Authority, trust, and healthcare communication in a religious minority: the case of the Haredi community in Israel during COVID-19.

BACKGROUND

Religious minority communities face distinctive healthcare barriers during public health crises, yet the communicative mechanisms underlying these barriers remain underexplored. Applying Communication Ecology Theory, this study examines barriers to healthcare access in Israel's Haredi (ultra-Orthodox) community during the COVID-19 pandemic, conceptualizing healthcare inequality as a function of bounded communication ecologies rather than individual non-compliance, with implications for health equity in culturally and religiously diverse societies.

METHODS

A qualitative study was conducted using semi-structured interviews with 30 Haredi community members and analysis of 20 pashkevils (religious street posters) circulated during the pandemic. The Haredi community experienced infection and mortality rates substantially higher than the national average during COVID-19. Both data sources were analyzed thematically, guided by Communication Ecology Theory.

RESULTS

Three interconnected barriers emerged: (1) internal versus external-secular communication-reliance on community channels that conveyed partial or misleading health information; (2) rabbinic versus professional authority-prioritization of rabbinic rulings over medical guidance; and (3) religious versus scientific interpretation-viewing the pandemic as divine punishment requiring spiritual rather than medical responses.

CONCLUSIONS

Healthcare barriers in the Haredi community reflect bounded communication ecologies where information legitimacy depends on alignment with religious authority and theological worldviews. Effective public health engagement requires culturally adapted strategies that operate within existing communication systems, collaborate with rabbinic leadership, and address both informational and structural barriers, thereby advancing health equity in religious minority populations. These findings are relevant for understanding healthcare barriers among religious minorities worldwide.