Israeli Central Bureau Of Statistics Research Articles

Predictors of death at home among cancer patients in Israel: a population-based study

BackgroundMost cancer patients prefer to die at home; however, many die in hospital. The aim of the current study is to elucidate the association between dying at home and various personal factors in the Israeli population of cancer patients.MethodsData on cancer incidence (2008–2015) and death (2008–2017) was provided by the Israeli Central Bureau of Statistics and the Israel National Cancer Registry. Binary logistic regression analyses were performed to assess odds ratios for death at home following cancer diagnosis while controlling for age, sex, ethnicity, years of education, residential socioeconomic score, and time from diagnosis. We also assessed the relation between place of death and specific cancer sites, as well as the time trend from 2008 to 2017.ResultsAbout one quarter (26.7%) of the study population died at home. Death at home was most frequent among patients diagnosed with brain tumors (37.0%), while it was the lowest among patients with hematologic malignancies (lymphoma and leukemia, 20.3 and 20.0%, respectively). Rates of dying at home among patients with residential socioeconomic scores of 1, 2–9, and 10 were about 15, 30, and 42.9%, respectively. In patients from the 4th to the 7th decades of life, rates of death at home increased at a linear rate that increased exponentially from the 8th decade onwards. After controlling for potential confounders, predictive variables for death at home included age (OR = 1.020 per year, 95% CI 1.017–1.024), male sex (OR = 1.18, 95% CI 1.077–1.294), years of education (OR = 1.029 per year, 95% CI 1.018–1.040), and time from diagnosis (OR = 1.003 per month, 95% CI 1.001–1.005 all p < 0.001). No trend was seen from 2008 to 2013, while from 2014 to 2017 a slight increase in the rate of death at home was seen each year.ConclusionsThese results indicate wide variability in death at home exists among patients of different ages, sex, education, socioeconomic status and time from diagnosis. These findings stress the importance of delivering quality palliative care at home, mainly for patients with hematologic malignancies, younger patients, and patients of very low socioeconomic status. Understanding the complex mechanisms whereby patient preferences and the above variables may determine the preferred place of death remains an important research priority.

The Impact of Ongoing COVID-19 Stress on the General Population the Case for a New Type of Psychiatric Stress Disorder

Background: The COVID-19-related psychiatric burden is partly a result of prolonged social stress world-wide, trying to survive a pandemic that has infected more than 73 million people and killed 1·64 million people. Studies have examined the psychiatric impact of COVID-19 on DSM 5 and ICD 10 categories or considered a symptom list. We hypothesized that COVID-19-related psychopathology spans multiple DSM 5 and ICD 10 diagnoses, and empirical analysis of the associated symptoms will better describe COVID-19-related psychopathology.Methods: A bi-national research study: an Italian sample (N=21,217, studied March-April, 2020); and three representative longitudinal samples from Israel (N=1,276, 1,189, and 1,432 respectively, studied May-July, 2020). Data in Italy were collected by a national internet-based survey with an initially approached sample of about one million persons and in Israel by the Israeli Central Bureau of Statistics using probability-based national representative sampling. Data were analyzed focusing on the frequency and patterns of reported multiple mental health features. Outcomes: Combinations with all symptoms or features were more prevalent than combinations with fewer features. Results were not different between majorities and minorities in Italy and Israel, demonstrating the generalizability of the transdiagnostic syndrome. A history of previous mental disorder was a risk factor (Italian study) and an increase over time was found in Israel.Interpretation: Based on the current findings and the diverse complexity revealed, we propose a new syndrome termed Complex Stress Reaction Syndrome (CSRS). The existence of CSRS has implications for treatment and prevention approaches.Funding Statement: None.Declaration of Interests: We (all authors) have nothing to disclose.Ethics Approval Statement: The study was approved by the local Institutional Review Board at the University of L’Aquila. Online consent was obtained from all participants.

