Melbourne School of Population and Global Health - Research Publications
Permanent URI for this collection
Search Results
1 - 10 of 11
-
ItemThe association between experiences of religious discrimination, social-emotional and sleep outcomes among youth in Australia(ELSEVIER SCI LTD, 2021-09)BACKGROUND: Religious-based hate crimes are on the rise worldwide. However, the relationship of religious discrimination on health and well-being, especially earlier on the lifecourse, is largely understudied. This study examines the prevalence of religious discrimination and the relationship it has on social-emotional adjustment and sleep outcomes among a diverse sample of students in Australia. METHODS: Data came from Speak Out Against Racism, a population-representative cross-sectional study of 4664 public school students in grades 5-9 in Australia in 2017. An adaption of the Adolescent Discrimination Distress Index (ADDI), was used to derive four measures of religious discrimination (peer, school, societal and the sum of those as a "total" score). The Strengths and Difficulties Questionnaire measured the total difficulties, conduct, emotional, and prosocial behavior subscales. Measures of sleep outcomes included duration, latency, and disruption. RESULTS: 27 % (95 % CI 22.82, 31.12) of students reported experiences of direct total religious discrimination with higher levels being reported by students identifying as a religious minority. There was strong evidence that experiences of religious discrimination (across all four sources) was related to all measures of socioemotional adjustment and sleep outcomes. DISCUSSION: Religious discrimination is an understudied form of social disadvantage that has implications for adolescents' development, health and well-being. Conclusion: More programs, particularly in the school-context, address religious-based discrimination may reduce inequities in health.
-
ItemPromoting proactive bystander responses to racism and racial discrimination in primary schools: a mixed methods evaluation of the 'Speak Out Against Racism' program pilot(BMC, 2021-07-21)BACKGROUND: Racism and racial discrimination are fundamental causes and determinants of health and health inequalities globally, with children and adolescents particularly vulnerable. Racial discrimination is a common stressor in the lives of many children and adolescents, with growing evidence of negative associations between racial discrimination and multiple domains of child and adolescent health. Addressing racism and racial discrimination must be core public health priorities, even more so among children and young people. Schools are key settings in the lives of children and adolescents and become increasingly more important to identity formation. School communities, teachers and peers greatly influence children and adolescents' beliefs about race and difference. Schools are therefore key sites for the delivery of population-based programs to reduce racism and promote proactive bystander behaviour and healthy resistance to racism among all children and adolescents as well as among the adults. METHODS: This study examines the feasibility and acceptability of the 'Speak Out Against Racism (SOAR)' program, a whole of school, multi-level, multi-strategy program that aimed to promote effective bystander responses to racism and racial discrimination in primary schools. A mixed-methods, quasi-experimental design was used. Students in Years 5 and 6 (10-12 years) across six schools completed surveys pre- and post- intervention (N = 645; 52% female; 6% Indigenous, 10% Middle Eastern, African, Latinx or Pacific Islander, 21% Asian, 52% Anglo/European). Focus groups with students and interviews with staff collected qualitative data about their experiences of the program and their views about the program's perceived need, implementation, impacts and suggested improvements. RESULTS: Quantitative data showed student prosocial skills and teacher inter-racial climate improved in intervention schools compared to comparison schools. Qualitative data highlighted teacher attitudinal and behaviour change regarding racism, and student reduced interpersonal racial discrimination, improved peer prosocial norms, commitment to anti-racism, knowledge of proactive bystander responses and confidence and self-efficacy to intervene to address racism. CONCLUSIONS: This study provides quantitative evidence of the potential of the SOAR program to improve the prosocial skills of students and their perceptions of the inter-racial school climate provided by their teachers. This program also provided qualitative evidence of the potential to promote teacher and student attitudinal and behavioural change. Further refinement and testing of the program in a large scale implementation trial is recommended.
