Race-based experiences of ethnic minority health professionals: Arab physicians and nurses in Israeli public healthcare organizations

Ethn Health. 2018 May;23(4):442-459. doi: 10.1080/13557858.2017.1280131. Epub 2017 Jan 19.

Abstract

Increasing workforce diversity was found to contribute to the narrowing of disparities in health. However, racism toward ethnic minority health professionals has not been adequately researched. In Israel, public healthcare organizations that serve a mixed Jewish-Arab population employ Arab minority healthcare professionals. Instances of prejudice and manifestations of racism toward them, which frequently surface in public discussion and the media, have unfortunately gained little scholarly attention. We used the intergroup contact approach and the theory of the social process of everyday racism as a theoretical framework. The objective of the research was to study race-based experiences of Israeli Arab healthcare professionals.

Methodology: We used a qualitative research method that allows respondents to describe their views, experiences, beliefs and behavior in the way they think about them. During 2013 and 2014 we conducted in-depth interviews with a snowball sample of 10 Arab physicians and 13 Arab nurses who work in Israeli public hospitals. The study protocol was ethically approved.

Findings: Interviewees noted institutional efforts to maintain egalitarianism and equality. However, at the micro-level, interviewees, mostly nurses, reported instances that ranged from refusal to accept treatment from an Arab nurse, through verbal abuse, to the use of physical violence against them. At the meso-level, interviewees, mostly physicians, reported experiences of institutional discrimination. At the macro-level, one physician reported policy-related discrimination in the context of the immigration of Russian Jewish physicians to Israel.

Conclusions: We recommend combining the intergroup contact approach with the social process theory of racism to examine minorities' subjective perceptions, especially in conflictual and violent contexts; conducting broad-based quantitative research in Israeli healthcare organizations, which may have important implications for the specific strategies to be used; and emphasizing the importance of institutional support. By reconstructing race-based experiences of ethnic minority health professionals, health organizations can better manage racial situations and reduce their frequency.

Keywords: Racism; ethnic minority; health professionals; hospitals.

MeSH terms

  • Adult
  • Arabs / psychology
  • Arabs / statistics & numerical data
  • Attitude of Health Personnel
  • Cultural Diversity*
  • Female
  • Hospitals, Public / standards*
  • Humans
  • Israel / ethnology
  • Male
  • Middle Aged
  • Minority Groups
  • Minority Health / ethnology
  • Needs Assessment
  • Nurses* / psychology
  • Nurses* / statistics & numerical data
  • Physicians* / psychology
  • Physicians* / statistics & numerical data
  • Qualitative Research
  • Racism* / ethnology
  • Racism* / prevention & control
  • Racism* / psychology
  • Social Perception*
  • Treatment Refusal / ethnology