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以色列阿拉伯贝都因人群的医疗保健获取障碍与利用情况:一项横断面研究。

Healthcare access barriers and utilization among the Arab Bedouin population in Israel: a cross-sectional study.

作者信息

Shibli Haneen, Feder-Bubis Paula, Daoud Nihaya, Aharonson-Daniel Limor

机构信息

Faculty of Health Sciences School of Public Health, Ben-Gurion University of the Negev, P.O.B. 653, Beer-Sheva, 8410501, Israel.

PREPARED Centre for Emergency Response Research, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

出版信息

Int J Equity Health. 2025 Feb 10;24(1):40. doi: 10.1186/s12939-025-02398-2.

Abstract

BACKGROUND

The Arab Bedouin Muslim minority in Israel, is one of the country's most vulnerable groups. They are residents of the Israeli geographical and social periphery. Bedouin's healthcare service utilization is shaped by its sociocultural and environmental characteristics. This study explores healthcare access barriers and utilization patterns among the Arab Bedouin population, focusing on two types of legal status locality: a legally recognized Bedouin town and the surrounding unrecognized villages.

METHODS

We conducted a cross-sectional study among Arab Bedouin adults (N = 246) residing in a Bedouin recognized town and unrecognized villages. Using an anonymous, self-administered questionnaire in Arabic. We collected information about healthcare visits, types of services accessed, access barriers and the factors influencing healthcare-seeking behavior. Multivariate linear regression was conducted to examine the predictors of healthcare services utilization.

RESULTS

Of the 246 participants, 60% resided in a recognized Bedouin town and 40% resided in unrecognized villages. Most participants were female (61%) and the mean age was 37.8 ± 13.9 years. The findings showed that barriers to seeking care differed based on the residence town's legal status. While residents of unrecognized villages face significant physical access barriers, they also show a notable reliance on cross-border healthcare providers, particularly in the Palestinian Authority. Chronic medical conditions (B = 1.147, p < 0.001), gender (B = -0.459, p < 0.01), and parental status (B = 0.667, p = 0.001) have been identified as strong predictors of healthcare service utilization.

CONCLUSION

This study offers new insights regarding the complexity of healthcare access and utilization in the Arab Bedouin population in Israel, emphasizing that barriers are not only structural but also deeply intertwined with cultural and linguistic factors. The study highlights the universal message of addressing both physical and systemic barriers to healthcare access, ensuring that healthcare services are culturally and linguistically tailored to the specific needs of marginalized populations locally and globally. These findings provide actionable insights for policymakers emphasizing the need to improve health equity by addressing the access barriers faced by the Arab Bedouin population, including structural, cultural, and linguistic challenges, and ensuring targeted interventions for marginalized communities both locally and globally.

摘要

背景

以色列的阿拉伯贝都因穆斯林少数群体是该国最脆弱的群体之一。他们居住在以色列的地理和社会边缘地区。贝都因人的医疗服务利用情况受其社会文化和环境特征的影响。本研究探讨阿拉伯贝都因人群体中的医疗服务获取障碍和利用模式,重点关注两种法律地位地区:合法认可的贝都因城镇及周边未被认可的村庄。

方法

我们对居住在一个被认可的贝都因城镇和未被认可村庄的阿拉伯贝都因成年人(N = 246)进行了一项横断面研究。使用一份匿名的阿拉伯文自填式问卷。我们收集了有关医疗就诊、所获得的服务类型、获取障碍以及影响就医行为的因素的信息。进行多变量线性回归以检验医疗服务利用的预测因素。

结果

在246名参与者中,60%居住在被认可的贝都因城镇,40%居住在未被认可的村庄。大多数参与者为女性(61%),平均年龄为37.8 ± 13.9岁。研究结果表明,根据居住城镇的法律地位,寻求医疗服务的障碍有所不同。虽然未被认可村庄的居民面临重大的实际获取障碍,但他们也显著依赖跨境医疗服务提供者,尤其是巴勒斯坦权力机构的提供者。慢性疾病(B = 1.147,p < 0.001)、性别(B = -0.459,p < 0.01)和父母身份(B = 0.667,p = 0.001)已被确定为医疗服务利用的有力预测因素。

结论

本研究为以色列阿拉伯贝都因人群体中医疗服务获取和利用的复杂性提供了新的见解,强调障碍不仅是结构性的,而且与文化和语言因素紧密相连。该研究突出了应对医疗服务获取的实际和系统性障碍这一普遍信息,确保医疗服务在文化和语言上符合当地和全球边缘化人群的特定需求。这些发现为政策制定者提供了可采取行动的见解,强调需要通过解决阿拉伯贝都因人群体面临的获取障碍来改善健康公平,包括结构性、文化和语言挑战,并确保在当地和全球对边缘化社区进行有针对性的干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d566/11808989/cf8aee07bef4/12939_2025_2398_Fig1_HTML.jpg

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