176 napa Bulletin 27/ Health Beliefs among Hmong Immigrants NAPA BULLETIN 27, pp. 176–195, series ISSN 1556-4789, eISSN 1556-4797; this edition ISBN 1-931303-33-9. © 2007 by the American Anthropological Association. All rights reserved. Please direct all requests for permission to photocopy or reproduce article content through the University of California Press’s Rights and Permissions website, http://www.ucpressjournals.com/ reprintInfo.asp. DOI: 10.1525/napa.2007.27.1.176. “IS IT THE SPIRIT OR THE BODY?”: SYNCRETISM OF HEALTH BELIEFS AMONG HMONG IMMIGRANTS TO ALASKA Jacob R. Hickman University of Chicago Because of the emphasis within the Hmong folk health system on spirituality and nonphysio- logical etiologies, there has been a significant degree of conflict between Hmong refugees and the Western health care system since the beginning of the Hmong migration to the United States in the mid-1970s. This conflict has been well documented in the literature, but previous research on Hmong health has tended toward a totalization of Hmong health beliefs to emphasize its distinctness from Western biomedicine and subsequently advocate culturally sen- sitive health care. In doing so, however, researchers have overlooked the burgeoning syncretism of health beliefs among Hmong in the United States. The present study seeks to explain how and why the Hmong health system in Alaska is developing into a syncretism of the folk beliefs and elements from the Western biomedical paradigm. This syncretism has lead to an intricate system of combined physical and spiritual diagnoses that significantly affects the way health care decisions are made within the Hmong community. Alaskan Hmong use contextual fac- tors (regularity, longevity, and spiritual manifestations) as well as the course of traditional and biomedical treatments to assign and reassign spiritual or biomedical root causes to ailments. As this argument unfolds, I also address the use of “syncretism” as a theoretical construct and ultimately argue that it is the most useful concept for understanding changing health beliefs among the Hmong in Alaska, despite the pejorative historical use of the term. Understanding health seeking behaviors through a syncretic paradigm, health care professionals and anthro- pologists can better account for the multifaceted treatment paradigms that Hmong seek as well as account for changes between traditional and biomedical treatment regimes. Key Words: Hmong, folk health, syncretism, medicalization, hybridity America’s “secret war” in Laos during the late 1960s and early 1970s displaced hundreds of thousands of Hmong refugees who would, after years in Thai refugee camps, eventu- ally resettle in various Western and Latin American countries following the communist takeover of Indochina in 1975 (for a summary of the conflict, see Robbins 1987). Even as recently as the summer of 2004, the United States granted resettlement to up to 15,000 Hmong who had been living in Wat Tham Krabok, a refugee community in Thailand, since the end of the war in Laos. By the end of this most recent program, a total of