Examines the health care needs and practices of Southeast Asian and Central American refugees from the standpoint of identity. For example, during the civil war in Nicaragua, the decision to use a modernized health care system or to rely on traditional remedies was determined by a person?s political identity, with potentially fatal consequences if one was a victim of an attack on a health clinic. Identity also appeared to play a role in disease risk for victims of traumatic events once they assumed refugee status; for example, the marked prevalence of Sudden Unexpected Death Syndrome among Hmong refugee men is connected with their inability to conduct religious practices in the United States and the intense psychological stress produced by this dramatically altered role. The choice of health systems also may be an expression of identity: that is, the decision to select among or combine elements of traditional and Western biomedical practices is a reflection of individual self-perception. For refugees who have lost and suffered much, the use of health care practices is dependent upon whatever remains of the identity shared with those left behind, combined with the emergence of a new identity based on the experiences of migration and acculturation.
