Traditional medicinal practices are influenced by Chinese culture, particularly that of yin and yang. Yin is the female principle associated with cold, the breath, and the right side; yang is the male principle associated with heat, the blood, and the left side (16). The internal balance of yin and yang is thought to relate to hot and cold forces in the body, which have an impact on health and vitality. Others, especially those from more rural areas, may believe that illnesses are caused by ghosts or spirits (17).


The four elements—air, fire, water, and earth—are thought to be present in the body, and each is


associated with a different characteristic: cold, hot, wet, and dry. The thought is that one must maintain a balance between hot and cold for health and prosperity. Certain foods are deemed “hot,” ”cold,” or “neutral,” and, depending on one’s condition, these foods should be avoided or consumed. For instance, if someone is feverish, he or she should stay away from cold foods like vegetables and fruits because the person is thought to already be losing too much heat. Instead, foods that are neutral, such as rice, eggs, broth, and sweets, should be eaten (17). During life changes, especially pregnancy, the practice of eating hot and cold foods may be more stringently followed (18). It is thought that during pregnancy, a woman should avoid both hot and cold foods; after childbirth, the woman is thought to be in a cold state and requires hot foods to warm up (16). Following these food habits does not appear to have an effect on infant birth weight (18).


In addition to traditional natural remedies, the use of herbal medicine, acupuncture, and cupping or


coining are common healing practices used to treat everything from headaches and the common cold to respiratory and gastrointestinal diseases. It is a common belief that nature can cure, which goes hand in hand with a common fear of any invasive treatments, particularly those that involve the use of needles (17).


Today, Vietnamese immigrants are the fourth largest foreign-born population from Asian countries, with almost 1.5 million in United States, based on the 2012 US Census. An estimated 160,000 are undocumented, representing about 1% of the estimated 11.4 million undocumented immigrants in the United States (13). Prior to 1975, Vietnamese immigrants were limited to military spouses and their children. In the spring of 1975, the United States sponsored the evacuation of about 125,000 Vietnamese refugees. They were settled in Camp Pendleton in California, Fort Chaffee in Arkansas, Eglin Air Force Base in Florida, and Fort Indiantown Gap in Pennsylvania. Later that year, the passage of the Indochina Migration and Refugee Act established domestic resettlement assistance for refugees who fled from Cambodia and Vietnam. In the late 1970s, a wave of ethnic Chinese immigrants from Vietnam occurred as these people emigrated to escape persecution (13,19,20).


In 1980, there were only 231,000 Vietnamese immigrants. The Refugee Act of 1980 allowed for


increased immigration by setting numbers of admissions from Vietnam at 50,000 people per year, and additional laws allowed for children of US military personnel and former political prisoners to enter the US legally. During the next two decades, most immigrants from Vietnam were not refugees but rather the children and spouses of US military personnel (13,19,20).


Forty percent of Vietnamese immigrants settled in California, as of the 2012 US Census. Texas,


Washington State, Florida, and Virginia contain another 23% of the Vietnamese immigrants in the United States. Forty-one percent of Vietnamese immigrants are clustered in Los Angeles, San Jose, Houston, San Francisco, and Dallas.


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