![]() Protocol PROSPERO registration number: CRD42013005464. ![]() Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Age, sex, birthplace and education level did not moderate the effects of racism on health. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Moderation effects were found for some outcomes with regard to study and exposure characteristics. Racism was also associated with poorer general health ( r = -.13 (95% CI, k = 30), and poorer physical health ( r = -.09, 95% CI, k = 50). Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI, k = 227 positive mental health: r = -.13, 95% CI, k = 113), including depression, anxiety, psychological stress and various other outcomes. Data from 293 studies reported in 333 articles published between 19, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health.
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