Socio-economic status and chronic disease in the West Bank and the Gaza Strip: in and outside refugee camps
The study investigated the association between socio-economic status (SES) and self-reported chronic disease (CD) among the Palestinian population in the Occupied Palestinian Territory, and whether this association was similar in the refugee camps.
We used data from representative samples in 2006 and 2010 collected by the Palestinian Central Bureau of Statistics. SES was defined by education, wealth and employment status. Associations between SES and CD were analysed and stratified by living in or outside refugee camps.
CD prevalence increased among men and decreased among women in all SES categories and the Odds Ratio for CD was higher inside than outside the refugee camps, except for women in 2006. In both 2006 and 2010 the odds ratio of CD was higher among the lowest SES groups. The pattern of the negative association between SES and CD was similar in and outside the refugee camps.
We found that the highest burden of CD is among those with low SES. In spite of a higher CD Odds Ratio in the refugee camps, the pattern of association between SES and CD did not differ in the refugee camps.
KeywordsPalestinian Socio-economic factors Chronic disease Refugees
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Participants in the study have given an informed consent to participate.
- Abu-Rmeileh NME, Hammoudeh W, Mataria A, Husseini A, Khawaja M, Shannon HS, Hogan D, Watt GCM, Zurayk H, Giacaman R (2012) Health-related quality of life of Gaza Palestinians in the aftermath of the winter 2008-09 Israeli attack on the strip. Eur J Pub Health 22(5):732–737. https://doi.org/10.1093/eurpub/ckr131 CrossRefGoogle Scholar
- Bates K, Leone T, Ghandour R, Mitwalli S, Nasr S, Coast E, Giacaman R (2017) Women’s health in the occupied palestinian territories: contextual influences on subjective and objective health measures. PLoS ONE 12(10):e0186610. https://doi.org/10.1371/journal.pone.0186610 CrossRefPubMedPubMedCentralGoogle Scholar
- Chaaban J, Ghattas H, Habib R, Hanafi S, Sahyoun N, Salti N, Seyfert K, Naamani N (2010) Socio-economic survey of Palestinian refugees in Lebanon. The American University of Beirut (AUB) & the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA)Google Scholar
- Daniel K (2008) Chronic disease epidemiology. In: Boslaugh Sarah, McNutt Louise-Anne (eds) Encyclopedia of epidemiology. Sage, Thousand Oaks, pp 181–185Google Scholar
- Diderichsen F, Evans T, Whitehead M (2001) The social basis of disparities in health. In: Evans T, Whitehead M, Diderichsen F, Bhuiya A, Wirth M (eds) Challenging inequities in health: from ethics to action. Oxford University Press, OxfordGoogle Scholar
- GBD 2015 Eastern Mediterranean Region Cardiovascular Disease Collaborators Int J Public Health (2017b) Cardiovascular diseases in the Eastern Mediterranean region, 1990–2015: findings from the Global Burden of Disease 2015 Study. Int J Public Health. https://doi.org/10.1007/s00038-017-1012-3 CrossRefGoogle Scholar
- Husseini A, Abu-Rmeileh NME, Mikki N, Ramahi TM, Abu Ghosh H, Barghuthi N, Khalili M, Bjertness E, Holmboe-Ottesen G, Jervell J (2009) Cardiovascular diseases, diabetes mellitus, and cancer in the occupied Palestinian territory’. Lancet 373(9668):1041–1049. https://doi.org/10.1016/S0140-6736(09)60109-4 CrossRefPubMedGoogle Scholar
- Kaplan GA (2001) Socioeconomic status and health. In Smelser NJ, Baltes PB (eds) International encyclopedia of the social and behavioral sciences. Pergamon, Oxford, pp. 14554–14558. http://www.sciencedirect.com/science/article/pii/B0080430767038274 CrossRefGoogle Scholar
- Mokdad AH, Jaber S, Abdel Aziz MI, AlBuhairan F, AlGhaithi A, AlHamad NM, Al-Hooti SN et al (2014) The state of health in the Arab World, 1990–2010: an analysis of the burden of diseases, injuries, and risk factors. Lancet (Lond Engl) 383(9914):309–320. https://doi.org/10.1016/S0140-6736(13)62189-3 CrossRefGoogle Scholar
- Palestinian Central Bureau of Statistics (2007) Palestinian Family Health Survey, 2006: Preliminary Report. Palestinian Central Bureau of Statistics, RamallahGoogle Scholar
- Palestinian Central Bureau of Statistics (2013) Final Report of the Palestinian Family Survey 2010. Palestinian Central Bureau of Statistics, RamallahGoogle Scholar
- Palestinian Central Bureau of Statistics (2014) Palestine in figures 2013. Palestinian Central Bureau of Statistics, Ramallah. http://www.pcbs.gov.ps/Downloads/book2040.pdf. Accessed 2 June 2018
- Palestinian Central Bureau of Statistics (PCBS), Food and Agriculture Organization of the United Nations (FAO), World Food Programme (WFP), and The United Nations Relief and Works Agency (UNRWA) (2012) Socio-Economic & Food Security Survey 2012—West Bank and Gaza Strip, Palestine. Palestinian Central Bureau of Statistics, FAO, WFP, UNRWA, PalestineGoogle Scholar
- Rocco L, Tanabe K, Suhrcke M, Fumagalli E (2011) Chronic diseases and labor market outcomes in Egypt. The World Bank. http://elibrary.worldbank.org/doi/abs/10.1596/1813-9450-5575. Accessed 2 June 2018CrossRefGoogle Scholar
- Shahraz S, Forouzanfar MH, Sepanlou SG, Dicker D, Naghavi P, Pourmalek F, Mokdad A et al (2014) Population health and burden of disease profile of Iran among 20 countries in the region: from Afghanistan to Qatar and Lebanon. Arch Iranian Med 17(5):336–342. https://doi.org/0141705/AIM.006Google Scholar
- Sozmen K, Unal B, Saidi O, Romdhane HB, Abu-Rmeileh NME, Husseini A, Fouad F et al (2015) Cardiovascular risk factor trends in the Eastern Mediterranean region: evidence from four countries is alarming. Int J Public Health 60(Suppl 1):S1–S2. https://doi.org/10.1007/s00038-014-0610-6 CrossRefGoogle Scholar
- The United Nations Relief and Works Agency (2014) Annual Report 2013. UNRWA health department. http://www.unrwa.org/sites/default/files/health_annual_report_2013.pdf
- The United Nations Relief and Works Agency (2016) UNRWA 2018. http://www.unrwa.org/where-we-work. Accessed 1 Mar 2018
- World Health Organization (2010) Global status report on noncommunicable diseases 2010. World Health Organization, GenevaGoogle Scholar
- World Health Organization (2012) WHO/NMH/CCS/03—STEPS_Instrument_v2.1.pdf. http://www.who.int/ncds/surveillance/steps/STEPS_Instrument_v2.1.pdf