**6. Impact of Racialization on Health**

Health and social research support the evidence that racism is a social determinant of health and that it contributes to a disproportionate health inequality and poor access to services for racialized populations [55–57]. As Marmot argues, 'inequities in health arise from inequities in society' [58], p. 512. Taking a critical race theory (CRT) perspective, we argue that processes of 'racial subordination, prejudice, and inequity' produce experiences of exclusion and fractured belonging and have a significant human cost in terms of mental wellbeing [55,59]. A CRT perspective explores how complex processes of racialization are enacted in health care and in health seeking behaviours [60]. Within an Australian context, CRT focuses particularly on the critical understandings of health and wellbeing for Black people, particularly Aboriginal and Torres Strait Islander peoples, while also attempting to de-center whiteness as the standard by which experiences of health and wellbeing are measured [49]. Within this theorization, whiteness is not seen merely as a skin colour but rather a social process of racial hierarchical structuring where markers of value, universality and social capital are consciously or unconsciously bestowed upon white people. Whiteness consequently dominates other ways of knowing, being and experiencing the world. Through this assumed universality, the western biomedical model of health care amplifies white- and Euro-centric health practices which can unwittingly perpetuate racialized pathologization of Black people. Without critically examining how race and colour-blind approaches to health care impact minoritized peoples, the health care system itself becomes complicit in perpetuating racism [61].

As Durey and Thompson argue, 'people often view racism solely as referring to interpersonal relations, where a person is treated unfairly . . . because of race. However, racism that exists systemically and institutionally, where the production, control and access to resources operates to advantage selected racial/cultural groups and disadvantage others, is more insidious' [49], p. 3. Continually highlighting the health gaps and inequalities between Black people in comparison to white people without a critical theorization of the colonial, historical, social, cultural, and political inequities driving those 'gaps' perpetuates rhetorics that pathologize blackness [62], which in and of itself, is form of racial gaslighting. As defined in the National Aboriginal Health Strategy, health for Indigenous peoples (and other colonized Black peoples), health is:

*Not just the physical wellbeing of the individual, but the social, emotional and cultural wellbeing of the whole community* . . . *[it is] a matter of dignity, of community self-esteem and of justice. It is not merely a matter of the provision of doctors, hospitals, medicines or the absence of disease and incapacity*. [56], p. 26

Addressing racism and discrimination is a public health imperative. In their research, Ferdinand, Paradies, and Kelaher suggest that 'preventing racial discrimination will be a more constructive approach to protecting the health of racial and ethnic minority communities than relying on the use of appropriate response mechanisms after a racist incident has occurred' [46], p. 12. As such, transforming cultures of care must start with the acknowledgement that different forms of historical, structural as well as interpersonal oppression combine and contribute to the poor health and chronic physical and psychological ailments that are suffered by racialized and colonized peoples in Australia and globally [49,57].

#### **7. Conclusions**

The emerging literature on Black African migrant experiences in Australia highlights not only the precarities of conditional belonging, constant boundary-work and the resulting

experiences of battle fatigue that they must contend with on a variety of systemic and quotidian levels, but also the variety of strategies of resilience that are employed in response to these challenging circumstances. Among the solutions highlighted in the literature are finding belonging and solidarity within tightly-knit migrant communities [43], and developing 'negotiated' or 'hyphenated' borderlands identities 'so that both cultures can become a part of how they inhabit space in Australia' [63]. As we have also highlighted in this paper, there are significant implications for public health policy and practice in understanding and combating the impacts of racism in order to support the wellbeing and health of Black African migrants. As ongoing conversations and debates about migration are complicated by the rising influence of nationalist discourses in the context of international border closures and surging social anxiety, it becomes imperative that the stories and experiences of Africans in Australia be effectively shared and documented with a dignified sociological nuance, and that the significance of anti-racism within Australian public health discourses be substantially amplified.

Navigating the formation of novel and resilient diasporic identities is a key theme in the literature regarding African migration to Australia. Moral panics and the construction of Black African 'strangerhood' raise particular challenges for traversing the fallout from reified and homogenized black/African migrant/outsider labelling [7]. Because of such experiences, blackness can be carried as a burden within a settler-colonial society such as Australia. As African migrants are among the most 'visible' social groups in Australia in terms of phenotypical differences, the significant problems relating to their marginalization and minoritization extend beyond poor physical, psychological and economic outcomes. Given that this is an extremely salient aspect of migrant subjectivity, we see a need for further research investigating the nuances of new diasporic identities, and how they metamorphosize through different environments and experiences. More so, it is crucial to probe how Black Africans develop resilience in countering the impacts of hypervisibility and scrutinization and of being rendered invisible.

We conclude this paper by considering the words of Falkof who emphasized that moral panics have 'ideological motives, they are stories that we tell ourselves and each other to help us make sense of insecurity and social change' [41]. This means there are ways that new stories about what it means to be Australian can be told, other than the continual recycling of racialized moral panics of one form or another. To accommodate the diversity of Australian culture and the subjectivity of diverse experiences, a significant re-imagining of the Australian community is required, one that can own up to the past and current realities of racism and its impacts and find a place for those historically constructed as 'strangers' within the nation. This is a challenging proposition, but this nascent potential is within our grasp.

**Author Contributions:** Conceptualization, K.G. and L.A.; writing—original draft preparation, K.G.; writing—review and editing, K.G. and L.A. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Conflicts of Interest:** The authors declare no conflict of interest.

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