Health-promoting behaviors and health locus of control from a multicultural perspective

Objectives: To assess the relationships between health-promoting behaviors and health locus of control (HLC) in the context of cultural differences between Jewish and Arab Israelis. Methods: A random, population-based sample of 358 Jews and 162 Arabs, aged 50-75 years, participated in a telephone survey. Questionnaires included demographic variables and details on three health behaviors, namely balanced nutrition, physical activity and regular checkups, and HLC. Results: Arab respondents, especially Arab women, reported lower internal HLC and lower engagement in physical activity, while external HLC, balanced nutrition, and attending regular checkups varied by ethnicity only. According to multiple regression analyses, Jewish ethnicity and male sex were significantly related to internal HLC, while Arab ethnicity, older age and lower education were significantly related to external HLC. Although internal and external HLC were significantly correlated with balanced nutrition and regular physical activity, the regression analysis revealed that only higher internal HLC explained the variance of balanced nutrition. The variance of all health-promoting behaviors was explained by ethnicity, while physical activity was also explained by sex, and balanced nutrition was explained by higher economic status and higher religiosity. Regular medical checkups were also explained by higher economic status. Conclusions: Health-promoting behaviors and HLC were each mainly related to ethnicity and sex. Messages to enhance health-promoting behaviors should be adjusted culturally, especially for women.