April 2014

ECCWA Research Brief 01

Racism

Dr. Zarrin S Siddiqui President 20 View Street, North Perth WA 6006 eccwa.info@gmail.com @eccwa

Preamble
One of the objectives of our strategic plan 2014-2016 is to promote Multiculturalism, Integration and Harmony so the ethnic communities can participate effectively. In order to achieve this it is important to undertake research, consultation, and collaborative projects to identify, address and advocate the needs of ethnic and CaLD communities. ECCWA Research Brief will thus be produced quarterly to keep abreast of recent research in the areas that are important for ethnic communities. During the month of March the Attorney General George Brandis has tabled proposed amendments in the Racial Discrimination Act 1975 for feedback hence it is timely that our first Research Brief provides an over view of the recent literature related to Racism. I hope you find the information valuable. As the ECCWA is not receiving funding, we can only contribute a summary of research available however it is anticipated that our future Research Briefs will actually be integrative or systematic reviews subject to state funding which will allow us to employ policy officers. Please do not hesitate to provide feedback.

D. Zarrin S Siddiqui

Literature on Racism 1. Lifetime racism and blood pressure changes during pregnancy: Implications for fetal growth.
Health Psychology, Volume 33, 2014, 43-51
HILMERT, CLAYTON J.; DOMINGUEZ, TYAN PARKER ; SCHETTER, CHRISTINE DUNKEL ; SRINIVAS, SINDHU K.; GLYNN, L AURA M.; HOBEL, CALVIN J.; SANDMAN, CURT A.

This research suggests that exposure to racism partially explains why African American women are 2 to 3 times more likely to deliver low birth weight and preterm infants. However, the physiological pathways by which racism exerts these effects are unclear. This study examined how lifetime exposure to racism, in combination with maternal blood pressure changes during pregnancy, was associated with fetal growth. Methods: African American pregnant women (n = 39) reported exposure to childhood and adulthood racism in several life domains (e.g., at school, at work), which were experienced directly or indirectly, meaning vicariously experienced when someone close to them was treated unfairly. A research nurse measured maternal blood pressure at 18 to 20 and 30 to 32 weeks gestation. Standardized questionnaires and trained interviewers assessed maternal demographics. Neonatal length of gestation and birth weight data were collected from medical charts. Results: Childhood racism interacted with diastolic blood pressure to predict birth weight. Specifically, women with two or more domains of indirect exposure to racism in childhood and increases in diastolic blood pressure between 18 and 32 weeks had lower gestational age adjusted birth weight than the other women. A similar pattern was found for direct exposure to racism in childhood. Conclusions: Increases in diastolic blood pressure between the second and third trimesters predicted lower birth weight, but only when racism exposure in childhood (direct or indirect) was relatively high. Understanding pregnant African American womens lifetime direct and indirect experiences with racism in combination with prenatal blood pressure may improve identification of highest risk subgroups within this population.

2. Structural racism and myocardial infarction in the United States

Social Science & Medicine, Volume 103, 2014, 42-50
ALICIA LUKACHKO , MARK L. HATZENBUEHLER, KATHERINE M. KEYES

There is a growing research literature suggesting that racism is an important risk factor undermining the health of Blacks in the United States. Racism can take many forms, ranging from interpersonal interactions to institutional/structural conditions and practices. Existing research, however, tends to focus on individual forms of racial discrimination using selfreport measures. Far less attention has been paid to whether structural racism may disadvantage the health of Blacks in the United States. The current study addresses gaps in the existing research by using novel measures of structural racism and by explicitly testing

the hypothesis that structural racism is a risk factor for myocardial infarction among Blacks in the United States. State-level indicators of structural racism included four domains: (1) political participation; (2) employment and job status; (3) educational attainment; and (4) judicial treatment. State-level racial disparities across these domains were proposed to represent the systematic exclusion of Blacks from resources and mobility in society. Data on past-year myocardial infarction were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions (non-Hispanic Black: N = 8245; non-Hispanic White: N = 24,507), a nationally representative survey of the U.S. civilian, non-institutionalized population aged 18 and older. Models were adjusted for individual-level confounders (age, sex, education, household income, medical insurance) as well as for state-level disparities in poverty. Results indicated that Blacks living in states with high levels of structural racism were generally more likely to report past-year myocardial infarction than Blacks living in low-structural racism states. Conversely, Whites living in high structural racism states experienced null or lower odds of myocardial infarction compared to Whites living in lowstructural racism states. These results raise the provocative possibility that structural racism may not only harm the targets of stigma but also benefit those who wield the power to enact stigma and discrimination.

