Structural racism and the health of Palestinian citizens of Israel

ABSTRACT

Palestinian citizens of Israel (PCI) constitute almost 20% of the Israeli population. Despite having access to one of the most efficient healthcare systems in the world, PCI have shorter life expectancy and significantly worse health outcomes compared to the Jewish Israeli population. While several studies have analysed the social and policy determinants driving these health inequities, direct discussion of structural racism as their overarching etiology has been limited. This article situates the social determinants of health of PCI and their health outcomes as stemming from settler colonialism and resultant structural racism by exploring how Palestinians came to be a racialized minority in their homeland. In utilising critical race theory and a settler colonial analysis, we provide a structural and historically responsible reading of the health of PCI and suggest that dismantling legally codified racial discrimination is the first step to achieving health equity.

KEYWORDS:

• Racism
• ethnicity
• Israel
• Arabs
• Palestine
• health disparities

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Notes

1 While this paper focuses on PCI and not Palestinian residents of occupied East Jerusalem, Palestinians in the rest of the oPt or Palestinian refugees in neighboring countries, it is important to emphasize that these different populations are all Palestinians that Zionist settler colonialism has fragmented to several dismembered geographies and different lived realities(Asi et al., 2022). The occupation of the oPt adversely affects the health of PCI. Many PCI are denied family unification (when one of the spouses does not hold an Israeli ID), leading to several health concerns, including a lack of access to Israeli healthcare services for their spouses (Daoud, Alfayumi-Zeadna, et al., 2018a; Tanous, Wispelwey, et al., 2022). Another less studied field is the effect of the occupation and military aggressions against Palestinians in the West Bank and Gaza Strip on the health of PCI due to constant stress, fear and worrying for their people and extended families.

2 This division between Jews and all other people is clearly manifested in the issuing of ID cards for the populations that live under Israeli control. Up until 2005, every Israeli ID card had an ethnicity category stating if the person was Jewish, Arab, Druze, or Bedouin. Palestinians in Jerusalem hold a resident, not citizen, ID card and Palestinians in the oPt carry a green Palestinian ID. Every Jewish person, whether living in Tel Aviv or in a settlement in the West Bank holds a blue Israeli ID card. Reminiscent of the settler colonial pass system developed for US plantations and reservations (Mamdani, 2015), this color-coded stratification of ID cards determines much of one’s ability to move, study, work, and live in different places. (Tawil-Souri, 2012).

3 Per Hannah Arendt, any state founded on a homogeneous idea of the nation is bound to expel those who do not belong to the nation and so to reproduce the structural relation between the nation state and the production of stateless persons (Butler, 2012).

4 This law, while using neutral language, aims to shrink the space of civil society through the targeting of NGOs that are critical of the government, especially organizations focusing on issues related to discrimination, racism, and occupation, most of whom receive grant funding from foreign governments and funds. Right wing and settler organizations that are heavily funded by private foreign donors are not held to the standard of this law (Adalah, 2016).

5 The amendment targets and harms PCI, making it specifically challenging for the Palestinian parties, representing the different political ideologies, to successfully contend for seats in the election (Adalah, 2014).