000			03779nab a22003497a 4500
999			_c8529 _d8529
005			20250625151654.0
008			240201s2024 -nz|| |||| 00| 0 eng d
040			_aAFVC
100			_aHarris, Ricci _912601
245			_aThe impact of racism on subsequent healthcare use and experiences for adult New Zealanders : _ba prospective cohort study _cRicci Harris, Donna Cormack, Andrew Waa, Richard Edwards and James Stanley
260			_bBMC, _c2024
500			_aBMC Public Health, 2024, 24: 136
520			_aBackground: Racism is an important determinant of health and driver of racial/ethnic health inequities. Experience of racism has been linked to negative healthcare use and experiences although most studies have been cross-sectional. This study examines the relationship between reported experience of racism and subsequent use and experience of health services. Methods: This is a prospective cohort study design. The 2016/2017 adult New Zealand Health Survey (NZHS) provided the sampling frame and baseline data on exposures, health status and confounders. This stand-alone study invited all exposed individuals to participate when sampled based on their reported experience of racism (ever), stratified by broad ethnic groupings (Māori, Pacific, Asian, European/Other). Equal numbers of unexposed participants were selected for invitation using propensity score matching (propensity to experience racism, based on key available predictive factors). Follow-up was one to two years after NZHS interview. Outcome variables (last 12 months) were: unmet healthcare need (overall, for mental health, for a general practitioner); satisfaction with usual medical centre; and experiences with general practitioners (explaining care, involvement in decision-making, treated with respect/dignity, confidence and trust). Logistic regression models examining the association between experience of racism (at baseline) and health service use and experience (at follow-up) used doubly-robust estimation to weight for propensity scores used in the sampling with additional adjustment for confounders. Results: The study had 2010 participants. Experience of racism (ever) at baseline was associated with higher overall unmet need at follow-up (adjusted OR (aOR) = 1.71, 95% CI 1.31, 2.23), with similar patterns for other unmet need measures. Experience of racism was associated with higher dissatisfaction with a usual medical centre (aOR = 1.41, 95% CI 1.10, 1.81) and with higher reporting of negative patient experiences. Conclusion: In line with how racism structures oppression, exposure to racism is largely felt by non-European groups in Aotearoa New Zealand. Experiences of racism potentially lead to poorer healthcare and healthcare inequities through higher unmet need, lower satisfaction and more negative experiences of healthcare. The health system has a critical role to play in addressing racism within healthcare and supporting societal efforts to eliminate racism and ethnic inequalities. (Authors' abstract). Record #8529
650			_aASIAN PEOPLES _966
650			_aETHNIC COMMUNITIES _98712
650			_aHAUORA _9281
650			_aHEALTH _9283
650			_aMĀORI _9357
650			_aPACIFIC PEOPLES _93408
650			_aPASIFIKA _9419
650			_aRACISM _93087
650			_aWHAKAHĀWEA IWI _97831
651		4	_aNEW ZEALAND _92588
700			_aCormack, Donna _910910
700			_aWaa, Andrew _912602
700			_aEdwards, Richard _912603
700			_aStanley, James _94681
773	0		_tBMC Public Health, 2024, 24: 136
830			_aBMC Public Health _94668
856			_uhttps://doi.org/10.1186/s12889-023-17603-6 _zDOI: 10.1186/s12889-023-17603-6 (Open access)
942			_2ddc _cARTICLE _hnews125