title: The DRUID study: exploring mediating pathways between racism and depressive symptoms among indigenous Australians.
abstract: OBJECTIVE
  Racism is an important determinant of mental and physical health for minority populations. However, to date little is known about the relationship between racism and ill-health outside of the U.S. or the causal pathways between racism and poor health. This paper focuses on the relationship between racism and depression in a non-U.S. indigenous population, including examination of novel mediators and moderators.
  
  
  METHODS
  One hundred and eighty-five adults in the Darwin Region Urban Indigenous Diabetes study responded to a validated instrument assessing multiple facets of racism. Depressive symptoms were assessed using the Centre for Epidemiologic Studies Depression Scale. Stress, optimism, lack of control, social connections, cultural identity and reactions/responses to interpersonal racism were considered as possible mediators and moderators in linear regression models.
  
  
  RESULTS
  Interpersonal racism was significantly associated with depression after adjusting for socio-demographic factors (β = 0.08, p < 0.001). Lack of control, stress, negative social connections and feeling ashamed, amused or powerless as reactions to racism were each identified as significant mediators of the relationship between racism and depressive symptoms. All examined mediators together accounted for 66% of the association between interpersonal racism and depressive symptoms.
  
  
  CONCLUSIONS
  This study demonstrates that racism is associated with depressive symptoms in an indigenous population. The mediating factors between racism and depressive symptoms identified in this study suggest new approaches to ameliorating the detrimental effects of racism on health.
authors.affiliation: Onemda Unit and McCaughey Centre, Melbourne School of Population Health, University of Melbourne, Level 5, 207 Bouverie St, Melbourne, VIC, 3010, Australia. yinp@unimelb.edu.au
authors.forename: Yin C
authors.initials: YC
authors.lastname: Paradies
authors.forename: Joan
authors.initials: J
authors.lastname: Cunningham
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000208:ethnology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D015987:Effect Modifier, Epidemiologic; D005260:Female; D006306:Health Surveys; D006801:Humans; D007398:Interpersonal Relations; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D012933:Social Identification; D012938:Social Perception; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult