Most recent refugees have experience with western medical care and ideas. Local Resources - Many Vietnamese physicians have practices in SE and Central Seattle where there are a large number of Vietnamese businesses. They come from peasant backgrounds and many are illiterate. Acculturation has been slow and there are few native Cambodian health care providers. Many families spent years in refugee camps in Thailand and Philippines.
Prolonged bottle feeding and iron deficiency in toddlers due to exclusive cow milk diets is common.
Depression and post traumatic stress syndrome are common in older adults and parents. TB control was good in SE Asian camps and there is little active TB in refugees. Older adults have little experience with western medical culture and are highly influenced by Chinese medical thought, ancestors, and spirits. They also spent time in refugee camps in Thailand. Many Hmong families have moved from Seattle to California in the past 5 years.