Chronic structural inequalities, acute stressors, and psychological distress among Palestinian Bedouin women across locality types in the Naqab

Background Palestinian Bedouin women in southern Israel experience health-relevant structural inequities and intersecting stressors, including political violence (i.e., exposure to war-related events), discrimination, housing demolitions, and spatial marginalization. Research on exposure to these stressors and psychological distress across distinct types of Bedouin localities has been scarce, particularly during the recent Israel-Gaza war. This study aimed to assess locality-based differences in exposure to acute and chronic structural stressors and psychological distress among Palestinian Bedouin women in southern Israel, to examine associations between these stressors and psychological distress, and whether these associations vary by type of locality. Methods This cross-sectional study was conducted among a convenience sample of 301 Palestinian Bedouin women (ages 19–77, M = 43) residing in recognized-developed, recognized-underdeveloped, and unrecognized localities in southern Israel. Participants completed self-administered questionnaires assessing psychological distress, exposure to political violence (i.e., war-related events), perceived discrimination, exposure to home demolitions, and sociodemographic characteristics. Results Women residing in unrecognized localities reported the highest levels of discrimination, exposure to home demolitions, war-related events, and psychological distress, indicating marked locality-based disparities. Discrimination was the strongest predictor of psychological distress; exposure to war-related events and home demolitions did not have independent main effects. Exposure to war-related events was significantly associated with greater distress among women living in recognized-underdeveloped localities, but not among women in unrecognized localities, where distress levels were consistently high regardless of exposure. Conclusions Chronic structural stressors, particularly perceived discrimination, were associated with psychological distress, while associations with war-related events varied across locality contexts. These findings highlight health inequities within marginalized localities and underscore the need for equity-oriented health and social policies and accessible services that address structural inequality and locality-specific conditions, particularly in unrecognized and underdeveloped Bedouin localities.