BackgroundThe role of residential segregation and spatial separation of population groups along racial or ethnic lines is well documented as a factor contributing to health disparities, such as rates of homicide and crime in African Americans. Most of the two million Palestinian citizens in Israel live in segregated, exclusively Palestinian towns, whereas approximately 132 000 live in mixed Jewish Palestinian cities that were Palestinian cities before the Palestinian exodus, in 1948, when most inhabitants were expelled, turning the Palestinians who remained into a minority. Despite having higher employment rates, Palestinians in so-called mixed cities live in enclaves with higher poverty, poorer educational facilities, and more intracommunal crime than Palestinian communities in segregated towns. The aim of this study was to assess the prevalence of trust in the Israeli government and in police commitment in crime fighting among Palestinian citizens in Israel in different towns. MethodsData were collected in 2018 using a stratified multistage random sample of 2040 households (n=7985 adults). A scale was computed measuring reports on trust in the government and in the police's commitment in curbing crime (Cronbach's α=0·92). Bivariate analyses were done to test for significant associations between the dependent variable of trust in police or government and associated factors. Binary logistic regression was done to check for confounders. The Galilee Society Ethics Committee approved the study. FindingsParticipants living in mixed cities were more likely to report high levels of violence in their communities (OR 4·3, P=0·001) and were less likely to trust the police or the government in curbing crime (odds ratio [OR] 0·32 [95% CI 0·19–0·54]; p<0·05) than participants in segregated towns. Compared with participants older than 35 years, younger people were more likely to trust the police or government (1·39 [1·12–1·72]; p<0·05). Muslims were less likely to trust the police or government than Druze and Christians (0·51 [0·35–0·75]; p<0·05). Those living in communities unrecognised by the Israeli government were less likely to trust the police or government than those living in recognised communities (0·33 [0·22–0·49]; p<0·05). Those living in large towns (ie, with more than 15 000 inhabitants) and medium-sized towns (with populations of 5000–15 000) were less likely to trust the police or the government (OR 0·47 [95% CI 0·34–0·66]; p<0·05 for inhabitants of large towns and 0·65 [0·46–0·91]; p<0·05 for inhabitants of medium-sized towns) than people living in small-size towns (ie, with less than 5000 inhabitants). Those unable to cover daily expenses were less likely to trust the police or the government to control crime than those who could cover daily expenses (OR 0·68 [95% CI 0·55–0·85]; p<0·05). Other variables were not significant. InterpretationPalestinians living in mixed cities view their environment as more violent and have less trust in the government or police's commitment to fight crime. A pattern of urban segregation with urban violence and breakage of social cohesion that is spatially expressed as urban enclaves or so-called purified localities has been used to describe the Palestinian lived experience in mixed cities, and might contribute to worse public health effects than completely segregated Palestinian towns. The lived experience of mixed and segregated livelihood for Palestinian citizens in Israel is substantially different from that of African Americans in the USA, and requires further research. Because violence, crime, and homicide are important public health problems, every effort should be made to measure the prevalence of crime in various communities and uncover its underlying causes so that crime can be effectively reduced. FundingThe research was funded by the Galilee Society and the Palestinian Central Bureau of Statistics.
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