Abstract
Israel represents a complex and pluralistic society comprising two major ethno-national groups, Israeli Jews and Israeli Arabs, which differ in terms of religious and cultural values as well as social constructs. According to the so-called “diversification hypothesis”, within the framework of e-health and in the era of new information and communication technologies, seeking online health information could be a channel to increase health literacy, especially among disadvantaged groups. However, little is known concerning digital seeking behavior and, in particular, digital mental health literacy. This study was conducted in order to fill in this gap. Concerning raw figures, unadjusted for confounding variables (time, population size, Internet penetration index, disease rate), “depression” searched in Hebrew was characterized by 1.5 times higher search volumes, slightly declining throughout time, whereas relative search volumes (RSVs) related to “depression” searched in Arabic tended to increase over the years. Similar patterns could be detected for “phobia” (in Hebrew 1.4-fold higher than in Arabic) and for “anxiety” (with the searches performed in Hebrew 2.3 times higher than in Arabic). “Suicide” in Hebrew was searched 2.0-fold more than in Arabic (interestingly for both languages search volumes exhibited seasonal cyclic patterns). Eating disorders were searched more in Hebrew: 8.0-times more for “bulimia”, whilst “anorexia” was searched in Hebrew only. When adjusting for confounding variables, association between digital seeking behavior and ethnicity remained statistically significant (p-value < 0.0001) for all psychiatric disorders considered in the current investigation, except for “bulimia” (p = 0.989). More in details, Israeli Arabs searched for mental health disorders less than Jews, apart from “depression”. Arab and Jewish Israelis, besides differing in terms of language, religion, social and cultural values, have different patterns of usage of healthcare services and provisions, as well as e-healthcare services concerning mental health. Policy- and decision-makers should be aware of this and make their best efforts to promote digital health literacy among the Arab population in Israel.
Highlights
Israel represents a complex, multicultural and pluralistic society where sometimes clashing and opposite tendencies coexist
The two groups differ in terms of religious and cultural values as well as social constructs: for instance, Israeli Arabs hold a traditional collectivist values, highly cohesive culture, whereas Israeli Jews are more imbued with Western codes and influences
Concerning raw figures, unadjusted for confounding variables, ‘‘depression’’ searched in Hebrew was characterized by 1.5 times higher search volumes, slightly declining throughout time, whereas relative search volumes (RSVs) related to ‘‘depression’’ searched in Arabic tended to increase over the years
Summary
Multicultural and pluralistic society where sometimes clashing and opposite tendencies coexist. Israel comprises two major ethno-national groups, Israeli Jews and Israeli Arabs, with about 79% of the population being Jewish. The two groups reside in geographically different areas and settings, and utilize separate social and cultural networks, such as schools, educational and religious institutions, as well as mass media and other channels (Abbas & Mesch, 2015; Mesch, 2016). These differences reflect in health literacy and in the use of healthcare services: Israeli Arabs tend to underutilize healthcare facilities and support with respect to Israeli Jews. Concerning mental health services, Arab-Israeli patients tend to contact physicians with a two-fold delay compared to Jews, due to lower schooling and distrust in the treatment (Ponizovsky et al, 2007)
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