Background
Security emergencies may increase mental distress and impair access to healthcare services. During the Israel-Hamas war, residents of southern and northern Israel, especially those living along the confrontation line, were exposed to more intense fighting. However, knowledge about disparities in the extent of mental distress and in access to healthcare services by area of residence remains limited.
Objective
To examine differences by residential area in war-related mental distress, help-seeking, proactive identification of mental distress, access to services, satisfaction with the healthcare system and the health plans, and trust in the system during the war.
Method
A secondary analysis was conducted using data from the public opinion survey on the level of service and performance of the healthcare system, which was conducted during the war between June and December 2024 among a nationally representative sample of adults ages 22 and over (N = 2,448).
Respondents were classified into three groups:
- Residents of the confrontation line in the south and north ‒ up to 11 km from the Lebanese border and up to 40 km from the Gaza Strip
- Residents of the south and north outside the confrontation line
- Residents of the rest of the country
Logistic regression models were adjusted for sociodemographic and economic characteristics.
Findings
The likelihood of war-related mental distress was twice as high among residents of the confrontation line and 1.4 times higher among residents of the south and north outside the confrontation line, compared with residents of the rest of the country.
Despite this, no significant differences were found between the groups in rates of seeking help from the health plans. The reported rate of proactive identification of mental distress by medical staff was slightly higher among residents of the south and north, both within and outside the confrontation line (16%–17%), than among residents of the rest of the country (12%). However, after adjustment, these differences were not statistically significant.
The likelihood of appointment cancellations or postponements for war-related reasons was twice as high among residents of the confrontation line and 1.4 times higher among residents of the south and north outside the confrontation line, compared with residents of the rest of the country.
At the same time, levels of satisfaction with the health plans and the healthcare system, as well as trust in the system, were similar across all groups.
Conclusions and Recommendations
Despite higher levels of mental distress in the south and north, both within and outside the confrontation line, no significant differences were found across areas of residence in rates of help-seeking or in proactive identification of mental distress by the healthcare system. Access to healthcare services was more adversely affected in the south and north, both within and outside the confrontation line, than in the rest of the country.
It is recommended that mechanisms for proactive identification of mental distress be strengthened, particularly in areas more exposed to emergency situations, and that service continuity in these areas be improved where possible and essential.
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Suggested citation (APA):
Fialko, S., Laron, M., & Gorelik, Y. (2026). Between the Confrontation Line and the Rest of the Country: Disparities in Mental Health and Access to Services during the Israel-Hamas War. S-244-26. Myers-JDC-Brookdale Institute.