International Journal of Public Health

, Volume 63, Issue 7, pp 875–882 | Cite as

Socio-economic status and chronic disease in the West Bank and the Gaza Strip: in and outside refugee camps

  • Marie JonassenEmail author
  • Amira Shaheen
  • Mohammed Duraidi
  • Khaled Qalalwa
  • Bernard Jeune
  • Henrik Brønnum-Hansen
Original Article



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.


Palestinian Socio-economic factors Chronic disease Refugees 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Participants in the study have given an informed consent to participate.


  1. Abukhdeir HF, Caplan LS, Reese L, Alema-Mensah E (2013) Factors affecting the prevalence of chronic diseases in palestinian people: an analysis of data from the Palestinian Central Bureau of Statistics. East Mediterr Health J 19(4):307–313CrossRefPubMedPubMedCentralGoogle Scholar
  2. 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. CrossRefGoogle Scholar
  3. Al-Khatib IA, Kamal N, Hamed N, Hmeidan N, Massad S (2003) Impact of housing conditions on the health of the people at Al-Ama’ri refugee camp in the West Bank of Palestine. Int J Environ Health Res 13(4):315–326. CrossRefPubMedGoogle Scholar
  4. Al-Khatib IA, Arafat RN, Musmar M (2005) Housing environment and Women’s health in a Palestinian Refugee Camp. Int J Environ Health Res 15(3):181–191. CrossRefPubMedGoogle Scholar
  5. 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. CrossRefPubMedPubMedCentralGoogle Scholar
  6. Batniji R, Rabaia Y, Nguyen-Gillham V, Giacaman R, Sarraj E, Punamaki R, Saab H, Boyce W (2009) Health as human security in the occupied Palestinian territory. Lancet 373(9669):1133–1143. CrossRefPubMedGoogle Scholar
  7. Boutayeb A, Boutayeb S, Boutayeb W (2013) Multi-morbidity of non communicable diseases and equity in WHO eastern mediterranean countries. Int J Equity Health. CrossRefPubMedPubMedCentralGoogle Scholar
  8. 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
  9. Christos PJ, Chemaitelly H, Abu-Raddad LJ, Zirie MA, Deleu D, Mushlin AI (2014) Prevention of type II diabetes mellitus in Qatar: who is at risk? Qatar Med J. CrossRefPubMedPubMedCentralGoogle Scholar
  10. Daniel K (2008) Chronic disease epidemiology. In: Boslaugh Sarah, McNutt Louise-Anne (eds) Encyclopedia of epidemiology. Sage, Thousand Oaks, pp 181–185Google Scholar
  11. 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
  12. GBD 2015 Eastern Mediterranean Region Cancer Collaborators Int J Public Health (2017a) Burden of cancer in the Eastern Mediterranean Region, 2005–2015: findings from the Global Burden of Disease 2015 Study. Int J Public Health. CrossRefGoogle Scholar
  13. 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. CrossRefGoogle Scholar
  14. Habib RRZ, Fawaz MM, Basma SH, Yeretzian JS (2009) Housing quality and ill health in a disadvantaged urban community. Public Health 123(2):174–181. CrossRefPubMedGoogle Scholar
  15. 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. CrossRefPubMedGoogle Scholar
  16. Jackson RT, Al-Mousa Z, Al-Raqua M, Prakash P, Muhanna AN (2002) Multiple coronary risk factors in healthy older Kuwaiti males. Eur J Clin Nutr 56(8):709–714. CrossRefPubMedGoogle Scholar
  17. 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. CrossRefGoogle Scholar
  18. 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. CrossRefGoogle Scholar
  19. Palestinian Central Bureau of Statistics (2007) Palestinian Family Health Survey, 2006: Preliminary Report. Palestinian Central Bureau of Statistics, RamallahGoogle Scholar
  20. Palestinian Central Bureau of Statistics (2013) Final Report of the Palestinian Family Survey 2010. Palestinian Central Bureau of Statistics, RamallahGoogle Scholar
  21. Palestinian Central Bureau of Statistics (2014) Palestine in figures 2013. Palestinian Central Bureau of Statistics, Ramallah. Accessed 2 June 2018
  22. 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
  23. Rocco L, Tanabe K, Suhrcke M, Fumagalli E (2011) Chronic diseases and labor market outcomes in Egypt. The World Bank. Accessed 2 June 2018CrossRefGoogle Scholar
  24. Salame J, Tyan P, Salameh P, Waked M (2014) Hyperreactive airway disease in adults: data from a national study in Lebanon. Leban Med J 62(3):143–149CrossRefGoogle Scholar
  25. Shah NM, Behbehani J, Shah MA (2010) Prevalence and correlates of major chronic illnesses among older Kuwaiti nationals in two governorates. Med Prin Pract Int J Kuwait Univ Health Sci Cent 19(2):105–112. CrossRefGoogle Scholar
  26. 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. Scholar
  27. 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. CrossRefGoogle Scholar
  28. The United Nations Relief and Works Agency (2014) Annual Report 2013. UNRWA health department.
  29. The United Nations Relief and Works Agency (2016) UNRWA 2018. Accessed 1 Mar 2018
  30. World Health Organization (2010) Global status report on noncommunicable diseases 2010. World Health Organization, GenevaGoogle Scholar
  31. World Health Organization (2012) WHO/NMH/CCS/03—STEPS_Instrument_v2.1.pdf.
  32. Zabaneh JE, Watt GCM, O’Donnell CA (2008) Living and health conditions of Palestinian refugees in an unofficial camp in the Lebanon: a cross-sectional survey. J Epidemiol Community Health 62(2):91–97. CrossRefPubMedGoogle Scholar

Copyright information

© Swiss School of Public Health (SSPH+) 2018

Authors and Affiliations

  • Marie Jonassen
    • 1
    Email author
  • Amira Shaheen
    • 2
  • Mohammed Duraidi
    • 3
  • Khaled Qalalwa
    • 3
  • Bernard Jeune
    • 4
  • Henrik Brønnum-Hansen
    • 1
  1. 1.Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
  2. 2.Public Health DivisionAn-Najah National UniversityNablusPalestine
  3. 3.Palestinian Central Bureau of StatisticsRamallahPalestine
  4. 4.Institute of Public Health, University of Southern DenmarkOdenseDenmark

Personalised recommendations