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Experiences of Racial Discrimination in Toronto: Prevalence, Socio-demographic and Health Correlates Donna Ansara 1 , Jennifer Levy 1 , Patricia O’Campo 2 1 Toronto Public Health 2 Centre for Research on Inner City Health, Toronto Canadian Public Health Association Conference May 28, 2014. - PowerPoint PPT Presentation
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Experiences of Racial Discrimination in Toronto: Prevalence, Socio-demographic and Health Correlates
Donna Ansara1, Jennifer Levy1, Patricia O’Campo2 1 Toronto Public Health2 Centre for Research on Inner City Health, Toronto
Canadian Public Health Association ConferenceMay 28, 2014
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Rationale
• Toronto Public Health Reports Racialization and Health Inequities in
Toronto (2013) The Global City: Newcomer Health in
Toronto (2011) The Unequal City: Income and Health
Inequalities in Toronto (2008)
•Toronto is the most diverse city in Canada – half of residents are racialized
Objectives
1. To examine experiences of racial discrimination in Toronto
2. To examine how these experiences differ by socio-demographic characteristics in Toronto
3. To examine the health correlates of racial discrimination in Toronto
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Project Advisory Committee
• Toronto community/academic researchers Grace-Edward Galabuzi Bob Gardner David Hulchanski Axelle Janczur Kwame McKenzie Patricia O'Campo Yogendra Shakya
• Leading American researcher David Williams
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Definitions
Racialization is “the process by which societies construct races as real, different and unequal in ways that matter to economic, political and social life” (Ontario Human Rights Commission, 2005)
Racialized groups “can be understood as non-dominant ethno-racial communities who, through the process of racialization, experience race as a key factor in their identity and experience of inequality” (Galabuzi, 2006)
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Racialization and Health
•International research shows racialized groups have poorer health than non-racialized groups on several outcomes
•Canadian research is more recent but shows some evidence of racialized health inequities
•Racial discrimination is one mechanism that may explain racialized health inequities
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Racial Discrimination
•Interpersonal Structural
•Interpersonal discrimination: unfair or negative treatment because of race
•Structural discrimination: policies or practices that result in the inequitable treatment of racialized groups
•Discrimination may be unintentional
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Racial Discrimination and Health
•Most research focuses on self-reported interpersonal discrimination
•Racial discrimination morbidity, esp. poor mental health, health behaviours
•Racial discrimination = Stress
•Mechanisms: negative emotional states, behavioural coping, physiologic responses
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Data
•Neighbourhood Effects on Health and Well-being Study (NEHW)
•Probability sample collected 2009-2011 in Toronto (n=2,412)
•Includes residents 25-64, spoke English, lived in neighbourhood for 6 months
•Conducted by CRICH (Toronto) in collaboration with the Univ. of Toronto
•Response rate = 72%
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Measurement of Racial Discrimination
•Everyday Discrimination Scale1. You are treated with less respect than
other people2. You receive poorer service than other
people at restaurants or stores3. People act as if they are afraid of you4. People think that they're better than you5. You are called names or are insulted6. You are threatened or harassed
10Williams et al., 1997
Health Outcomes
Construct Measurement Coding
Life stress 40-item stress scale 2/3, 1/3
Work stress 6-item stress subscale 2/3, 1/3
Depressive symptoms
20-item CESD-R <16, 16+
Self-rated health
In general, would you say your health, compared to other people of your age, is: excellent, very good, good, fair, poor
f/p, g/vg/e
High blood pressure