3. Talking culture? Egalitarianism, color-blindness and racism in Australian elementary schools

Teaching and Teacher Education Volume39, 2014, 112 - 122
JESSICA WALTON, NAOMI PRIEST, EMMA KOWAL, FIONA WHITE, KATIE BRICKWOOD, BRANDI FOX, YIN PARADIES.

This study examines egalitarianism as an ethnic-racial socialization message used by teachers with 8 to12 year old children in four socio-demographically diverse elementary schools in Melbourne, Australia. The three main types of egalitarian messages identified are i) procedural-justice color-blindness, ii) distributive-justice colour-blindness and iii) colormuteness, and each is explored in relation to how teachers talk to children about racial, ethnic and cultural diversity, and racism. We conclude that teacher confidence and capability, and to a lesser degree, school context, influenced the types of egalitarian messages used about diversity and the extent to which teachers had explicit and critical discussions about racism.

4. Advancing racism with Facebook: Frequency and purpose of Facebook use and the acceptance of prejudiced and egalitarian messages.
Computers in Human Behavior, Volume 29, 2013 610 - 615 SHANNON M RAUCH, KIMBERLY SCHANZ

The present study examined the relationship between frequency of Facebook use and attitude toward negative racial messages that are presented via Facebook. White participants completed a measure of Facebook use and then read one of three persuasive messages regarding race: an egalitarian message, a negative message with a superiority focus, or a negative message with a victim focus. Participants indicated their attitude toward the message and their Facebook-related behavioral intentions. Results showed that frequency of Facebook use related positively to message acceptance, particularly messages with overt racist content. Facebook users who were motivated by information seeking needs discriminated the most between messages, accepting an egalitarian message and rejecting messages with racist content.

5. Denial of racism and its implications for local action

Discourse Society, Vol. 24, 2013, 89-109 JACQUELINE K NELSON

Literature on modern racism identifies denial as one of its key features. This article examines the discourses of denial that feature in the talk of local anti-racism actors in Australia, and asks what drives these discourses. The research draws on qualitative interviews undertaken with participants involved in local anti-racism in two case study areas, one in South Australia and the other in New South Wales. This article explores the way local participants in the case study areas deployed four discourses to deny or minimise racism: temporal deflections; spatial deflections; deflections from the mainstream; and absence discourses. Place defending and the desire to protect ones local area from being branded a racist space is discussed as a driver of those local denial discourses. Local denial of racism is also linked to national politics of racism and anti-racism. In particular, the Australian governments retreat from multiculturalism, and the preference for harmony rather than anti-racism initiatives, was linked to the avoidance of the language of racism within participants responses. The way denial discourses narrow the range of possibilities for local anti-racism is discussed, as is the importance of acknowledgement of racism, particularly institutional and systemic racism. Public acknowledgement of these forms of racism will broaden the scope of local anti-racism.

6. Cultural diversity, racialisation and the experience of racism in rural Australia: the South Australian case
Journal of Rural Studies, Vol. 30, 2013, 1-9. JAMES FORRESTA, , KEVIN DUNNB

Rural spaces in settler nations like Australia are commonly perceived as white, with low numbers of non-white ethnic minorities. Perhaps because of this, although ethnic diversity is a feature of some rural communities, there is a paucity of research into issues of cultural exclusion. This is surprising in view of recent federal government initiatives to encourage non-Anglo immigrants to settle in rural areas. How welcoming are the receiving communities? Set within a constructivist paradigm, racism is analysed here as a social construction within places, reflecting the local ethnic mix and socio-demographic profiles. From a telephone survey in 2007 and questions looking at old, new and symbolic racisms, this study finds that levels of tolerance and intolerance are everywhere different. Traditional associations between racism and higher education or increasing age are sometimes true, sometimes not; degree of contact is sometimes associated with acceptance, sometimes not. Particulars of the ethnic mix are especially important. Consistent with new racist attitudes, dispositions towards out-groups varies between acceptance of immigrants from Britain and Europe and lesser acceptance of those from subSaharan Africa, Asia, or the Middle East (Muslims). However, while rural South Australians are less tolerant than people living in metropolitan Adelaide, low levels of experience of racist behaviour are found among ethnic minority group members than analysis of attitudes might have suggested.

