Ethnic Health Inequalities in Unequal Societies: Morbidity Gaps Between Palestinians and Jews in Israel

Responsiveness of inpatient care and provision of dignity: Insights from a patient experience survey in Israel

The paper contributes to the literature on the responsiveness of care, patient dignity, and disparities in the provision of health services. It does so by evaluating indicators of patient responsiveness while focusing on aspects of dignified treatment. The data were taken from the Patient Experience Survey of General Public Hospitals conducted by the Israel Ministry of Health in 2018. The analysis focuses on two indicators of responsiveness (i.e., actual) and three indicators of patient satisfaction with responsiveness (i.e., satisfaction). The analysis reveals that variations of these indicators are associated with patients' sociodemographic attributes and the hospitals' characteristics. However, while the likelihood of the actual provision of responsive care tends to be lower for vulnerable patients, the satisfaction of vulnerable populations with responsiveness tends to be higher. The data also reveal that the likelihood of responsive treatment and patient satisfaction with this tends to be lower for patients hospitalized in smaller hospitals and hospitals located in the periphery. The findings and their meaning are discussed in the context of studies on responsiveness of care, health disparities, dignified treatment, and patient satisfaction with the provision of health services.

Why are Older Israeli Arabs not Part of the Protests Against the Judicial Reform? A Qualitative Study

In the protests against the proposed judicial reform that began in early 2023 in Israel, the lack of participa• Policymakers should make efforts to reduce the socioeconomic gaps between older people from minority and majority groups.tion of Israeli Arabs, especially the absence of older Israeli Arabs, was noticeable. The purpose of the present study was to investigate the attitudes of older Israeli Arabs regarding the proposed judicial reform in Israel and to explore the reasons for their absence from the protests. Semi-structured interviews were conducted with 23 older Israeli Arabs. Thematic analysis revealed two main themes. The first pertained to the attitudes of this cohort in relation to the judicial reform. Participants unanimously opposed the judicial reform and believed it could seriously harm Israeli Arabs by increasing discrimination against them in employment, housing, and the receipt of social and health services. The second theme pertained to the reasons for Israeli Arabs' nonparticipation in the protests, which included: 1) perceiving the protests as an internal Jewish conflict; 2) being accustomed to discrimination; 3) a perceived lack of political efficacy 3) having concerns about openly expressing political positions; 4) being in poor health; and 5) being a woman. Our findings provide important insights regarding the barriers to participation in politics and decision-making processes among older people in minority groups.

Does affiliation with a minority group affect patient activation?

OBJECTIVE

To systematically review published studies assessing associations between ethnicity and patient activation (PA) among people with chronic conditions.

METHODS

A systematic review (PROSPERO-CRD42022320793) was performed by searching in PubMed, CINAHL, Scopus, and Google Scholar. Studies were included according to the following criteria: age > 18, diagnosis of at least one chronic condition, assessment of PA, report of ethnic minority group, and statistical analyses of PA scores include between-group comparisons or correlation or regression with ethnic group affiliation. Two reviewers conducted independent screening of records and full-text articles published until July 2021. Quality was evaluated using the National Institutes of Health study quality assessment tool.

RESULTS

From 197 records identified, 12 studies were included. The majority of studies focused on participants of White, Black and Hispanic ethnicity. Seven studies establish a significant association between ethnicity and PA, while the remainder of the studies found no association or inconclusive results.

CONCLUSIONS

The findings indicate that ethnicity is related to PA although additional, multiple explanatory variables other than ethnicity to PA were identified. Practice implications Programs to promote PA should be adjusted to participants' ethnic affiliation but consider differences in the barriers to PA and their magnitude that may differ across different ethnicities.

Health information seeking on social media: the diversification approach

Purpose

Internet studies have rarely addressed gender and/or ethnic differences in health information seeking on social media. Moreover, the role of locality size in explanation of this phenomenon has been overlooked. This study proposed a diversification approach to address these issues. According to it, belonging to numerous disadvantaged groups increases the probability of health-related Internet/social media use.

Design/methodology/approach

The data were collected via telephone survey. The sample consisted of 798 Israeli Internet users who reported using social media for any purpose, gender, ethnic affiliation and locality of residence. The data were analysed using a logistic regression technique.

Findings

Arab female social media users, who resided in small localities, were more likely than the other studied social groups to seek both non-medical and medical information on social media. Furthermore, Arab female social media users were found having the highest likelihood among all studied social groups to seek information regarding physical activity and medications on social media.