-
ItemUpdated systematic review and meta-analysis of studies examining the relationship between reported racism and health and well-being for children and youth: a protocol(BMJ PUBLISHING GROUP, 2021)INTRODUCTION: Racism is a critical determinant of health and health inequities for children and youth. This protocol aims to update the first systematic review conducted by Priest et al (2013), including a meta-analysis of findings. Based on previous empirical data, it is anticipated that child and youth health will be negatively impacted by racism. Findings from this review will provide updated evidence of effect sizes across outcomes and identify moderators and mediators of relationships between racism and health. METHODS AND ANALYSIS: This systematic review and meta-analysis will include studies that examine associations between experiences of racism and racial discrimination with health outcomes of children and youth aged 0-24 years. Exposure measures include self-reported or proxy reported systemic, interpersonal and intrapersonal racism. Outcome measures include general health and well-being, physical health, mental health, biological markers, healthcare utilisation and health behaviours. A comprehensive search of studies from the earliest time available to October 2020 will be conducted. A random effects meta-analysis will examine the average effect of racism on a range of health outcomes. Study-level moderation will test the difference in effect sizes with regard to various sample and exposure characteristics. This review has been registered with the International Prospective Register of Systematic Reviews. ETHICS AND DISSEMINATION: This review will provide evidence for future research within the field and help to support policy and practice development. Results will be widely disseminated to both academic and non-academic audiences through peer-review publications, community summaries and presentations to research, policy, practice and community audiences. PROSPERO REGISTRATION NUMBER: CRD42020184055.
-
ItemInterventions to improve cultural competency in healthcare: a systematic review of reviews(BMC, 2014-03-03)BACKGROUND: Cultural competency is a recognized and popular approach to improving the provision of health care to racial/ethnic minority groups in the community with the aim of reducing racial/ethnic health disparities. The aim of this systematic review of reviews is to gather and synthesize existing reviews of studies in the field to form a comprehensive understanding of the current evidence base that can guide future interventions and research in the area. METHODS: A systematic review of review articles published between January 2000 and June 2012 was conducted. Electronic databases (including Medline, Cinahl and PsycINFO), reference lists of articles, and key websites were searched. Reviews of cultural competency in health settings only were included. Each review was critically appraised by two authors using a study appraisal tool and were given a quality assessment rating of weak, moderate or strong. RESULTS: Nineteen published reviews were identified. Reviews consisted of between 5 and 38 studies, included a variety of health care settings/contexts and a range of study types. There were three main categories of study outcomes: patient-related outcomes, provider-related outcomes, and health service access and utilization outcomes. The majority of reviews found moderate evidence of improvement in provider outcomes and health care access and utilization outcomes but weaker evidence for improvements in patient/client outcomes. CONCLUSION: This review of reviews indicates that there is some evidence that interventions to improve cultural competency can improve patient/client health outcomes. However, a lack of methodological rigor is common amongst the studies included in reviews and many of the studies rely on self-report, which is subject to a range of biases, while objective evidence of intervention effectiveness was rare. Future research should measure both healthcare provider and patient/client health outcomes, consider organizational factors, and utilize more rigorous study designs.
