ABSTRACT

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 [F(11,600), p < .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 (β = −0.52), which, in turn, was negatively associated with stress (β = −0.10). Furthermore, discrimination was positively associated with perceived threat (β = 0.21), which, in turn, was positively associated with stress (β = 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.

摘要

在大流行期间，少数群体可能会承受很大的压力，这可能会损害他们的身心健康。但是，据我们所知，在 COVID-19 大流行期间，以色列的少数民族尚未对此进行过检查。因此，本研究探讨了第一波 COVID-19 爆发期间以色列阿拉伯少数民族的压力，以及其与人们感知到的 COVID-19 威胁、对医疗保健系统的信任、遵守预防指南和感知到的歧视的关系.

该研究分析了对 626 名以色列阿拉伯人的横断面在线调查。大多数参与者 (65%) 报告了中度压力，10% 报告了严重压力。与其他少数群体相比，贝都因人的压力明显更高。参与者还报告了高度感知威胁、中度至高度歧视、对医疗保健系统的中等信任度以及对指南的高度遵守。

分层回归分析表明，年龄、宗教信仰、对医疗保健系统的信任、感知威胁和遵守指南都是压力的重要预测因素 [ F (11,600), p  < .001]。该模型解释了 24% 的压力变化。结构方程模型（SEM）显示，参与者感知到的威胁和信任在他们感知到的歧视和压力之间起中介作用[间接效应 = 0.13, SE = 0.03 CI = (0.08, 0.18)]，其中歧视与信任呈负相关（β  = -0.52），这反过来又与压力呈负相关（β  = -0.10）。此外，歧视与感知威胁呈正相关（β = 0.21），而这又与压力呈正相关（β  = 0.35）。歧视是健康的重要社会决定因素——尤其是在卫生紧急情况下，对医疗保健系统的信任和感知到的威胁至关重要。因此，我们的研究结果可以帮助政策制定者制定适合不同人群的公平政策，并可能降低少数族裔的压力水平，从而改善他们的身心健康。