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Racism as a Determinant of Health: A Systematic Review and Meta-Analysis

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 f...

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Autores principales: Paradies, Yin, Ben, Jehonathan, Denson, Nida, Elias, Amanuel, Priest, Naomi, Pieterse, Alex, Gupta, Arpana, Kelaher, Margaret, Gee, Gilbert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4580597/
https://www.ncbi.nlm.nih.gov/pubmed/26398658
http://dx.doi.org/10.1371/journal.pone.0138511
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author Paradies, Yin
Ben, Jehonathan
Denson, Nida
Elias, Amanuel
Priest, Naomi
Pieterse, Alex
Gupta, Arpana
Kelaher, Margaret
Gee, Gilbert
author_facet Paradies, Yin
Ben, Jehonathan
Denson, Nida
Elias, Amanuel
Priest, Naomi
Pieterse, Alex
Gupta, Arpana
Kelaher, Margaret
Gee, Gilbert
author_sort Paradies, Yin
collection PubMed
description 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.
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spelling pubmed-45805972015-10-01 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 Gee, Gilbert PLoS One Research Article 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. Public Library of Science 2015-09-23 /pmc/articles/PMC4580597/ /pubmed/26398658 http://dx.doi.org/10.1371/journal.pone.0138511 Text en © 2015 Paradies et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Paradies, Yin
Ben, Jehonathan
Denson, Nida
Elias, Amanuel
Priest, Naomi
Pieterse, Alex
Gupta, Arpana
Kelaher, Margaret
Gee, Gilbert
Racism as a Determinant of Health: A Systematic Review and Meta-Analysis
title Racism as a Determinant of Health: A Systematic Review and Meta-Analysis
title_full Racism as a Determinant of Health: A Systematic Review and Meta-Analysis
title_fullStr Racism as a Determinant of Health: A Systematic Review and Meta-Analysis
title_full_unstemmed Racism as a Determinant of Health: A Systematic Review and Meta-Analysis
title_short Racism as a Determinant of Health: A Systematic Review and Meta-Analysis
title_sort racism as a determinant of health: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4580597/
https://www.ncbi.nlm.nih.gov/pubmed/26398658
http://dx.doi.org/10.1371/journal.pone.0138511
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