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The following excerpt from Paradies Y, Harris R, Anderson I from the Co-operative Research Centre for Aboriginal Health, p. 9 sums up the role of racism in the health of Aboriginal Australians in this way:-

Health among human populations is a multifaceted and complex phenomenon, and this is no less so for

Indigenous peoples. For Indigenous peoples, unlike white Australians and Pākehā New Zealanders, racism is a fundamental driver of health. Pathways from racism to ill-health may include:

  • reduced and unequal access to the societal resources required for health (e.g. employment, education, housing, medical care, social support);
  • increased exposure to risk factors associated with ill health (e.g. differential marketing of dangerous
  • goods, exposure to toxic substances (Krieger 1999));
  • direct impacts of racism on health via racially motivated physical assault;
  • stress and negative emotion reactions that contribute to mental ill health, as well as adversely affecting the immune, endocrine and cardiovascular systems; and
  • negative responses to racism, such as smoking, alcohol and other drug use. (Paradies Y, Harris R, Anderson I, p. 9)

The euphemism racism makes you sick is actually true.  This is not just in the sense that most of us find racism ethically repugnant. It is because there is now a significant body of evidence that describes patho-physiological pathway between racism and poorer both, mental and physical health.

Racism is a significant cause of stress among those it targets.1 The relationship between stress and poorer mental health has been well described. More recent research has shown that loss of autonomy and marginalisation and the stress they cause, are directly related to higher levels of metabolic syndrome, cardiovascular disease and shorter life expectancy – that is, they actually make people physically and mentally sick! 2 Persistent activation of the stress response by chronic psychosocial stressors (including racism) leads to more of all the following health issues, all of which are of much higher frequency among Indigenous Australians:-

  • Metabolic syndrome
  • High blood pressure
  • Atherosclerosis (stiffening of the blood vessels)
  • Type 2 diabetes
  • Immune suppression and infections
  • Reproductive impairments (infertility, decreased libido)
  • Affective disorders (anxiety and depression)

U.S. studies have repeatedly found that those who perceived that they experienced racism on regular basis had higher levels of cardiovascular and metabolic syndrome, when others factors associated with racism, such as lower socio-economic status, were controlled for.3 Aboriginal and Torres Strait Islanders are disproportionately affected by stress experiencing 3 times the level of very high psychological distress than other Australians.4 A recent study in Victoria found that 70% of Aboriginal people had experienced at least 8 instances of racism in the previous year.5 Other Australians such as immigrants and refugees are also targets racism.

Hospitals and health services have become smoke free zones because of its health effects of smoking.   Now that we understand the negative health impacts of racism, both physical and mental, it seems inconceivable that we would continue to tolerate it in health care.

A short video clip describing patho-physiology of racism can be viewed here.

1. Mellor D. Responses to racism: a taxonomy of coping styles used by Aboriginal Australians. Am J Orthopsychiatry 2004; 74(1): 56-71.
2. Marmot MG Wilkinson RGT. Social Determinants of Health. Oxford Uni Press. 2002.
3. Duru et al., J. Natl. Med. Assoc., 2012.
4. Cunningham and Paradies, BMC Public Health, 2012.
5. Racism in Victoria. University of Melbourne, VicHealth, Lowitja Institute, and beyondblue