Internal displacement and health among the Palestinian minority in Israel.

Long term health impacts of internal displacement (ID) resulting from political violence are not well documented or understood. One such case is the ID of 300,000-420,000 Palestinian citizens of Israel and their descendants during the Nakba of 1948 (Palestinian Catastrophe). We aim to document the long term health impacts of this ID. We draw on data collected in 2005 from a nationwide random sample of 902 individuals aged 30-70. Research participants were interviewed in person after being selected through a multistage sampling procedure. About 24% of participants reported that either they or their families had been internally displaced. Palestinian internally displaced persons (IDPs), that is, those who were forcibly displaced and dispossessed from their homes and lands during the Nakba and its aftermath, as well as their families and descendants, and who reside within the current borders of Israel, had an odds ratio of 1.45 (95% CI = 1.02-2.07) for poor self-rated health (SRH) compared to non-IDPs after controlling for demographic, socioeconomic and psychosocial factors. No difference was found between IDPs and non-IDPs in limiting longstanding illness following control for confounders. Low socioeconomic position and chronic stress were significantly related to ID and to SRH. Our findings suggest adverse long term health impacts of the Nakba on the IDPs when compared to non-IDPs. We propose that these disparities might stem from IDPs' unhealed post-traumatic scars from the Nakba, or from becoming a marginalized minority within their own society due to their displacement and loss of collective identity. Given these long term health consequences, we conclude that displacement should be addressed with health and social policies for IDPs.