The impact of racism on the future health of adults: protocol for a prospective cohort study.

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dc.contributor.author Stanley, James en
dc.contributor.author Harris, Ricci en
dc.contributor.author Cormack, Donna en
dc.contributor.author Waa, Andrew en
dc.contributor.author Edwards, Richard en
dc.date.accessioned 2019-09-19T01:35:25Z en
dc.date.issued 2019-03-28 en
dc.identifier.citation BMC public health 19(1):346 28 Mar 2019 en
dc.identifier.issn 1471-2458 en
dc.identifier.uri http://hdl.handle.net/2292/47754 en
dc.description.abstract BACKGROUND:Racial discrimination is recognised as a key social determinant of health and driver of racial/ethnic health inequities. Studies have shown that people exposed to racism have poorer health outcomes (particularly for mental health), alongside both reduced access to health care and poorer patient experiences. Most of these studies have used cross-sectional designs: this prospective cohort study (drawing on critical approaches to health research) should provide substantially stronger causal evidence regarding the impact of racism on subsequent health and health care outcomes. METHODS:Participants are adults aged 15+ sampled from 2016/17 New Zealand Health Survey (NZHS) participants, sampled based on exposure to racism (ever exposed or never exposed, using five NZHS questions) and stratified by ethnic group (Māori, Pacific, Asian, European and Other). Target sample size is 1680 participants (half exposed, half unexposed) with follow-up survey timed for 12-24 months after baseline NZHS interview. All exposed participants are invited to participate, with unexposed participants selected using propensity score matching (propensity scores for exposure to racism, based on several major confounders). Respondents receive an initial invitation letter with choice of paper or web-based questionnaire. Those invitees not responding following reminders are contacted for computer-assisted telephone interview (CATI). A brief questionnaire was developed covering current health status (mental and physical health measures) and recent health-service utilisation (unmet need and experiences with healthcare measures). Analysis will compare outcomes between those exposed and unexposed to racism, using regression models and inverse probability of treatment weights (IPTW) to account for the propensity score sampling process. DISCUSSION:This study will add robust evidence on the causal links between experience of racism and subsequent health. The use of the NZHS as a baseline for a prospective study allows for the use of propensity score methods during the sampling phase as a novel approach to recruiting participants from the NZHS. This method allows for management of confounding at the sampling stage, while also reducing the need and cost of following up with all NZHS participants. en
dc.format.medium Electronic en
dc.language eng en
dc.relation.ispartofseries BMC public health en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Humans en
dc.subject Health Surveys en
dc.subject Prospective Studies en
dc.subject Mental Disorders en
dc.subject Adolescent en
dc.subject Adult en
dc.subject Aged en
dc.subject Middle Aged en
dc.subject Ethnic Groups en
dc.subject Patient Acceptance of Health Care en
dc.subject New Zealand en
dc.subject Female en
dc.subject Male en
dc.subject Health Status Disparities en
dc.subject Young Adult en
dc.subject Racism en
dc.title The impact of racism on the future health of adults: protocol for a prospective cohort study. en
dc.type Journal Article en
dc.identifier.doi 10.1186/s12889-019-6664-x en
pubs.issue 1 en
pubs.begin-page 346 en
pubs.volume 19 en
dc.rights.holder Copyright: The authors en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype research-article en
pubs.subtype Journal Article en
pubs.elements-id 769099 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Te Kupenga Hauora Maori en
pubs.org-id Office of Tumuaki en
pubs.org-id TKHM Teaching en
dc.identifier.eissn 1471-2458 en
pubs.record-created-at-source-date 2019-03-30 en
pubs.dimensions-id 30922286 en


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