Department of Nursing, The Max Stern Yezreel Valley College, Yezreel, Israel.
Department of Health Systems Management, The Max Stern Yezreel Valley College, Emek Yezreel, Israel.
Ethn Health. 2022 Aug;27(6):1377-1394. doi: 10.1080/13557858.2021.1899139. Epub 2021 Mar 18.
During pandemics, minorities may experience high stress levels, which could harm their mental and physical health. However, to the best of our knowledge, this has not been examined among minorities in Israel during the COVID-19 pandemic. This study, therefore, explores stress among the Arab minority in Israel during the first wave of the COVID-19 outbreak, and its association with the population's perceived COVID-19 threat, trust in the healthcare system, adherence to preventative guidelines, and perceived discrimination.The study analyzed a cross-sectional online survey of 626 Israeli Arabs. Most participants (65%) reported moderate levels of stress, and 10% reported severe levels. The Bedouin population reported significantly higher levels of stress compared to other minority groups. The participants also reported a high degree of perceived threat, a moderate-to-high level of discrimination, a moderate level of trust in the healthcare system, and very high adherence to guidelines.Hierarchical regression analysis showed that age, religion, trust in the healthcare system, perceived threat, and adherence to guidelines were all significant predictors of stress [(11,600), < .001]. The model explained 24% of the variance in stress. Structural equation modeling (SEM) revealed that the participants' perceived threat and trust mediated the association between their perceived discrimination and stress [indirect effect = 0.13, SE = 0.03 CI = (0.08, 0.18)], whereby discrimination was negatively associated with trust ( = -0.52), which, in turn, was negatively associated with stress ( = -0.10). Furthermore, discrimination was positively associated with perceived threat ( = 0.21), which, in turn, was positively associated with stress ( = 0.35). Discrimination is an important social determinant of health - especially during health emergencies when trust in healthcare systems and perceived threats are crucial. As such, our findings could assist policymakers in developing fair policies that are tailored to various population groups and that may reduce stress levels among minorities, thereby improving both their mental and physical health.
在大流行期间，少数群体可能会经历高水平的压力，这可能会损害他们的身心健康。然而，据我们所知，在 COVID-19 大流行期间，以色列的少数民族并没有对此进行过研究。因此，本研究探讨了 COVID-19 爆发第一波期间以色列阿拉伯少数民族的压力，以及这种压力与人群对 COVID-19 威胁的感知、对医疗保健系统的信任、对预防指南的遵守以及感知到的歧视之间的关系。
该研究分析了一项针对 626 名以色列阿拉伯人的横断面在线调查。大多数参与者（65%）报告说压力处于中等水平，10%的参与者报告说压力处于严重水平。贝都因人的压力水平明显高于其他少数民族群体。参与者还报告说，他们感受到了高度的威胁、中度到高度的歧视、对医疗保健系统的中度信任以及非常高的指南遵守度。
层次回归分析表明，年龄、宗教、对医疗保健系统的信任、感知威胁和对指南的遵守都是压力的显著预测因素[（11,600），<.001]。该模型解释了压力方差的 24%。结构方程模型（SEM）显示，参与者的感知威胁和信任中介了他们感知到的歧视与压力之间的关系[间接效应=0.13，SE=0.03 CI=（0.08, 0.18)]，即歧视与信任呈负相关（ =−0.52），而信任与压力呈负相关（ =−0.10）。此外，歧视与感知威胁呈正相关（ =0.21），而感知威胁与压力呈正相关（ =0.35）。歧视是健康的一个重要社会决定因素——尤其是在医疗保健系统和感知威胁至关重要的健康紧急情况下。因此，我们的研究结果可以帮助政策制定者制定针对不同人群群体的公平政策，这些政策可能会降低少数民族的压力水平，从而改善他们的身心健康。
