During pandemics, minorities may experience high stress levels, which could harm their mental and physical health. However, to the best of our knowledge, this has not been examined among minorities in Israel during the COVID-19 pandemic. This study, therefore, explores stress among the Arab minority in Israel during the first wave of the COVID-19 outbreak, and its association with the population’s perceived COVID-19 threat, trust in the healthcare system, adherence to preventative guidelines, and perceived discrimination. The study analyzed a cross-sectional online survey of 626 Israeli Arabs. Most participants (65%) reported moderate levels of stress, and 10% reported severe levels. The Bedouin population reported significantly higher levels of stress compared to other minority groups. The participants also reported a high degree of perceived threat, a moderate-to-high level of discrimination, a moderate level of trust in the healthcare system, and very high adherence to guidelines. Hierarchical regression analysis showed that age, religion, trust in the healthcare system, perceived threat, and adherence to guidelines were all significant predictors of stress [F(11,600), p < .001]. The model explained 24% of the variance in stress. Structural equation modeling (SEM) revealed that the participants’ perceived threat and trust mediated the association between their perceived discrimination and stress [indirect effect = 0.13, SE = 0.03 CI = (0.08, 0.18)], whereby discrimination was negatively associated with trust (β = −0.52), which, in turn, was negatively associated with stress (β = −0.10). Furthermore, discrimination was positively associated with perceived threat (β = 0.21), which, in turn, was positively associated with stress (β = 0.35). Discrimination is an important social determinant of health – especially during health emergencies when trust in healthcare systems and perceived threats are crucial. As such, our findings could assist policymakers in developing fair policies that are tailored to various population groups and that may reduce stress levels among minorities, thereby improving both their mental and physical health.

Social distancing was found to prevent COVID-19 contagion. Therefore, understanding the factors associated with the public’s adherence is important. Acknowledging the importance of emotional wellbeing regarding older people’s health, and understanding their emotional state during the pandemic, are crucial. This study assessed factors associated with older people’s adherence to social distancing and their emotional status. A cross-sectional online survey was conducted among 1822 respondents above the age of 60. Distancing adherence, negative emotion, trust, social support, threat perception, attitudes, and subjective norms were assessed, and a path analysis was performed. Adherence was positively associated with attitudes (β = 0.10; p < 0.001), and with subjective norms (β = 0.19; p < 0.001). Negative emotions were positively associated with threat perception (β = 0.33; p < 0.001), and negatively associated with social support (β = −0.13; p < 0.001) and subjective norms (β = −0.10; p < 0.001). Attitudes mediated the relationship of threat perception (95% CI = 0.009, 0.034), trust (95% CI = 0.008, 0.029), and social support (95% CI = 0.006, 0.023) with distancing adherence. Subjective norms mediated the relationship between threat perception (95% CI = 0.014, 0.034), trust (95% CI = 0.026, 0.055), and social support (95% CI = 0.002, 0.048) with distancing adherence. Subjective norms mediated the relationship between threat perception (95% CI = −0.022, −0.006), trust (95% CI = −0.034, −0.010), and social support (95% CI = −0.029, −0.009) with negative emotions. When promoting social distancing adherence, subjective norms and attitudes must be considered, as they play a role in promoting adherence and negative-emotion regulation.

Israel was among the first countries to initiate adolescent COVID-19 vaccination. As adolescent vaccination requires parental consent, we evaluated the factors associated with parents’ willingness to vaccinate their adolescents and their point of view regarding adolescents’ involvement in this decision. An online survey was completed by 581 parents of adolescents aged 16–18. The main independent variables included trust in the healthcare system, components of the Health Belief Model (HBM) and adolescents’ involvement in the decision, as well as background data, including demographics. Analysis included a multiple logistic regression and mediation examination. Parents reported that 446 adolescents (76.8%) have been or will soon be vaccinated against COVID-19, 12.2% chose not to vaccinate their child and 11% have not yet decided. Vaccination was significantly associated with HBM components and with adolescents’ involvement in the decision. The perceived vaccination benefits acted as a mediator in the association between parents’ COVID-19 perceived threat and adolescent vaccination, as well as between parents’ trust in the healthcare system and adolescent vaccination. Addressing vaccination benefits and barriers is pivotal in the attempt to enhance adolescents’ vaccination adherence. Considering the importance of adolescents’ involvement in the decision, addressing them directly may also be beneficial in improving vaccination rates.

Background: Endometriosis is a chronic, inflammatory, estrogen-dependent gynecological disease in which endometrial-like tissue grows in areas outside the uterus. This condition may significantly influence women’s life course and mental health. Personal, behavioral, social, and environmental factors play a crucial role in predicting these outcomes. The current study aimed to compare the Perceived Life Course Impact (PLCI) and mental health of women with Endometriosis to those without the disease, as well as to explore the factors associated with PLCI and mental health. Methods: This cross-sectional study surveyed 543 Israeli women (270 with Endometriosis, 273 without). Participants completed a validated questionnaire assessing perceptions of life course impact in several life domains (intimacy and relationships, employment, education) and mental health. Multiple regression analyses were used to identify factors associated with PLCI and mental health among participants. Results: Women with Endometriosis reported a significantly greater negative perceived impact on intimacy and relationships, employment, and education, with poorer mental health, as compared to the control group. Women with Endometriosis also experienced higher social negativity and lower social support. Multiple regression analyses indicated social negativity as a strong predictor of negative PLCI. Additionally, menstrual pain, social support, and healthcare accessibility were found to be significant predictors of both PLCI and mental health. Conclusions: Comprehensive care for women with Endometriosis requires a multidisciplinary approach, with interventions focused on improving healthcare accessibility, enhancing social support networks, and mitigating social negativity within interpersonal environments.

: During pandemics, minorities may experience high stress levels, which could harm their health. This study explores stress among the Arab minority in Israel during the first wave of the COVID-19 outbreak, and its association with the population's perceived COVID-19 threat, trust in the healthcare system, adherence to guidelines, and perceived discrimination. The study analyzed a cross-sectional online survey of 626 Israeli Arabs. Most participants (65%) reported moderate levels of stress, and 10% reported severe levels. The Bedouin population reported significantly higher levels of stress compared to other minority groups. The participants also reported a high degree of perceived threat, a moderate-to-high level of discrimination, a moderate level of trust in the healthcare system, and very high adherence to guidelines. Structural equation modeling (SEM) revealed that the participants' perceived threat and trust mediated the association between their perceived discrimination and stress [indirect effect=0.13, SE = 0.03 CI = (0.08, 0.18)], whereby discrimination was negatively associated with trust (β=-0.52), which, in turn, was negatively associated with stress (β=-0.10). Furthermore, discrimination was positively associated with perceived threat (β = 0.21), which, in turn, was positively associated with stress (β = 0.35). Discrimination is an important social determinant of health - especially during health emergencies when trust in healthcare systems and perceived threats are crucial. Our findings could assist policymakers in developing fair policies, that are tailored to various population groups and that may reduce stress levels among minorities, thereby improving their mental and physical health. Key messages: The results highlight the relationships between discrimination, trust, perceived threat and stress. To reduce minorities’ stress, it is vital to create a credible and fair atmosphere during pandemics.