Abstract
BackgroundA growing body of literature highlights that racial discrimination has negative impacts on child health, although most studies have been limited to an examination of direct forms of racism using cross-sectional data. We aim to provide further insights on the impact of early exposure to racism on child health using longitudinal data among Indigenous children in Australia and multiple indicators of racial discrimination.MethodsWe used data on 1239 Indigenous children aged 5–10 years from Waves 1–6 (2008–2013) of Footprints in Time, a longitudinal study of Indigenous children across Australia. We examined associations between three dimensions of carer-reported racial discrimination (measuring the direct experiences of children and vicarious exposure by their primary carer and family) and a range of physical and mental health outcomes. Analysis was conducted using multivariate logistic regression within a multilevel framework.ResultsTwo-fifths (40%) of primary carers, 45% of families and 14% of Indigenous children aged 5–10 years were reported to have experienced racial discrimination at some point in time, with 28–40% of these experiencing it persistently (reported at multiple time points). Primary carer and child experiences of racial discrimination were each associated with poor child mental health status (high risk of clinically significant emotional or behavioural difficulties), sleep difficulties, obesity and asthma, but not with child general health or injury. Children exposed to persistent vicarious racial discrimination were more likely to have sleep difficulties and asthma in multivariate models than those with a time-limited exposure.ConclusionsThe findings indicate that direct and persistent vicarious racial discrimination are detrimental to the physical and mental health of Indigenous children in Australia, and suggest that prolonged and more frequent exposure to racial discrimination that starts in the early lifecourse can impact on multiple domains of health in later life. Tackling and reducing racism should be an integral part of policy and intervention aimed at improving the health of Australian Indigenous children and thereby reducing health disparities between Indigenous and non-Indigenous children.
Highlights
A growing body of literature highlights that racial discrimination has negative impacts on child health, most studies have been limited to an examination of direct forms of racism using cross-sectional data
The results, indicate that it was more common for older Indigenous children and primary carers to have experienced racial discrimination
Children aged 9–10 years were over 4 times more likely (OR = 4.4; 95% Confidence interval (CI): 2.85– 6.79) to be treated badly or discriminated against because they were Indigenous than children aged 5–6 years
Summary
A growing body of literature highlights that racial discrimination has negative impacts on child health, most studies have been limited to an examination of direct forms of racism using cross-sectional data. The pathways by which racism impacts on health are multifaceted and complex, for all populations [7, 19] They include the direct impacts of racism on health (e.g. racially motivated physical assault), and the indirect effects that stem from reduced and unequal access to medical, social and economic resources required for good health, increased exposure to risk factors associated with ill health, such as withdrawal from health care and health promoting activities, and the stress of racism and its ill effects [20, 21]. Few studies have examined how vicarious racism impacts on child health and wellbeing, the hypothesised mechanisms are centred around the stress associated with parental experiences of (direct and vicarious) racism and the resultant impact on parenting practices [23,24,25]
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