Background Although racism is increasingly acknowledged as a determinant of health, few studies have examined the relationship between racism, housing and child health outcomes.
Methods Cross-sectional data from the Housing Improvement and Child Health study collected in ten remote indigenous communities in the Northern Territory, Australia were analysed using hierarchical logistic regression. Carer and householder self-reported racism was measured using a single item and child illness was measured using a carer report of common childhood illnesses. A range of confounders, moderators and mediators were considered, including socio-demographic and household composition, psychosocial measures for carers and householders, community environment, and health-related behaviour and hygienic state of environment.
Results Carer self-reported racism was significantly associated with child illness in this sample after adjusting for confounders (OR 1.65; 95% CI 1.09 to 2.48). Carer negative affect balance was identified as a significant mediator of this relationship. Householder self-reported racism was marginally significantly associated with child illness in this sample after adjusting for confounders (OR 1.43; 95% CI 0.94 to 2.18, p=0.09). Householder self-reported drug use was identified as a significant mediator of this relationship.
Conclusions Consistent with evidence from adult populations and children from other ethnic minorities, this study found that vicarious racism is associated with poor health outcomes among an indigenous child population.
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Funding This research has been supported by a National Health & Medical Research Council Project Grant (No. 236205), with additional funding provided by the Northern Territory Department of Community Development, Sport and Cultural Affairs, and the Northern Territory Department of Health and Community Services. NP is supported by a VicHealth research grant, NHMRC postdoctoral training fellowship (#628897) and a NHMRC Population Health Capacity-Building Program (#236235). YP author is supported by a University of Melbourne McKenzie Fellowship. RB supported by a National Health and Medical Research Centre Senior Research Fellowship No. 283303.
Competing interests None declared.
Ethics approval This study was conducted with the approval of the Health Research Ethics Committees in the Top End and Central regions of the NT; formal agreements to participate were signed by peak organisations in each of the ten indigenous communities.
Provenance and peer review Not commissioned; externally peer reviewed.
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