University of Otago, PO Box 7343, Wellington, Wellington South 6242, New Zealand.
BMC Public Health. 2013 Sep 13;13:844. doi: 10.1186/1471-2458-13-844.
In New Zealand, there are significant and long-standing inequalities in a range of health outcomes, risk factors and healthcare measures between Māori (indigenous peoples) and Pākehā (European). This study expands our understanding of racism as a determinant of such inequalities to examine the concept of socially-assigned ethnicity (how an individual is classified by others ethnically/racially) and its relationship to health and racism for Māori. There is some evidence internationally that being socially-assigned as the dominant ethnic group (in this case European) offers health advantage.
We analysed data from the 2006/07 New Zealand Health Survey for adult participants who self-identified their ethnicity as Māori (n = 3160). The association between socially-assigned ethnicity and individual experience of racial discrimination, and socially-assigned ethnicity and health (self-rated health, psychological distress [Kessler 10-item scale]) was assessed using logistic and linear regression analyses, respectively.
Māori who were socially-assigned as European-only had significantly lower experience of racial discrimination (adjusted odds ratio [OR] = 0.58, 95% confidence interval [CI] = 0.44, 0.78) than Māori who were socially-assigned as non-European. Being socially-assigned as European-only was also associated with health advantage compared to being socially-assigned non-European: more likely to respond with self-rated very good/excellent health (age, sex adjusted OR = 1.39, 95% CI = 1.10, 1.74), and lower Kessler 10 scores (age, sex adjusted mean difference = -0.66, 95% C I = -1.22, -0.10). These results were attenuated following adjustment for socioeconomic measures and experience of racial discrimination.
Results suggest that, in a race conscious society, the way people's ethnicities are viewed by others is associated with tangible health risk or advantage, and this is consistent with an understanding of racism as a health determinant.
在新西兰，毛利人（原住民）和欧洲裔新西兰人（欧洲人）在一系列健康结果、风险因素和医疗保健措施方面存在显著且长期存在的不平等。本研究扩展了我们对种族主义作为这些不平等决定因素的理解，以研究社会分配种族（个人如何被他人在种族/民族上分类）的概念及其与毛利人健康和种族主义的关系。国际上有一些证据表明，被社会分配为占主导地位的族群（在这种情况下是欧洲人）会带来健康优势。
我们分析了 2006/07 年新西兰健康调查中自我确定为毛利人（n=3160）的成年参与者的数据。使用逻辑回归和线性回归分析，分别评估社会分配种族与个体经历种族歧视以及社会分配种族与健康（自我报告的健康、心理困扰[Kessler 10 项量表]）之间的关联。
与被社会分配为非欧洲人的毛利人相比，被社会分配为仅欧洲人的毛利人经历种族歧视的可能性显著降低（调整后的优势比[OR]=0.58，95%置信区间[CI]=0.44，0.78）。与被社会分配为非欧洲人相比，被社会分配为仅欧洲人也与健康优势相关：更有可能对自我报告的非常好/优秀健康做出反应（年龄、性别调整的 OR=1.39，95%CI=1.10，1.74），并且 Kessler 10 得分较低（年龄、性别调整后的平均差异=-0.66，95%CI=-1.22，-0.10）。这些结果在调整社会经济措施和经历种族歧视后有所减弱。
结果表明，在一个种族意识社会中，人们的种族被他人看待的方式与有形的健康风险或优势有关，这与将种族主义理解为健康决定因素的观点一致。
