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      Investigating the Relationship between Ethnic Consciousness, Racial Discrimination and Self-Rated Health in New Zealand

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          Abstract

          In this study, we examine race/ethnic consciousness and its associations with experiences of racial discrimination and health in New Zealand. Racism is an important determinant of health and cause of ethnic inequities. However, conceptualising the mechanisms by which racism impacts on health requires racism to be contextualised within the broader social environment. Race/ethnic consciousness (how often people think about their race or ethnicity) is understood as part of a broader assessment of the ‘racial climate’. Higher race/ethnic consciousness has been demonstrated among non-dominant racial/ethnic groups and linked to adverse health outcomes in a limited number of studies. We analysed data from the 2006/07 New Zealand Health Survey, a national population-based survey of New Zealand adults, to examine the distribution of ethnic consciousness by ethnicity, and its association with individual experiences of racial discrimination and self-rated health. Findings showed that European respondents were least likely to report thinking about their ethnicity, with people from non-European ethnic groupings all reporting relatively higher ethnic consciousness. Higher ethnic consciousness was associated with an increased likelihood of reporting experience of racial discrimination for all ethnic groupings and was also associated with fair/poor self-rated health after adjusting for age, sex and ethnicity. However, this difference in health was no longer evident after further adjustment for socioeconomic position and individual experience of racial discrimination. Our study suggests different experiences of racialised social environments by ethnicity in New Zealand and that, at an individual level, ethnic consciousness is related to experiences of racial discrimination. However, the relationship with health is less clear and needs further investigation with research to better understand the racialised social relations that create and maintain ethnic inequities in health in attempts to better address the impacts of racism on health.

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          Most cited references15

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          Self-rated health and mortality: a review of twenty-seven community studies.

          We examine the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples. Twenty-seven studies in U.S. and international journals show impressively consistent findings. Global self-rated health is an independent predictor of mortality in nearly all of the studies, despite the inclusion of numerous specific health status indicators and other relevant covariates known to predict mortality. We summarize and review these studies, consider various interpretations which could account for the association, and suggest several approaches to the next stage of research in this field.
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            Perceived discrimination in health care and health status in a racially diverse sample.

            Despite the surge of recent research on the association between perceived discrimination and health-related outcomes, few studies have focused on race-based discrimination encountered in health care settings. This study examined the prevalence of such discrimination, and its association with health status, for the 3 largest race/ethnic groups in the United States. Data were drawn from the 2004 Behavioral Risk Factor Surveillance System survey. The primary variables were perceived racial discrimination in health care and self-reported health status. Multivariable logistic regression was used to compare the prevalence of perceived discrimination for whites, African Americans, and Hispanics, and to examine the association between perceived discrimination and health status, controlling for sex, age, income, education, health care coverage, affordability of medical care, racial salience, and state. Perceived discrimination was reported by 2%, 5.2%, and 10.9% of whites, Hispanics, and African Americans, respectively. Only the difference between African Americans and whites remained significant in adjusted analyses [odds ratio (OR) = 3.22, 95% confidence interval (CI) = 2.46-4.21]. Racial/ethnic differences in perceived discrimination depended on income, education, health care coverage, and affordability of medical care. Perceived discrimination was associated with worse health status for the overall sample (OR = 1.71, 95% CI = 1.35-2.16). Stratified analyses revealed that this relationship was significant for whites (OR = 2.00, 95% CI = 1.45-2.77) and African Americans (OR = 1.95, 95% CI = 1.39-2.73), but not for Hispanics (OR = 0.55, 95% CI = 0.24-1.22). Perceived racial discrimination in health care is much more prevalent for African Americans than for whites or Hispanics. Furthermore, such discrimination is associated with worse health both for African Americans and for whites.
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              The relation of racial identity, ethnic identity, and racial socialization to discrimination-distress: a meta-analysis of Black Americans.

              This meta-analysis synthesized the results of 27 studies examining the relations of racial identity, ethnic identity, and racial socialization to discrimination-distress for Black Americans. The purpose was to uncover which constructs connected to racial identity, ethnic identity, and racial socialization most strongly correlate with racial discrimination and psychological distress. Discrimination significantly related to aspects of racial identity, including immersion-emersion, public regard, encounter, Afrocentricity/racial centrality/private regard, and internalization. Distress significantly correlated with preencounter/assimilation, encounter, public regard, immersion-emersion, and Afrocentricity/racial centrality/private regard. Several of these relationships were significantly moderated by the measure of racial identity or demographic variables (gender or age). Implications of these findings are discussed.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                23 February 2015
                2015
                : 10
                : 2
                : e0117343
                Affiliations
                [1 ]Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago, Wellington, PO Box 7343, Wellington, 6242, New Zealand
                [2 ]Dean’s Department, University of Otago, Wellington, PO Box 7343, Wellington, 6242, New Zealand
                Queensland University of Technology, AUSTRALIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: RH DC JS. Analyzed the data: JS RH RR. Wrote the paper: RH DC JS RR.

                Article
                PONE-D-14-22344
                10.1371/journal.pone.0117343
                4338199
                25706560
                31cf8fa7-1828-406d-a365-b775d10d13c3
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 19 May 2014
                : 22 December 2014
                Page count
                Figures: 0, Tables: 6, Pages: 15
                Funding
                The Crown is the owner of the copyright of the data and the Ministry of Health is the funder of the data collection. This current study was funded by the Health Research Council of New Zealand as a 3-year project grant. The project number is 10/416. The funder's website is: ( www.hrc.govt.nz). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The results presented in this paper are the work of the authors.
                Categories
                Research Article
                Custom metadata
                The study undertakes secondary analysis of data from the 2006/07 New Zealand Health Survey. Data are available as confidentialised unit record files on application to Statistics New Zealand. Researchers must meet the eligibility criteria for access to this data. Information on access to CURF data can be found at ( http://www.stats.govt.nz/tools_and_services/microdata-access/confidentialised-unit-record-files.aspx).

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