Background: Experience of interpersonal racism has been negelected as a mechanism by which inequalities between Aboriginal and non-Aboriginal people are created and maintained.

Methods: Cross-sectional survey of randomly selected residents of a rural Australian town (n=639). Interpersonal racism was measured by two questions on experiences in the past four weeks of negatively based treatment that evoked an emotional or physical response. Health was measured with the mental and physical health component scores of the Short-Form 12 and self reported fair or poor general health. Linear and logistic regressions modeled the effects of interpersonal racism on health, controlling for age, sex, socioeconomic status and Aboriginality.

Findings: The 183 Aboriginal respondents had lower health component scores, were more than twice as likely to report fair-to-poor general health (34%0 compared with 17%, p<0.001), and 2.6 to 5.0 times more likely to report negative racially based treatment. After controlling for other variables, Aboriginal respondents who reported negative treatment were more likely to have poor health on all three measures. Non Aboriginal respondents who reported experiencing negative treatment had lower mental health component scores.

Implications: Experiencing racist treatment should be recognised as a social determinant of health. Improved health care and other initiatives may not eliminate health inequalities in the absence of fundamental changes in how non-Aboriginal people behave towards Aboriginal people.