Advertisement

The European Journal of Health Economics

, Volume 10, Issue 1, pp 93–101 | Cite as

The quality of life of Palestinians living in chronic conflict: assessment and determinants

  • Awad MatariaEmail author
  • Rita Giacaman
  • Angelo Stefanini
  • Nirmala Naidoo
  • Paul Kowal
  • Somnath Chatterji
Original paper

Abstract

This study assessed the quality of life (QoL) of Palestinians living in conditions of chronic conflict and examined its determinants. An adapted World Health Organization quality of life (WHOQoL-Bref) instrument was used in a representative sample of 1,008 adults. Factor analysis and multiple regression were conducted to determine associations between demographic and socioeconomic characteristics and scores of extracted principal determinants, and estimated overall and domain-specific QoL scores. Men, older persons and those less educated reported lower QoL than their counterparts. Negative associations were also found with higher distress and fear levels, and lower financial and freedom status. The chronic and entrenched conflict over generations resulted in lower QoL for the population of the Occupied Palestinian Territory.

Keywords

Quality of Life WHOQoL-Bref Conflict Determinants Occupied Palestinian Territory 

JEL Classification

I10 I18 

Notes

Acknowledgments

The authors would like to thank the World Health Organization–Eastern Mediterranean Regional Office (WHO-EMRO), for funding the study and providing the technical assistance needed. Thanks are also due to the two anonymous referees, for their comments that very much improved the quality of the paper, and to the Palestinian Central Bureau of Statistics (PCBS), for conducting the fieldwork. The analyses and ideas presented in the paper are the responsibility of the authors and do not necessarily reflect the position of the WHO or the PCBS. The paper was presented at the 6th international Health Economics Association congress in Copenhagen, Denmark, and at the 14th Economic Research Forum Conference in Cairo, Egypt.

