This large, nationally representative study provides prevalence estimates of secondary school student's experience of ethnicity-related bullying at school and their experience of ethnic discrimination by health professionals and by the police. In doing so, it contributes to a limited literature about the effect of experiencing ethnic discrimination on the health and wellbeing of young people. It also contributes to a very limited evidence base regarding the effects of ethnic discrimination on the health of indigenous youth.
Māori, Pacific, Asian and Other ethnic group participants were significantly more likely to report experiencing ethnic discrimination than their NZ European peers. Furthermore, the reporting of being unsure about ethnic discrimination was significantly more likely among Māori, Pacific, Asian and Other ethnic groups than the NZ European ethnic group.
Participants who reported 'yes' or 'unsure' to the questions on ethnic discrimination were significantly less likely to report excellent/very good/good health, feel safe in their neighbourhood, and report their achievement at school as about the middle or higher. These participants were also significantly more likely to: have experienced depressive symptoms in the previous 12 months, smoke cigarettes at least weekly, and to have had an episode of binge drinking in the previous 4 weeks. The adverse associations between being 'unsure' about ethnic discrimination and health/wellbeing outcomes were remarkably similar to those who reported 'yes' to experiencing this ethnic discrimination. Our results suggest that for both 'yes' and 'unsure' groups ethnic discrimination may be an important determinant of health and wellbeing.
Youth/school student experience of ethnic discrimination by a health professional has not been, to our knowledge, reported in the literature. However, our findings are consistent with those of the 2002/2003 NZ health survey (participants ≥ 15 years of age) which found that Māori, Pacific, and Asian adults were significantly more likely to report unfair treatment by a health professional than NZ Europeans [4
] and with the international literature that reports that adults from ethnic minorities are more likely to experience differential and unfair treatment by health professionals than dominant ethnic groups [38
]. Our findings that Pacific, Māori, Asian and Other ethnic group's participants were significantly more likely to report ethnic discrimination by the police is consistent with international literature that shows youth from minority ethnic groups are most likely to report ethnic discrimination or harassment by the police [42
Compared with NZ European students, all other ethnic groups in the current study were more likely to report being bullied at school because of their ethnicity/culture, with Asians having the highest self-report rates of all groups. The Youth2000 survey also found that Asian students were the ethnic group most likely to report ethnicity related bullying in schools, with Pacific then Maori students the next highest groups [45
]. A NZ survey of international students (92% of whom were Asian and most were at secondary school), revealed that less than half believed that New Zealanders have positive attitudes towards international students and a third believed that ethnic discrimination was a common experience among international students [46
]. The studies noted above were not designed to explore the reasons for these findings. However, a small pilot study of secondary school students in New Zealand suggests that inter-ethnic 'intimidatory practices' experienced by Asian ethnic minorities may reflect social distance (separation) between Asian and non-Asian ethnic groups and/or the Asian ethnic groups' perceptions about acceptance in the wider community [47
]. These issues require further exploration alongside consideration of potential intersecting issues such as the experience of being (in some cases) newer migrants [48
]. Literature from the US and the UK also document the prevalence and severity of ethnicity-related bullying among minority ethnic groups in comparison to the dominant ethnic group [49
In NZ, Harris et al. [4
] found that adults who reported experiencing ethnic discrimination were significantly more likely to report poor/fair self-rated health, lower physical functioning, poorer mental health, and current smoking. Our findings amongst secondary students were similar, with students who reported ethnic discrimination being more likely to report fair/poor self-rated health, have experienced significant depressive symptoms, and be cigarette smokers. Our findings are also consistent with international reports that, among adult and youth populations, ethnic discrimination is associated with negative self-reported health and poorer overall health status [9
], depressive symptoms or depression [7
], smoking [14
], alcohol use [14
], and use of other substances [14
]. International literature has also reported that youth who experience ethnic discrimination are more likely to feel unsafe in their neighbourhood because of bullying that started in school and overflowed into the victims' neighbourhood [59
] and that those who experience ethnicity-related bullying in schools are more likely to have lower levels of academic achievement [60
]. While our study used 'any ethnic discrimination' rather than ethnicity-related bullying specifically, the international conclusions are consistent with our findings.
Due to the cross-sectional design of the study we are able to report associations but not attribute causality. Other literature discusses hypothesised mechanisms and pathways between experiencing ethnic discrimination and adverse health outcomes [14
]. Williams and Mohammed [14
] describe three potential pathways through which experiencing ethnic discrimination may adversely affect health. They argue that exposure to stress (ethnic discrimination) results in psychological distress that adversely affects health; that behavioural coping strategies to manage stress may include unhealthy behaviours such as smoking and alcohol misuse; and that psychological and behavioural responses to stressors can lead to structural and functional alterations in physiological systems [14
]. Personal and social factors such as the strategies used to cope with stressors, social support, level of vigilance and anticipatory anxiety about ethnic discrimination, ethnic identity, and ethnic group identification may also moderate or mediate the effect of experiencing ethnic discrimination on health outcomes [14
]. Bals, Turi, Skre and Kvernmo [62
] found that 'enculturation factors' such as participation in cultural activities and Sami language competence were associated with decreased mental health problems among Indigenous Sami youth. The interactions between enculturation/cultural resilience, experiencing ethnic discrimination and health outcomes require further elucidation.
This study has a number of strengths: it is a large, nationally representative survey with good school and student response rates. The anonymous survey using M-CASI allowed investigation of sensitive issues that may be under-reported using other data collection methods such as face-to-face interviewing.
There are a number of limitations that should be considered. Firstly, the survey was conducted with young people attending secondary schools. The experiences and health outcomes among young people who are not attending school may systematically differ from those who are attending school [63
]. In addition, ethnic discrimination has been described as a significant influence on early school leavers [64
]. Māori and Pacific youth in NZ leave school early [65
] suggesting that the findings in this study may underestimate the prevalence of ethnic discrimination among the 'total' (i.e. including those that are not at school) population of young people in this age group.
Secondly, participants were asked about their experience of ethnicity-related bullying and ethnic discrimination by health professionals and the police. There are a number of other domains where participants may have been exposed to ethnic discrimination, for example by staff at schools and in other social settings, which have not been included in the current study. Furthermore, institutional forms of discrimination are unlikely to have been captured by the measures used in the current study. As a result our findings may underestimate the overall experience of ethnic discrimination experienced by participants.
Thirdly, some data may be vulnerable to recall bias. As the accuracy of recall is unlikely to be influenced by the participant's ethnic group, or their experience of ethnic discrimination, it is unlikely that recall bias will substantially alter the effect estimates. Fourthly, the measurement of socio-economic position among adolescents poses challenges as they may be unable to provide accurate information about common measures of socio-economic position such as parental occupation, education level, or income [67
]. This study used three alternative socio-economic variables; however, there may still be residual confounding by socio-economic position.
Finally, we are unable to ascertain whether students who responded they were 'unsure' were unsure whether they had experienced discrimination, or were unsure whether this was because of their ethnicity. 'Unsure' responses may reflect attributional ambiguity where the experience is ambiguous and difficult for recipients to label as discriminatory [14
Future research could address ethnic discrimination in the school setting, non-bullying ethnic discrimination by peers, and the nature, frequency and intensity of discriminatory experiences. In addition, studies are needed to clarify the nature of 'unsure' responses and to examine the associations between ethnic discrimination and health/wellbeing outcomes with a view to understanding the pathways between experiencing ethnic discrimination and adverse health and wellbeing outcomes and potential interventions.