Adult functioning in the occupied Palestinian territory: a survey and event history calendar assessment. (August 2017)

• Record Type: Journal Article
• Authors: Barber, Brian K; McNeely, Clea; Allen, Chenoa; Belli, Robert F
• Is Part Of: Lancet. Volume 390(2017)Supplement 2
• Page Start: S22
• Publication Date: 2017-08
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(17)32073-1
• Languages: English
• ISSNs: 0140-6736

Abstract

Abstract: Background: The 2009 Lancet special issue on the Health of Palestinians noted that Palestinian voices have been marginalised in dialogues about international health and called for rigorous empirical evidence on Palestinian functioning. This study aimed to obtain such evidence. Methods: In October, 2011, a survey on current wellbeing and an event history calendar (a validated method of collecting retrospective data via a quantitative grid of key life events and time in years) covering 1987–2011 were administered to a representative sample of residents in the West Bank, East Jerusalem, and the Gaza Strip (response rate 97%; n=1778; mean age 37·04, SD 3·55; 50·3% female; 43·6% refugees). The clustered probability sample was drawn from all enumeration areas from updated 2007 Palestine Central Bureau of Statistics census maps. Instruments were administered by household interview in Arabic by trained local field workers from the Palestinian Center for Policy and Survey Research. The study was approved by institutional review boards of this centre and the University of Tennessee; written informed consent was obtained. Findings: Of the total sample, 51·3% had a family income above poverty level, 49·2% had been employed for a full year, 23·1% had inadequate food, 40·1% had inadequate water, 83·5% experienced human insecurity, 20·6% perceived government stability, 85% reported family satisfaction, and 36·3% had poor self-rated health. 38·7% (87·8% since 1987) had heard or felt the effects of a bomb, 3·3% (77·9%) had had their home raided, and 16·0% (73·8%) had witnessed humiliation of someone close to them. Travel was barred or delayed for 24·1% of those requiring travel for medical care (98·3% since 1987), 34·9% of those requiring travel to visit family (95·1%), and 32·2% of those requiring travel for work (91·9%). Mean scores (SD, range) were 3·34 (0·81, 1–5) for sense of belonging, 4·10 (0·74, 1–5) for positive marital functioning, 3·08 (1·14, 1–5) for feeling broken or destroyed, 1·08 (0·77, 0–3) for feelings of depression, and 1·13 (0·93, 0–3) for trauma-related stress. Interpretation: These findings cover a broad, representative sample of the Palestinian adult population, document functioning comprehensively, and are relevant for guiding intervention efforts and health policy in Palestine and other populations enduring long-term adversity. Funding: The Jacobs Foundation, Switzerland.