Logo image
Back
To what extent could eliminating racial discrimination reduce inequities in mental health and sleep problems among Aboriginal and Torres Strait Islander children? A causal mediation study
Journal article   Open access   Peer reviewed

To what extent could eliminating racial discrimination reduce inequities in mental health and sleep problems among Aboriginal and Torres Strait Islander children? A causal mediation study

Naomi Priest, Shuaijun Guo, Rushani Wijesuriya, Catherine Chamberlain, Rosemary Smith, Sharon Davis, Janine Mohamed and Margarita Moreno-Betancur
The Lancet regional health. Western Pacific, Vol.51, 101196
2024
DOI: https://doi.org/10.1016/j.lanwpc.2024.101196
pdf
Published296.28 kBDownloadView
CC BY V4.0,  Open Access

Abstract

Children Indigenous Life course Mental health Racism Sleep
Background Racism is a fundamental cause of health inequities for Aboriginal and Torres Strait Islander children. We estimated the potential reduction in inequities in Aboriginal and Torres Strait Islander children's mental health and sleep problems if interpersonal racial discrimination was eliminated. Methods We drew on cross-sectional data from the Speak Out Against Racism (SOAR; N = 2818) and longitudinal data from the Longitudinal Study of Australian Children (LSAC; N = 8627). The SOAR was completed in 2017 and the LSAC followed children from 2004 to 2014 in the kindergarten cohort and from 2008 to 2018 in the birth cohort. Exposure: Aboriginal and Torres Strait Islander status (Aboriginal and Torres Strait Islander/Anglo-European), a proxy measure of structural racism (SOAR: 10–15 years; LSAC: 4–5 years); Mediator: interpersonal racial discrimination (yes/no) (SOAR: 10–15 years; LSAC: 12–13 years); Outcomes: mental health problems (yes/no) and sleep problems (yes/no) (SOAR: 10–15 years; LSAC: 14–15 years). An interventional effects causal mediation approach was used. Findings Aboriginal and Torres Strait Islander children had higher prevalence of mental health problems (SOAR: 40.1% versus 13.5%; LSAC: 25.3% versus 7.6%) and sleep problems (SOAR: 28.5% versus 18.4%; LSAC: 14.0% versus 9.9%) than Anglo-European children. Hypothetical interventions eliminating Aboriginal and Torres Strait Islander children's experiences of interpersonal racial discrimination could reduce 42.4% and 48.5% of mental health and sleep inequities in SOAR (equivalent to 11.2% and 4.7% absolute reductions) and 25.6% and 1.6% of mental health and sleep inequities in LSAC (equivalent to 5.5% and 0.1% absolute reductions). Absolute remaining inequities were similar across both studies for both outcomes. Interpretation Targeted policy interventions that eliminate racial discrimination against Aboriginal and Torres Strait Islander children could have high potential to reduce inequities in mental health and sleep problems. Addressing racism and racial discrimination needs a multi-component and multi-level approach directed by Aboriginal and Torres Strait Islander communities. Funding National Health and Medical Research Council of Australia and Medical Research Future Fund of Australia.

Details

UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

#10 Reduced Inequalities

Metrics

3 File views/ downloads
42 Record Views
1 Times Cited - Web of Science

InCites Highlights

These are selected metrics from InCites Benchmarking & Analytics tool, related to this output

Collaboration types
Domestic collaboration
Citation topics
1 Clinical & Life Sciences
1.156 Healthcare Policy
1.156.436 Health Inequities
Web Of Science research areas
Health Care Sciences & Services
Public, Environmental & Occupational Health
ESI research areas
Clinical Medicine
Logo image