Racism as a Determinant of Health: A Systematic Review and Meta-Analysis
By Y. Paradies, J. Ben, N. Denson, A. Elias, N. Priest, Alex L. Pieterse, Arpana Gupta, M. Kelaher, G. Gee. PLoS ONE, 2015
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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.
Subfields: Clinical Psychology, Health, Sociology and Political Science
View Paper: https://www.semanticscholar.org/paper/99415c2535d15757f81caca28cfbcfc820cedb4f
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Citations in the corpus
- The social determinants of mental health and disorder: evidence, prevention and recommendations (2024, background): “Racial dis crimination has been prospectively associated with poorer mental health and distress 163 , common mental disorders 164,165 , psychotic disorders 166 , and risk for conversion to psychosis among those at high risk 167 .”
- Asians and Asian Americans’ experiences of racial discrimination during the COVID-19 pandemic: Impacts on health outcomes and the buffering role of social support. (2020, background): “Seventy-three percent of participants were born in the United States, and those who were not had been living in the United States for an average of 19 years (SD 10.13, range 0–47).”
- Stress and the Mental Health of Populations of Color:Advancing Our Understanding of Race-related Stressors (2018, background): “…and preclinical indicators of disease (e.g., allostatic load, inflammation, shorter telomere length, body mass index [BMI], incident obesity, coronary artery calcification, cortisol dysregulation, and oxidative stress) that are not assessed via self-report (Lewis et al. 2015; Paradies et al. 2015).”
- Exploring U.S. Shifts in Anti-Asian Sentiment with the Emergence of COVID-19 (2020, background): “In this way, cultural racism is systemic and produces an environment where institutional and individual-level discrimination can thrive [14], both of which have been associated with adverse mental and physical health outcomes [6,15].”