"Discrimination tends to fly under the radar in public discourse. We assume we have legislation and measures in place that work, but this study suggests otherwise," says Jan Georg Friesinger from the University of Agder.
He is behind an article based on the Public Health Survey in Agder from 2023, which had over 18,500 participants. 2023 was the first year the survey included questions about discrimination. Nearly one in five residents of Agder (17.8%) reported being discriminated against in the past year.
Discrimination is about people being treated poorly because of things like age, gender, sexuality, ethnicity or religion.
Concerning findings
"We see that there's a clear connection between discrimination and health problems. It's quite concerning that we don't have a functioning system to counteract it," says Friesinger.
Those who are discriminated against for a single reason have twice the risk of poor health. But the effect becomes much worse when several reasons are combined.
"The most surprising finding was the compounded effect of discrimination. We see that the more reasons you are treated differently, the worse the impact on self-perceived health," says Friesinger.
Two reasons for discrimination result in three times higher risk. Three or more reasons lead to four times higher risk of poor health.
"This is particularly serious because we know that poor self-perceived health is associated with an increased risk of dying early," Friesinger notes.
Health is the most common reason
Facing health challenges was the most common reason for people being discriminated against, followed by unequal treatment based on gender.
Other common reasons included age, functional impairment, ethnic background and political views. The lowest proportion of participants, around one per cent, cited sexual identity as a reason for discrimination.
It may sound paradoxical that being discriminated against for health challenges can lead to poorer health. Even when the researchers took this into account in their analysis, discrimination had an impact.
Comparable figures with Europe
Friesinger was surprised that the figures from Agder are similar to the rest of Europe. In the Eurobarometer survey, around one in five people also report experiencing discrimination.
The researcher believes this challenges the perception that Norway is much better than other countries when it comes to equality and inclusion.
"I expected the figures to be slightly different in Norway. After all, we have this impression that we've come further in the fight against discrimination in this country," Friesinger says.
From discrimination to poor living conditions
But why does discrimination impact health so severely?
The research shows that discrimination affects health both directly and indirectly.
"When we are discriminated against, it affects us both in the short and long term. Immediate consequences can be stress, which in turn can lead to high blood pressure and other physical reactions," says Friesinger.
Discrimination can also lead to poorer living conditions over time. If you don't get the salary you are entitled to or are treated differently at work, it can result in poorer social and economic conditions, it can result in poorer social and economic conditions (what researchers call socioeconomic status), which in turn affects health.
Social support as a counterbalance
There is however something that might mitigate the negative effects of discrimination. The survey showed that people with strong social support had better self-perceived health than those with fewer social connections to lean on.
The researchers will take a closer look at what can reduce discrimination and the subsequent health damage in another study, which Friesinger hopes will be ready next year.
They will also investigate how different forms of discrimination are related. They will examine how various types of discrimination are combined, known as intersectionality, and how they relate to health and quality of life.
"Preliminary findings show, for example, that those who have experienced discrimination due to gender often also experienced it due to age, and there was some overlap between discrimination for both politics and religion," Friesinger says.