Abstract:
BACKGROUND: In New Zealand, there are significant and long-standing inequalities in a range of health outcomes, risk factors and healthcare measures between Māori (indigenous peoples) and Pākehā (European). This study expands our understanding of racism as a determinant of such inequalities to examine the concept of socially-assigned ethnicity (how an individual is classified by others ethnically/racially) and its relationship to health and racism for Māori. There is some evidence internationally that being socially-assigned as the dominant ethnic group (in this case European) offers health advantage. METHODS: We analysed data from the 2006/07 New Zealand Health Survey for adult participants who self-identified their ethnicity as Māori (n = 3160). The association between socially-assigned ethnicity and individual experience of racial discrimination, and socially-assigned ethnicity and health (self-rated health, psychological distress [Kessler 10-item scale]) was assessed using logistic and linear regression analyses, respectively. RESULTS: Māori who were socially-assigned as European-only had significantly lower experience of racial discrimination (adjusted odds ratio [OR] = 0.58, 95% confidence interval [CI] = 0.44, 0.78) than Māori who were socially-assigned as non-European. Being socially-assigned as European-only was also associated with health advantage compared to being socially-assigned non-European: more likely to respond with self-rated very good/excellent health (age, sex adjusted OR = 1.39, 95% CI = 1.10, 1.74), and lower Kessler 10 scores (age, sex adjusted mean difference = -0.66, 95% C I = -1.22, -0.10). These results were attenuated following adjustment for socioeconomic measures and experience of racial discrimination. CONCLUSIONS: Results suggest that, in a race conscious society, the way people's ethnicities are viewed by others is associated with tangible health risk or advantage, and this is consistent with an understanding of racism as a health determinant.
