Utilization, Access to Healthcare Services, and Unmet Healthcare Needs Among the Arab Bedouin Minority

Background: The Arab Bedouin Muslim community in Israel, is one of the country’s most vulnerable groups. They are residents of the Israeli geographical and social periphery, living mainly in two types of residence: 1) Bedouin-recognized towns; 2) Bedouin-unrecognized villages by the state. The Bedouins face systemic marginalization and socio-cultural challenges. Residents of the unrecognized villages have limited access to healthcare and basic infrastructure such as water supply and electricity connections. Bedouin’s healthcare service utilization is shaped by its sociocultural and environmental characteristics.

This study moves beyond environmental determinants to delve into the complex interplay of social, cultural, and systemic factors that impact healthcare access and utilization among the Bedouin minority in Israel and aims to explore the socio-cultural and intersectional factors influencing healthcare services utilization among Bedouin residents in Israel, emphasizing the disparities between recognized and unrecognized villages in the Bedouin community.

Methods: A cross-sectional study was conducted among 246 Bedouin adults in two types of residences. The study involved a self-completed anonymous Arabic-language survey that evaluated demographics, patterns of healthcare service utilization, reasons for referral to healthcare services, and challenges in accessing healthcare services. Statistical analyses, including descriptive statistics and multivariate logistic regression, were applied to explore predictors of healthcare utilization, particularly visits to family physicians.

Results: Family physicians were the most utilized healthcare service. A significant difference (p<0.01) was identified between residents of townships recognized by the government and unrecognized villages in three types of healthcare services: the average number of annual visits to (1) specialist physicians (M=2.89±2.13 vs M=1.85±1.38), (2) medical acute/after-hours centers (M=2.48±1.48 vs M=1.46±0.905( and (3) private physicians (M=2.46±1.55 vs M=1.45±0.8), all higher among recognized township residents. Cultural barriers and social stigma were prominently reported by residents of unrecognized villages, where 57.6% cited lack of physical access as a barrier, compared to 41.2% in recognized townships.

Conclusion & Implications: The findings highlight the critical role of socio-cultural and systemic barriers in shaping healthcare access among Bedouin minority residents in Israel. By integrating an intersectional lens in examining healthcare disparities, the study points to deeper issues of social periphery and living conditions in terms of accessing health. To reduce gaps and improve healthcare accessibility, policymakers should consider the unique cultural and social contexts of the Bedouin community, advocating for targeted interventions that address both recognized and unrecognized village needs, thereby promoting health equity and enhancing social welfare practices for marginalized groups.