The impact of racial discrimination on the health of Australian Indigenous children aged 5–10 years: analysis of national longitudinal data

Abstract

BackgroundA growing body of literature highlights that racial discrimination has negative impacts on child health, although most studies have been limited to an examination of direct forms of racism using cross-sectional data. We aim to provide further insights on the impact of early exposure to racism on child health using longitudinal data among Indigenous children in Australia and multiple indicators of racial discrimination.MethodsWe used data on 1239 Indigenous children aged 5–10 years from Waves 1–6 (2008–2013) of Footprints in Time, a longitudinal study of Indigenous children across Australia. We examined associations between three dimensions of carer-reported racial discrimination (measuring the direct experiences of children and vicarious exposure by their primary carer and family) and a range of physical and mental health outcomes. Analysis was conducted using multivariate logistic regression within a multilevel framework.ResultsTwo-fifths (40%) of primary carers, 45% of families and 14% of Indigenous children aged 5–10 years were reported to have experienced racial discrimination at some point in time, with 28–40% of these experiencing it persistently (reported at multiple time points). Primary carer and child experiences of racial discrimination were each associated with poor child mental health status (high risk of clinically significant emotional or behavioural difficulties), sleep difficulties, obesity and asthma, but not with child general health or injury. Children exposed to persistent vicarious racial discrimination were more likely to have sleep difficulties and asthma in multivariate models than those with a time-limited exposure.ConclusionsThe findings indicate that direct and persistent vicarious racial discrimination are detrimental to the physical and mental health of Indigenous children in Australia, and suggest that prolonged and more frequent exposure to racial discrimination that starts in the early lifecourse can impact on multiple domains of health in later life. Tackling and reducing racism should be an integral part of policy and intervention aimed at improving the health of Australian Indigenous children and thereby reducing health disparities between Indigenous and non-Indigenous children.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-017-0612-0) contains supplementary material, which is available to authorized users.

Bedsharing and Breastfeeding: The Academy of Breastfeeding Medicine Protocol #6, Revision 2019

“…Racial discrimination of M aori and Australian Indigenous peoples and other minorities by health professionals and society is associated with a wide range of negative health outcomes in New Zealand and Australia. 40,114 Risk minimization policies and strategies…”

Caregiver experiences of racism are associated with adverse health outcomes for their children: a cross-sectional analysis of data from the New Zealand Health Survey

“…Whilst the reasons for this cannot be determined, it is possible that this might be driven by differences in study measures. For example, whereas we have reported on vicarious racism and reports of having doctor-diagnosed asthma with concurrent treatment, other studies have focussed on personally experienced racism, reported asthma ever in the child's lifetime (Shepherd et al, 2017) and phenotypic measures of asthma (Thakur et al, 2017). It is also possible that our definition of medicated asthma may have limited our ability to detect any potential association since it requires the children and their family to have access to healthcare, which we have shown is impacted by vicarious racism (Paine et al, 2018).…”

“…However, the relation between vicarious racism and mental health outcomes remains unclear. For example, a longitudinal study of indigenous Australian children (5 to 10 years) found that child or primary carer experiences of racism, discrimination, or prejudice were associated with poor mental health as measured on the Strengths and Difficulties questionnaire but that family experiences were not (Shepherd et al, 2017). In another Australian study (school students aged 8 to 15 years), Priest et al, (2017) reported no association between vicarious racism (students observing racism directed towards other students) on later depressive symptoms or loneliness, beyond the effect of direct experience of racism.…”

“…The health impacts of vicarious racism for Indigenous children are poorly understood (Heard-Garris et al, 2017;Priest et al, 2013). A longitudinal study of Indigenous children in Australia (n = 1,239 aged 5 to 10 years) showed that children of primary carers who experienced 'persistent' racial discrimination had higher odds of reporting sleep difficulties and asthma (Shepherd et al, 2017).…”

Identifying the cultural heritage of patients during clinical handover and in hospital medical records

“…The possibility that cultural bias among physicians contributes to disparities in health care is increasingly recognised, but remains poorly investigated . Most research into racial prejudice and health care inequality has relied on self‐reports by patients, while Aboriginal communities have reported experiencing prejudice when accessing health care . Investigations of bias from the health care providers’ perspective are limited to a few qualitative studies based on personal attitude questionnaires, clinical vignettes, or experimental situations .…”