Assistant Professor, University of Maryland Baltimore School of Pharmacy and School of Medicine
In the field of public health, home—if examined at all—is often treated as a solitary variable in a multivariable regression model—static, muted, and one-dimensional. It is rendered as a crude binary—“do you rent?” or “do you own?”—demarcating by proxy both stability and wealth. For those of us who understand the political and social determinants of health, this categorization is woefully insufficient at capturing the dynamic processes that underlie lived experiences of being “home.” We understand the central role that home, and by extension community, plays in determining individual and population health outcomes. Among core determinants of health, home speaks to access (how close are you to a quality health provider?), to wealth (do you have running water?), and to conditions of the built environment (is the paint that adorns your walls mixed with lead? do you live near a polluting industry?). Perhaps most importantly, home speaks to the level and depth of your social capital. To the generations of familial and non-familial relationships that can be leveraged to mitigate acute health stressors and chronic disease. The neighbor who notices your absence in the Friday prayers, for example. That is, your social capital can be as central to the maintenance of health as your blood pressure.
For Palestinians living in the West Bank, exposure to forced home displacement and home destruction in places like the Jordan Valley and Jerusalem have become commonplace. Displacement, and disruptions and fissures in social capital that result, can be devastating to health. In studies in the United States, proximal experiences of displacement have been associated with lower mental health and lower access to healthcare. Serial displacement results in a phenomenon defined by social psychiatrist Mindy Fullilove as “root shock.” Fullilove describes how displacement through the destruction of urban neighborhoods and communities, whether by natural or man-made forces, causes mental anguish and a reaction similar to that of physical shock in the individual experiencing the displacement and loss—a “root shock.”
What of Palestinian communities in the West Bank who have been the subjects of serial displacement? What do we know about the impact of displacement on individual and community health in Palestine? How can examples of research from the United States augment, inform, problematize, and challenge the public health research and advocacy we conduct in occupied land around right to housing and health? How, and do, Palestinians experience “root shock”?
I borrow from previous research conducted in the Jordan Valley and current work to attempt to answer some of these questions. Among other questions I explore: what are the short- and long-term health consequences of violent untethering from home? Is it possible for a person to maintain any semblance of health, when their home is constantly under threat of demolition, and their unit, as a body, a family, a community, a nation, is in a state of persistent precarity?
Danya M. Qato, PharmD, MPH, PhD, is an Assistant Professor and Graduate Program Director at the University of Maryland, Baltimore, and holds appointments in the School of Pharmacy and School of Medicine Department of Epidemiology and Public Health. Dr. Qato is a practicing pharmacist, epidemiologist, and health services researcher. She is founder of the Chicago Palestine Film Festival and holds a PhD in health services research from the Brown University School of Public Health, a Doctor of Pharmacy (PharmD) from the University of Illinois, and a Master of Public Health (MPH) with a concentration in international health from Harvard University. Her substantive areas of research pertain to improving health in vulnerable populations through evidence-based policies and advocacy. She was previously a U.S. research fellow of the Palestinian American Research Center (PARC) and the Arab Council for the Social Sciences funded by the Swedish International Development Agency. In the 2015–2016 academic year, Danya was based at the Institute for Community and Public Health at Birzeit University in Palestine, where she was a Fulbright Scholar and conducted research with the Palestinian National Institute of Public Health and the World Health Organization.