种族歧视与健康：英国少数族裔的前瞻性研究
Racial discrimination and health: a prospective study of ethnic minorities in the United Kingdom.
作者信息
Hackett Ruth A, Ronaldson Amy, Bhui Kamaldeep, Steptoe Andrew, Jackson Sarah E
机构信息
Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Department of Behavioural Science and Health, University College London, London, UK.
出版信息
BMC Public Health. 2020 Nov 18;20(1):1652. doi: 10.1186/s12889-020-09792-1.
BACKGROUND
Racism has been linked with poor health in studies in the United States. Little is known about prospective associations between racial discrimination and health outcomes in the United Kingdom (UK).
METHODS
Data were from 4883 ethnic minority (i.e. non-white) participants in the UK Household Longitudinal Study. Perceived discrimination in the last 12 months on the basis of ethnicity or nationality was reported in 2009/10. Psychological distress, mental functioning, life satisfaction, self-rated health, physical functioning and reports of limiting longstanding illness were assessed in 2009/10 and 2011/12. Linear and logistic regression analyses adjusted for age, sex, income, education and ethnicity. Prospective analyses also adjusted for baseline status on the outcome being evaluated.
RESULTS
Racial discrimination was reported by 998 (20.4%) of the sample. Cross-sectionally, those who reported racial discrimination had a greater likelihood on average of limiting longstanding illness (odds ratio (OR) = 1.78, 95% confidence interval (CI) 1.49; 2.13) and fair/poor self-rated health (OR = 1.50; 95% CI 1.24; 1.82) than those who did not report racial discrimination. Racial discrimination was associated with greater psychological distress (B = 1.11, 95% CI 0.88; 1.34), poorer mental functioning (B = - 3.61; 95% CI -4.29; - 2.93), poorer physical functioning (B = - 0.86; 95% CI -1.50; - 0.27), and lower life satisfaction (B = - 0.40, 95% CI -0.52; - 0.27). Prospectively, those who reported racial discrimination had a greater likelihood on average of limiting longstanding illness (OR = 1.31, 95% CI 1.01; 1.69) and fair/poor self-rated health (OR = 1.30; 95% CI 1.00; 1.69), than those who did not report racial discrimination. Racial discrimination was associated increased psychological distress (B = 0.52, 95% CI 0.20; 0.85) and poorer mental functioning (B = - 1.77; 95% CI -2.70; - 0.83) over two-year follow-up, adjusting for baseline scores.
CONCLUSIONS
UK adults belonging to ethnic minority groups who perceive racial discrimination experience poorer mental and physical health than those who do not. These results highlight the need for effective interventions to combat racial discrimination in order to reduce inequalities in health.
背景
在美国的研究中，种族主义与健康状况不佳有关。对于英国种族歧视与健康结果之间的前瞻性关联，人们知之甚少。
方法
数据来自英国家庭纵向研究中的4883名少数族裔（即非白人）参与者。2009/10年报告了过去12个月基于种族或国籍的感知歧视情况。在2009/10年和2011/12年评估了心理困扰、心理功能、生活满意度、自评健康状况、身体功能以及长期慢性病受限情况报告。线性和逻辑回归分析对年龄、性别、收入、教育程度和种族进行了调整。前瞻性分析还对所评估结果的基线状态进行了调整。
结果
样本中有998人（20.4%）报告了种族歧视。横断面分析显示，报告种族歧视的人比未报告种族歧视的人平均更有可能患有长期慢性病受限（优势比（OR）=1.78，95%置信区间（CI）1.49；2.13）以及自评健康状况为中等/差（OR=1.50；95%CI 1.24；1.82）。种族歧视与更大的心理困扰（B=1.11，95%CI 0.88；1.34）、更差的心理功能（B=-3.61；95%CI -4.29；-2.93）、更差的身体功能（B=-0.86；95%CI -1.50；-0.27）以及更低的生活满意度（B=-0.40，95%CI -0.52；-0.27）相关。前瞻性分析显示，报告种族歧视的人比未报告种族歧视的人平均更有可能患有长期慢性病受限（OR=1.31，95%CI 1.01；1.69）以及自评健康状况为中等/差（OR=1.30；95%CI 1.00；1.69）。在对基线分数进行调整后，经过两年随访，种族歧视与心理困扰增加（B=0.52，95%CI 0.20；0.85）和心理功能变差（B=-1.77；95%CI -2.70；-0.83）相关。
结论
认为遭受种族歧视的英国少数族裔成年人比未遭受歧视的人心理健康和身体健康状况更差。这些结果凸显了采取有效干预措施打击种族歧视以减少健康不平等现象的必要性。
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