Effects of self-reported racial discrimination and deprivation on Maori health and inequalities in New Zealand: cross-sectional study
Effects of self-reported racial discrimination and deprivation on Maori health and inequalities in New Zealand: cross-sectional study
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DOI：
10.1016/s0140-6736(06)68890-9
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发表时间：
2006-06-17
期刊：
影响因子：
168.9
通讯作者：
Nazroo, James
中科院分区：
文献类型：
--
作者：
Harris, Ricci;Tobias, Martin;Nazroo, James
背景新西兰不同种族之间的健康不平等在毛利人和欧洲人之间最为明显。我们的目的是评估自我报告的种族歧视和剥夺对这两个民族健康不平等的影响。方法使用2002/03新西兰健康调查数据，通过分析对五个问题的回答，评估毛利人(n=4108)和欧洲人(n=6269)自我报告的种族歧视经历的流行率：言语攻击、身体攻击和卫生专业人员在工作中或购买或租赁住房时的不公平待遇。我们进行了Logistic回归分析，以评估调整种族歧视和剥夺经历对不同健康结果的种族不平等的影响。结果发现，毛利人在所有评估的情况下更有可能报告自我报告的种族歧视经历，并且在三个或更多环境中经历歧视的可能性几乎是欧洲人的十倍(4.5%[95%可信区间3.2-5.8]比0.5%[0.3-0.7])。在调整了歧视和剥夺因素后，毛利人和欧洲民族比较的优势比(95%CI)从1.67(1.35~2.08)降至1.18(0.92~1.50)，身体机能低下从1.70(1.42~2.02)降至1.21(1.00~1.47)，心理健康低下从1.30(1.11~1.54)降至1.02(0.85~1.22)，心血管疾病1.46(1.12-1.91)至1.11(0.82-1.51)。解释种族主义，无论是人际关系还是制度上的种族主义，都会导致毛利人的健康损失，并导致新西兰毛利人和欧洲人之间的健康不平等。改善毛利人健康和解决这些不平等问题的干预措施和政策应考虑到种族主义对健康的影响。
Background Inequalities in health between different ethnic groups in New Zealand are most pronounced between Maori and Europeans. Our aim was to assess the effect of self-reported racial discrimination and deprivation on health inequalities in these two ethnic groups.Methods We used data from the 2002/03 New Zealand Health Survey to assess prevalence of experiences of self-reported racial discrimination in Maori (n=4108) and Europeans (n=6269) by analysing the responses to five questions about: verbal attacks, physical attacks, and unfair treatment by a health professional, at work, or when buying or renting housing. We did logistic regression analyses to assess the effect of adjustment for experience of racial discrimination and deprivation on ethnic inequalities for various health outcomes.Findings Maori were more likely to report experiences of self-reported racial discrimination in all instances assessed, and were almost ten times more likely to experience discrimination in three or more settings than were Europeans (4.5% [95% CI 3.2-5.8] vs 0.5% [0.3-0.7]). After adjustment for discrimination and deprivation, odds ratios (95% CI) comparing Maori and European ethnic groups were reduced from 1.67 (1.35-2.08) to 1.18 (0.92-1.50) for poor or fair self-rated health, 1.70 (1.42-2.02) to 1.21 (1.00-1.47) for low physical functioning, 1.30 (1.11-1.54) to 1.02 (0.85-1.22) for low mental health, and 1.46 (1.12-1.91)to 1.11 (0.82-1.51) for cardiovascular disease.Interpretation Racism, both interpersonal and institutional, contributes to Maori health losses and leads to inequalities in health between Maori and Europeans in New Zealand. Interventions and policies to improve Maori health and address these inequalities should take into account the health effects of racism.