Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia.
School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia.
BMC Public Health. 2020 Dec 7;20(1):1881. doi: 10.1186/s12889-020-09978-7.
Increased allostatic load is linked with racial discrimination exposure, providing a mechanism for the biological embedding of racism as a psychosocial stressor. We undertook an examination of how racial discrimination interacts with socioecological, environmental, and health conditions to affect multisystem dysregulation in a First Nations population.
We conducted latent class analysis (LCA) using indicators of life stress, socioeconomic background, and physical and mental health from a nationally representative sample of Australian Aboriginal adults (N = 2056). We used LCA with distal outcomes to estimate the effect of the latent class variable on our derived allostatic load index and conducted a stratified analysis to test whether allostatic load varied based on exposure to racial discrimination across latent classes.
Our psychosocial, environmental, and health measures informed a four-class structure; 'Low risk', 'Challenged but healthy', 'Mental health risk' and 'Multiple challenges'. Mean allostatic load was highest in 'Multiple challenges' compared to all other classes, both in those exposed (4.5; 95% CI: 3.9, 5.0) and not exposed (3.9; 95% CI: 3.7, 4.2) to racial discrimination. Allostatic load was significantly higher for those with exposure to racial discrimination in the 'Multiple challenges' class (t = 1.74, p = .04) and significantly lower in the 'Mental health risk' class (t = - 1.67, p = .05).
Racial discrimination may not always modify physiological vulnerability to disease. Social and economic contexts must be considered when addressing the impact of racism, with a focus on individuals and sub-populations experiencing co-occurring life challenges.
累积性应激负荷与种族歧视经历有关，为种族主义作为一种社会心理压力源的生物学嵌入提供了一种机制。我们研究了种族歧视如何与社会生态、环境和健康状况相互作用，影响第一民族人群的多系统失调。
我们使用来自澳大利亚原住民成年人的全国代表性样本（n=2056）的生活压力、社会经济背景以及身心健康指标进行潜在类别分析（LCA）。我们使用具有远端结果的 LCA 来估计潜在类别变量对我们得出的累积性应激负荷指数的影响，并进行分层分析以检验累积性应激负荷是否根据种族歧视的暴露情况在潜在类别中发生变化。
我们的心理社会、环境和健康措施为一个四类别结构提供了信息：“低风险”、“面临挑战但健康”、“心理健康风险”和“多重挑战”。与其他所有类别相比，“多重挑战”类别的平均累积性应激负荷最高，包括暴露（4.5；95%置信区间：3.9，5.0）和未暴露（3.9；95%置信区间：3.7，4.2）于种族歧视的个体。在“多重挑战”类别中，种族歧视暴露者的累积性应激负荷显著更高（t=1.74，p=0.04），而在“心理健康风险”类别中则显著更低（t=−1.67，p=0.05）。
种族歧视不一定总是改变对疾病的生理易感性。在解决种族主义的影响时，必须考虑社会和经济背景，重点关注同时面临生活挑战的个体和亚人群。
