Ethnic Health Inequalities in Unequal Societies: Morbidity Gaps Between Palestinians and Jews in Israel

Health inequalities between ethnic groups are found in many multiethnic societies. A widely used model for explaining these inequalities posits that social inequalities among ethnic groups account for a large portion of differences in their health statuses. By analyzing gaps in morbidity in Israel between the Palestinian minority and the Jewish majority, this study applies this model in a context characterized by large social inequalities. Propensity score matching is applied to form two ethnic groups, minority and majority, with similar social positions, using data from the Israel Health Survey 1999–2000. The matched groups are then compared in prevalence of two chronic diseases: diabetes and heart disease. In addition, reduction in the ethnic health gap is decomposed into two components: size of social inequalities between the two groups and strength of the socioeconomic gradient of health among the majority group. Results show that social inequality may only partially account for higher morbidity among the Palestinian minority. Reduction in the female gap was higher than that in the male gap, which reflects larger social inequalities between females in addition to a stronger female socioeconomic gradient of health. Results also show that matching was not completely successful in forming comparable minority and majority groups, which indicates that in societies characterized by high inequality there is a methodological limitation in estimating the role of social inequalities in explaining ethnic health gaps.