The Hmong are an indigenous group from East and Southeast Asia. Today, there is a large community of Hmong people in the United States. Faced with persecution, the Hmong were political refugees from the Vietnam War and migrated to countries like Australia, Canada, the United States, and more.
According to a 2021 report by the American Community Survey, there are 368,609 Hmong Americans, many of them face socio-economic, cultural, and linguistic barriers to accessing essential services like healthcare and education.
This blog explores the history, culture, and language of the Hmong people, the challenges they face, and how organizations can assume cultural sensitivity and improve language access to engage and support the Hmong community.
Hmong History: Where Did the Hmong People Come From?
The Hmong people are an ethnic group tracing back over 4,000 years to China and were originally part of the Miao ethnic groups dwelling in the fertile lowlands of southern China.
In the 19th century, the Hmong migrated from southern China to the mountainous regions of Laos, Vietnam, and Thailand to escape imperialism and preserve their cultural identity. Their original home is believed to have been in the Huang He (Yellow River) basin of Central China.
In the early 1960s, the CIA recruited the Hmong people for the Vietnam War against the North Vietnamese and the communist Pathet Lao. After the war, many Hmong spent time in Thailand refugee camps, before settling in countries like Australia, France, Canada, Germany, and the United States.
Although the Hmong arrived as political refugees, their resilience and contributions have enriched U.S. history.
Hmong Demographics
The 2021 American Community Survey reported a population count of 368,609 Hmong Americans. Many Hmong communities settled in states like California, Minnesota, and Wisconsin. One of the largest Hmong communities resides in Minneapolis-St Paul, Minnesota.
| U.S. State | Hmong Population |
|---|---|
California | 91,224 |
Minnesota | 66,181 |
Wisconsin | 49,240 |
North Carolina | 10,864 |
Michigan | 5,924 |
Socio-Economic Challenges Faced by Hmong People
1. Educational Attainment
According to the Pew Research Center, educational attainment among the Hmong population in 2019 was notably low. A majority, 46%, had completed high school or less, while only 17% held a bachelor’s degree, and a mere 6% had obtained a postgraduate degree.
Educational Attainment of Hmong Population in the U.S. (2019)
% of those ages 25 and older, by educational attainment
2. Economic Stability
According to the Southeast Asia Resource Action Center (SEARAC), nearly 60% of Hmong Americans fall into the low-income bracket, with 1 in every 4 individuals living in poverty. Limited job opportunities make it difficult for Hmong families to build a brighter future. The lack of employment opportunities limits economic mobility. Many Hmong families struggle to achieve financial stability and suffer from income inequality.
3. Healthcare Services
Many Southeast Asian Americans, including Hmong Americans, face challenges in accessing physical and mental health services due to cultural and linguistic barriers. Like African Americans, they also experience lower enrollment rates for public health insurance, at just 38%. Several factors contribute to this issue, such as limited awareness of available health programs, language barriers, and cultural beliefs.
Hmong Culture
1. Family and Community
Family ties are highly valued in the Hmong culture and families will often live in multigenerational households. Respect for elders, especially grandparents and the eldest members of the family, holds great importance. In many households, they are called upon first when seeking advice, making decisions, or resolving disputes. If the elderly are unable to make decisions, the responsibility then falls on the eldest son.
Community cohesion is another major theme, as mutual support, cooperation, and clan relationships play big roles. Younger members often prioritize the needs of the family and the community before their personal desires. Providing care for aging parents is not only seen as a duty but as a reciprocation for the care and support received during their childhood.
2. Hmong Clan Structure
Hmong people are organized into 18 clans or tribes, each tracing their lineage to a common paternal ancestry. Children are considered members of their father’s clan. On the other hand, although married women become members of their husband’s clan, they retain their original clan or maiden name. This maintains a connection to their familial roots while integrating into their spouse’s clan. Members of the same clan name regard each other as family.
Hmong clan names
1. Chang (Cha)
2. Cheng
3. Chue (Chu)
4. Fang
5. Hang
6. Her (Herr or Heu)
7. Khang
8. Kong
9. Kue
10. Lee (Le or Ly)
11. Lor (Lo)
12. Moua (Mua)
13. Pha
14. Thao (Thor)
15. Vang (Va)
16. Vue (Vu)
17. Xiong
18. Yang (Ya)
3. Gender Roles
Hmong culture observes traditional gender roles where men are responsible for decision-making and providing for the family, while women often manage household tasks and childcare.
However, due to the influence of American culture and generational shifts, younger generations of Hmong Americans grow up to be more gender inclusive.
Hmong Religion and Spirituality
The Hmong practice Animism, which is the belief that objects, places, and creatures all possess a spiritual essence or soul. Many Hmong homes will have altars, where offerings are made to ancestral spirits to seek their protection from illness and natural disasters.
The Hmong people believe in 32 spirits, or Khwan, which offer protection and prosperity. They also believe that those who die under certain circumstances (e.g., by accident, violence, or during childbirth) may become evil spirits. Surgery and autopsy are thought to disrupt reincarnation, potentially allowing evil spirits to enter.
