paradies-racismasadeterminant-2015.pdf (3.32 MB)
Racism as a determinant of health: a systematic review and meta-analysis
journal contribution
posted on 2015-09-23, 00:00 authored by Yin ParadiesYin Paradies, Jehonathan BenJehonathan Ben, N Denson, Amanuel EliasAmanuel Elias, N Priest, A Pieterse, A Gupta, M Kelaher, G GeeDespite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464.
History
Journal
PLoS oneVolume
10Issue
9Article number
e0138511Pagination
1 - 48Publisher
PLoSLocation
San Francisco, Calif.Publisher DOI
eISSN
1932-6203Indigenous content
This research output may contain the names and images of Aboriginal and Torres Strait Islander people now deceased. We apologise for any distress that may occur.Language
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2015, The AuthorsUsage metrics
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No categories selectedKeywords
African-American womenSelf-reported racismRace-related stressPerceived ethnic discriminationScience & TechnologyMultidisciplinary SciencesScience & Technology - Other TopicsLATINO PSYCHOLOGICAL DISTRESSAMBULATORY BLOOD-PRESSUREOTHER-GROUP ORIENTATIONARTERY RISK DEVELOPMENTOF-THE-LITERATUREBODY-MASS INDEX
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