Racial discrimination and allostatic load among First Nations Australians: a nationally representative cross-sectional s
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RESEARCH ARTICLE
Open Access
Racial discrimination and allostatic load among First Nations Australians: a nationally representative cross-sectional study Leah Cave1,2* , Matthew N. Cooper1, Stephen R. Zubrick1,3 and Carrington C. J. Shepherd1,4
Abstract Background: Increased allostatic load is linked with racial discrimination exposure, providing a mechanism for the biological embedding of racism as a psychosocial stressor. We undertook an examination of how racial discrimination interacts with socioecological, environmental, and health conditions to affect multisystem dysregulation in a First Nations population. Methods: We conducted latent class analysis (LCA) using indicators of life stress, socioeconomic background, and physical and mental health from a nationally representative sample of Australian Aboriginal adults (N = 2056). We used LCA with distal outcomes to estimate the effect of the latent class variable on our derived allostatic load index and conducted a stratified analysis to test whether allostatic load varied based on exposure to racial discrimination across latent classes. Results: Our psychosocial, environmental, and health measures informed a four-class structure; ‘Low risk’, ‘Challenged but healthy’, ‘Mental health risk’ and ‘Multiple challenges’. Mean allostatic load was highest in ‘Multiple challenges’ compared to all other classes, both in those exposed (4.5; 95% CI: 3.9, 5.0) and not exposed (3.9; 95% CI: 3.7, 4.2) to racial discrimination. Allostatic load was significantly higher for those with exposure to racial discrimination in the ‘Multiple challenges’ class (t = 1.74, p = .04) and significantly lower in the ‘Mental health risk’ class (t = − 1.67, p = .05). Conclusions: Racial discrimination may not always modify physiological vulnerability to disease. Social and economic contexts must be considered when addressing the impact of racism, with a focus on individuals and sub-populations experiencing co-occurring life challenges. Keywords: Racial discrimination, Allostatic load, Latent class analysis
Background Racial discrimination is a well-established contributor to adverse physical health outcomes in ethnic/cultural minority populations [1–6]. Evidence detailing how racial discrimination affects physiology within the context of broader life circumstances is needed to encourage the * Correspondence: [email protected] 1 Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia 6872, Australia 2 School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia Full list of author information is available at the end of the article
development of informed strategies to prevent or eradicate racism in the settings where it occurs. This approach is particularly essential for Indigenous populations within high-income countries, where racial discrimination is often compounded by ongoing social marginalisation, land dispossession, and loss of sovereignty [7]. In
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