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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.

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dc.contributor.authorPriest N.
dc.contributor.authorGuo S.
dc.contributor.authorWijesuriya R.
dc.contributor.authorChamberlain C.
dc.contributor.authorSmith R.
dc.contributor.authorDavis S.
dc.contributor.authorMohamed J.
dc.contributor.authorMoreno-Betancur M.
dc.date.accessioned2024-11-19T05:30:35Z
dc.date.available2024-11-19T05:30:35Z
dc.date.copyright2024
dc.date.issued2024-10-13en
dc.description.abstractBackground: 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. Method(s): 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. Finding(s): 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(s): 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(s): National Health and Medical Research Council of Australia and Medical Research Future Fund of Australia.Copyright © 2024 The Author(s)
dc.description.grantOrganisation: (ARC) Australian Research Council Organisation No: 501100000923 Country: Australia
dc.description.grantOrganisation: (NHMRC) National Health and Medical Research Council Organisation No: 501100000925 Country: Australia
dc.description.grantOrganisation: (NJ DOE) State of New Jersey Department of Education Organisation No: 100004839 Country: United States
dc.description.grantOrganisation: NSW Department of Education Organisation No: 501100002122 Country: Australia
dc.identifier.citationThe Lancet Regional Health - Western Pacific. Vol.51, 2024.
dc.identifier.doihttps://dx.doi.org/10.1016/j.lanwpc.2024.101196
dc.identifier.institution(Priest) The Centre for Social Policy Research, Australian National University, Canberra, Australia
dc.identifier.institution(Priest, Guo) Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
dc.identifier.institution(Priest, Chamberlain) Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
dc.identifier.institution(Guo, Wijesuriya, Moreno-Betancur) Department of Pediatrics, University of Melbourne, Melbourne, Australia
dc.identifier.institution(Wijesuriya, Moreno-Betancur) Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
dc.identifier.institution(Chamberlain) Judith Lumley Centre, La Trobe University, Melbourne, Australia
dc.identifier.institution(Chamberlain, Smith, Mohamed) The Lowitja Institute, Carlton, Australia
dc.identifier.institution(Chamberlain) NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch, Australia
dc.identifier.institution(Davis) Goorlil Consulting, Canberra, Australia
dc.identifier.urihttps://lowitja.intersearch.com.au/handle/1/827
dc.relation.ispartofThe Lancet Regional Health - Western Pacific
dc.subject.keywordsMental health
dc.subject.keywordsSleep medicine
dc.subject.keywordsSocial determinants of health
dc.titleTo 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.
dc.typeArticle

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