7. A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people
Social Science & Medicine, Volume 95, October 2013, Pages 115-127
NAOMI PRIEST, YIN PARADIES, BRIGID TRENERRY, MANDY TRUONG, SAFFRON KARLSEN , YVONNE KELLY

Racial discrimination is increasingly recognised as a determinant of racial and ethnic health inequalities, with growing evidence of strong associations between racial discrimination and adult health outcomes. There is a growing body of literature that considers the effects of racial discrimination on child and youth health. The aim of this paper is to provide a systematic review of studies that examine relationships between reported racial discrimination and child and youth health. We describe the characteristics of 121 studies identified by a comprehensive search strategy, including definitions and measurements of racial discrimination and the nature of reported associations. Most studies were published in the last seven years, used cross-sectional designs and were conducted in the United

States with young people aged 1218 years. African American, Latino/a, and Asian populations were most frequently included in these studies. Of the 461 associations examined in these studies, mental health outcomes (e.g. depression, anxiety) were most commonly reported, with statistically significant associations with racial discrimination found in 76% of outcomes examined. Statistically significant associations were also found for over 50% of associations between racial discrimination and positive mental health (e.g. self-esteem, resilience), behaviour problems, wellbeing, and pregnancy/birth outcomes. The field is currently limited by a lack of longitudinal studies, limited psychometrically validated exposure instruments and poor conceptualisation and definition of racial discrimination. There is also a need to investigate the complex and varying pathways by which reported racial discrimination affect child and youth health. Ensuring study quality in this field will allow future research to reveal the complex role that racial discrimination plays as a determinant of child and youth health.

8. Racism and Social Capital: The implications for social and physical well-being
Journal of Social Issues, Volume 68, 2012, 358 - 384
ELIZABETH BRONDOLO , MADELINE LIBRETTI, LUIS RIVERA, KATRINA M.WALSEMANN

Racism can be manifest at the cultural, institutional and individual levels, and can exert effects at the intrapersonal level if targeted individuals internalize attitudes toward their own racial/ethnic groups. The general aim of this article is to examine the ways in which all levels of racism undermine the development of peer relations, one component of social capital; and consequently affect the health and well-being of targeted individuals. The evidence suggests that cultural racism inculcates attitudes that may foster race-related social distancing; institutional racism isolates individuals from the opportunities to develop the skills needed to develop cross race-relations and promotes engagement with peers who exhibit antisocial behavior; interpersonal racism may erode the quality of routine interpersonal exchanges and engender anxiety about interacting with cross-race peers; and internalized racism may undermine the benefits of cross-race peer interactions. To the degree that racism affects the ability to form, maintain and benefit from peer relationships; it can contribute to racial disparities in economic, social and health-related outcomes and undermine the types of social cohesion that promote national unity.

9. More than culture: Structural racism, intersectionality theory, and immigrant health
Social Science & Medicine, Vol.75, 2012, 2099-106
EDNA A. VIRUELL-FUENTES A, PATRICIA Y. MIRANDA B, SAWSAN ABDULRAHIM C

Explanations for immigrant health outcomes often invoke culture through the use of the concept of acculturation. The over reliance on cultural explanations for immigrant health

outcomes has been the topic of growing debate, with the critics main concern being that such explanations obscure the impact of structural factors on immigrant health disparities. In this paper, we highlight the shortcomings of cultural explanations as currently employed in the health literature, and argue for a shift from individual culture-based frameworks, to perspectives that address how multiple dimensions of inequality intersect to impact health outcomes. Based on our review of the literature, we suggest specific lines of inquiry regarding immigrants experiences with day-to-day discrimination, as well as on the roles that place and immigration policies play in shaping immigrant health outcomes. The paper concludes with suggestions for integrating intersectionality theory in future research on immigrant health.

