The cycle of distrust in health policy and behavior: Lessons learned from the Negev Bedouin

Hermesh, Barak; Rosenthal, Anat; Davidovitch, Nadav

doi:10.1371/journal.pone.0237734

Cited by 25 publications

(19 citation statements)

References 67 publications

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“…The Statnet Poll (2014) showed a genuine feeling of discrimination among the Arab community: 39% of respondents believe there is discrimination in Israeli institutions and 53% believe there is only partial equality. 28 Trust in governmental institutions is lower than for the Jewish population, 29 although trust in the health system was found to be higher among Arab compared with Jewish respondents in a survey. 30 The COVID-19 crisis was managed by collaboration between central government, local authorities and the MOH.…”

Section: Discussionmentioning

confidence: 98%

COVID-19 morbidity in an ethnic minority: changes during the first year of the pandemic

et al. 2021

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Objectives During the COVID-19 pandemic, ethnic minorities have been more susceptible to infection and demonstrated poorer outcomes. This study describes COVID-19 morbidity and mortality by ethnic group, represented by Arab and Jewish localities in Israel, during the different waves of the outbreak and addresses sociocultural aspects of the pandemic. Study design A retrospective national archive study was conducted in Israel. Methods Data were obtained from the Ministry of Health's database, including daily information on Arab, Jewish or mixed localities, from February 2020 to February 2021. Results During the first wave of the pandemic, the incidence of COVID-19 in Arab compared with Jewish localities was 67% lower and mortality was 85% lower, in addition to lower rates of severe disease requiring hospitalisation. During the second and third waves, these trends reversed, with the proportion of positive tests, incidence and mortality in Arab localities reaching and then surpassing rates in Jewish localities. By September 2020, COVID-19 mortality was twice as high in Arab compared with Jewish localities. Conclusions After low morbidity during the first wave of the COVID-19 pandemic, a surge in infections occurred in the Arab population during subsequent waves, to match and surpass the high incidence seen in the Jewish population. This unique pattern highlights the changing experiences of a minority group as the pandemic progressed and demonstrates how COVID-19 exacerbates existing disparities.

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Section: Discussionmentioning

confidence: 98%

COVID-19 morbidity in an ethnic minority: changes during the first year of the pandemic

et al. 2021

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“…The Arab ethnic minority in Israel differs culturally and religiously from the Jewish majority, living typically in lower SES areas, more than half of them in the geographic periphery, and demonstrating poorer health outcomes compared with the general population [ 8 ]. Despite being hit harder especially in the second and third waves of the pandemic, vaccination uptake was low, which could be partly explained by a lower level of trust in governmental institutions, compared with the general population [ 19 ]. This pattern contrasts with routine childhood vaccinations in Israel, where rates are higher in the Arab compared to the Jewish population [ 20 ], but compares to research around the world where lower immunization rates were demonstrated in ethnic minorities and in low SES groups [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic gradient in COVID-19 vaccination: evidence from Israel

Saban

Myers

Ben-Shetrit

et al. 2021

Int J Equity Health

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Background Low socioeconomic status (SES) groups have been disproportionately affected by the COVID-19 pandemic. We aimed to examine COVID-19 vaccination rate by neighborhood SES and ethnicity in Israel, a country which has achieved high vaccination rates. Methods Data on vaccinations were obtained from the Israeli Ministry of Health’s open COVID-19 database, for December 20, 2020 to August 31, 2021. Correlation between vaccination rate and neighborhood SES was analyzed. Difference in vaccination rate between the first and second vaccine dose was analyzed by neighborhood SES and ethnicity. Findings A clear socioeconomic gradient was demonstrated, with higher vaccination rates in the higher SES categories (first dose: r = 0.66; second dose: r = 0.74; third dose: r = 0.92). Vaccination uptake was lower in the lower SES groups and in the Arab population, with the largest difference in uptake between Jewish and Arab localities for people younger than 60, and with the gap widening between first and third doses. Conclusions Low SES groups and the Arab ethnic minority demonstrated disparities in vaccine uptake, which were greater for the second and third, compared with the first vaccine dose. Strategies to address vaccination inequity will need to identify barriers, provide targeted information, and include trust-building in disadvantaged communities.

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“…It is reasonable to assume that the main and perhaps only information source for Northern Bedouin mothers is the Ministry of Health. Studies have shown that Bedouin mothers usually take institutional health directives seriously and implement them regardless of their level of trust [ 89 , 90 ]. Moreover, despite this low level of trust in the system this group has a very high level of trust in doctors, making the family doctor’s recommendation a highly influential factor in mothers’ decision-making regarding vaccines.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with seasonal influenza and HPV vaccination uptake among different ethnic groups in Arab and Jewish society in Israel

Shahbari

Gesser‐Edelsburg

Davidovitch

et al. 2021

Int J Equity Health

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Background Parents in the Arab population of Israel are known to be “pro-vaccination” and vaccinate their children at higher rates than the Jewish population, specifically against human papilloma virus (HPV) and seasonal influenza. Objectives This study seeks to identify and compare variables associated with mothers’ uptake of two vaccinations, influenza and HPV, among different subgroups in Arab and Jewish society in Israel. Methods A cross-sectional study of the entire spectrum of the Israeli population was conducted using a stratified sample of Jewish mothers (n = 159) and Arab mothers (n = 534) from different subgroups: Muslim, Christian, Druse and Northern Bedouins. From March 30, 2019 through October 20, 2019, questionnaires were distributed manually to eighth grade pupils (13–14 years old) who had younger siblings in second (7–8 years old) or third (8–9 years old) grades. Results Arab mothers exhibited a higher rate of uptake for both vaccinations (p < .0001, HPV – 90%; influenza – 62%) than Jewish mothers (p = 0.0014, HPV – 46%; influenza – 34%). Furthermore, results showed that HPV vaccination uptake is significantly higher than seasonal influenza vaccination uptake in both populations. Examination of the different ethnic subgroups revealed differences in vaccination uptake. For both vaccinations, the Northern Bedouins exhibited the highest uptake rate of all the Arab subgroups (74%), followed by the Druse (74%) and Muslim groups (60%). The Christian Arab group exhibited the lowest uptake rate (46%). Moreover, the uptake rate among secular Jewish mothers was lower than in any of the Arab groups (38%), though higher than among religious/traditional Jewish mothers, who exhibited the lowest uptake rate (26%). A comparison of the variables associated with mothers’ vaccination uptake revealed differences between the ethnic subgroups. Moreover, the findings of the multiple logistic regression revealed the following to be the most significant factors in Arab mothers’ intake of both vaccinations: school-located vaccination and mothers’ perceived risk and perceived trust in the system and in the family physician. These variables are manifested differently in the different ethnic groups. Conclusions This research shows that all Arabs cannot be lumped together as one monolithic group in that they exhibit major differences according to religion, education and access to information. Ranking of variables associated with uptake of the two vaccines can provide decision-makers an empirical basis for tailoring appropriate and specific interventions to each subgroup to achieve the highest vaccine uptake rate possible. Media campaigns targeting the Arab population should be segmented to appeal to the various sub-groups according to their viewpoints, needs and health literacy.

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The cycle of distrust in health policy and behavior: Lessons learned from the Negev Bedouin

Cited by 25 publications

References 67 publications

COVID-19 morbidity in an ethnic minority: changes during the first year of the pandemic

COVID-19 morbidity in an ethnic minority: changes during the first year of the pandemic

Socioeconomic gradient in COVID-19 vaccination: evidence from Israel

Factors associated with seasonal influenza and HPV vaccination uptake among different ethnic groups in Arab and Jewish society in Israel

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