Social Psychiatry and Psychiatric Epidemiology

, Volume 53, Issue 10, pp 1111–1122 | Cite as

Interpersonal and institutional ethnic discrimination, and mental health in a random sample of Palestinian minority men smokers in Israel

  • Nihaya Daoud
  • Meiyin Gao
  • Amira Osman
  • Carles Muntaner
Original Paper



We sought to extend research into the health effects of discrimination to a non-Western context. We examined the associations between interpersonal and institutional ethnic discrimination, and anxiety and depression among Palestinian–Arab minority men citizens of Israel.


We used data from a nationwide stratified random sample of 964 Arab men in Israel, current or former smokers (age 18–64), who were interviewed as part of a 2012–2013 study on cessation. The questionnaire included an adapted Arabic version of the Experiences of Discrimination scale and a new scale on perceived institutional group discrimination. Logistic regression models estimated the effects of both forms of discrimination on depressive symptoms (Center for Epidemiological Studies Depression Scale) and anxiety (State-Trait Anxiety Inventory), while adjusting for socio-demographic and economic factors.


The prevalence of depressive symptoms was 24.7% and anxiety 45.5%. Approximately 42% of men reported experiencing interpersonal discrimination, and 50.8% reported perceived institutional group discrimination. Controlling for covariates, experiencing interpersonal discrimination was associated with higher odds for depressive symptoms [OR = 2.36, 95% confidence intervals (CI) = 1.69–1.57] and anxiety (OR = 1.92, 95% CI = 1.45–2.55). Perceived institutional group discrimination was associated only with anxiety (OR = 1.76, 95% CI = 1.32–2.35). Introducing both forms of discrimination into the same model slightly attenuated these associations.


Interpersonal and institutional forms of ethnic discrimination are independently associated with poorer mental health among Arab minority men current and former smokers in Israel. Future research is warranted into both forms of discrimination in the general Arab population in Israel, including women.


Interpersonal and institutional discrimination Minority men Smokers Depressive symptoms and anxiety Mental health Arab–Palestinian in Israel 



The original study on smoking cessation was supported by grant number R/152/10 of the Israel National Institution for Health Policy and Research (NIHP). The current analysis was not funded.

Author contributions

ND initiated the study, prepared the first draft of the paper, and participated in preparing all sections of the paper. MG conducted the data analyses with guidance from ND. AO helped draft the background section. CM critically reviewed different versions of the paper. All co-authors contributed to the study design, read previous versions of the paper, and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval and consent to participate

The study was approved by the Faculty of Health Sciences Review Board at Ben-Gurion University of the Negev. Each participant signed an informed consent form to participate in the study before starting the interview.

Supplementary material

127_2018_1531_MOESM1_ESM.docx (29 kb)
Supplementary material 1 (DOCX 29 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Public Health, Faculty of Health SciencesBen-Gurion University of the NegevBeer ShevaIsrael
  2. 2.Critical Care ServicesTorontoCanada
  3. 3.Center for Regulatory Research on Tobacco Communication, Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Department of Psychiatry and Center for Research in Inner City Health, Bloomberg Faculty of Nursing, Dalla Lana School of Public Health, St Michael’s HospitalUniversity of TorontoTorontoCanada

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