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IJE Advance Access published online on April 3, 2006
International Journal of Epidemiology, doi:10.1093/ije/dyl056
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2006; all rights reserved.
Accepted March 7, 2006

Original paper

A systematic review of empirical research on self-reported racism and health

Yin Paradies 1 *

1 Centre for Health and Society, University of Melbourne, Australia; Menzies School of Health Research, Charles Darwin University, Australia

* To whom correspondence should be addressed.
Yin Paradies, E-mail: yin.paradies{at}menzies.edu.au


  Abstract

This paper reviews 138 empirical quantitative population-based studies of self-reported racism and health. These studies show an association between self-reported racism and ill health for oppressed racial groups after adjustment for a range of confounders. The strongest and most consistent findings are for negative mental health outcomes and health-related behaviours, with weaker associations existing for positive mental health outcomes, self-assessed health status, and physical health outcomes. Most studies in this emerging field have been published in the past 5 years and have been limited by a dearth of cohort studies, a lack of psychometrically validated exposure instruments, poor conceptualization and definition of racism, conflation of racism with stress, and debate about the aetiologically relevant period for self-reported racism. Future research should examine the psychometric validity of racism instruments and include these instruments, along with objectively measured health outcomes, in existing large-scale survey vehicles as well as longitudinal studies and studies involving children. There is also a need to gain a better understanding of the perception, attribution, and reporting of racism, to investigate the pathways via which self-reported racism affects health, the interplay between mental and physical health outcomes, and exposure to intra-racial, internalized, and systemic racism. Ensuring the quality of studies in this field will allow future research to reveal the complex role that racism plays as a determinant of population health.

Keywords: Race; ethnic groups; racism; discrimination; stress; review.
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