10. The pervasive effects of racism: Experiences of racial discrimination in New Zealand over time and associations with multiple health domains
Social Science & Medicine, Volume 74, Issue 3, February 2012, Pages 408-415
RICCI HARRIS, DONNA CORMACK, MARTIN TOBIAS, LI-CHIA YEH, NATALIE TALAMAIVAO , JOANNA MINSTER, ROIMATA TIMUTIMU

Self-reported experience of racial discrimination has been linked to a range of health outcomes in various countries and for different ethnic groups. This study builds on previous work in New Zealand to further investigate the prevalence of self-reported experience of racial discrimination by ethnicity, changes over time and associations with multiple health measures. The study uses data from the 2002/03 (n = 12,500) and 2006/07 (n = 12,488) New Zealand Health Surveys, nationally representative population-based surveys of adults (15+ years). Reported experience of racial discrimination was measured in both surveys and covered 5 items: experience of an ethnically motivated physical or verbal attack; and unfair treatment because of ethnicity by a health professional, in work, or when gaining housing. Ethnicity was classified as Maori, Pacific, Asian or European. Health indicators included measures of: mental health (SF36 mental health scale, psychological distress, doctor diagnosed mental health condition); physical health (self-rated health, SF36 physical functioning scale, cardiovascular disease); and health risk (smoking, hazardous drinking, excess body fat). Logistic regression was used to examine changes in prevalence of reported experience of racial discrimination over time and associations with health. Reported experience of racial discrimination increased between 2002/03 (28.1% ever) and 2006/07 (35.0% ever) among Asian peoples but remained largely unchanged for other ethnic groupings (Maori 29.5%, Pacific 23.0%, European 13.5%). Experience of racial

discrimination was associated with all negative health measures except excess body fat. Where there were significant associations, a dose-response relationship was also evident. We conclude that racial discrimination experienced across a range of settings has the potential to impact on a wide range of health outcomes and risk factors. While ongoing research is needed to understand the multifarious nature of racism and the pathways by which it leads to poor health, it is feasible to monitor experiences of racial discrimination in national surveys.

11. Responding to racism: Insights on how racism can damage health from an urban study of Australian Aboriginal people
Social Science & Medicine, Volume 73, 2011, 1045-1053
ANNA M. ZIERSCH, GILBERT GALLAHER, FRAN BAUM, MICHAEL BENTLEY

This paper examines responses to racism and the pathways through which racism can affect health and wellbeing for Aboriginal people living in an urban environment. Face-to-face interviews were conducted in 2006/07 with 153 Aboriginal people living in Adelaide, Australia. Participants were asked about their experience of, and responses to, racism, and the impact of these experiences on their health. Racism was regularly experienced by 93% of participants. Almost two thirds of people felt that racism affected their health. Using a thematic analysis with a particular focus on how agency and structure interacted, a number of key reactions and responses to racism were identified. These included: emotional and physiological reactions; and responses such as gaining support from social networks; confronting the person/situation; ignoring it; avoiding situations where they might experience racism; minimising the significance or severity of racism or questioning whether incidents were racist; and consuming alcohol, tobacco and other drugs. A further theme was a conscious decision to not allow racism to affect health. Our study found that most people used more than one of these coping strategies, and that strategies were selected with an awareness of positive and negative health impacts. While individuals demonstrated substantial agency in their responses, there were clear structural constraints on how they reacted and responded. We found that not only was racism potentially detrimental to health, but so too were some responses. However, while some strategies appeared healthier than others, most strategies entailed costs and benefits, and these depended on the meanings of responses for individuals. This paper concludes that initiatives to promote health-protective responses to racism need to consider structural constraints and the overarching goal of reducing systemic racism.

12.

