Associations between life conditions and self-rated health among Palestinians residing in refugee camps in Lebanon

Background: Palestinian refugees in Lebanon live in camps characterized by poor housing, inadequate environmental services, and poverty. Research on the association between standards of living and health disparities found that neighborhood socioeconomic, physical, and psychosocial characteristics were related to self-ratings of health.

Objective: This study assesses the association between self-rated health and factors that affect these perceptions among Palestinians in Lebanon.

Methods: A representative sample of Palestinian refugees in Lebanon was surveyed in 2010. 2,501 households were randomly selected from a national sampling frame. Face-to-face interviews were conducted using structured questionnaires. Self-rated health was analyzed against multi-morbidity (mental health, chronic and acute illnesses, disability) and standard of living (poverty index including education, assets, food insecurity, water leakage, crowding). Logistic regression models were conducted using STATA 10.

Results: Respondents (N=2,501) were mostly women (80%) with average age of 47 years, and 31% reporting poor self-rated health. Eighty percent reported at least one health problem and 93% reported one or more socioeconomic disadvantage. Respondents reporting two health problems and those reporting three or more were nearly three and seven times respectively more likely to rate their health as poor (OR=2.96; CI=2.29–3.83 and OR=6.59; CI=5.06–8.58). With each unit increase in the poverty index, respondents were 32% more likely to report poor self-rated health (OR=1.32; CI=1.19–1.47).

Conclusion: Findings show that poor self-rated health reflects declining health that may be amplified by poverty. More resources should be mobilized to assess the social roots of health problems and develop appropriate interventions.