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

Purpose 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. Methods 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. Results 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. Conclusions 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.