Remittances of Immigrant Citizens, Attachment to the Host Country and Transnationalism

The purpose of the paper was to investigate the remittance behavior of immigrant citizens and the motivations behind it, to conceptualize and investigate the determinants of remittances, which have unique implications for immigrant citizens. In addition to the general effects, this study considered effects across immigrant groups and justified that these effects were similar regardless immigrants' origin. The study is based on the data of the 2011 Immigrant Survey that was conducted by the Israel Central Bureau of Statistics. This survey is unique since this is the only survey of immigrants in Israel which included questions about personal remittances, transnational activities and social adaptation. The sample of the survey was representative of the population of immigrant citizens in Israel and included 3,952 respondents. The study results revealed that remittance behavior of immigrant citizens is predominantly driven by motives of altruism, and only in part by insurance and investment motivation.

Lack of Uniformity in the Israeli Property Tax System 1997–2017

There are two different forms of property tax systems: value-based tax, which is used in most countries of the world, and area-based tax, which is used mainly in Central and Eastern Europe and developing countries in Africa. Area-based property tax provides more stable and predictable budget revenues. It is simpler to administer and scores worse on equity grounds from the perspective of the ability-to-pay principle of taxation. Against this background, Israel’s property tax system, known as Arnona, is complex, spatially diversified, and causes a lack of uniformity that leads to tax distortion. This paper’s primary purpose is to identify the weaknesses of Israeli property tax from 1997 to 2017 and indicate how to improve the property tax system. This paper is based on case studies from four of the most important cities in Israel: Tel Aviv, Jerusalem, Haifa, and Beersheba, which have four different measurement methods for calculating property tax. Unique data were collected from the Israel Central Bureau of Statistics. According to this analysis, it was found that there are substantial differences in property tax between the four cities over the two decades analyzed. The main weakness is the lack of uniformity of the taxation system; the solution is to unify the measurement of real estate area for tax purposes using drone technology.

Migration and Food Consumption: The Impact of Culture and Country of Origin on Obesity as an Indicator of Human Health

Previous research demonstrates that the 1965 American immigration wave has tended to attenuate the obesity pandemic in the United States. Based on a survey carried out by the Israeli Central Bureau of Statistics (ICBS) in 2012 and 2016, we observe the correlation between BMI, age, native language, and years-since-migration to Israel. BMI (=kgm2) is a conventional measure of obesity, where BMI ≥ 25 is considered overweight and BMI ≥ 30 as type I obesity. The results indicate that compared to 11 groups of immigrants, the median BMI among native Israelis is lower. While the prevalence of overweight (BMI ≥ 25) among Hebrew speakers is below 50%, in 11 groups of immigrants, the prevalence of overweight is above 50%. A noteworthy exception is the immigrants from Ethiopia, who exhibit lower overweight prevalence compared to native Israelis and all other population groups. Finally, while male Hebrew and Russian speakers cross the overweight benchmark at the same age (35 years), native Israeli women (Hebrew speakers) cross this benchmark only when they reach 50 years (15 years after the males) and Russian women cross this benchmark only five years after the Russian men. These research findings may be of assistance in public health and culture-oriented medicine.

The “battle of sexes” construct among ultra-Orthodox Jews: what is the optimal number of children for a minimal BMI?

Obesity is a prominent risk factor for an extensive series of health problems as well as for higher mortality rates. This study demonstrates a conflict of interest (“battle of sexes” construct) between ultra-Orthodox Jewish (UO) females and males. The study is based on a panel dataset of up to four measured points in time (2012, 2013, 2014–2015, and 2016) generated by the Israeli Central Bureau of Statistics (ICBS). Based on this dataset, the methodology of the random-effect probit binary model is employed, where the dependent variable measures the projected probability of type I obesity. According to the outcomes obtained, this conflict of interest is unique to the UO group. While projected body mass index (BMI = weight÷height2, where weight is measured in kilograms, and height in meters), and likelihood of type I obesity (BMI ≥ 30), among UO females rises with the number of children, the opposite trend occurs for UO males. Consequently, in terms of likelihood to suffer from type I obesity as a prominent risk factor for health, an increase in the number of children tends to be detrimental to the health of UO females and beneficial to the health of the UO male. Research findings thus stress the importance of cultural differences among different religious groups and the need for cultural and gender-oriented health policies.

Trust in the Israeli Healthcare System Among Arabs, Jewish Immigrants, and Non-immigrants.

