This thesis is a transdisciplinary study aimed at exploring the role of race, racism and stress as determinants of health for indigenous populations and other oppressedethnoracial groups. Commencing with an analysis of continuing racialisation in health research, it is shown that there is no consistent evidence that oppressed ethnoracial groups, who suffer disproportionately from type 2 diabetes, are especially genetically susceptible to this disease. Continued attribution of ethnoracial differences in health to genetics highlights the need to be attentive to both environmental and genetic risk factors operating within and between ethnoracial groups. This exploration of racialisation is followed by a theoretical examination of racism as a health risk factor. This includes a comprehensive definition of racism, a diagrammaticrepresentation of the aetiological relationship between racism and health and an examination of the dimensions across which perceived racism can be operationalised.An empirical review of 138 quantitative population-based studies of self-reported racism as a determinant of health reveals that self-reported racism is related to ill-health(particularly mental health) for oppressed ethnoracial groups after adjustment for a range of confounders. This review also highlights a number of limitations in thisnascent field of research. This thesis then attempts to clarify the plethora of conceptual approaches used in thestudy of stress and health as a first step towards comprehending how stress interacts with both racism and health. A review of the empirical association between stress and chronic disease for fourth world indigenous populations and African Americans was also conducted. This review, which located 65 studies, found that a range of chronic diseases (especially chronic mental conditions) were associated with psychosocial stress. Utilising the conceptual work on operationalising racism discussed above, an instrument was developed to measure racism and its correlates as experienced by Indigenous Australians. This instrument demonstrated good face, content, psychometric andconvergent validity in a pilot study involving 312 Indigenous Australians. The majority of participants in this study (70%) reported some experience of inter-personal racism, with this exposure most commonly reported in employment and public settings, from service providers and from other Indigenous people. Strong and consistent associations were found between racism and chronic stress as well as between racism and depression (CES-D), poor/fair self-assessed health status/poor general mental health (SF-12) and a marker of CVD risk (homocysteine), respectively. There was also evidence that the association between inter-personal racism and poor mental health outcomes was ediated by somatic and inner-directed disempowered reactions to racism as well as by chronic stress and a range of psychosocial characteristics. To conclude this thesis, an examination of approaches to addressing racism forIndigenous Australians is undertaken. The theoretical issues pertinent to the study of anti-racism are discussed along with empirical findings from social psychology oneffective approaches to anti-racism. Recommendations for implementing these approaches through institutional and legal policies are also presented. Strategies for engendering political will to combat racism in the current neo-liberal capitalist climate are also briefly considered.
| Identifer | oai:union.ndltd.org:ADTP/245246 |
| Creators | Paradies, Dr Yin C |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | Terms and Conditions: Copyright in works deposited in the University of Melbourne Eprints Repository (UMER) is retained by the copyright owner. The work may not be altered without permission from the copyright owner. Readers may only, download, print, and save electronic copies of whole works for their own personal non-commercial use. Any use that exceeds these limits requires permission from the copyright owner. Attribution is essential when quoting or paraphrasing from these works., Open Access |
Page generated in 0.0022 seconds