Experiencing racism in health care: the mental health impacts for Victorian Aboriginal communities

Abstract

Objectives: 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%. Main outcome measures: Being above or below the threshold for high or very high psychological distress on the Kessler Psychological Distress Scale. Results: 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. Conclusions: 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.

The power of talk and power in talk: a systematic review of Indigenous narratives of culturally safe healthcare communication

“…Health communication is one area at risk of this approach, with cultural communication publications often focusing on Indigenous communication styles (Coleman 2010), language or miscommunication (Anderson et al 2008). There appear to be deeper communication barriers, however, with nearly onethird of Aboriginal survey respondents reporting experiencing racism in health settings, the majority by communication (Kelaher et al 2014).…”

Inequalities in exposure to the air pollutants PM2.5 and NO2 in Australia

“…Similarly, ethnic minorities have been shown to be more vulnerable to exposure from air pollution (Sacks et al 2011, Bell et al 2014, Wang et al 2017. This may be partly explained by their socio-economic status (SES), cultural factors and institutional discrimination, which can make it harder for ethnic minorities to access resources to reduce their exposure or address health issues (Johnstone and Kanitsaki 2008, Durey et al 2012, Sherwood 2013, Kelaher et al 2014.…”

Lining up the ducks: aligning the hidden, formal and informal curricula in an immersed learning environment

“…On the contrary, it can be a powerful factor in learning what it takes to be a "good doctor" for Aboriginal people. The hidden curriculum, however, is experienced differently, often depending on one's ethnicity and prior learning; what may be hidden to non-Aboriginal practitioners and staff can be experienced overtly by Aboriginal people, who continue to be recipients of inequity, bias and different forms of racism and prejudice (Kelaher, Ferdinand, & Paradies, 2014). Furthermore, it is often overlooked that medical students and registrars are already enculturated into the practice of mainstream medicine through educational and clinic-based experiences.…”