Centre for Health Policy, University of Melbourne, Melbourne, VIC, Australia.
Centre for Citizenship and Globalisation, Deakin University, Melbourne, VIC, Australia.
Med J Aust. 2014 Jul 7;201(1):44-7. doi: 10.5694/mja13.10503.
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 over 18 years who had resided in the relevant LGA for at least a year. The response rate across all LGAs was 99%.
Being above or below the threshold for high or very high psychological distress on the Kessler Psychological Distress Scale.
221 participants reported experiences of racism in health settings in the past 12 months. The results suggested that people experiencing racism in health settings (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.
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.
探讨澳大利亚原住民在卫生保健环境中经历种族主义的经历及其对心理健康的影响。
设计、地点和参与者：2010 年 12 月 1 日至 2011 年 10 月 31 日，在维多利亚州两个大都市和两个农村地方政府管辖区（LGA）进行了横断面调查，以了解种族主义经历和心理健康状况。参与者包括在相关 LGA 居住至少一年的 755 名年龄在 18 岁以上的澳大利亚原住民。所有 LGA 的回复率均为 99%。
Kessler 心理困扰量表上的高或极高心理困扰阈值。
在过去 12 个月中，有 221 名参与者报告在卫生保健环境中经历过种族主义。结果表明，在卫生保健环境（OR，4.49；95%CI，2.28-8.86）和非卫生保健环境（OR，2.66；95%CI，1.39-5.08）中经历种族主义的人比没有经历种族主义的人更有可能处于高或极高心理困扰的阈值之上。
在卫生保健环境中经历人际种族主义与心理困扰的增加有关，这超过了在其他环境中预期的情况。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和其他澳大利亚人之间健康差距的一种手段的理由。要利用这一投资，就需要明确评估这些举措对减少患者经历种族主义的影响。
