123 In the medium to long-term at a population level, racism has been linked to a range of mental and physical health outcomes, including anxiety, depression, suicidality, high blood pressure, cardiovascular disease, diabetes, genetic damage, inflammation, poor immune functioning, and so on.
124 Racism is also a social determinant of health that shapes people's environments, resources and opportunities, driving diverse pathways leading to ill-health. Racism impacts jobs and careers, education, formal and informal networks, transport, recreation, housing and access to healthcare.
125 Racism can directly affect the body through activating the stress response, resulting in short, medium and long-term biological changes. Through mechanisms such as epigenetic changes, exposure to racism in one generation might propagate adverse health effects to subsequent generations. For example, a recent study found that in models adjusting for covariates, including socio-economic status and health status, Māori mothers who experienced a racist physical attack during pregnancy had children who, at 4.5 years of age, had significantly shorter telomere length than children of Māori mothers who did not report a racist physical attack during pregnancy. Telomeres are structures made from DNA sequences and proteins found at the ends of chromosomes required for cell division. They cap and protect the end of chromosomes.
126 Racism is perceived as, and often is, a threat which activates stress response pathways. Being exposed to racism regularly over the course of one's life can lead to chronic activation of an energy-consuming emergency response that results in physiological wear and tear as well as dysregulation at the cellular level. It can lead to poor self-worth, self-efficacy and self-esteem.
127 Professor Paradies gave evidence that Senator Hanson's tweet is a common form of racism which can be described as "go back to where you came from." A 2011 study surveyed 580 culturally and linguistically diverse (CALD) Victorian women from four local areas in Victoria, including both rural and urban communities. They were asked, amongst other questions, whether someone had suggested to them that "you do not belong in Australia, that you should 'go home' or 'get out' and so on." Among the 35.2% (n=204) of Muslim women participants, 50% (compared to 36.4% of non-Muslim women) reported being told that they do not belong, and that they should "go home" or "get out." Adjusting for local government area, education, age, country of birth and duration of residence in Australia, Muslim women had 1.61 times the odds of being told that they do not belong in Australia and should go back to their