Previous studies have shown that minorities and immigrants have low levels of trust in healthcare systems (HCSys), which might present a barrier in access to and utilization of healthcare services. We compared the levels of trust in Israel's HCSys among the Arab minority, immigrant Jews, and non-immigrant Jew sand draw on the integrative model of organizational trust to explore factors that can explain differences in the trust level within and between the study groups. We obtained cross-sectional census data from the 2017 Social Survey of the Israel Central Bureau of Statistics. We studied levels of trust based on a survey question: "Do you have trust in the HCSys?" We used logistic regression models to compare levels of trust in HCSys among the study groups, adjusting for components of the integrative model: characteristics (sex, age, education, religiosity, and healthcare service use), abilities (private health insurance ownership), integrity (discrimination, trusting the justice system and government), and perceived risk (self-reported health). Our findings revealed that Arabs (odds ratio (OR) = 4.20, 95% confidence intervals (CI) = 4.17, 4.23) and immigrant Jews (OR = 2.54, 95% CI = 2.51, 2.58) had more trust in the HCSys compared to non-immigrant Jews, even after adjusting for all the component variables. Different components of the integrative model explained trust in each population group. Minority and immigrant groups had greater trust in the HCSys compared to the non-immigrant group. These findings may indicate different expectations with respect to patient-caregiver relations and HCSys utilization and raise questions regarding access to HCS and quality of care among minority and immigrant groups.

Incidence of AChR Ab-positive myasthenia gravis in Israel: A population-based study.

The incidence of myasthenia gravis (MG) has traditionally been low, ranging between 2-6/106 . Several recent epidemiological studies have reported a higher incidence. We, therefore, aimed to assess and characterize the incidence of MG in Israel. We retrospectively reviewed the records of all four laboratories that performed the acetylcholine receptor antibody (AChR Ab) test in Israel between 1994 and 2013 and documented the number of newly diagnosed seropositive MG patients each year. To assure that data indeed reflect only newly diagnosed patients, patient's names and ID numbers were screened at the Hadassah medical center database since 1978, the year when the test was first performed in Israel. In order to calculate the annual incidence of the disease, the population at risk was derived from the annual publication of the Israeli Central Bureau of Statistics. The annual incidence of MG for this time period was 13.1/106 inhabitants. The mean incidence of MG between 1994 and 2003 was 7.695/106 /y, while the mean incidence between 2004 and 2013 was 18.49/106 (P<.0001). Mean age of diagnosis between 1994 and 2003 was 56.65±0.9351, while between 2004 and 2013, it was 59.89±0.5336 (P=.0012). Male to female (M:F) incidence ratio in the years 1994-2003 and 2004-2013 was 2:3.2 and 3:1.8, respectively, reflecting increased incidence among males (P<.0001). The incidence of MG in Israel has increased significantly during the last decade, especially among males of older age. These findings may reflect an etiological role of an environmental factor, increased awareness, and increased longevity in general.

Trends and perceptions of choosing chemistry as a major and a career

In many countries, the choice of a STEM career, especially in chemistry, is decreasing. A shortage of appropriately skilled workers can become a threat to any country's future achievements. Our research strives to understand behavioral trends and career choice factors related to personal and environmental themes. Building on the foundations of the Social Cognitive Career Theory, the research sheds light on prospective trends and retrospective perceptions of chemistry-related professionals in choosing chemistry in high school, as a career, and as a STEM occupation. To analyze the prospective trends in choosing chemistry, we used data curated by the Israel Central Bureau of Statistics on 545 778 high school graduates. For the retrospective perceptions of choosing a chemistry career, we investigated three research groups (N = 190): chemists and chemical engineers, chemistry teachers, and third year undergraduate chemistry students. We found that choosing chemistry as a major and profession decreases from high school to higher education. Women tend to choose chemistry more than men at high school and university levels, and minorities tend to choose it more in high school but less in higher education compared to non-minorities. Task-oriented self-efficacy was the factor which contributed the most to chemistry career choice in all three research groups. The theoretical contribution is the unique SCCT application through the integration of both the prospective views on the behavioral theme and the retrospective views on the personal and environmental themes. Furthermore, we present new chemistry-related factors within the personal theme of this theoretical framework that can extend the SCCT framework.

