Abstract
BackgroundRacism 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).MethodsData 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.ResultsRacial 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.ConclusionsUK 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.
Highlights
Racism has been linked with poor health in studies in the United States
There were no differences in sex or income, but reports of racial discrimination did vary by ethnic group
Raising awareness of racial discrimination has been necessary to promote activism to bring about legislative and social change to improve the position of ethnic minority groups
Summary
Little is known about prospective associations between racial discrimination and health outcomes in the United Kingdom (UK). In the United Kingdom (UK), the 1965 Race Relations Act [2] outlawed discrimination on the grounds of colour, nationality and ethnic or national origins. Race remains a protected characteristic under contemporary equality law [3]. Despite this legislative effort, ethnic inequalities in education, work, health and criminal justice remain [4]. Discrimination on the basis of ethnic origin is regarded as the most common type of prejudice in Europe, with 64% of adults perceiving racial discrimination to be widespread in a survey of 27,718 people [5]. Against the backdrop of the vote to leave the European Union (Brexit), hostility towards migrants and the growth in right-wing nationalist movements [9], these figures reflect a rise in reported racial discrimination in both the UK and Europe [5, 6]
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