A new report claims racial discrimination is costing Australia almost $45 billion a year, which would make it a bigger health cost than smoking.
The research by the Alfred Deakin Institute for Citizenship and Globalisation in Melbourne found racial discrimination costs 3.6 per cent of Australia's Gross Domestic Product each year.
The study, partly funded by the Australian Human Rights Commission and VicHealth, attempted to calculate the public health costs associated with racism.
That included mental illnesses and post-traumatic stress disorder.
The research by Yin Paradies and Amanuel Elias found one in five Australians experience racism.
It calculated that racism cost a total of more than 285,000 years from healthy lives, compared to the almost 205,000 lost as a result of smoking.
Professor Paradies says racism can cost Australia's health system as much as $44.9 billion a year.
"We focus on a few specific health outcomes, mental-health outcomes -- depression, anxiety and psychological disorders. Obviously, there would be other impacts of racism, but that's the cost for those particular disorders, from our study. So, basically, racism is a form of stress. It contributes to poor health. That's been known for some years. What we add to that is exactly what and how much that contribution is, so the extent to which people's lives are reduced, in terms of what they can achieve because of the fact that they have depression, and to what extent racism and the form of stress contributes to that depression tells us the cost. What we did is form that link between racism, as a form of stress, and those health outcomes."
Professor Paradies says the research shows the growing cost of mental health issues on Australia's health system.
"It really is a part of the broader pattern across the world of the increasing importance of mental health at a global scale. We know that, within 10 or 15 years, depression will be the largest cause of burden of disease in the world. So it's really drawing in that notion of mental health as the emerging factor of interest towards the middle of the century. And we also know that, for things like smoking, they are being reduced over time. There have been effective public health campaigns, so that will increasingly become a smaller contributor to the overall burden of disease as time goes by. What we haven't done enough of is trying to address things like racism and other forms of stress which do create this growing burden of mental health."
However, the research has drawn some criticism in the wake of its release.
The director of policy at the Institute of Public Affairs, Simon Breheny, says the research has too much of a political agenda.
"Discriminating against a person because of their race, on the basis of their skin colour or their ethnicity, is clearly immoral. I think most Australians would accept that. And I don't think we need research into the effects of discrimination to know that it is wrong. So I think this is really a case of a political agenda infusing science, and that's something that should always be avoided."
Mr Breheny suggests the research could be presenting racism as a greater health problem than it actually is.
"The significant risks that come out of this are that we're misled about the seriousness of racial discrimination in Australia. The reality is that we are a very open, very tolerant, country. If you go to a lot of places around the world, they're nowhere near as open and as tolerant as we are here. And so I think this gives a misleading picture of where Australia is at the moment, socially. I think that's the greatest risk from this research."
Dr Paradies rejects that criticism.
"We studied the topic closely for three years. This is figure we've come up with. There are limitations to the study. Certainly, more work could be done looking at what other forms of stress contribute to these health outcomes, and so, therefore, perhaps racism's role will be reduced, or it may be increased, we don't know. There are other factors at play, and not all of those have been accounted for, but it's not clear what direction that will have, in terms of reducing or increasing the dollar figure. To me, when people say the figure sounds too large, it's not really a criticism, it's too vague. It doesn't tell us what we've done wrong in our methods, which we've very vigorously applied."
University of Queensland health economics professor Paul Frijters says the numbers in the study could be larger than they are in actuality.
However, he says it is possible the costs of racism could still be high when other factors and impacts are considered.
"Even though it's a very high number, what the authors have done is to focus only on the health costs of racism, and they do this essentially by looking at people who say they felt instances of being discriminated (against) and see whether those are also the people who are slightly less healthy. The methodology is not at the frontier, but, on the other hand, they don't talk about the cost to education, or they don't talk about the cost to self-esteem in the next generation, which can potentially also be very large. And so there are also areas where discrimination and racism are known in other countries to have quite a big effect, because we know, if people feel down because they feel racially discriminated (against), their brains actually operate less efficiently. And so there are also potential avenues that would increase the number. And so, even though I think that the number is much too high, if you walk through all the various paths via which racism will have an effect, we could nevertheless come up with a reasonably high number anyway."