-
ItemDifferences in health behaviours between immigrant and non-immigrant groups: a protocol for a systematic review.(Springer Science and Business Media LLC, 2014-06-10)BACKGROUND: Health behaviours are important determinants of health and adoption of unhealthy behaviour is considered as one of the mechanisms through which immigrants' health changes over time in the host country. The change in health behaviours over time can contribute either to improving or worsening the overall health status of immigrants. Despite being the important mediators for the change in overall health status and chronic health conditions, no previous review (either general or systematic) has examined differences in key health behaviours simultaneously between immigrants and non-immigrants. This study aims to provide a systematic overview of the current global literature on differences in key health behaviours (that is, tobacco smoking, physical activity and alcohol drinking) between immigrant and non-immigrant groups. METHODS/DESIGN: Empirical studies in English language reporting quantitative data simultaneously on both immigrant and non-immigrant groups will be considered for this systematic review. Electronic scientific searches will be conducted on seven databases to identify relevant studies of interests: MEDLINE, CINAHL, PsycINFO, EMBASE, Global Health, SocINDEX and ProQuest. In addition, Google/Google Scholar will be used to find the relevant studies and personal contact with experts will also be undertaken. Titles, abstracts and keywords of studies identified in the search strategies will be screened for inclusion criteria. The authors will select the studies following the PRISMA guidelines. The quality of included studies will be appraised using the Critical Appraisal Skills Programme (CASP) checklists. A descriptive summary statistics of included studies will describe the study designs, socio-demographic characteristics, and the exposure (immigrant and non-immigrant groups) and outcome (key health behaviours) measures. P-values and confidence intervals (CIs) for the associations between exposure and key health behaviours will also be reported. DISCUSSION: This systematic review will facilitate a better understanding of differences in key health behaviours between immigrant and non-immigrant counterparts. It will provide a rigorous and reliable research base for future research and advance information on key health behaviours for a range of immigrant groups compared to non-immigrants in the high-migrant-receiving countries. SYSTEMATIC REVIEW REGISTRATION: This systematic review protocol has been registered with PROSPERO (registration number: CRD42014008688).
-
ItemExperiences of racial discrimination and cardiometabolic risk among Australian children(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2020-07)Cardiometabolic disease is a leading cause of adult morbidity and mortality globally. There is considerable evidence that childhood adversity is associated with markers of cardiometabolic disease risk in childhood, including obesity, blood pressure trajectories, and chronic inflammation. Experiences of racial discrimination may be an important, yet under explored, form of childhood adversity influencing childhood cardiometabolic risk. This study aimed to examine associations between self-reported racial discrimination and cardiometabolic risk markers among children. A total of 124 children (73 female) aged 11.4 years (SD 0.71) participated in the study. Most children (n = 79) identified as being from an Indigenous or an ethnic minority background. Markers of cardiometabolic risk were BMI, waist circumference, weight height ratio, systolic and diastolic blood pressure, and five inflammatory markers (C-reactive protein (CRP), Interleukin (IL)-1β, IL-6, IL-8, and TNF-α). Results showed that two or more reported experiences of racial discrimination were associated with increased BMI z-score (Beta 0.58, 95% CI 0.18, 0.99), waist circumference (Beta 4.91 cm, 95% CI 0.71, 9.1), systolic blood pressure (Beta 2.07 mmHg, 95% CI 0.43, 3.71) and IL-6 (Beta 0.13, 95% CI 0.00, 0.27) and marginally associated with TNF-α (Beta 0.22, 95% CI -0.09, 0.54) after adjusting for socio-demographic covariates. Findings from this study suggest the need to address racism and racial discrimination as important social determinants of cardiometabolic risk and of the inequitable burden of cardiometabolic disease experienced by those from Indigenous and minoritized ethnic backgrounds.
-
ItemEffects over time of self-reported direct and vicarious racial discrimination on depressive symptoms and loneliness among Australian school students(BIOMED CENTRAL LTD, 2017-02-03)BACKGROUND: Racism and racial discrimination are increasingly acknowledged as a critical determinant of health and health inequalities. However, patterns and impacts of racial discrimination among children and adolescents remain under-investigated, including how different experiences of racial discrimination co-occur and influence health and development over time. This study examines associations between self-reported direct and vicarious racial discrimination experiences and loneliness and depressive symptoms over time among Australian school students. METHODS: Across seven schools, 142 students (54.2% female), age at T1 from 8 to 15 years old (M = 11.14, SD = 2.2), and from diverse racial/ethnic and migration backgrounds (37.3% born in English-speaking countries as were one or both parents) self-reported racial discrimination experiences (direct and vicarious) and mental health (depressive symptoms and loneliness) at baseline and 9 months later at follow up. A full cross-lagged panel design was modelled using MPLUS v.7 with all variables included at both time points. RESULTS: A cross-lagged effect of perceived direct racial discrimination on later depressive symptoms and on later loneliness was found. As expected, the effect of direct discrimination on both health outcomes was unidirectional as mental health did not reciprocally influence reported racism. There was no evidence that vicarious racial discrimination influenced either depressive symptoms or loneliness beyond the effect of direct racial discrimination. CONCLUSIONS: Findings suggest direct racial discrimination has a persistent effect on depressive symptoms and loneliness among school students over time. Future work to explore associations between direct and vicarious discrimination is required.
