Abstract
BackgroundRacial discrimination is acknowledged as a central social determinant of Australian Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) health, although quantitative empirical literature on the impacts of racism on Aboriginal children remains sparse. We use a novel, longitudinal dataset to explore the relationship between caregiver-perceived racism exposure and a range of mental health and related behavioural and physiological outcomes in childhood.MethodThe study cohort comprised 1759 Aboriginal children aged 4–12 years from waves 2–8 (2009–2015) of the Footprints in Time: The Longitudinal Study of Indigenous Children (LSIC) dataset. We examined exposure to caregiver-perceived racism between 4 and 11 years as a predictor for mental health and related outcomes at ages 7–12 and substance use at 10–12 years. Unadjusted models and models adjusted for remoteness, community-level and family-level socio-economic status, child age and gender were used in analysis. Multilevel logistic regression was used in all analysis.ResultsIn fully adjusted models, perceived exposure to racism at ages 4–11 was associated with twice the risk of negative mental health (95% CI: 1.3–3.0), sleep difficulties (95% CI: 1.4–3.0), and behaviour issues at school (95% CI: 1.2–2.9), 1.7 times the risk of obesity (95% CI: 1.1–2.5), and nearly 7 times the risk of trying cigarettes (95% CI: 1.1–43.9). Increased risks were also found for being underweight and trying alcohol though estimates did not reach statistical significance. There was no evidence that racism was associated with poorer general health.ConclusionExposure to racial discrimination in Aboriginal children increased the risk for a spectrum of interrelated psychological, behavioural and physiological factors linked to negative mental health. Our results further affirm the importance of interventions aimed at reducing the prevalence of racial discrimination for the benefits of population health and health inequalities. The services and institutions which aim to support the mental health and wellbeing of Aboriginal children should also support interventions to reduce racism and implement accountable policies which prioritise this goal.
Highlights
Racial discrimination is acknowledged as a central social determinant of Australian Aboriginal and Torres Strait Islander health, quantitative empirical literature on the impacts of racism on Aboriginal children remains sparse
We found that Aboriginal children exposed to racial discrimination between ages 4–11 were at higher risk of negative mental health and related behavioural and physical outcomes compared to children without racism exposure
While our study focused on racism exposure during childhood, the positive associations we found between racism and both trying cigarettes and alcohol reflect those seen between trajectories of racial discrimination throughout adolescence and later risk of substance use [52,53,54,55]
Summary
Racial discrimination is acknowledged as a central social determinant of Australian Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) health, quantitative empirical literature on the impacts of racism on Aboriginal children remains sparse. The negative health effects of racism as a pervasive stressor have been shown to be stronger in children and young people when compared to adults [10, 16]. This is unsurprising given that the early years are understood to present a critical period of health vulnerability to adversity and stress [17, 18]. An increasing number of studies have examined the association between racial discrimination and health and wellbeing outcomes in children aged below 12 years in recent years, relatively few have focused on children from Indigenous populations [12]
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