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Racism as a determinant of health: a systematic review and meta-analysis

Paradies, Yin, Ben, Jehonathan, Denson, Nida, Elias, Amanuel, Priest, Naomi, Pieterse, Alex, Gupta, Arpana, Kelaher, Margaret and Gee, Gilbert 2015, Racism as a determinant of health: a systematic review and meta-analysis, PLoS one, vol. 10, no. 9, Article number : e0138511, pp. 1-48, doi: 10.1371/journal.pone.0138511.

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Title Racism as a determinant of health: a systematic review and meta-analysis
Author(s) Paradies, YinORCID iD for Paradies, Yin
Ben, Jehonathan
Denson, Nida
Elias, Amanuel
Priest, Naomi
Pieterse, Alex
Gupta, Arpana
Kelaher, Margaret
Gee, Gilbert
Journal name PLoS one
Volume number 10
Issue number 9
Season Article number : e0138511
Start page 1
End page 48
Total pages 48
Publisher PLoS
Place of publication San Francisco, Calif.
Publication date 2015-09-23
ISSN 1932-6203
Keyword(s) Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
Summary Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464.
Language eng
DOI 10.1371/journal.pone.0138511
Field of Research 111701 Aboriginal and Torres Strait Islander Health
Socio Economic Objective 970116 Expanding Knowledge through Studies of Human Society
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2015, PLoS
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