-
ItemRacism and health among urban Aboriginal young people(BIOMED CENTRAL LTD, 2011-07-15)BACKGROUND: Racism has been identified as an important determinant of health but few studies have explored associations between racism and health outcomes for Australian Aboriginal young people in urban areas. METHODS: Cross sectional data from participants aged 12-26 years in Wave 1 of the Victorian Aboriginal Health Service's Young People's Project were included in hierarchical logistic regression models. Overall mental health, depression and general health were all considered as outcomes with self-reported racism as the exposure, adjusting for a range of relevant confounders. RESULTS: Racism was reported by a high proportion (52.3%) of participants in this study. Self-reported racism was significantly associated with poor overall mental health (OR 2.67, 95% CI 1.25-5.70, p = 0.01) and poor general health (OR 2.17, 95% CI 1.03-4.57, p = 0.04), and marginally associated with increased depression (OR 2.0; 95% CI 0.97-4.09, p = 0.06) in the multivariate models. Number of worries and number of friends were both found to be effect modifiers for the association between self-reported racism and overall mental health. Getting angry at racist remarks was found to mediate the relationship between self-reported racism and general health. CONCLUSIONS: This study highlights the need to acknowledge and address racism as an important determinant of health and wellbeing for Aboriginal young people in urban areas of Australia.
-
ItemNo Preview AvailablePatterns of Intergroup Contact in Public Spaces: Micro-Ecology of Segregation in Australian Communities(MDPI, 2014-03)The use of public spaces can promote social cohesion and facilitate interpersonal interactions within the community. However, the ways racial and ethnic groups interact in public spaces can also reflect and influence informal segregation in the wider community. The present study aimed to examine patterns of intergroup contact within public spaces in Victoria, Australia through short-term observation in four localities. Data were collected on within-group, intergroup and absence of contact for people from minority and majority groups. A total of 974 contacts were observed. Findings indicate that in the observed public spaces, people from visible minority groups tended to have no contact with others or to interact with people from other ethnic/racial groups. In contrast, those from the majority group tended to interact predominately with other majority group members. This suggests that majority group members are more likely to ‘self-segregate’ in public spaces than those from minority groups.
-
ItemExperiences of Racism, Racial/Ethnic Attitudes, Motivated Fairness and Mental Health Outcomes Among Primary and Secondary School Students(SPRINGER/PLENUM PUBLISHERS, 2014-10)While studies investigating the health effects of racial discrimination for children and youth have examined a range of effect modifiers, to date, relationships between experiences of racial discrimination, student attitudes, and health outcomes remain unexplored. This study uniquely demonstrates the moderating effects of vicarious racism and motivated fairness on the association between direct experiences of racism and mental health outcomes, specifically depressive symptoms and loneliness, among primary and secondary school students. Across seven schools, 263 students (54.4% female), ranging from 8 to 17 years old (M = 11.2, SD = 2.2) reported attitudes about other racial/ethnic groups and experiences of racism. Students from minority ethnic groups (determined by country of birth) reported higher levels of loneliness and more racist experiences relative to the majority group students. Students from the majority racial/ethnic group reported higher levels of loneliness and depressive symptoms if they had more friends from different racial/ethnic groups, whereas the number of friends from different groups had no effect on minority students' loneliness or depressive symptoms. Direct experiences of racism were robustly related to higher loneliness and depressive symptoms in multivariate regression models. However, the association with depressive symptoms was reduced to marginal significance when students reported low motivated fairness. Elaborating on the negative health effects of racism in primary and secondary school students provides an impetus for future research and the development of appropriate interventions.