Arab Association for Human Rights (HRA) 26 February 2009
Since 2003, the Arab Association for Human Rights (HRA) has periodically published reports examining different aspects of the discrimination faced by Palestinian citizens of the State of Israel. In 2009, HRA has decided to focus on the right to health — an important factor that influences other human rights and shapes human dignity.
Economic and social rights form an important component of universal human rights. These rights, including the right to health, have not been well received by many governments with a capitalist orientation, which tend to see these issues as a manifestation of human needs rather than human rights. This reflects a tendency to avoid granting these rights an obligatory character and to free the state from the need to invest the resources required for their realization.
The right to health is enshrined in numerous international conventions and declarations. The first reference comes in Article 25(1) of the 1948 Universal Declaration of Human Rights: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”
The commitment to this right was defined more substantively in the 1966 International Covenant on Economic, Social and Cultural Rights: “The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health” (Article 12(1)). The Committee on Economic, Social and Cultural rights established by the United Nations to monitor the implementation of this covenant later adopted a comment (General Comment 14) extending the meaning of the right to health beyond medical treatment for the sick. This comment specifies the conditions in which this right is maintained: availability, sufficiency, quality, and accessibility — in terms of the absence of discrimination and in terms of physical and economic access for all:
“With respect to the right to health, equality of access to health care and health services has to be emphasized. States have a special obligation to provide those who do not have sufficient means with the necessary health insurance and health-care facilities, and to prevent any discrimination on internationally prohibited grounds in the provision of health care and health services, especially with respect to the core obligations of the right to health.” (Para. 19)
The opening sentence of the National Health Insurance Law, enacted in Israel in 1994, states: “National health insurance in accordance with this law shall be founded on the principles of justice, equality and mutual assistance.” It is now apparent that the enactment of this law has not succeeded in narrowing gaps in health between the Arab and Jewish populations. Indeed, in some parameters the gaps have widened still further (examples include infant mortality rate, life expectancy, morbidity and mortality, chronic diseases, cancer, etc.) Moreover, the subsequent legislative development of the law has eroded the social principles on which founded, such as the need to remove economic and cultural barriers that prevent optimum access to health services.
In the current report HRA presents several principles and findings that emphasize the scale and scope of the discrimination faced by the Palestinian Arab population in Israel. The following are some examples:
- There is a proven and close correlation between individual and collective health and socioeconomic status. Poverty, limited education, overcrowding, and unemployment all lead to an increase in rates of morbidity and mortality. The Arab population continues to be poorer than the Jewish population, with higher unemployment and lower education levels. Gaps in health remain.
- The Arab population is young — 42 percent of Arabs are under the age of 15. Accordingly, this population has a heightened need for health services intended for young people, such as family health centers.
- Arabs have lower levels of education: 35.3 percent did not attend high school. The proportion of Arabs in the workforce is low (54.9 percent in the 25-54 age range).
- Arabs are poorer than Jews: 61.3 percent of Arab families are below the poverty line. Government support rescues just 10 percent of these families from poverty.
- Overcrowding is more prevalent in the Arab population — the average number of persons per room is 1.43 among Arab citizens and 0.84 among their Jewish peers.
- Life expectancy is lower among Arabs and the gap between Arabs and Jews has widened since 1996.
- Infant mortality rates among Arabs are twice those among Jews. The gap has existed since the establishment of the state and has grown over the years.
- The general mortality rate is higher among Arabs than among Jews.
- The main causes of death among Arabs are heart diseases, cancer, external injury, diabetes, and cerebrovascular diseases.
- A very rapid increase has been seen in the incidence of lung cancer and breast cancer among Arabs. Cancer is detected at an advanced stage and the disease appears at a younger age — both factors that reduce survival rates.
- The incidence of diabetes is higher among Arabs and the disease is less balanced, leading to complications.
- Arabs report more physical problems that cause them significant or very significant difficulties in everyday functioning. Arabs suffer more from chronic back pain, sleep disorders, psychological disorders and arthritis.
These findings, and others presented in the report, illustrate the failure of the Israeli government to realize their obligations toward the Palestinian Arab population in Israel. This failure constitutes a gross violation of Israel’s undertaking to implement international conventions regarding social, economic and cultural rights — documents that Israel ratified in 1966. These failings also violate official undertakings Israel assumed as part of its agreements with the European Union, in particular the association agreement and agreements in the European-Mediterranean Partnership.
Accordingly, the Arab Association for Human Rights urges Israel’s international partners (and particularly the institutions of the European Union) to respect their obligation in accordance with these agreements and to act immediately in order to oblige the Israeli government to meet its part in these agreements, and to condition the development of political and economic relations on the full and egalitarian implementation of the existing agreements.
Download the full report [PDF]