Perceptions of violence and mistrust in authorities among Palestinians in Israel, an unrecognised public health crisis: a cross-sectional study

Abstract

BackgroundBetween 1948 and 2020, Palestinians living in Israel have seen an 11-times increase in population density. Palestinian citizens of Israel (PCI) comprise 20% of the population, restricted to living in 2·7% of the land. The effects of the resulting overcrowding are spatial, political, cultural, economic, and administrative and are also associated with intracommunal crime and violence. Between 2000–17, from 122 annual homicide cases in Israel, 79 (65%) victims were PCI. Palestinians have a 5·5 times higher risk of dying from homicide than Jewish citizens of Israel. 2021 saw a peak in homicide rates, where 126 (74%) of the 170 homicide cases in Israel were among PCI. 83% of homicides among PCI were a result of gunshots, with more than 400 000 illegal firearms estimated to circulate among the Palestinian community in Israel. Yet, only 23% of homicide cases among PCI were solved by the police compared with 73% of cases among Jewish citizens of Israel. This study examines the attitudes of PCI towards violence, crime, safety, and trust in the Israeli police. MethodsWe did a cross-sectional study; the survey form included demographic data and questions about exposure and attitudes towards safety, violence, crime, and the police and government handling of crime. Participants were all PCI living in Palestinian towns and in mixed cities in Palestinian neighbourhoods. Participants were randomly chosen from 68 towns, and conducted in private homes by trained surveyors. The study sample was a stratified multi-stage random sample, divided into four levels of stratification: region (north, centre, or south of Israel), community size (small [<5000], medium [5000–15 000], or large [>15 000]), locality classification (cities or villages), and locality type (recognised and unrecognised as official towns by the state). The main outcomes assessed were participant perceptions of the prevalence in violence among PCI and the authorities’ commitment to curb it. The Galilee Society Ethics Committee approved the study and informed consent was obtained from all participants. FindingsInterviews were done in 2040 households housing 7985 family members, recruited and interviewed in 2018. Personal interviews were conducted with one person per family. Of these 2040 interviews, 1970 interviews were included in the analysis. 1283 (65·1%) of 1970 participants estimated the prevalence of violence as being high or moderate in their towns. 958 (48·6%) participants estimated that violence has increased in their town during the past year. 1062 (53·9%) participants that they could be a possible target of violence. 1027 (52·1%) participants reported that crime is the biggest problem that the Palestinian community in Israel faces, followed by racist laws (436 [22·1%]) and the difficult economic situation (282 [14·3%]). 1474 (74·8%) participants reported that the use of weapons has become normal in everyday disputes. 1496 (75·9%) reported that the state is interested in the spread of violence in the Palestinian towns in Israel. 1728 (87·7%) participants stated that an absence of governmental interest in addressing the problem of unauthorised weapons is the cause of their spread, and 1634 (82·9%) participants stated that police complicity is a cause of the spread of unauthorised weapons. 1411 (71·6%) participants disagreed with the statement that the Israeli police deals with violence seriously. InterpretationPCI perceive a high exposure to violence within their communities, with most participants reporting that communal violence is linked to the Israeli government and police being disinterested in addressing the problem, and the complicity of the Israeli police (which reflects a mistrust in the Israeli government and police force, and that crime among PCI becomes a justification to further criminalise, stigmatise, and police these communities). Given that violence, crime, and homicide are major causes of morbidity and mortality and thus urgent public health problems, every effort should be made to advocate for addressing these problems among PCI, especially among medical and health-care communities. FundingGalilee Society and Palestinian Central Bureau of Statistics.