Chumnguh Thlam: Understanding liver illness and hepatitis B among Cambodian immigrants

Background: Cambodian immigrants are over 25 times more likely to have evidence of chronic hepatitis B infection than the general US population. Carriers of hepatitis B are over 100 times more likely to develop liver cancer than non-carriers. Liver cancer incidence is the second leading cancer for Cambodian men and the sixth for Cambodian women. Despite this, this underserved population has received very little attention from health disparities researchers. Culturally and linguistically appropriate interventions are necessary to increase hepatitis B knowledge, serologic testing, and vaccination among Cambodian Americans. Methods: Eight group interviews were held with Cambodian American men (48) and women (49). Results: Focus group discussions revealed social and cultural issues important to hepatitis B and liver cancer control programs focused on Cambodian Americans. Participants discussed a range of understandings and concerns about hepatitis B illness, transmission and prevention, spanning from etiology informed by humoral theories to more biomedical understandings of disease course. We categorized the content of these discussions into dominant themes about liver health and illness influenced by 1) Theravada Buddhist beliefs and practices, Khmer medicine, and experiences with/understandings of biomedicine (Therapeutic Pluralism); and 2) beliefs about hepatitis B transmission and causes embedded in personal experiences and socio-historical circumstances of migration (Transculturation). Conclusions: Our findings reveal the value of qualitative exploration in providing cultural context to biomedical information – a formula for effective health promotion and practice.