Racism and Hypertension: A Review of the Empirical Evidence and Implications for Clinical Practice
American Journal of Hypertension, Volume 24,2011, 518-529.
ELIZABETH BRONDOLO , ERICA E. LOVE, MELISSA PENCILLE , ANTOINETTE SCHOENTHALER ,GBENGA OGEDEGBE

Despite improved hypertension (HTN) awareness and treatment, racial disparities in HTN prevalence persist. An understanding of the biopsychosocial determinants of HTN is necessary to address racial disparities in the prevalence of HTN. This review examines the evidence directly and indirectly linking multiple levels of racism to HTN. Published empirical research in EBSCO databases investigating the relationships of three levels of racism (individual/interpersonal, internalized, and institutional racism) to HTN was reviewed. Direct evidence linking individual/interpersonal racism to HTN diagnosis is weak. However, the relationship of individual/ interpersonal racism to ambulatory blood pressure (ABP) is more consistent, with all published studies reporting a positive relationship of interpersonal racism to ABP. There is no direct evidence linking internalized racism to BP. Populationbased studies provide some evidence linking institutional racism, in the forms of residential racial segregation (RRS) and incarceration, to HTN incidence. Racism shows associations to stress exposure and reactivity as well as associations to established HTN-related risk factors including obesity, low levels of physical activity and alcohol use. The effects vary by level of racism. Overall the findings suggest that racism may increase risk for HTN; these effects emerge more clearly for institutional racism than for individual level racism. All levels of racism may influence the prevalence of HTN via stress exposure and reactivity and by fostering conditions that undermine health behaviors, raising the barriers to lifestyle change.

13. Racial/Ethnic Differences in Self-Reported Racism and Its Association With Cancer-Related Health Behaviors
American Journal of Public Health, Volume 100, 2010, 364 374. SALMA SHARIFF-MARCO, ANN C. KLASSEN JANICE V. BOWIE

This study used population-based survey data to estimate the prevalence of self-reported racism across racial/ethnic groups and to evaluate the association between self-reported racism and cancer-related health behaviors. Cross-sectional data from the 2003 California Health Interview Survey was used. Questions measured self-reported racism in general and in health care. The cancer risk behaviors we assessed were smoking, binge drinking, not walking, being overweight or obese, and not being up to date with screenings for breast, cervical, colorectal, and prostate cancers. Analyses included descriptive analyses and logistic regression. Prevalence of self-reported racism varied between and within aggregate racial/ethnic groups. In adjusted analyses, general racism was associated with smoking,

binge drinking, and being overweight or obese; health care racism was associated with not being up to date with screening for prostate cancer. Associations varied across racial/ethnic groups. Associations between general racism and lifestyle behaviors suggest that racism is a potential stressor that may shape cancer-related health behaviors, and its impact may vary by race/ethnicity.

14. Responses to Racism: A Taxonomy of Coping Styles Used by Aboriginal Australians American
Journal of Orthopsychiatry, volume 74, 2004, 56-71
MELLOR, DAVID.

In this article the author has explored the coping responses of those who experience racism. Previous attempts to provide taxonomies of responses to racism-discrimination-oppression are reviewed. An analysis of data derived from semi-structured interviews conducted with 34 Indigenous Australians that explored experiences of racism and emotional and behavioral responses is reported, and taxonomy of coping made up of 3 broad categories is presented. The defining feature of these categories is the purpose of the responses contained therein: to defend the self, to control or contain the reaction, or to confront the racism. It is argued that this may be a more useful way to understand responses to racism than taxonomies previously proposed.

Glossary

Racism Cultural Racism

Institutional Racism

The process, norms, ideologies, and behaviours that perpetuate racial inequality1 Societal beliefs and customs that promote the assumption that the products of white culture (e.g., language, traditions, appearance) are superior to those of non-White cultures.2 the collective failure of an organization to provide an appropriate and professional service to people because of their colour, culture, or ethnic origin3,4

Gee, G. C., Ro, A., Shariff-Marco, S., & Chae, D. (2009). Racial discrimination and health among Asian Americans: Evidence, assessment, and directions for future research. Epidemiologic Reviews, 31, 130 151. 2 Helms, J. E. (1990). An overview of Black racial identity theory. In J. E. Helms (Ed.), Black and White racial identity: Theory, research, and practice (pp. 9 32). Westport, Conn: Praeger. 3 The Stephen Lawrence Inquiry, Report of an inquiry by Sir William MacPherson of Cluny (The MacPherson Report): Chapter 6". The Stationery Office. February 1999. Retrieved 6 January 2011. 4 Griffith, Derek, Childs, Erica L., Eng, Eugenia, and Jefferies, Vanessa. "Racism in organizations: The case of a county public health department." Journal of Community Psychology 35.3Apr 2007 287-302. 6 November 2008.