Mortality in two Jewish populations--Montreal and Israel: environmental determinants of differences.

Abstract

Mortality was compared in the Jewish populations of Montreal and Israel and the overall Canadian population, to investigate whether the Israeli pattern of low male mortality and relatively high female mortality is replicated among Jews living elsewhere. In Montreal, death certificates were obtained from Jewish funeral homes (where all Jewish deaths are believed to be handled) for 1986-1990 and coded. All-cause cumulative mortality for ages 35-74 (CM), was exceedingly low in Montreal Jews, both in males (CM = 0.312, 95% confidence interval [CI]: 0.274-0.350) and females (CM = 0.202, 95% CI: 0.172-0.232), compared to all Canadians (CM = 0.425; 95% CI: 0.414-0.435 and 0.251; 95% CI: 0.243-0.253) and Israeli Jews (CM = 0.406; 95% CI: 0.379-0.434, and 0.299; 95% CI: 0.276-0.322), for males and females. Sex ratios (male:female) were 1.36, 1.54, and 1.69 for Israeli Jews, Montreal Jews, and Canadians, respectively. Differences were due mainly to substantially lower cumulative mortality from circulatory diseases in Montreal Jews (CM = 0.139, 0.043 versus 0.203, 0.125 in Israeli Jews and 0.199, 0.081 in Canadians, in males and females, respectively); these differences were all highly significant. Sex ratios for circulatory deaths were lowest in Israel (1.63), highest in Montreal (3.23) and intermediate in Canadians (2.47). Among men, the circulatory diseases mortality ratio for Canadians versus Montreal Jews was 1.43, and 1.46 between Israeli and Montreal Jews; in women, these ratios were 1.87 and 2.90, respectively. These findings suggest that the mortality pattern characteristic of Israeli Jews is not a universal Jewish phenomenon and may be affected by modifiable environmental factors. Similar studies conducted in other Jewish communities would aid in confirming these observations.