Factors in the Healthcare Experience of Cambodian Americans and the Impact of Trauma: A Qualitative Analysis

Abstract

Background: Cambodian Americans have relatively poor mental and physical health outcomes compared to the general U.S. population and other Asian American subgroups. Additionally, many services such as screenings and mental health treatment are underutilized. Barriers such as cost, low-English proficiency, and acculturation stress impact their ability to access healthcare. However, there is a lack of research on the holistic healthcare experience of Cambodian Americans. Purpose: This study aimed to further explore the 1) health beliefs and values of Cambodian-Americans, 2) perceived factors that affect their healthcare experience, and 3) perceived factors that affect their health care seeking behavior. Methods: Purposive and convenience sampling were used by members of the Khmer Health Board to conduct 3 focus groups and 30 interviews with Cambodian Americans in the Seattle Metropolitan area for a total of 50 participants ranging from 19 to 75 of age. Results: A qualitative analysis identified challenges navigating the health system, socio-cultural influences, and historical trauma as major themes that informed Cambodian Americans health beliefs, healthcare experience, and healthcare seeking behavior. Implications: This study found that the experience of historical trauma not only contributes to health outcomes such as post-traumatic stress disorder, but can be a mediating factor in healthcare utilization. When also considering the preference participants showed towards wellness activities among peers, efforts to culturally-tailor health services should also consider community-level interventions and how to avoid potential re-traumatization of patients.