The DRUID study: exploring mediating pathways between racism and depressive symptoms among Indigenous Australians
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.
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.
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.
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.
KeywordsIndigenous Racism Mental health Depression Australia
The authors gratefully acknowledge the support of DRUID study participants, study staff, members of the Indigenous Steering Group, and partner organisations. Ms Hannah Reich provided research assistance in the drafting of this manuscript. The DRUID Study was funded by the National Health and Medical Research Council (NHMRC Project Grant #236207), with additional support from the Australian Government Department of Employment and Workplace Relations, the Clive and Vera Ramaciotti Foundation, the Vincent Fairfax Family Foundation, the International Diabetes Institute (AusDiab Partnership), and Bayer HealthCare. The DRUID Study is an in-kind project of the Cooperative Research Centre for Aboriginal Health (CRCAH). The first author was supported by an NHMRC Population Health Capacity-Building Program (#236235). The second author was supported by an NHMRC Career Development Award (#283310) and an NHMRC Research Fellowship (#545200).
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