007/s10903-010-9392-y

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Keywords

  • Refugees
  • Health
  • Disability
  • Cambodian
  • Asian