Experiencing racism in health care: the mental health impacts for Victorian Aboriginal communities
Experiencing racism in health care: the mental health impacts for Victorian Aboriginal communities
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DOI：
10.5694/mja13.10503
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发表时间：
2014-07-07
影响因子：
11.4
通讯作者：
Paradies, Yin
中科院分区：
文献类型：
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作者：
Kelaher, Margaret A.;Ferdinand, Angeline S.;Paradies, Yin
目的：调查健康环境中的种族主义经历及其对澳大利亚原住民心理健康的影响。 设计、环境和参与者：2010 年 12 月 1 日至 2011 年 10 月 31 日期间，在维多利亚州两个大都市和两个农村地方政府地区 (LGA) 进行了一项关于种族主义和心理健康经历的横断面调查。参与者包括 755 名年龄在 18 岁或以上且在相关 LGA 居住了至少一年的澳大利亚原住民。年。所有 LGA 的回复率为 99%。 主要结果指标：高于或低于凯斯勒心理困扰量表中高或非常高心理困扰的阈值。结果：221 名参与者报告了过去 12 个月在健康环境中遭受种族主义的经历。结果表明，在健康环境中（比值比 [OR]，4.49；95% CI，2.28-8.86）和非健康环境中（OR，2.66；95% CI，1.39-5.08）经历过种族主义的人比没有经历过种族主义的人更有可能高于高度或极高心理困扰的阈值。结论：在健康环境中经历人际种族主义与其他环境中预期的心理困扰增加有关。这一发现支持了提高文化能力和减少种族主义作为缩小原住民与其他澳大利亚人之间健康差距的一种手段的理由。利用这项投资需要明确评估这些举措对减少患者种族主义经历的影响。
Objective: To examine experiences of racism in health settings and their impact on mental health among Aboriginal Australians.Design, setting and participants: A cross-sectional survey of experiences of racism and mental health was conducted in two metropolitan and two rural Victorian local government areas (LGAs) between 1 December 2010 and 31 October 2011. Participants included 755 Aboriginal Australians aged 18 years or older who had resided in the relevant LGA for at least a year. The response rate across all LGAs was 99%.Main outcome measures: Being above or below the threshold for high or very high psychological distress on the Kessler Psychological Distress Scale.Results: 221 participants reported experiences of racism in health settings in the past 12 months. The results suggested that people experiencing racism in health settings (odds ratio [OR], 4.49; 95% CI, 2.28-8.86) and non-health settings (OR, 2.66; 95% CI, 1.39-5.08) were more likely than people who did not experience racism to be above the threshold for high or very high psychological distress.Conclusions: Experiencing interpersonal racism in health settings is associated with increased psychological distress over and above what would be expected in other settings. This finding supports the rationale for improving cultural competency and reducing racism as a means of closing the health gap between Aboriginal and other Australians. Capitalising on this investment will require explicitly evaluating the impact of these initiatives on reducing patient experiences of racism.