Nihaya Daoud1, Varda Soskolne2, Jennifer S Mindell3, Marilyn A Roth3, Orly Manor4. 1. Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, 84015, Beer Sheva, Israel. daoud@bgu.ac.il. 2. Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel. 3. Research Department of Epidemiology and Public Health, UCL, London, UK. 4. Braun School of Public Health, Hebrew University-Hadassah, Jerusalem, Israel.
Abstract
OBJECTIVES: Ethnic inequalities in health (EIH) are unjust public health problem that emerge across societies. In Israel, despite uniform healthcare coverage, marked EIH persist between Arabs and Jews. METHODS: We draw on the ecosocial approach to examine the relative contributions of individual socioeconomic status (SES), psychosocial and health behavioral factors, and the living environment (neighborhood problems, social capital, and social participation) to explaining ethnic differences in self-rated health (SRH). Data were derived from two nationwide studies conducted in 2004-2005 of stratified samples of Arabs (N = 902) and Jews (N = 1087). RESULTS: Poor SRH was significantly higher among Arabs after adjustment for age and gender [odds ratio and 95% confidence interval (CI) = 1.94 (1.57-2.40)]. This association was reversed following adjustment for all possible mediators: OR (95% CI) = 0.70(0.53-0.92). The relative contribution of SES and the living environment was sizable, each attenuating the EIH by 40%, psychosocial factors by 25%, and health behaviors by 16%. CONCLUSIONS: Arabs in Israel have poorer SRH than Jews. Polices to reduce this inequality should mainly focus on improving the SES and the living conditions of the Arabs, which might enhance health behaviors and well-being.
OBJECTIVES: Ethnic inequalities in health (EIH) are unjust public health problem that emerge across societies. In Israel, despite uniform healthcare coverage, marked EIH persist between Arabs and Jews. METHODS: We draw on the ecosocial approach to examine the relative contributions of individual socioeconomic status (SES), psychosocial and health behavioral factors, and the living environment (neighborhood problems, social capital, and social participation) to explaining ethnic differences in self-rated health (SRH). Data were derived from two nationwide studies conducted in 2004-2005 of stratified samples of Arabs (N = 902) and Jews (N = 1087). RESULTS: Poor SRH was significantly higher among Arabs after adjustment for age and gender [odds ratio and 95% confidence interval (CI) = 1.94 (1.57-2.40)]. This association was reversed following adjustment for all possible mediators: OR (95% CI) = 0.70(0.53-0.92). The relative contribution of SES and the living environment was sizable, each attenuating the EIH by 40%, psychosocial factors by 25%, and health behaviors by 16%. CONCLUSIONS: Arabs in Israel have poorer SRH than Jews. Polices to reduce this inequality should mainly focus on improving the SES and the living conditions of the Arabs, which might enhance health behaviors and well-being.
Entities:
Keywords:
Arabs and Jews Israel; Ecosocial; Ethnic inequalities; Living environment; Minorities’ health; Self-rated health; Socioeconomic status
Authors: Nancy Krieger; Anna Kosheleva; Pamela D Waterman; Jarvis T Chen; Karestan Koenen Journal: Am J Public Health Date: 2011-07-21 Impact factor: 9.308
Authors: J S Mindell; C S Knott; L S Ng Fat; M A Roth; O Manor; V Soskolne; N Daoud Journal: J Epidemiol Community Health Date: 2014-08-05 Impact factor: 3.710