By Brooke Timmons, ’26, Lawrence University
In many Hmong households, conversation is the center of daily life.
Elders share stories, families gather around meals, and traditions are passed from general through spoken language. But for some older adults, those conversations are becoming harder to follow.
Hearing loss is one of the most common health conditions affecting older adults worldwide (World Health Organization, 2021). According to the World Health Organization, nearly one in five people globally experiences some form of hearing loss, and untreated hearing loss is associated with social isolation, depression, and reduced quality of life.
For Hmong elders in the United States, hearing loss is not only a medical issue, but also shaped by culture, language barriers, and access to healthcare.
Communities like Appleton, Wisconsin illustrate how these challenges intersect with race and ethnicity. Wisconsin is home to one of the largest Hmong populations in the United States, with more than 50,000 Hmong Americans living in the state (U.S. Census Bureau, 2022). Many settled there after arriving as refugees following the Vietnam War in the 1970s and 1980s.
Organizations like New Hmong, a community-based group in Appleton, work to support Hmong families across generations.
Pa Der Lee, a community health and wellness coordinator with New Hmong says the organization focuses on improving health, well-being, and belonging for Hmong families in the Fox Valley region.
“Our mission is to support and cultivate the whole community in the Northeast region,” Lee explained. “We focus on building trust, improving health and well-being for all generations, and honoring Hmong identity, values, and traditions.”
The organization offers a variety of programs designed to support both youth and elderly. These programs include education, youth development activities, and community wellness initiatives that help families navigate resources like health insurance enrollment and healthy eating education.
New Hmong also operates programs that help elders stay active and engaged in the community. One example is a farming program that allows elders to grow food and maintain traditional agriculture practices.
“It gives them a mental health and wellness incentive too, because it keeps them engaged,” Lee said.
Health disparities occur when certain groups experience worse health outcomes due to social, economic, or structural barriers. Research shows that immigrant and refugee communities often face additional challenges in accessing healthcare, including language barriers, limited insurance coverage, and cultural differences in healthcare systems. For Hmong elders, these barriers can make it more difficult to receive hearing evaluations, treatment, or hearing aids compared to the general U.S. population (Gaeta & Hang, 2023; Lor, 2018).
Research conducted by Gaeta and Hang (2023) examined barriers to hearing healthcare access among Hmong older adults in the United States. The study found that many elders experience difficulty accessing hearing care due to structural barriers such as high costs, limited insurance coverage and language differences in healthcare settings.
One major finding from the study was that the cost of hearing aids and audiology services often prevents elders from seeking treatment. Hearing aids can cost thousands of dollars, and insurance coverage for hearing services is often limited or nonexistent.
Another key finding was the role of communication barriers between healthcare providers and Hmong patients. Many elders rely on interpreters or family members to translate medical information during appointments.
Lee explains how language differences can make healthcare communication especially challenging.
“When it comes to translating medical terminology, there’s not always an effective way,” Lee said. “The Hmong language does not always have exact words for conditions like diabetes or stroke, so interpreters have to describe the symptoms instead.”
Even when translated materials are available, literacy barriers can create additional challenges.
“Many elders can’t read or write, even in Hmong,” Lee explained. “So even if resources are translated, someone still needs to explain them verbally.”
These barriers can make healthcare appointments confusing or frustrating for patients.
Another issue Hmong elders face is the need to repeatedly explain their medical history when visiting different healthcare providers.
“Sometimes there’s a loss in translation or a new interpreter every visit,” Lee said. “Having to retell your story again and again can create frustration and even distrust.”
Research shows that untreated hearing loss can contribute to feelings of embarrassment, sadness, and social withdrawal, particularly when individuals struggle to participate in conversations with family members (World Health Organization, 2021). For Hmong elders, these communication challenges can affect more than just health, they can impact cultural connection.
Family relationships play a central role in Hmong culture, and many households are multigenerational.
“A lot of our families here live in multigenerational households,” Lee said. “Decisions are usually made together, and family input is very important.”
This collectivist structure can also be a powerful community strength. Hmong are very family based, many decisions that are made are based on family input because their culture values the well-being of the group (Lor, 2018). When elders experience health problems, family members often step in to help them navigate the healthcare system. Relatives frequently accompany elders to medical appointments, provide interpretation and help explain treatment recommendations in ways that feel trustworthy. Because of this strong family support system, community organizations can play an important role in improving healthcare access.
New Hmong works to connect families with resources and advocate for culturally responsive healthcare services. One strategy Lee believes could improve healthcare experiences for elders is increasing partnerships between healthcare providers and community organizations.
Lee explains that “Healthcare facilities having someone from the community to help navigate their system would be really helpful.”
If there were more community health workers who understood the culture and needs of elders, it would make a huge difference. Workshops, community events, and culturally tailored health education programs could also help raise awareness about common health conditions such as stroke, heart disease, and hearing loss.
Researchers studying hearing healthcare disparities agree that improving access will require broader systemic changes. In their study Gaeta & Hang recommended expanding interpreter services, increasing affordability of hearing aids, and developing culturally appropriate health education programs designed for Hmong communities.
These solutions highlight the importance of addressing not only medical treatment but also the social and cultural factors that shape healthcare access. Lee says that building trust between healthcare providers and the community is essential.
“Trust goes a long way for the Hmong community,” Lee explained, “People often rely on recommendations from organizations or individuals they know and trust.”
Understanding the historical context of the Hmong community is also important.
The Hmong community recently marked 50 years since arriving in the United States following the end of the Vietnam War. Many families continue to navigate the long-term effects of displacement and trauma.
“There’s an increase in mental health challenges right now among both youth and elders,” Lee said. Some of that trauma that stems from the war hasn’t fully been processed yet.
For public health professionals, these experiences highlight the importance of culturally responsive care that acknowledges historical trauma and community strengths. Ultimately, improving hearing health outcomes will require collaboration between researchers, healthcare professionals, and community organizations.
For the Hmong community in Appleton and across the United States, the goal is not just to better healthcare access, but ensuring that elders remain connected to their families, culture, and community. When elders can hear clearly, they can continue to share stories, guiding younger generations, and preserving traditions that define the Hmong community.
References
- Gaeta, L., & Hang, A. (2023). Identification of barriers to hearing healthcare access among Hmong older adults in the United States. Hmong Studies Journal, 25, 1–22.
- Lor, M. (2018). Health promotion and disease prevention among Hmong adults in the United States: A review of the literature. Journal of Racial and Ethnic Health Disparities, 5(3), 458–467.
- World Health Organization. (2021). World report on hearing. https://www.who.int
- U.S. Census Bureau. (2022). Hmong population in the United States. https://www.census.gov
About the Author:
Brooke Timmons is a biology student interested in health equity, community health, and racial and ethnic health disparities. Her work focuses on understanding how cultural identity, structural barriers, and social determinants influence healthcare access for diverse communities in the United States.
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