Telethon Kids Institute, The University of Western Australia, P.O. Box 855, West Perth, WA, 6872, Australia.
WZB Berlin Social Science Center, Reichpietschufer 50, 10785, Berlin, Germany.
Int J Equity Health. 2017 Jul 3;16(1):116. doi: 10.1186/s12939-017-0612-0.
A growing body of literature highlights that racial discrimination has negative impacts on child health, although most studies have been limited to an examination of direct forms of racism using cross-sectional data. We aim to provide further insights on the impact of early exposure to racism on child health using longitudinal data among Indigenous children in Australia and multiple indicators of racial discrimination.
We used data on 1239 Indigenous children aged 5-10 years from Waves 1-6 (2008-2013) of Footprints in Time, a longitudinal study of Indigenous children across Australia. We examined associations between three dimensions of carer-reported racial discrimination (measuring the direct experiences of children and vicarious exposure by their primary carer and family) and a range of physical and mental health outcomes. Analysis was conducted using multivariate logistic regression within a multilevel framework.
Two-fifths (40%) of primary carers, 45% of families and 14% of Indigenous children aged 5-10 years were reported to have experienced racial discrimination at some point in time, with 28-40% of these experiencing it persistently (reported at multiple time points). Primary carer and child experiences of racial discrimination were each associated with poor child mental health status (high risk of clinically significant emotional or behavioural difficulties), sleep difficulties, obesity and asthma, but not with child general health or injury. Children exposed to persistent vicarious racial discrimination were more likely to have sleep difficulties and asthma in multivariate models than those with a time-limited exposure.
The findings indicate that direct and persistent vicarious racial discrimination are detrimental to the physical and mental health of Indigenous children in Australia, and suggest that prolonged and more frequent exposure to racial discrimination that starts in the early lifecourse can impact on multiple domains of health in later life. Tackling and reducing racism should be an integral part of policy and intervention aimed at improving the health of Australian Indigenous children and thereby reducing health disparities between Indigenous and non-Indigenous children.
越来越多的文献强调，种族歧视对儿童健康有负面影响，尽管大多数研究仅限于使用横断面数据检查直接形式的种族主义。我们旨在使用澳大利亚土著儿童的纵向数据和多种种族歧视指标，进一步了解早期接触种族主义对儿童健康的影响。
我们使用了来自澳大利亚各地土著儿童纵向研究“足迹时间”（Footprints in Time）第 1-6 波（2008-2013 年）中 1239 名 5-10 岁土著儿童的数据。我们研究了三种照顾者报告的种族歧视维度（衡量儿童的直接经历和其主要照顾者和家庭的间接经历）与一系列身体和心理健康结果之间的关联。使用多元逻辑回归在多层次框架内进行分析。
五分之二（40%）的主要照顾者、45%的家庭和 14%的 5-10 岁土著儿童在某个时候报告经历过种族歧视，其中 28-40%的人持续经历种族歧视（在多个时间点报告）。主要照顾者和儿童经历种族歧视都与儿童心理健康状况不佳（有临床显著情绪或行为困难的高风险）、睡眠困难、肥胖和哮喘有关，但与儿童一般健康或伤害无关。在多变量模型中，持续经历间接种族歧视的儿童比经历时间有限的儿童更有可能出现睡眠困难和哮喘。
研究结果表明，直接和持续的间接种族歧视对澳大利亚土著儿童的身心健康有害，并表明在生命早期开始的长期和更频繁的种族歧视暴露会影响生命后期多个健康领域。解决和减少种族主义应该是旨在改善澳大利亚土著儿童健康、从而减少土著儿童和非土著儿童之间健康差距的政策和干预措施的一个组成部分。
