Barriers to the Healthcare System Faced by Ultra-Orthodox Religious Disaffiliates

Abstract

Many religious disaffiliates, similar to immigrants, experience health vulnerabilities. Yet, few studies address their ability to access the healthcare system. This article contributes to filling this void by examining the case of Israeli Jewish ultra-Orthodox disaffiliates. The study analyzes the barriers that hinder these disaffiliates’ access to the healthcare system, adversely affecting their well-being. This research is based on 36 in-depth, semi-structured interviews with ultra-Orthodox disaffiliates, analyzed using qualitative thematic analysis. Six barriers were identified: lack of health-related education and knowledge of the healthcare system, poverty and structural determinants of health, lack of respect for authority, communication gaps, lack of belonging, and stigmas, particularly in mental health. We recommend training healthcare providers and students to better understand and address these barriers and disaffiliates’ unique needs when providing care for them. Specifically, we suggest incorporating this overlooked subject in the frameworks of cultural competency and structural competency, encouraging collaboration between healthcare practitioners and religious disaffiliates to promote equitable and inclusive policies. Implications for community organizations include offering courses, simulations, peer guidance, and consultation for disaffiliates on health-related issues, as well as engaging disaffiliates in self-advocacy. We propose that this study is relevant to disaffiliates from varied insular, high-tension religious communities worldwide.