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      Discrimination experienced by Aboriginal and Torres Strait Islander males in Australia: Associations with suicidal thoughts and depressive symptoms

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          Abstract

          Introduction:

          Globally, Indigenous populations have higher rates of suicidal behavior and psychological distress compared to non-Indigenous populations. Indigenous populations also report high rates of exposure to discrimination, which could potentially contribute to poor mental health outcomes. The objectives of this paper were to estimate the prevalence of discrimination among Aboriginal and Torres Strait Islander males in Australia and to examine the role of discrimination in the association between Aboriginal and Torres Strait Islander status and suicidal thoughts and depressive symptoms.

          Methods:

          We used cross-sectional data on 13,697 males aged 18–55 years from the Australian Longitudinal Study on Male Health. We undertook a Poisson regression with robust standard error analyses to examine Aboriginal and Torres Strait Islander status and self-perceived exposure to discrimination in the past 2 years as correlates of recent suicidal ideation. We used zero-inflated negative binomial regression to assess Aboriginal and Torres Strait Islander status and self-perceived exposure to discrimination as correlates of recent depressive symptoms.

          Results:

          Aboriginal and Torres Strait Islander males have a twofold higher prevalence of self-perceived discrimination (39.2% vs 19.3%, p < 0.001), suicidal ideation (21.8% vs 9.4%, p < 0.001) and moderate or worse depressive symptoms (24.0% vs 12.2%, p < 0.001) as compared to their non-Indigenous counterparts. After adjusting for sociodemographics and substance use, Aboriginal and Torres Strait Islander status was significantly associated with suicidal thoughts (odds ratio = 1.49, p = 0.019) and depressive symptoms (prevalence rate ratio = 1.19, p = 0.018). About 15.3% and 28.7% of the association between Aboriginal and Torres Strait Islander status and suicidal thoughts and depressive symptoms, respectively, was explained by discrimination.

          Conclusion:

          Our analyses add to evidence that discrimination is a contributor to mental health disparities between Aboriginal and Torres Strait Islander and non-Indigenous populations in Australia. Reducing discrimination ought to be considered as part of strategies to improve the social and emotional well-being of Aboriginal and Torres Strait Islander people.

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          Most cited references48

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            A modified poisson regression approach to prospective studies with binary data.

            G Zou (2004)
            Relative risk is usually the parameter of interest in epidemiologic and medical studies. In this paper, the author proposes a modified Poisson regression approach (i.e., Poisson regression with a robust error variance) to estimate this effect measure directly. A simple 2-by-2 table is used to justify the validity of this approach. Results from a limited simulation study indicate that this approach is very reliable even with total sample sizes as small as 100. The method is illustrated with two data sets.
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              Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.

              Ilan Meyer (2003)
              In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
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                Author and article information

                Contributors
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                Journal
                Australian & New Zealand Journal of Psychiatry
                Aust N Z J Psychiatry
                SAGE Publications
                0004-8674
                1440-1614
                July 13 2021
                : 000486742110311
                Affiliations
                [1 ]Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
                [2 ]Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
                [3 ]Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Melbourne, VIC, Australia
                [4 ]Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
                [5 ]Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
                [6 ]Centre for Adolescent Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
                [7 ]School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
                [8 ]National Drug Research Institute, Curtin University, Perth, WA, Australia
                Article
                10.1177/00048674211031168
                34256631
                779042a0-09fd-47b9-a028-db2967e78dcc
                © 2021

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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