Background:
Workplace violence (WPV) in healthcare facilities is an increasing global problem, particularly since the emergence of COVID-19. WPV can impact healthcare systems and patient’s health, as well as healthcare workers (HCWs) job satisfaction and resignations. Racial harassment (RH) in healthcare services can add complexity to WPV, as it targets more minority HCWs and patients.

Aims:
We examined associations between RH and WPV types (physical and psychological or verbal) among physicians and nurses in Israeli hospitals and compared these in different groups (Indigenous Palestinian-Arab citizens versus Jewish).

Methods:
An online cross-sectional survey was conducted in July to September 2022, including a sample of 921 physicians and nurses working in ERs and internal medicine departments in four large hospitals. The online questionnaire was distributed via WhatsApp groups of physicians and nurses (response rate= 89.1%). The association between RH and WPV types was examined via multivariable logistic regression analysis for each study groups while considering relevant variables (age, gender, physicians vs. nurses, work position, years of work, education level).

Findings:
Palestinian-Arab pshycians and nurses reported significantly higher RH based on national identity compared to Jewish counterparts (42.5% vs. 24.3%). However, Jewish HCWs reported higher physical, and psychological WPV (24.9%, and 72.2%, respectively) compared to Palestinain-Arab HCWs (14.6%, and 54.1%, respectively). In the multivariate analysis, RH was associated with higher physical WPV in Palestinian-Arab HCWs (adjusted odds ratio and 95% confidence intervals, AOR, 95%CI=2.55, 1.39-.68) comapred to Jewish HCWs (1.06, 0.49-2.26), and higher psychological WPV among Palesinina-Arab HCWs comapred to Jewish (3.76, 2.44-5.79 vs. 2.39, 1.12-4.79 respectively).

Significance:
RH was significantly associated with higher physical and psychological WPV in Palestinian-Arab minority physicians and nurses compared to their Jewish counterparts. Future research should explore mechanisms connecting RH and WPV in these groups and suggest interventions to eliminate WPV in hospitals.