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Not just another passing comment: how racism is damaging our health

Reem is a 17-year-old immigrant from Syria. She moved to Australia with her parents a few years ago and has been studying successfully at high school. Every morning Reem catches the bus to school. Her parents work – her mother at a Syrian radio station and her father is a senior researcher at a university in Melbourne. Although Reem is of average height, she stands out – she is a devout Muslim. Her rounded face and brown eyes are bolstered by a colourful orange hijab. And while this is a powerful symbol for her spirituality, for many others it is a symbol to be feared.

Reem is reluctant to be interviewed and wants to make only one point. She speaks not in whispers, but confidently emphasizes and annunciates each word. “When I catch the bus, why must I either be stared at, moved away from or be verbally abused?” she said, her voice building to a crescendo.

Earlier this year, Professor Kevin Dunn from the University of Western Sydney conducted a survey, on behalf of a TV network, on racism and prejudice in Australia. Almost one in three respondents said that they had experienced racism within their workplace. Those with a Language Other Than English (LOTE) background reported a staggering 54.1 percent of workplace racism. The experience of racism in public spaces was only marginally less; transport or in the street was 34.1 per cent, and at a shop or shopping centre was 32.2 per cent.

Apart from the societal, legal and economic concerns of racial discrimination (Deakin University researchers found racism cost the Australian economy $44.9 billion each year in the decade from 2001-11) now there is a growing body of academic literature that suggests racial discrimination can negatively affect our health.

A recent study by Dr Ashaunta Anderson, Assistant Professor of Pediatrics at the University of California, Riverside, found that perceived racial discrimination by children (although in this case their caregivers) was significantly linked to decreased reports of excellent health across all racial and ethnic groups. The average proportion of children reported by parents to be in “excellent health” decreased by 5.4 percent among those exposed to perceived discrimination and boosted their odds of ADHD by 3.2 percent.

According to the study, the ramifications of racism do not discriminate. “Minority children from low socio-economic backgrounds, particularly Hispanics, displayed the biggest reduction in general health,” says Anderson, “but some children from higher socio-economic backgrounds also suffered from negative health effects due to exposure to racial discrimination.

“I wanted to describe the health implications of racial discrimination and the resulting need for effective racial socialisation,” Dr Anderson said, asserting that this research is more relevant now than previously due to the current climate of tense race relations not just in the United States but also globally.

Her her work is now focused on developing a program to help children and their parents navigate race issues in a healthy way, such as cultural pride reinforcement which is already associated with positive health and school outcomes.

Multiple schools around Australia already run successful anti-racism campaigns, and some have even adopted an anti-racism app, Everyday Racism, by charity All Together Now. Developed for children, the user will be assigned an ethnicity and will receive daily prompts such as text messages, videos and images to experience racial discrimination.

Although Dr Anderson’s research is not focused on patholgising racism’s influence on child health, previous international studies have revealed that cause and effect operate through biological and mental health pathways and social limitation of opportunities and resources.

In Australia, Professor Yin Paradies, Dr Mandy Truong and Dr Naomi Priest are at the forefront of research demonstrating how racial discrimination has detrimental effects not only on mental health but also on physical health, such as heart disease, blood pressure, obesity, asthma, and even our health related behaviours such as substance abuse, not pursuing further medical consultations, and in fact, many other areas of an individual’s health.

One study, for instance, that took place over seven years with 3,302 women from ethnic backgrounds (Black, White, Hispanic, Chinese and Japanese) who had initially been cleared of cardiovascular problems, demonstrated that over those seven years, everyday discrimination – a social stressor – was associated with greater inflammation, a contributing biomarker for cardiovascular disease.

“What we know is that racism affects health at the biological and physiological level,” says Dr Mandy Truong, Research Officer at the ANU Centre for Social Research and Methods. “Things like stress biomarkers on DNA, inflammatory biomarkers – there’s a lot of research coming out that even at the cellular level, exposure to stress over periods of time and certain stress, chronic exposure to racism which causes chronic stress, can affect things at a biological level which will later affect those broader health problems like heart disease, blood pressure and obesity.”

A recent incident at QUT of alleged racism by the former administration assistant at the Oodgeroo Unit, Ms Cindy Prior, reported that she could no longer work with ‘white’ people, and felt “physically sick and abandoned” when three non-indigenous students posted a series of comments on social media after they were reportedly told to leave an Indigenous-only computer pool.

“Just got kicked out of the unsigned Indigenous computer room. QUT stopping segregation with segregation.” Another wrote, “Equality for Indigenous students, for example, would not be giving them a room away from everyone else. That implies two things: They need extra resources because they have special needs; and they can’t study around people who are not like them. It’s not exactly flattering.”

Professor Yin Paradies, at the Alfred Deakin Institute says that the QUT incident is a prime example of racist acts at any scale wreaking havoc with a person’s wellbeing, explaining that these physical reactions to racism are common and have been widely studied.

“It’s stress-related reactions and there’s definitely evidence for that and it does have real impacts on people,” Professor Paradies said. “There’s a lot of talk about racism with the proposed changes to [Section] 18C [of the Racial Discrimination Act 1975] how racism isn’t really a big deal, and people should just get over it or get used to it, but it’s just one of those things, it’s stressful for people and it’s something that you just sort of take quite personally even if you don’t want to and there’s ways of learning to deal with it but it’s a pretty stressful life event when it happens.”

But opponents argue that there is tenuous relationship between racial discrimination and adverse health effects, when there could be other factors present such as a history of disease and disadvantaged socio-economic circumstances that may influence results.

Professor Paradies said that although health is a multifaceted phenomenon affected by a range of things, they are always adjusted for in studies, but the data still suggests that racism has an independent effect on health that can contribute above and beyond those other factors.

Others argue that a perception bias can also affect results. But Professor Paradies says that in fact, people tend to perceive less discrimination and underreport it.

“People are more reluctant to perceive something as racism and more reluctant to report something as racism,” Professor Paradies explains. “What the literature tells us is that racism is underreported so that the bias is towards not reporting racism. People tend to give other people the benefit of the doubt and they’ll only think of something as racist and say to a researcher that racism happened in cases that are more clear-cut to them.”

Even subtler forms of racism are often not reported, explains Professor Paradies. People may try to deny racism happened, and in many cases, survey measures of racism are an underestimate of how much racism is really happening.

But until such time as there is more certainty, researchers like Dr Anderson and Truong and Paradies argue that the health care system as a whole should consider racial discrimination as an important and real health issue and efforts should be made to find solutions that diminish systemic discrimination.

“We’re understanding more about how racism is a strong social determinant for health,” says Dr Truong, “and that is across so many different levels in society. There’s a lot more work on how it affects people at a biological and cellular level as well and what happens when we’re young. When we’re children it really affects us throughout our entire lifespan. You may be exposed to the racist or discriminatory events when you’re young, but it doesn’t mean you’re free of the effects of it as an adult.”

 

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