Elsevier

The Lancet

Volume 400, Issue 10358, 1–7 October 2022, Pages 1130-1143
The Lancet

Articles
Flexible resources and experiences of racism among a multi-ethnic adolescent population in Aotearoa, New Zealand: an intersectional analysis of health and socioeconomic inequities using survey data

https://doi.org/10.1016/S0140-6736(22)01537-9Get rights and content

Summary

Background

As societies become increasingly diverse, understanding the complex nature of racism for multiple ethnic, social, and economic identities of minority youth is required. Here we explore the experience of racism between and among privileged majority adolescent groups and targeted minority (Indigenous and ethnic) adolescents in New Zealand. Using the concept of structural and embodiment flexible resources, which act as risk and protective factors, we examine the social and health effects on minority youth.

Methods

In this intersectional analysis, we use self-reported data from the Youth2000 survey series administered in 2001, 2007, 2012, and 2019 to large, representative samples of students from mainstream state and private schools in the Auckland, Tai Tokerau, and Waikato regions of New Zealand. Students were in school years 9–13 and mostly aged 13–17 years. Ethnic or migrant group, income level of country of origin, and migrant generation were used as measures of structural resources and perceived ethnicity as a measure of embodiment resource. Racism and its effects were measured as socioeconomic inequities (household, neighbourhood, and school-level deprivation); interpersonal discrimination (unfair treatment, bullying, and safety); and health inequities (forgone health care, symptoms of depression, and attempted suicide). We used generalised linear models to explore variations in economic, interpersonal, and health outcomes for Indigenous and migrant youth, adjusting for mediating effects of household deprivation and measures of flexible resources (migration generation, income level of country of origin, and perceived ethnicity).

Findings

We collected data from a total of 20 410 adolescents from the four survey waves between 2001 and 2019. Participants had a median age of 15 years (IQR 14–16). Socioeconomic, interpersonal, and health inequities varied with access to flexible resources among Māori and racialised migrant youth. Māori and racialised migrants from low-income and middle-income countries in particular experienced high levels of socioeconomic inequities. Racialised migrant youth experienced persistent socioeconomic inequities extending over three generations, especially Pasifika migrant adolescents. Minorities perceived as White experienced less discrimination and had more advantages than visibly racialised groups. Regression models showed that embodiment resources, and to a lesser extent structural resources, mediated, but did not eliminate ethnic disparities in socioeconomic status and interpersonal discrimination; these resources did not strongly mediate ethnic disparities in health. Trend analyses indicate consistency in these patterns with ethnicity-based inequities persisting or increasing over time.

Interpretation

Indigenous and ethnic minority experiences of racism are heterogeneous. Structural flexible resources (wealth) and, more substantially, embodiment flexible resources (perceived Whiteness) mitigate individual experiences of racism. In multi-ethnic western societies, anti-racist interventions and policies must address both structural deprivation and associated intergenerational mobility and colourism (ie, implicit and explicit bias against non-White youth).

Funding

Health Research Council of New Zealand.

Introduction

On March 15, 2019, a White supremacist killed worshippers at two mosques in Christchurch, New Zealand; a painful reminder of deeply rooted racism prevalent in society. Racism is not new to New Zealand. Indigenous Māori were colonised by White European settlers in the 18th century and deprived of their land, resources, and authority to self-determination, despite signing Te Tiriti o Waitangi—a treaty with the English Crown that some Māori chiefs signed in 1840 that gave the Queen of England complete government over New Zealand; allowed Māori to maintain sovereignty over their lands, villages, properties, and treasures; and bestowed Māori with the same rights and privileges as British subjects. Since the 1980s, changes to immigration law brought increased numbers of migrants from Asia, Africa, the Middle East, and Latin America to New Zealand. In 2018, more than a quarter (1 268 933 [27·0%] of 4 699 755 people) of New Zealand's population were born overseas, up from 698 628 (18·7%) of 3 737 280 people in 2001.1 New Zealand Europeans and other Europeans (hereafter referred to collectively as Pākehā) were still the largest ethnic group, comprising 70% of the population; followed by Māori (16%); Asian (15%); Pasifika (8%); and Middle Eastern, Latin American, and African (MELAA) ethnic groups (1·5%) in 2018. New Zealand's migrant populations (ie, non-Pākehā and non-Indigenous Māori) are a heterogeneous group; there is considerable diversity in their countries of origin, socioeconomic status, length of time lived in New Zealand, and visa and citizenship status.

Research in context

Evidence before this study

We reviewed scholarship on racism, intersectionality, and health. Research on racism typically focuses on the asymmetrical and linear relationships between privileged–targeted groups and majority–minority groups, highlighting the contribution of racism to negative health effects such as chains of risk and weathering. There are limitations of a linear causative approach when applied to migrant populations in multi-ethnic societies. Young migrants are increasingly identifying with multiple identities and are becoming increasingly socially mobile and adaptive to dominant cultural settings; these are factors that enhance positive health outcomes. At the same time, young migrants have ongoing experiences of racism. These contradictions call for a new non-linear approach to investigate diversity of identities and associated racism experiences. Although flexible resources as protective factors that mitigate inequity is an established concept in the literature, it has not been applied to the context of intersectionality and identity characterised in minority youth.

Added value of this study

Our study investigates heterogeneity among minority young people and how their multiple social identities give them differential access to flexible resources. We extend the concept of flexible resources into two types: structural resources (ethnic or migrant group, income level of country of origin, and generational status), or resources that affect access to determinants of health and embodiment resources that are based on societal attitudes to perceived Whiteness. We examine the effects of the flexible resources on the health of ethnic minority adolescents in New Zealand. Our analysis shows that there are significant variations in discrimination among ethnic minority youth based on the flexible resources they have access to.