Lasted 6 months+ and diagnosed by a healthcare professional
yes, no
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Statistical Analyses
1. Prevalence (%) – 2 tests2. Socio-demographic correlates
• multivariate logistic regression• sex, age, racialized group, immigrant
status, Engl. proficiency, education, SES
3. Health correlates• multivariate logistic regression,
adjusting for age, sex, immigrant status, income
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Characteristics of the Sample
Socio-demographic factors (n=2,412) n (%)
SexMale Female
1,022 (42.4)1,390 (57.6)
Age group25-3435-4445-5455-64
319 (13.2) 555 (23.0) 763 (31.6) 775 (32.1)
Racialized groupWhiteBlackSouth/West Asian/ArabEast/Southeast AsianL.A./Multiple/Other
1,700 (72.1) 150 (6.4) 146 (6.2) 136 (5.8) 224 (9.5)
Immigrant statusBorn in Canada Immigrant >10 yearsImmigrant <= 10 years
1,496 (62.1) 769 (31.9) 143 (5.9)
Proficiency in EnglishLowerIntermediateHigher
314 (13.3) 594 (25.1)1,460 (61.7)
EducationHigh school or lessNon-univ cert/diplomaUniversity
490 (20.3) 616 (25.5)1,305 (54.1)
Monthly financesA lot of money left overA little money left overJust enoughNot enough
422 (17.7)1,089 (45.7) 681 (28.6) 192 (8.1)
13* p< 0.05
Prevalence of Racial Discrimination (%)
Everyday Discrimination Scale (α = 0.86)Whit
e Racial-ized
You are treated with less respect than other people
20.1 49.8*
You receive poorer service than other people at restaurants or stores
14.8 37.2*
People act as if they are afraid of you 11.4 20.5*People think that they're better than you 27.8 54.8*You are called names or are insulted 15.4 24.7*You are threatened or harassed 13.4 17.2*Any racial discrimination No racial discrimination 63.8 33.1 Any racial discrimination 36.2 66.9* Less frequent racial discrimination 22.1 35.4* More frequent racial discrimination 14.1 31.5*
14* p<0.05 (2 tests)
Socio-Demographic Correlates
Socio-demographic factors (n=2,259)
AOR
SexMale Female
1.000.89
Age group25-3435-4445-5455-64
2.02*1.69*1.71*1.00
Racialized groupWhiteBlackSouth/West Asian/ArabEast/Southeast AsianL.A./Multiple/Other
1.005.10*2.20*3.92*3.24*
Immigrant statusBorn in Canada Immigrant >10 yearsImmigrant <= 10 years
1.000.67*0.59*
Proficiency in EnglishLowerIntermediateHigher
3.45*1.88*1.00
EducationHigh school or lessNon-univ cert/diplomaUniversity
0.900.961.00
Monthly financesA lot of money left overA little money left overJust enoughNot enough
1.001.70*1.58*2.94*
* p< 0.05 15
Health Correlates
Health Outcomes nNever(AORa
)
Less frequen
t(AORa)
More frequen
t(AORa)
High life stress 2,374 1.00 1.53* 3.37*
High work stress 1,742 1.00 1.76* 2.77*
Depressive symptoms
2,363 1.00 1.17 2.90*
Self-rated health 2,373 1.00 1.49* 1.62*
High blood pressure 2,370 1.00 0.92 1.30
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* p < 0.05a adjusts for age, sex, immigrant status, income
Summary
•Discrimination was prevalent in Toronto, particularly for racialized group members
•Discrimination also varied by other socio-demographic characteristics
•Racial discrimination was negatively associated with health outcomes
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Limitations
•Aggregating racialized groups could mask heterogeneity between groups
•Representativeness
•Measure of discrimination primarily assessed interpersonal discrimination
•Possible time lag between exposure to discrimination and health outcomes
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Implications
•More research is needed examining the prevalence and health consequences of racial discrimination in Canada
•Research is needed testing interventions aimed at eliminating discrimination
•Programs/policies are needed to address racial discrimination and reduce the associated poorer health outcomes
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Definitions
Racial discrimination is "any distinction, conduct or action, whether intentional or not, but based on a person’s race, which has the effect of imposing burdens on an individual or group, not imposed upon others or which withholds or limits access to benefits available to other members of society" (Ontario Human Rights Commission, 2005).
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