Long-Term Health Consequences of Movement Restrictions for Palestinians, 1987-2011
Clea A McNeely1, Brian K Barber1, Rita Giacaman1
1Clea A. McNeely is with the Department of Public Health, University of Tennessee, Knoxville. Brian K. Barber is with New America, Washington, DC. Rita Giacaman is with the Institute of Community and Public Health, Birzeit University, West Bank, occupied Palestinian territory. Robert F. Belli is with the Department of Psychology, University of Nebraska-Lincoln. Mahmoud Daher is with the World Health Organization Gaza sub-office, Gaza Strip, occupied Palestinian territory.
Objectives:
To estimate the long-term association between Israeli-imposed restrictions on travel for medical care in the occupied Palestinian territory and health status in adulthood.
Methods:
Using event history calendar methods, we collected annual data from 1987 to 2011 from a representative sample of 1778 Palestinians aged 32 to 43 years and analyzed the subsample of whomever had a serious medical condition and needed to travel for medical care (n = 246; contributing 1163 person-years). We used ordered logistic regression with person-year data to test the association between movement restrictions from 1987 to 2011 and health status in 2011.
Results:
Two thirds (65%; n = 161) of participants reported travel restrictions, and 38% (n = 92) reported ever being barred from travel for medical care. Compared with study participants who experienced no travel restrictions in a year (n = 559 person-years), those who were barred from travel in that same year (n = 122 person-years) reported worse self-rated health (57% vs 22% reported bad or very bad self-rated health; P < .05) and greater limits on daily functioning caused by physical health (41% vs 16% reported regular limits; P < .05).
Conclusions:
Being barred from travel for medical care was associated with poor health as long as 25 years later.
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