Each clan has a designated shaman who serves as a spiritual and community guide. They act as ministers, doctors, and psychologists, addressing spiritual and health-related issues. Their expertise is sought for rituals, ceremonies, and ailments, which reflects their central role in traditional Hmong healing practices.
On the other hand, while many Hmong people were initially introduced to Christianity by missionaries in China in the 1800s and Laos in the 1900s, it was primarily in the United States that many Hmong converted to Christianity. American refugee policies inadvertently influenced Hmong beliefs and made it difficult to practice traditional Hmong religion as families were often divided and had limited resources to perform rituals. Furthermore, since the refugee resettlement system relied on religious agencies and churches to provide essential services, many Hmong were heavily influenced by Christian beliefs. For Hmong Christians, this meant doing away with costly shaman rituals, bride prices, and changing funeral rites.
It is important to note how Hmong religious beliefs can impact their perception of healthcare. Traditional Hmong view illness as supernatural and rely on Shamans and herbal medicine for diagnosis and treatment. Their health practices are starkly different from Western medicine and often cause confusion and mistrust among Hmong immigrants when navigating the U.S. healthcare system. Cultural understanding and language access are crucial to bridge the gaps between traditional beliefs and modern healthcare for effective health delivery.
Hmong Language
The Hmong language is part of the Miao-Yao language group. The Hmong communicated their history orally or through story cloths known as “paj ntaub” since writing was prohibited during the Qing Dynasty in the 1600s. It was only in the 1950s that a Christian missionary developed a written form of the Hmong language based on the Romanized Popular Alphabet (RPA). The Romanized Popular Alphabet (RPA) takes into account the eight tones of the Hmong language; the final letter of each word indicates the tone.
Hmong Daw (White Hmong) and Mong Njua (Green Hmong) are the two main Hmong varieties. These clan varieties are named after the colors traditionally worn by women in each group. It’s important to note that these variations differ in pronunciation, accent, vocabulary, and grammar.
Language Barriers Faced by Hmong People
1. Access to Healthcare Services
The population of Hmong people aged at least 65 doubled between 2010 and 2020. Those with limited English proficiency often relied on their children to interpret when hospitals could not provide a professional interpreter. According to Estrada, President of the North Carolina Community Health Workers Association, relying on ad hoc interpreters can pose significant risks to patient safety.
"A lot of times for our words, there’s not an exact one-to-one translation and it makes it really tricky. So being able to interpret specifically those healthcare terms is really critical."
Many English terms lack direct equivalents in Hmong, such as “diabetes” and “cancer.” For instance, there is no direct term for “diabetes” in the Hmong language; instead, it is translated as “sweet blood.”
Recently, the Minnesota Department of Human Services faced criticism due to a poor Hmong translation for a Facebook post about Medical Assistance and MinnesotaCare, which was rife with errors. Hmong is a tonal language, which means that one small error in translation changes the meaning of the word entirely.
"This is not the first time that we're seeing this from a public institution, and it's outright insulting that you don't take care to have somebody take a look, have a second eye on the translation."
According to Xiong, public institutions often translate English to Hmong White variety even though many Minnesotans speak Green Hmong. Public institutions must take care in communicating in the variety spoken by its Hmong community.
Despite many Hmong patients having limited English proficiency (LEP), healthcare providers have a legal and ethical obligation to offer the same level of care as they do to English-speaking patients. Effective provider-patient communication is crucial for accurate diagnosis, treatment, and informed decision-making. Moreover, hospitals risk their CMS rating and federal funding if they fail to overcome language barriers. Learn how you can bridge care gaps for LEP patients with our free language access guide.
2. Barriers to Attaining Education
In the United States, educational attainment among Hmong Americans is low, even among other ethnic groups. Cultural transition is especially dramatic for Hmong youth. Hmong communities in Laos lived in rural areas with limited access to formal education and may not be literate in their native language. Hmong students who are born in the U.S. with access to English from an early age are overrepresented as English Learners in K-12 public schools and are reported as the third-largest limited English proficient (LEP) group in the country.
Take the example of Fresno State, a large minority-serving institution, which experienced a Hmong student enrollment increase from 1,097 in 2012 to 1,444 in 2018, a 32% increase. Their report claimed that 85% of Hmong students were first-generation college attendees, with a vast majority reporting that neither parent held a college degree. Alarmingly, only 3% of full-time Hmong freshmen graduated within four years, compared to 15% of their peers.
Many Hmong parents, especially first-generation refugees, expressed concern over the lack of familiarity with the American education system and struggled to support their child’s academic journey, as they themselves had limited English proficiency and little formal education.
A robust language access plan enables school districts not only to support English Learners to succeed academically but also to create an inclusive learning environment where students’ linguistic backgrounds are respected and their parents/guardians can fully participate in the educational process. If you’re interested in learning more, get our free guide to develop and implement a language access plan for your school district.
Language Access: Supporting the Hmong People
Piedmont Global Language Solutions (PGLS) is a leading provider of translation, localization, interpreting, and language training solutions in over 200 languages and regional varieties. As a preferred language access partner, we can help you deliver comprehensive language access: Hmong language translation and interpretation services. Get in touch with our team to learn more.