A recent study published in the Journal of the American Heart Association sheds light on the striking disparities in stroke incidence and characteristics between Hmong American adults and their white counterparts. The research, conducted by Dr. Haitham Hussein and his team at the University of Minnesota, highlights the urgent need for tailored healthcare outreach and preventive measures in the Hmong community.
The Hmong are an ethnic group hailing primarily from mountainous regions in Laos, China, Vietnam, and Thailand. Many Hmong individuals fought alongside the United States during the Vietnam War. They were forced to flee Southeast Asia in the mid-to late-1970s, with many seeking refuge in the United States. According to 2021 census data, the U.S. Hmong population is estimated to be around 368,609.
While previous research has indicated that refugees, including Hmong refugees, may have a higher prevalence of cardiovascular disease and risk factors, little was known about stroke among the Hmong population. The researchers utilized an American Heart Association database of medical records to analyze 128 Hmong stroke patients and 3,084 white stroke patients treated at Regions Hospital in St. Paul, Minnesota, between 2010 and 2019.
One key finding was that Hmong stroke patients experienced strokes at a much younger age compared to their white counterparts. On average, Hmong individuals suffered from clot-caused strokes eleven years earlier, at age 60, whereas white people experienced such strokes at 71. The age gap was even more significant for intracerebral hemorrhage, a type of stroke that causes bleeding in the brain. Hmong patients experienced this type of stroke at the age of 56, while white patients experienced it at the age of 70.
Moreover, the study showed that intracerebral hemorrhage was twice as common in Hmong stroke patients, with 31% experiencing this type of stroke compared to 15% among white patients. The Hmong population’s higher rate of intracerebral hemorrhage was comparable to that of other Asian ethnic groups. The research also revealed delays in seeking medical care among Hmong individuals with ischemic stroke (caused by a clot).
Hmong patients arrived at the emergency room nearly four hours later than their white counterparts and were less likely to utilize ambulance services. Additionally, Hmong stroke patients had higher blood sugar levels, particularly those with diabetes, and worse cholesterol and triglyceride levels than white patients. The severity of ischemic strokes was similar in both groups, but Hmong patients were less frequently discharged to rehabilitation facilities, indicating potential disparities in post-stroke care.
Dr. Hussein emphasized the importance of intensifying outreach efforts in the Hmong community, which has a distinct culture and lifestyle. The study found that the Hmong language lacks a word for “stroke,” leading to communication challenges and potentially hindering stroke education efforts. To address this issue, the research team collaborated in developing stroke educational materials, including videos featuring Hmong survivors and culturally adapted content.
Lan Ðoàn, an assistant professor at New York University Grossman School of Medicine, praised the study’s valuable insights into stroke disparities in the Hmong population. Ðoàn highlighted the need to recognize the diversity of Asian ethnicities and address health disparities in small and emerging communities. Despite the study’s retrospective design, the limited number of Hmong patients from a single hospital, and the lack of follow-up data, the findings underscore the importance of targeted healthcare interventions and outreach to tackle health inequities in the Hmong community.
Dr. Hussein stressed the need to start early with health education, involving the younger generations, to address health issues before they become severe and irreversible. The study’s findings emphasize the urgency of addressing stroke disparities in the Hmong American population. Tailored healthcare outreach and preventive care strategies are crucial to improve the health outcomes of this community and raise awareness of stroke risks and symptoms.