Tips for Clinicians: Communication

Since the majority of Hmong American elders (64%) are “unable to speak English” (Lee et al., 2003), a professional health-care interpreter is important. The interpreter must be able to speak the elders and families’ dialect (White Hmong or Green Hmong), and ideally should be of the same sex as the person who is the focus of communication.

There are numerous challenges associated with the interpreter’s work. First, the Hmong language does not include words that directly correspond to most medical words (Johnson, 2002). In addition, the Hmong language includes words that are not easily translated into English.

This becomes even more complicated when Hmong elder’s concepts of human anatomy are different from Western medicine (Culhane-Pera & Xiong, 2003) or when there is a lack of understanding for basic human anatomy and physiology (Gerdner, Xiong, & Yang, 2006). The national Council on Interpreting in Health Care has developed a web site ( to discuss this topic further.

Nonverbal Communication

Nonverbal communication becomes critical, especially during interactions between a non-Hmong speaking person and a non-English speaking Hmong individual. When a person is unable to understand the spoken words, body language and tone of voice become the focus. Therefore, it is important to use a soft gentle voice, make indirect eye contact or brief direct eye contact, and convey a sense of patience (Vawter, Culhane-Pera, Babbitt, Xiong, & Solberg, 2003).