Understanding the impact of discrimination on health and wellbeing

越来越多的证据表明，遭受歧视的人心理健康状况较差，甚至可能面临更大的身体健康状况风险，包括心血管疾病和肥胖。歧视作为一种社会压力源，可能通过生物压力途径对健康和福祉产生不利影响，促进不健康行为作为应对或逃避负面影响的手段，和/或限制获得或接受保健和疾病预防服务。这一领域的研究一直以美国的种族主义研究为主，目前关于歧视对健康影响的证据基础缺乏高质量的纵向数据，并且没有考虑到各种类型的歧视（例如基于年龄、性别、族裔、国籍、宗教、语言、性取向、健康状况、残疾和体重的歧视）。研究社会因素对心理健康的影响是ESRC的核心战略重点之一。随着移民危机、英国“脱欧”公投以及最近在英格兰和其他地方发生的恐怖袭击加剧了人们对社会少数群体的负面态度，歧视在欧洲成为一个热门话题。此外，解决健康不平等问题是一个主要的政策重点，因此，了解歧视如何影响弱势群体的健康和福祉，并确定可以减少因歧视直接导致的健康不平等的政策杠杆至关重要。这项研究是伦敦大学学院的一个学术小组和几个致力于歧视和福利问题的慈善机构（Age UK, Leonard Cheshire Disability and Weight Concern）之间的合作，并将使用来自英国和欧洲各地的大量成年人的数据来澄清这些关系。我们的合作慈善机构特别关注基于年龄、残疾和肥胖的歧视，但我们也将解决与性别、种族/国籍和宗教有关的问题。我们的具体目标是：1)估计感知到的歧视对健康和福祉的影响，包括影响根据歧视类型、健康结果和欧洲国家而变化的程度；2)审查与歧视的频率和普遍性有关的健康影响；3)探索歧视的多面性影响健康和福祉的机制。我们预计，这项研究的结果将有助于政策制定者和从业者制定政策和干预措施，帮助改善遭受歧视的不同群体的健康和福祉。

Growing evidence suggests that people who experience discrimination suffer poorer mental health and may even be at increased risk of physical health conditions, including cardiovascular disease and obesity. Discrimination, as a social stressor, may adversely affect health and wellbeing through biological stress pathways, promotion of unhealthy behaviours as a means to cope with or escape negative affect, and/or restricted access to or uptake of healthcare and disease prevention services. Research in this field has been dominated by studies of racism in the USA, and the current evidence base on the impact of discrimination on health lacks high-quality longitudinal data, and consideration of varied types of discrimination (e.g. discrimination on the basis of age, sex, ethnic group, nationality, religion, language, sexual orientation, health condition, disability and weight). Examining the influence of social factors on mental health is one of the ESRC's core strategic priorities. Discrimination is a topical issue in Europe with the migrant crisis, UK 'Brexit' vote and recent terrorist attacks in England and elsewhere fuelling negative attitudes towards social minority groups. Moreover, addressing health inequalities is a major policy focus, so it is crucial to understand how discrimination affects health and wellbeing in vulnerable groups and to identify the policy levers that can reduce inequalities in health that occur as a direct result of discrimination. This study is a collaboration between an academic group at University College London and several charities working on issues of discrimination and wellbeing (Age UK, Leonard Cheshire Disability and Weight Concern), and will clarify these relationships using data from large cohorts of adults from the UK and across Europe. Our partner charities have a specific focus on discrimination based on age, disability and obesity, but we shall also address issues related to gender, ethnicity/nationality, and religion. Our specific objectives are: 1) To estimate the impact of perceived discrimination on health and wellbeing, including the extent to which effects vary according to the type of discrimination, health outcome, and European country; 2) To examine health impacts in relation to the frequency and pervasiveness of discrimination; 3) To explore mechanisms through which the multi-faceted nature of discrimination affects health and wellbeing. We anticipate that findings from this study will help policy-makers and practitioners develop policies and interventions that can help improve health and wellbeing in the different groups that experience discrimination.