Harris Ricci, Tobias Martin, Jeffreys Mona, Waldegrave Kiri, Karlsen Saffron, Nazroo James
Ministry of Health, Wellington, New Zealand.
Soc Sci Med. 2006 Sep;63(6):1428-41. doi: 10.1016/j.socscimed.2006.04.009. Epub 2006 Jun 5.
Accumulating research suggests that racism may be a major determinant of health. Here we report associations between self-reported experience of racial discrimination and health in New Zealand. Data from the 2002/2003 New Zealand Health Survey, a cross-sectional survey involving face-to-face interviews with 12,500 people, were analysed. Five items were included to capture racial discrimination in two dimensions: experience of ethnically motivated attack (physical or verbal), or unfair treatment because of ethnicity (by a health professional, in work or when gaining housing). Ethnicity was classified using self-identification to one of four ethnic groups: Māori, Pacific, Asian and European/Other peoples. Logistic regression, accounting for the survey design, age, sex, ethnicity and deprivation, was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Māori reported the highest prevalence of "ever" experiencing any of the forms of racial discrimination (34%), followed by similar levels among Asian (28%) and Pacific peoples (25%). Māori were almost 10 times more likely to experience multiple types of discrimination compared to European/Others (4.5% vs. 0.5%). Reported experience of racial discrimination was associated with each of the measures of health examined. Experience of any one of the five types of discrimination was significantly associated with poor or fair self-rated health; lower physical functioning; lower mental health; smoking; and cardiovascular disease. There was strong evidence of a dose-response relationship between the number of reported types of discrimination and each health measure. These results highlight the need for racism to be considered in efforts to eliminate ethnic inequalities in health.
越来越多的研究表明，种族主义可能是健康的一个主要决定因素。在此，我们报告新西兰自我报告的种族歧视经历与健康之间的关联。对2002/2003年新西兰健康调查的数据进行了分析，该横断面调查涉及对12500人进行面对面访谈。纳入了五个项目以从两个维度捕捉种族歧视：出于种族动机的攻击（身体或言语上的）经历，或因种族而受到的不公平待遇（由医疗专业人员、在工作中或获得住房时）。种族按照自我认同分为四个种族群体之一：毛利人、太平洋岛民、亚洲人和欧洲/其他族裔。使用考虑了调查设计、年龄、性别、种族和贫困状况的逻辑回归来估计比值比（OR）和95%置信区间（CI）。毛利人报告“曾经”经历过任何一种种族歧视形式的比例最高（34%），其次是亚洲人（28%）和太平洋岛民（25%），比例相近。与欧洲/其他族裔相比，毛利人经历多种歧视类型几乎是其10倍（4.5%对0.5%）。报告的种族歧视经历与所检查的各项健康指标均相关。五种歧视类型中的任何一种经历都与自我健康评价差或一般、身体功能较低、心理健康状况较差、吸烟以及心血管疾病显著相关。有强有力的证据表明，报告的歧视类型数量与各项健康指标之间存在剂量反应关系。这些结果凸显了在消除健康方面的种族不平等努力中考虑种族主义的必要性。
