New Research Links Racial Discrimination To Health
New Research Links Racial Discrimination To Health
The Ministry of Health welcomes the release of new research findings about the impact of racial discrimination on the health of New Zealanders.
The research, a joint study by the Ministry of Health, Massey University and University College London, has been published in the prestigious medical journal the Lancet. A second article will appear later this month in the journal Social Science & Medicine.
There has been little information available about the link between an individual's experience of racial discrimination and their health status. To help fill this gap in knowledge, the 2002/2003 New Zealand Health Survey (NZHS) asked five questions about participants' experience of racial discrimination, including questions about verbal or physical racist attacks, and unfair treatment (because of ethnicity) in health care, work, and housing.
The research shows that Maori, Asian and Pacific people were more likely to report experiencing all types of discrimination than Europeans. For example, 34% of Maori, 28% of Asians, 25% of Pacific peoples and 15% of Europeans reported experiencing one or more types of discrimination ever in their lifetime. Maori were almost ten times more likely to report experiencing multiple types of discrimination than Europeans (4.5% versus 0.5%).
Experiencing discrimination was associated with self reporting poorer overall health, lower physical and mental health, more cardiovascular disease, and with smoking. These associations were found for all ethnic groups and persisted after statistically controlling for socioeconomic status. Poorer health was generally about one and a half times to twice as likely to be reported by people who experienced discrimination than by those who did not (after appropriate statistical adjustment).
Almost all of the disparity in self reported health between Maori and Europeans could be statistically accounted for by the combined effect of differences in socioeconomic status and differences in experience of discrimination.
The Ministry's Deputy Director General of Public Health Don Matheson says, "this research confirms that both deprivation and discrimination are important in explaining ethnic inequalities in health, in New Zealand as in other countries. These results amplify findings recently published in a joint Ministry of Health and University of Otago report, Decades of Disparity III, which examined ethnic and socioeconomic disparities in mortality."
The results also provide a baseline for the Ministry of Health to continue monitoring the contribution of discrimination to ethnic inequalities in health. The questions about discrimination used in the 2002/03 New Zealand Health Survey will be repeated in the upcoming 2006/07 New Zealand Health Survey.
Don Matheson says, "once that data is analysed we will be able to examine what trends are occurring over time. This monitoring may also prompt further research into the pathways linking discrimination to health outcomes."
"The evidence made available through this research supports the need for the Government’s Reducing Inequalities initiative, and its implementation through policies and strategies such as the He Korowai Oranga Maori Health Strategy and the Primary Health Care Strategy. The New Zealand Diversity Action Programme, facilitated by the Human RIghts Commission is also an important means of achieving community and government cooperation to foster positive action to address racial discrimination. Also, quite apart from any link with health outcomes, deprivation and discrimination matter to us all as a society. Both must be addressed, recognizing that deprivation may itself be a consequence of discrimination, at least in part.
Questions and Answers -
Why was the research done?
Racial discrimination has been identified internationally as an important area of health research, both as a possible determinant of health and as a possible contributor to inequalities in health between ethnic groups. There is little information on this topic in New Zealand. It was decided to include some relevant questions on personal experience of discrimination in the 2002/2003 New Zealand Health Survey (NZHS). The same questions will be included in the upcoming 2006/07 survey so that the Ministry of Health can begin to monitor trends over time.
How was the research done?
Five questions were asked in the NZHS about personal experience of racial discrimination ever in a lifetime and in the past 12 months. There were two questions about personal racist attack (verbal and physical) and three questions about unfair treatment because of ethnicity, covering health care, work, and housing. These questions were adapted from UK and USA surveys and are well validated in these countries.
The survey also asked people about their health and behaviours such as smoking. The data was then statistically analysed to estimate the prevalence of exposure to discrimination and the association between such exposure and selected self reported health outcomes, adjusting for age and deprivation (a measure of socioeconomic status).
Who did the research?
The research was carried out by a team of researchers from the Ministry of Health, Massey University and University College London. The latter included Professor James Nazroo, a leading expert in this field.
What can we take from the findings?
Racial discrimination does occur in New Zealand, as in other countries, and is linked to health status. Discrimination seems to affect health both through its impact on socioeconomic status and independently of this. Deprivation and discrimination are both important determinants of health and both must be addressed to improve population health and reduce disparities between ethnic groups.