title: Experiencing racism in health care: the mental health impacts for Victorian Aboriginal communities.
abstract: OBJECTIVE
  To examine experiences of racism in health settings and their impact on mental health among Aboriginal Australians.
  
  
  METHODS
  A cross-sectional survey of experiences of racism and mental health was conducted in two metropolitan and two rural Victorian local government areas (LGAs) between 1 December 2010 and 31 October 2011. Participants included 755 Aboriginal Australians aged over 18 years who had resided in the relevant LGA for at least a year. The response rate across all LGAs was 99%.
  
  
  METHODS
  Being above or below the threshold for high or very high psychological distress on the Kessler Psychological Distress Scale.
  
  
  RESULTS
  221 participants reported experiences of racism in health settings in the past 12 months. The results suggested that people experiencing racism in health settings (OR, 4.49; 95% CI, 2.28-8.86) and non-health settings (OR, 2.66; 95% CI, 1.39-5.08) were more likely than people who did not experience racism to be above the threshold for high or very high psychological distress.
  
  
  CONCLUSIONS
  Experiencing interpersonal racism in health settings is associated with increased psychological distress over and above what would be expected in other settings. This finding supports the rationale for improving cultural competency and reducing racism as a means of closing the health gap between Aboriginal and other Australians. Capitalising on this investment will require explicitly evaluating the impact of these initiatives on reducing patient experiences of racism.
authors.affiliation: Centre for Health Policy, University of Melbourne, Melbourne, VIC, Australia. a.ferdinand@unimelb.edu.au.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Kelaher
authors.affiliation: Centre for Health Policy, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Angeline S
authors.initials: AS
authors.lastname: Ferdinand
authors.affiliation: Centre for Citizenship and Globalisation, Deakin University, Melbourne, VIC, Australia.
authors.forename: Yin
authors.initials: Y
authors.lastname: Paradies
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D063505:Racism / Q000208:ethnology* / Q000523:psychology* / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data; D014739:Victoria; D055815:Young Adult