References

  1. 1.
    Shearer, D.: The humanitarian crisis in the occupied Palestinian territory: an overview. United Nations Office for the Coordination of Humanitarian Affairs (OCHA) Jerusalem. http://www.odihpn.org/report.asp?id=2664. Accessed 18 Dec 2007
  2. 2.
    United Nations: United Nations Consolidated Appeal Process (CAP) for the OPT: The humanitarian crisis: facts and figures, p. 3. http://www.ochaopt.org/?module=displaysection&section_id=117 (2007)
  3. 3.
    Hendrickson, D.: Humanitarian action in protracted crisis: an overview of the debates and dilemmas. Disasters. 22, 283–287 (1998)CrossRefGoogle Scholar
  4. 4.
    Stefanini, A., Ziv, H.: Occupied Palestinian Territory: linking health to human rights. Health Hum Rights 8, 160–175 (2004)CrossRefGoogle Scholar
  5. 5.
    Srour, R.W.: Children living under a multi-traumatic environment: the Palestinian case. Isr J Psychiatry Relat Sci 42, 88–95 (2005)Google Scholar
  6. 6.
    Thabet, A.A., Vostanis, P.: Child mental health problems in the Gaza Strip. Isr J Psychiatry Relat Sci. 42, 84–87 (2005)Google Scholar
  7. 7.
    Musallam, N., et al.: The psychological effects of Intifada Al Aqsa: acute stress disorder and distress in Palestinian–Israeli students. Isr J Psychiatry Relat Sci 42, 96–105 (2005)Google Scholar
  8. 8.
    World Psychiatric Association Cairo Declaration: Mass violence and mental health (2005)Google Scholar
  9. 9.
    Missing Pieces, Considering the needs of gun violence survivors. http://www.hdcentre.org/datastore/Small%20arms/Missing_Pieces/Theme%203.pdf. Accessed 19 Jan 2008
  10. 10.
    United Nations: Humanitarian plan of action for the Occupied Palestinian Territory. Technical Assessment Mission (2002)Google Scholar
  11. 11.
    Giacaman, R., Abu-Rmeileh, N.M., Wick, L.: The limitations on choice: Palestinian women’s childbirth location, dissatisfaction with the place of birth and determinants. Eur J Public Health. 17, 86–91 (2007)CrossRefGoogle Scholar
  12. 12.
    Salama, P., et al.: Lessons learned from complex emergencies over past decade. Lancet 364, 1801–1813 (2004)CrossRefGoogle Scholar
  13. 13.
    The World Bank: Two years after London: restarting Palestinian economic recovery. Economic Monitoring Report to The Ad Hoc Liason Committee (2007)Google Scholar
  14. 14.
    HDIP, Health, Development, Information and Policy Institute: Health and segregation II: the impact of the Israeli Separation Wall on access to health care services. An updated research, July 2005. http://www.health-now.org/mediafiles/mediafile81.pdf
  15. 15.
    United Nations, United Nations Office for the Coordination of Humanitarian Affairs OPT, East Jerusalem: The humanitarian impact of the West Bank Barrier. July 2007. http://www.ochaopt.org/documents/Jerusalem-30July2007.pdf
  16. 16.
    The World Bank: Four years—intifada, closures and Palestinian economic crisis. An assessment. The World Bank, October 2004Google Scholar
  17. 17.
    World Health Organization: Possible consequences on the health sector due to the reduction of support to the public services. WHO, Jerusalem, April 2006Google Scholar
  18. 18.
    Buchanan, C., Muggah, R.: No relief: surveying the effects of gun violence on humanitarian and development personnel,2005. Centre for Humanitarian Dialogue: Geneva, Switzerland. http://www.hdcentre.org/No%20Relief. Accessed 6 June 2006
  19. 19.
    United Nations: United Nations. Humanitarian update. Occupied Palestinian Territory. Special focus: emerging humanitarian risks, January 2006Google Scholar
  20. 20.
    Ware, J. Jr, Sherbourne, C.: The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 30, 473–483 (1992)CrossRefGoogle Scholar
  21. 21.
    Cotrufo, M., et al.: Treatment of extensive ischemic cardiomyopathy: quality of life following two different surgical strategies. Eur J Cardiothorac Surg 27, 481–487 (2005)Google Scholar
  22. 22.
    de Oliveira Filho G.R., Sturm E.J., Sartorato A.E.: Compliance with common program requirements in Brazil: its effects on resident’s perceptions about quality of life and the educational environment. Acad Med 80, 98–102 (2005)CrossRefGoogle Scholar
  23. 23.
    Fellinger, J., et al.: An innovative and reliable way of measuring health-related quality of life and mental distress in the deaf community. Soc Psychiatry Psychiatr Epidemiol 40, 245–50 (2005)CrossRefGoogle Scholar
  24. 24.
    Hanh, V.T., et al.: Health related quality of life of adolescents in Vietnam: cross-cultural adaptation and validation of the Adolescent Duke Health Profile. J Adolesc 28, 127–146 (2005)CrossRefGoogle Scholar
  25. 25.
    Kazlauskaite, M., Reklaitiene, R.: Assessment of quality of life in the middle-aged Kaunas population. Medicina (Kaunas) 41, 155–61 (2005)Google Scholar
  26. 26.
    Skevington, S.M., Lotfy, M., O’Connell, K.A.: The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res 13, 299–310 (2004)CrossRefGoogle Scholar
  27. 27.
    Skevington, S.M., Sartorius, N., Amir, M.: Developing methods for assessing quality of life in different cultural settings. The history of the WHOQOL instruments. Soc Psychiatry Psychiatr Epidemiol 39, 1–8 (2004)CrossRefGoogle Scholar
  28. 28.
    World Health Organization: WHOQoL Study Protocol. WHO (MNH7PSF/93.9) (1993)Google Scholar
  29. 29.
  30. 30.
    World Health Organization: WHO Programme on Mental Health, WHO/MSA/MNL/PSF/97.4Google Scholar
  31. 31.
    Giacaman, R., et al.: Quality of life in the Palestinian context: an inquiry in war-like conditions. Health Policy 81, 68−84 (2007)CrossRefGoogle Scholar
  32. 32.
    Muthen, L., Muthen, B.: Mplus confirmatory factor analysis. In: Muthen, M. (ed.) Mplus user’s guide. Los Angeles (2004)Google Scholar
  33. 33.
    Power, M.: Development of a common instrument for quality of life. EUROHIS: developing common instruments for health surveys (2003)Google Scholar
  34. 34.
    Ahmad, O., et al.: Age standardization of rates: a new WHO standard. GPE discussion paper series: no.31. EIP/GPE/EBD World Health Organization. http://www3.who.int/whosis/discussion_papers (2001)
  35. 35.
    Zahran, H., et al.: Health-related quality of life surveillance—United States, 1993–2002. MMWR Surveill Summ 54, 1–35 (2005)Google Scholar
  36. 36.
    Naess, O., Hernes, F.H., Blane, D.: Life-course influences on mortality at older ages: evidence from the Oslo Mortality Study. Soc Sci Med 62, 329–336 (2006)CrossRefGoogle Scholar
  37. 37.
    Giacaman, R., et al.: Humiliation: the invisible trauma of war for Palestinian youth. Public Health 121, 563–571 2007)CrossRefGoogle Scholar
  38. 38.
    Marmot, M.G.: Status syndrome: a challenge to medicine. JAMA 295, 1304–1307 (2006)CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Awad Mataria
    • 1
    • 2
    Email author
  • Rita Giacaman
    • 1
  • Angelo Stefanini
    • 3
  • Nirmala Naidoo
    • 4
  • Paul Kowal
    • 4
  • Somnath Chatterji
    • 4
  1. 1.Institute of Community and Public HealthBirzeit UniversityWest BankOccupied Palestinian Territory
  2. 2.Department of Economics, Faculty of Commerce and EconomicsBirzeit UniversityWest BankOccupied Palestinian Territory
  3. 3.Department of Medicine and Public HealthUniversity of BolognaBolognaItaly
  4. 4.Department of Measurement and Health Information SystemsWorld Health OrganizationGenevaSwitzerland

Personalised recommendations