Abstract
Aims: To test whether there is a positive association between experience of racial discrimination and hazardous alcohol use among New Zealand Māori and whether racial discrimination mediates hazardous alcohol use in this group.
Design: A cross-sectional mediation analysis using a stratified and nationally representative cross-sectional health survey collected from 2016 to 2017 in New Zealand. Setting New Zealand.
Participants: We used data from 9884 participants who identified as New Zealand European (7341; 56.9% female) or Māori (2543; 60.5% female) in the 2016-17 New Zealand Health Survey. Measurements We included reports from demographic items (sex, age, ethnicity), the Alcohol Use Disorder Identification Test (AUDIT) and experiences of past year discrimination. We conducted mediation analysis with Māori identification as the predictor, hazardous drinking as the binary outcome (0 = AUDIT score less than 8, 1 = 8+) and discrimination as the binary mediator (0 = no discrimination, 1 = experienced racial discrimination). Age, sex and deprivation index were included as covariates.
Findings: Māori were more likely to experience discrimination than New Zealand Europeans, and both Māori identification and experiencing discrimination were associated with elevated levels of hazardous alcohol use, P < 0.05. The association between Māori ethnicity on hazardous drinking was partially mediated by discrimination (34.7%, 95% confidence interval 9.70%, 59.60%).
Conclusion: The association between Māori ethnicity and hazardous drinking in New Zealand may be partially mediated by experience of discrimination.