Implications of all the available evidence

Racism is not a singular phenomenon and not all minorities experience it equally. Although racism is a fundamental cause of health inequities, the linkages between the two are complex. Flexible resources provide a better understanding of the mechanisms of racism for adolescents who have multiple ethnic, social, and economic identities. An intersectional lens helps to better develop targeted interventions for young people experiencing racism and to address broader system-level bias and discrimination.

The ongoing effect of colonisation is evident in contemporary structures and policies, systematically disadvantaging not only Indigenous Māori, but each wave of non-White migrants who are making New Zealand their home. There is a robust body of work on racism among Indigenous Māori2, 3 and Pasifika communities;4, 5 in contrast, other ethnic minority groups are relatively under-researched, despite evidence of Asians and migrants facing high degrees of racial discrimination.6, 7, 8 Experiences of racism are particularly understudied in the context of ethnic minority youth who comprise around 20% of New Zealand's total youth population, many of whom have multiple identities or markers of social difference, such as being first-generation or second-generation migrants, of belonging to diverse cultures and socioeconomic groups, and being visibly different. Existing research points to high rates of discrimination, bullying, and psychological distress among migrant youth overall.2, 9, 10, 11 However, the heterogeneity among ethnic minority youth means that young people experience inequality and discrimination differently.9 It is this diversity of experiences of racism and the underlying societal structures that our study seeks to understand.

The term racism is predominantly understood to be the inequitable relationship between a privileged group (in New Zealand, usually White, European, or Pākehā people) and, what is referred to as, a targeted group (typically, in New Zealand, these are Indigenous Māori and people of colour; namely, those of Pasifika, Asian, and MELAA ethnicity). Racism encompasses marginalisation and oppression at an individual, institutional, and societal level enabled through historical legacies and systems.12

One school of thought on the effects of racism on health argues that lower access to structural resources among targeted groups than among privileged groups results in poorer health outcomes for targeted groups than privileged groups.13, 14, 15, 16, 17, 18 Researchers have also shown that race is a fundamental cause of health inequity, independent of socioeconomic status; an indication of the pervasiveness of structural racism.13

In contrast, intersectionality researchers argue that racism does not affect all members in the targeted or minority groups equally.9, 19 Individuals in these groups have differential access to resources such as income, position, networks, and relationships. These are flexible resources that can be used in different ways in different situations, giving minorities a range of choices, opportunities, and vulnerabilities.13 Although flexible resources do not erase racism, they could act as protective factors. For example, members from a minority group who are wealthier have better outcomes than those from poorer backgrounds.20, 21 Additionally, studies on colourism have shown that perceived Whiteness among minority group members improves health and social outcomes.22, 23

In this study, we develop these conceptual arguments into an intersectional framework that explores the effects of differential flexible resources on racism. An intersectional analysis that examines racism effects between privileged and targeted groups as well as between and among targeted groups24 is particularly relevant in the context of multi-ethnic societies like New Zealand. Adapting the work of a 2015 study, we propose two kinds of flexible resources.13 First, we consider structural resources, such as employment, education, and income. For migrant populations, structural resources can also include country of origin (whether this is a high-income or low-income country); migration generational status (recent migrants or second or later generation); and ethnicity (of racialised or non-racialised origin). Second, we consider embodiment resources, which refers to the discrimination arising from visible racialisation or perceived Whiteness. Figure 1 represents the spectrum along which members of privileged and targeted groups might be located depending on their particular sets of structural and embodiment resources.

The overall aim of this study is to examine the effect of flexible resources (structural and embodiment) on the experience of racism between and among privileged and targeted groups in New Zealand. The analysis was guided by four specific questions: does access to structural resources mediate the effects on socioeconomic and health outcomes for minority groups? Do embodiment resources or perceived Whiteness of individuals from minority groups mediate experiences of discrimination and health outcomes? In what way do structural or embodiment resources differ in their effect on migrant experiences of racism and health outcomes? Is racism, as seen through the Youth2000 study waves, increasing in New Zealand?

Section snippets

Data sources and definitions

In this intersectional analysis, we use study data from the Youth2000 survey series that collects information on a wide range of things that contribute to young people's health and wellbeing. The surveys were administered in 2001, 2007, 2012, and 2019 to representative samples of New Zealand secondary school students (in school years 9–13 and mostly aged 13–17 years). Each survey was approved by the University of Auckland Human Participants Ethics Committee (reference numbers 1999/014 [2001],

Results

We collected data from a total of 20 410 adolescents from the four survey waves between 2001 and 2019 (table 1). Missing data for all outcome variables ranged from 0 to 833 (10·8%) of 7721 in 2019 (appendix p 2). There were slightly more female participants than males in all waves except 2007, and fewer adolescents in the oldest age group (aged 17 years and older) in 2001 than in the other three survey waves. The median age of participants was 15 years (IQR 14–16). The proportion of adolescents

Discussion

This study investigated the effects of flexible structural and embodiment resources on socioeconomic and health inequities (representing the effects of racism) among ethnic minority and migrant youth in New Zealand. We also included the unique profile of Māori youth, recognising their distinct experiences as Indigenous peoples, although findings and implications specific to Māori will be reported in future publications led by Indigenous researchers.

Overall, the findings suggest that Indigenous

Data sharing

Individual participant data collected for the study will not be made available as per the Adolescent Health Research Group (New Zealand) data access policy (https://www.fmhs.auckland.ac.nz/en/faculty/adolescent-health-research-group/collaborations-and-access-to-datasets.html). The data dictionary defining each field in the set is available at https://www.youth19.ac.nz/projects.

Declaration of interests

We declare no competing interests.

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