Racism and the Health of Indigenous Australians Yin Paradies

1. Racism and the Health of Indigenous Australians Yin Paradies Onemda Koori Health Unit & McCaughey Centre University of Melbourne

2. What is racism? • Racism is the inequitable distribution of opportunity, benefit or resources across ethnic/racial groups • Racism occurs through avoidable and unfair actions that : (i) further disadvantage minority ethnic/racial groups; or (ii) further advantage dominant ethnic/racial groups • Racism is expressed through attitudes, beliefs, behaviours, norms and practices and may be either intentional or unintentional

4. Interpersonal Racism Against Indigenous people • 5000 respondents in the 2001 NSW/Qld Racism Survey and 4000 respondents in the 2006 Victorian Racism Survey were asked: • Would you be concerned if a close relative were to marry an Indigenous person? • 28% in NSW/Qld and 25% in Vic expressed concern at such an occurrence

5. Systemic racism against Indigenous people • Although information on systemic racism is patchy at present, there is strong quantitative evidence of its existence in a number of settings including health, welfare, justice, housing and media • I will present brief findings from the health sector

6. The Health Sector • Five studies have shown disparities in medical care experienced by Indigenous patients • These studies found that Indigenous patients with the same characteristics as non-Indigenous patients were about a third less likely to receive appropriate medical care across all conditions (Cunningham 2002) as well as for lung cancer (Hall et al. 2004) and coronary procedures (Coory & Walsh 2005) in particular • Indigenous patients were only one-third as likely to receive kidney transplants (Cass et al. 2003)

7. Racism & ill-health • Inequitable and reduced access to societal resources required for health (e.g. employment, education, housing, medical care) • Inequitable exposure to risk factors associated with ill health (e.g. junk food, toxic substances, dangerous goods) • Stress and negative emotional/cognitive reactions which have negative impacts on mental health as well as affecting the immune, endocrine, cardiovascular and other physiological systems

8. Racism & ill-health • Engagement in unhealthy activities (e.g. smoking, alcohol and drug use) • Disengagement from healthy activities (e.g. sleep, exercise and taking medications) • Physical injury via racially motivated assault

9. Racism and Indigenous health Racism has been associated with a range of Indigenous health outcomes including: • poor general mental and physical health • stress, lack of control and psychological distress • anxiety, depression, suicide • increased alcohol, tobacco and drug use

11. Themes for Action Increasing empathy Raising awareness Providing accurate information Recognising incompatible beliefs Increasing personal accountability Promoting positive social norms Breaking down barriers between groups

14. LEAD • The LEAD Program is a multi-level, multi-setting and multi-method intervention to reduce racism within the Victorian LGAs of Whittlesea and Shepparton from 2009-12 • It is being funded and implemented through a consortium involving VicHealth, VEOHRC, CRCATSIH, beyondblue and DIaC

15. LEAD • LEAD aims to address racism against Asian, African, Middle Eastern, Muslim and Indigenous Australians in workplaces, retail and educational settings, sports/recreation, the media and local council • LEAD will include organisational development, diversity training, direct participation and social marketing strategies • LEAD will be evaluated using a pre-post with matched control design at the LGA level and within each setting

16. Questions yinp@unimelb.edu.au