Disparities in mental health outcomes and service use between Jews and Arabs in Israel, 2024

Abstract Background Mental health disparities between Jews and Arabs in Israel are well-documented, driven by systemic barriers and poverty. This study updates evidence and examines how ethnicity and poverty intersect across mental health outcomes and service use (self-reported), to support evidence-based policy. Findings may also inform global equity efforts targeting disadvantaged minorities. Methods Secondary analysis of the 14th round of the Public Opinion Survey on Healthcare Services, conducted in 2024 during the Israel-Hamas war, among adults aged 22+ in Israel (N = 2,558). Multivariate logistic models adjusted for gender, age, income, and region. An interaction term examined the joint effect of Arab ethnicity and low income. Results Between 2001 and 2021, emotional distress was higher among Arabs than Jews in most years, although gaps narrowed post-2016. In 2024, 38% of Arabs and 32% of Jews reported emotional distress; poor mental health was reported by 27% of Arabs and 19% of Jews. Among those distressed, 73% of Arabs and 82% of Jews attributed it to the war. 19% of distressed sought help from public health plans (HPs), with 88% satisfaction across groups. The main barrier to receiving help from HPs was unwillingness to seek help (74% among Arabs, 47% among Jews). Distance to services was reported as a barrier by 4% of Arabs and 1% of Jews. 3% of Arabs and 19% of Jews who did not receive help from HPs sought alternative care. Multivariate models showed that Arabs were more likely than Jews to report poor mental health (OR = 1.53, p < 0.05), but not emotional or war-related distress. The ethnicity-income interaction was not significant in any model. Conclusions Arabs are more likely to report poor mental health, while distress is linked to other background factors. No added disadvantage was found for low-income Arabs. Help-seeking remains lower among Arabs, especially outside HPs. Israel's 2015 mental health reform may have narrowed gaps, but barriers persist. Key messages • Culturally adapted care, alongside structural change, is essential to reduce disparities and promote mental health equity. • Insights from the Israeli context may support global efforts to reduce mental health inequities in disadvantaged minority groups.