Wellbeing and associated factors in an area C community in the West Bank: a cross-sectional study

• Published in: The Lancet (British edition) 2017-08, Vol.390, p.S9-S9
• Main Authors: Jasser, Jeda Jad, Shelleh, Nisreen, Mitwali, Suzan, Giacaman, Rita
• Format: Article
• Language: English
• Subjects: Adults; Cross-sectional studies; Crowding; Ethics; Expulsion; Households; Living conditions; Men; Older people; Poverty; Public health; Research ethics; Security; Socioeconomics; Statistical tests
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(17)32060-3

Wellbeing is influenced by several factors, including living conditions. In Palestine, area C communities are under administrative and security control and comprise about 60% of the West Bank. UN reports indicate that area C populations are considered most susceptible to expulsion (displacement from home and from land cultivated for livelihood) and sustenance interruption. This study aims to assess the relation between wellbeing in an area C community and associated factors. We did a cross sectional survey with a systematic random sample of 426 adults representing half the households in this community, with a high response rate (96·9%). A questionnaire was designed following focus group discussions to highlight the particular context of the community, and included security and distress questions developed by the Institute of Community and Public Health (ICPH) and published internationally, and the WHO-5 wellbeing index with 50 as the cutoff point. Descriptive statistics followed by multivariate binary logistic regression to test for confounders were performed with SPSS 17. Ethics approval was obtained from ICPH's Research Ethics Committee. 413 people were included: 200 men (48·4%) and 213 women (51·6%). 171 people (41·4%) reported moderate and high levels of wellbeing. There were no differences by sex and age. Lower wellbeing was associated with the presence of one or more older people at home compared with having no older people at home (odds ratio 0·467, 95% CI 0·221–0·987, p=0·046) and with having a crowded home (more than three members at home) compared with lower crowding (0·225, 0·084–0·603, p=0·003). Our findings suggest that lowered wellbeing is present among families with higher crowding and with older people at home, and might be linked with poverty nd the need for high levels of care, high dependency, and low socioeconomic status). Crowding at home might be linked to the special conditions found in area C, where building permits are difficult to obtain. Further studies addressing life conditions in area C are recommended to investigate the effects of these factors on wellbeing. None.