Racism and health: The relationship between experience of racial discrimination and health in New Zealand

Abstract

Accumulating research suggests that racism may be a major determinant of health. Here we report associations between self-reported experience of racial discrimination and health in New Zealand. Data from the 2002/2003 New Zealand Health Survey, a cross-sectional survey involving face-to-face interviews with 12,500 people, were analysed. Five items were included to capture racial discrimination in two dimensions: experience of ethnically motivated attack (physical or verbal), or unfair treatment because of ethnicity (by a health professional, in work or when gaining housing). Ethnicity was classified using self-identification to one of four ethnic groups: Māori, Pacific, Asian and European/Other peoples. Logistic regression, accounting for the survey design, age, sex, ethnicity and deprivation, was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Māori reported the highest prevalence of "ever" experiencing any of the forms of racial discrimination (34%), followed by similar levels among Asian (28%) and Pacific peoples (25%). Māori were almost 10 times more likely to experience multiple types of discrimination compared to European/Others (4.5% vs. 0.5%). Reported experience of racial discrimination was associated with each of the measures of health examined. Experience of any one of the five types of discrimination was significantly associated with poor or fair self-rated health; lower physical functioning; lower mental health; smoking; and cardiovascular disease. There was strong evidence of a dose-response relationship between the number of reported types of discrimination and each health measure. These results highlight the need for racism to be considered in efforts to eliminate ethnic inequalities in health.

Perceived racial/ethnic discrimination and psychological outcomes among adult international adoptees in Finland: Moderating effects of social support and sense of coherence.

“…These findings are in line with several reviews and studies that have consistently suggested that experienced discrimination has a harmful psychological impact on those against whom it is directed (e.g., Brondolo et al, 2009b;Harrell, 2000;Harris et al, 2006: Krieger, 1999Paradies, 2006;Priest et al, 2012;Williams & Mohammed, 2009;2013a;2013b).…”

“…Racial and ethnic discrimination has also been seen as affecting physical health through negative health behaviors, because several studies have consistently shown the relationship between perceived racial/ethnic discrimination and risky behaviors such as smoking and substance abuse (e.g., Borrell et al, 2010;Harris et al, 2006;Landrine & Klonoff, 1996).…”

Mental Health Status of Double Minority Adolescents: Findings from National Cross-Sectional Health Surveys

“…There are disparities in rates of mental health needs across specific ethnic groups, depending on age and the particular measures used. The specific needs of ethnic minority youth are sometimes overlooked due to racism and other barriers 12,13 . Māori and Pacific youth report higher rates of suicidality, violence, and use of substances than NZ European youth 14,15 .…”

Does geography explain ethnic inequalities in health in New Zealand?

“…However, if the policy goal at national level is to reduce ethnic inequalities in health, then the focus of policy (e.g. funding formulae) needs to be on factors directly linked to ethnicity, such as socio-economic deprivation and other manifestations of discrimination, [8][9][10] rather than on geographic variations in health and health care that have an impact on all ethnic groups more-or-less alike.…”