Racism and health and wellbeing among children and youth-An updated systematic review and meta-analysis

Naomi Priest; Kate Doery; Chiao Kee Lim; Jourdyn A Lawrence; Georgia Zoumboulis; Gabriella King; Dewan Lamisa; Fan He; Rushani Wijesuriya; Camila M Mateo; Shiau Chong; Mandy Truong; Ryan Perry; Paula Toko King; Natalie Paki Paki; Corey Joseph; Dot Pagram; Roshini Balasooriya Lekamge; Gosia Mikolajczak; Emily Darnett; Brigid Trenerry; Shloka Jha; Joan Gakii Masunga; Yin Paradies; Yvonne Kelly; Saffron Karlsen; Shuaijun Guo

doi:10.1016/j.socscimed.2024.117324

Racism and health and wellbeing among children and youth-An updated systematic review and meta-analysis

Soc Sci Med. 2024 Nov:361:117324. doi: 10.1016/j.socscimed.2024.117324. Epub 2024 Sep 21.

Authors

Naomi Priest¹, Kate Doery², Chiao Kee Lim³, Jourdyn A Lawrence⁴, Georgia Zoumboulis⁵, Gabriella King⁶, Dewan Lamisa⁷, Fan He⁸, Rushani Wijesuriya⁹, Camila M Mateo¹⁰, Shiau Chong³, Mandy Truong¹¹, Ryan Perry³, Paula Toko King¹², Natalie Paki Paki¹³, Corey Joseph¹⁴, Dot Pagram¹⁵, Roshini Balasooriya Lekamge¹⁶, Gosia Mikolajczak¹⁷, Emily Darnett¹⁸, Brigid Trenerry¹⁹, Shloka Jha²⁰, Joan Gakii Masunga²¹, Yin Paradies²², Yvonne Kelly²³, Saffron Karlsen²⁴, Shuaijun Guo²⁵

Affiliations

¹ The Centre for Social Policy Research, Australian National University, Canberra, Australia; Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia; Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia. Electronic address: naomi.priest@anu.edu.au.
² The Centre for Social Policy Research, Australian National University, Canberra, Australia; Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia.
³ The Centre for Social Policy Research, Australian National University, Canberra, Australia.
⁴ Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
⁵ School of Psychology, Deakin University, Burwood, Australia.
⁶ School of Psychology, Deakin University, Burwood, Australia; Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia.
⁷ Department of Sociology, Rutgers University, New Brunswick, NJ, USA.
⁸ Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia; The John Richards Centre for Rural Ageing Research, La Trobe University, Melbourne, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
⁹ Department of Pediatrics, University of Melbourne, Melbourne, Australia; Clinical Epidemiology & Biostatistics, Murdoch Children's Research Institute, Melbourne, Australia.
¹⁰ Division of General Pediatrics, Boston Children's Hospital, Boston MA, USA; Harvard Medical School, Boston, MA, USA.
¹¹ School of Nursing and Midwifery, Monash University, Melbourne, Australia.
¹² Te Rōpū Rangahau Hauora a Eru Pōmare, Department of Public Health, Ōtākou Whakaihu Waka/University of Otago, Wellington, New Zealand.
¹³ Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, Waipapa Taumata Rau/University of Auckland, New Zealand.
¹⁴ Refugee Health and Wellbeing, Monash Health, Melbourne, Australia.
¹⁵ ANU Research School of Psychology, Australian National University, Canberra, Australia.
¹⁶ School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
¹⁷ Global Institute for Women's Leadership, Australian National University, Canberra, Australia.
¹⁸ Swinburne University of Technology, Melbourne, Australia.
¹⁹ Lee Kuan Yew Centre for Innovative Cities, Singapore University of Technology and Design, Singapore.
²⁰ ANU College of Business and Economics, Australian National University, Canberra, Australia.
²¹ Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
²² Faculty of Arts and Education, Deakin University, Burwood, Australia.
²³ Epidemiology and Public Health, University College London, London, UK.
²⁴ School of Sociology, Politics and International Studies, University of Bristol, Bristol, UK.
²⁵ Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia.

PMID: 39369498
DOI: 10.1016/j.socscimed.2024.117324

Abstract

Background: Evidence of racism's health harms among children and youth is rapidly increasing, though attention to impacts on physical health and biomarker outcomes is more emergent. We performed a systematic review of recent publications to examine the association between racism and health among children and youth, with a meta-analysis of the specific relationships between racism and physical health and biomarkers.

Methods: We conducted a systematic literature search using four databases: Medline, PsycINFO, PubMed, and ERIC. Four inclusion criteria were used to identify eligible studies: (1) exposure was experiences of racism, (2) outcome was health and wellbeing, (3) quantitative methods were used to estimate the association between racism and health outcomes, and (4) the effect size of associations between racism and health and wellbeing was reported for participants aged 0-24 years. Correlation coefficients were used to report the pooled effect size for each outcome indicator.

Results: There were 463 eligible studies included in the screening process, with 42 studies focusing on physical health or biomarker outcomes. Random-effects meta-analysis found minimal to moderate positive associations between racism and C-reactive protein, Interleukin 6, body mass index (BMI), obesity, systolic blood pressure, salivary cortisol, asthma, and somatic symptoms. There were marginal positive associations between racism and Tumour Necrosis Factor-α, cortisol collected via saliva, urine and hair, BMI-z score, and diastolic blood pressure, with imprecise estimates and wide confidence intervals.

Conclusions: Racism is associated with negative physical health and biomarker outcomes that relate to multiple physiological systems and biological processes in childhood and adolescence. This has implications for health and wellbeing during childhood and adolescence and future chronic disease risk. Collective and structural changes to eliminate racism and create a healthy and equitable future for all children and youth are urgently required.

Keywords: Children; Health; Meta-analysis; Racism; Systematic review; Wellbeing; Youth.

Publication types

Systematic Review
Meta-Analysis

MeSH terms

Adolescent
Biomarkers / analysis
Child
Child, Preschool
Health Status
Humans
Racism* / psychology
Racism* / statistics & numerical data
Young Adult

Substances

Biomarkers