Practical implications

The findings largely supported the diversification approach and signal a major need for a greater supply of public health information for members of minority groups, especially those residing in small localities.

Originality/value

The study investigates triple social disadvantage in health-related social media use.

Ethnic differences in utilization of online health information sources: A test of the social inequality hypotheses

The goal of the current study was to understand ethnic differences in use of online health information sources. Social stratification and social diversification hypotheses were used as study’s theoretical framework. The data were obtained from the 2017 Israel Social Survey (N = 2166). Multinomial and logistic regression techniques were used for the multivariate analysis. The results suggest that Israeli Arab respondents were less likely than Israeli-born Jewish respondents to seek health information using the Health Funds’ call centers or websites, other websites, and to utilize any number of the online health information sources. The findings provide a strong support for the social stratification hypothesis. The findings imply that members of minority population should be more encouraged to use (public) online health information sources as a means of taking greater responsibility for their health as well as for the health of their communities.

Institution efficiency satisfaction and emotional responses to the COVID-19 pandemic in Arab citizens of Israel: An exploratory cross-sectional study

The COVID-19 pandemic has led to the emergence of various stressors among people around the world. However, rare are the studies that investigate stressors by employing institution evaluations as their predictors in ethnic minorities. The goal of the current study was to examine the association between satisfaction with the efficiency of institutions' work on mitigation of the COVID-19 spread, and stressors - emotional responses to the pandemic: worry of the COVID-19 spread, and fear of being hurt by its spread. The study was conducted among Israeli Arab citizens (N = 697), who participated in an annual personal security index survey. Multinomial logistic regression was used for the multivariate analysis. The main finding suggests that satisfaction with efficiency of the emergency institutions performance was associated with a lower likelihood of being highly worried of COVID-19 spread, as well as with a lower likelihood of having a great fear of being hurt by its spread. Satisfaction with efficiency of societal institutions performance was associated only with lower likelihood of being moderately worried of the COVID-19 spread. The results imply that the institutions have an ability to reduce the stressors in population by means of efficient performance in mitigating the consequences of the pandemic. The results also imply that institutions differ in this ability. The main policy implication is that institutions, which efficiency satisfaction was unrelated to the stressors, should significantly improve such performance in order to reduce the magnitude of negative emotional responses in ethnic minorities.

Unhealthy Immigrants: Sources for Health Gaps Between Immigrants and Natives in Israel

The study focuses on sources for health gaps between Jewish immigrants and native-born Israelis. Unlike traditional immigrant societies where immigration is viewed as economically motivated, immigrants returning to Israel are viewed as the "returning diaspora". Because immigrants in Israel are entitled to the same health benefits and medical services as native-born, we expect Israel to attract unhealthy immigrants in disproportionate numbers. The data for the analysis are obtained from the Israeli National Health Interview Survey (2013-2015). The data set provides detailed information on health status and illness, sociodemographic attributes and origin of immigrants. Three major origin groups of immigrants are distinguished: the former Soviet Union, Western Europeans or the Americans (mostly Ashkenazim), and Asians or North Africans (mostly Sephardim). Our findings lend support to the expectations that the health status of all immigrant groups is poorer than that of native-born Israelis. The nativity-illness gap is most pronounced in the case of male immigrants (from Europe or the Americas or South Africa or Australia) and for female immigrants (from countries in the Middle East or North Africa) and least pronounced in the case of immigrants arriving from the former Soviet Union for both gender groups. Decomposition of the gaps into components reveals that some portion of the illness gap can be attributed to nativity status, but the largest portion of the gap is attributed to demographic characteristics. Neither socioeconomic status nor health-related behavior accounts for a substantial portion of the nativity-illness gap for all subgroups of immigrants.

Displaced and segregated: The socio-economic status of the second generation of internally displaced Palestinians in Israel

This study investigates the effects of displacement on the socio-economic status of second-generation Palestinian internally displaced persons (IDPs) in Israel. The results show that members of this group do not differ from non-displaced Palestinians in their educational or occupational attainment, but that displaced households experience higher rates of poverty and poorer housing conditions than non-displaced households. I find that the relationship between displacement and the prime indicators of social mobility-education and jobs-was weakened by three factors: extreme spatial segregation between Palestinians and Jews, the concentration of disadvantage among Palestinian IDPs within the host communities, which were Palestinian spaces, and a high level of dependence on resources concentrated in Jewish spaces among all Palestinians, not just IDPs. These three conditions, however, do not eliminate gaps in assets and land ownership between IDPs and non-displaced Palestinians, which, I argue, contribute to higher poverty rates among displaced households.