Racism, stress, and sense of personal control among Aboriginal Australian pregnant women

Objectives To characterise racism experiences in the past year and to investigate a causal association between racism, stress, and sense of personal control in a sample of pregnant South Australian Aboriginal women. Methods Data was from the baseline sample of 369 Aboriginal women participating in a randomised controlled trial to prevent early caries in children. Data on demographics, racism experiences, stress, sense of personal control, and health behaviours were collected through interview-guided questionnaires. Linear regression modelling was used to test the association between racism and stress and sense of personal control in separate models. The final models presented were adjusted for confounding. Results Participant mean age was 24.7 years (SD +/- 0.30; Min-Max: 14-43 years). Almost two-thirds (64.7%) resided in rural and regional areas and the highest educational attainment for almost three-quarters (73.7%) was high school or less. Nearly half (48.3%) reported at least one experience of racism in the previous year and almost one third (31.8%) reported racism occurring in a public setting. The adjusted regression coefficients for the effect of racism on stress and sense of personal control were respectively 0.61 (95% confidence interval [CI] 0.28, 0.93) and -0.36 (95% CI -0.68, -0.04). Conclusions Our findings contribute with evidence that racism is one of the psychosocial causes of poor mental health among Aboriginal Australians. Culturally sensitive and safe mental health interventions may be beneficial in buffering racism effects during pregnancy. Societal-level policies aimed at both naming and reducing institutionalised racism against Aboriginal Australian Aboriginals are necessary.