"your Blood is Sweet": The illness experience of southeast Asian Refugees with type 2 diabetes

Purpose - Research on Asian Americans' health behavior has often cited socioeconomic status, race, language, cultural beliefs, acculturation, etc. as barriers to seeking health care services. Less is known about Southeast Asians refugees' help-seeking process. In this exploratory study, we examine the illness experiences of Southeast Asian refugees with a Type 2 diabetes diagnosis, and consider the factors that contribute to their understanding and management of diabetes. Design/methodology/approach - We used Pescosolido's network episode model to frame our understanding of the ways in which Southeast Asians maneuver through their social support networks, face barriers in accessing health care services, and manage their diabetes. We interviewed a convenience sample of 16 adults. All interviews were digitally recorded, transcribed, and coded. Analysis was guided by the grounded theory approach. Findings - Our findings revealed that Southeast Asians' definition, acceptance, and management of their diabetes was largely influenced by various factors including: trauma and PTSD from their refugee experience, challenges of acculturation, illness experience, mental health, and access and barriers to health care services. The network episode model provides a blueprint for understanding the social and cultural challenges that Southeast Asian refugees face with regards to their diabetes. Research limitations/implications - Research limitations include the small and convenience sample used for the study, which does not contribute to generalizability. However, our findings contribute to the limited but growing studies on Southeast Asian refugees in the United States, and emphasize the need for health care providers to consider the illness experience, health beliefs, and the social context of Southeast Asian refugees with diabetes. Although the adults in this study were not recent immigrants, their immigrant history and experiences influenced their understanding and management of their diabetes. Originality/value - Few qualitative studies focus on the health of Southeast Asians in the United States (Hmong, Laotian, Cambodian, and Vietnamese). This study has potential value for clinicians, social workers, and community providers serving ethnic minority populations, specifically Southeast Asians. In this study, older immigrant adults faced generational challenges that impacted their chronic illness (Type 2 diabetes).