Interpreting Islam in the Jewish State: Muftis and &amp;lt;i&amp;gt;Iftaʾ&amp;lt;/i&amp;gt; in Israel

Islam is the religion of the majority of Arab citizens in Israel. According to a report issued by Israeli Central Bureau of Statistics, there are 1.2 million Muslims in Israel, comprising about 80% of the Arab population in the country. Over the past four decades, Islam has become an important factor in the political and socio-cultural identity of the Arab minority; the number of Muslims in Israel who define their identity first and foremost in relation to their religious affiliation has steadily increased. This article studies the authority, ideologies and legal methods and mechanisms used by muftis practicing <i>iftaʾ</i> in the State of Israel when interpreting Islam for the resident Muslim minority. Key questions are: Who serve as the primary religious authorities for Muslims in Israel? Does a unique ‘Israeli-Islam’ exist? The present research found that the evolving Islamic law of minorities in Israel is much less developed than it is in the West; as such, one cannot yet identify Islam in Israel as ‘Israeli-Islam,’ as having its own distinct nature (as in the case of ‘Euro-Islam’). To date, there seems to be no single locus of Islamic religious authority in Israel; multiple groups claim to speak on Islam’s behalf. As such, there is religio-political fragmentation amid the Muslim community in Israel, each group seeking to create its own religious authority: CIS of the al-Qasemi Sufi Order; ICIF of NIM and, finally, the ad-hoc SIM <i>iftaʾ</i> committees. To date, none of these <i>iftaʾ</i> agencies in Israel has been able to formulate, authorize and apply a code of Islamic minority law in Israel, and they continue to rely heavily on foreign Islamic religious authorities. Israeli Muslims continue to maintain strong ties with the regional socio-cultural and religious space and with their peers in the Muslim-Arab world. Israeli <i>iftaʾ</i> agencies tend to adopt and adapt work methods used by foreign, regional Islamic religious authorities and to accept, as is, or adapt many of their opinions/decisions.

Validating reported cause of death using integrated electronic health records from a nation-wide database.

To compare the underlying cause of death reported by the Israeli Central Bureau of Statistics (CBS) with diagnoses in the electronic health records (EHR) of a fully integrated payer/provider healthcare system. Underlying cause of death was obtained from the CBS for deaths occurring during 2009-2012 of all Clalit Health Service members in Israel. The final cohort consisted of members who had complete medical records. The frequency of a supportive diagnosis in the EHR was reported for 10 leading causes of death (malignancies, heart disease, cerebrovascular disease, diabetes, kidney disease, septicemia, accidents, chronic lower respiratory disease, dementia and pneumonia and influenza). Of the 45680 members included in the study, the majority of deaths had at least one diagnosis in the EHR that could support the cause of death. The lowest frequency of supportive diagnosis was for septicemia (52.2%) and the highest was for malignancies (94.3%). Sensitivity analysis did not suggest an alternative explanation for the missing documentation. The underlying cause of death coded by the CBS is often supported by diagnoses in Clalit's EHR. Exceptions are septicemia or accidents that cannot be anticipated from a patient's EHR, and dementia which may be under-reported.

The Chicken and Egg Problem: Obesity and the Urban Monocentric Model

Recent medical studies have examined ways to offer enhanced spatial planning opportunities to increase a person’s level of physical activity. These studies demonstrate a decreasing prevalence of obesity in denser and less car-oriented communities with mixed land uses. Yet, these studies raise the chicken and egg problem, namely, whether or not prevalence of obesity motivate change of residence, or whether or not people who are more physically active prefer to live in denser and less car-oriented communities? Based on a two-year longitudinal survey of the Israeli Central Bureau of Statistics (CBS), we explore this question using a 3SLS methodology, where the two endogenous variables include: BMI and apartment size. The age of the housing unit in years and the structure type provide the exogenous variables that identify the BMI equation. This empirical model is justified based on the urban monocentric model, which forecasts smaller apartments in multi-story structures with smaller building footprints, where price of land is expensive (at the central cities), which, in turn, give rise to denser and less car-oriented communities. In contrast, single family units with larger lot size, which give rise to more car-oriented communities, are typical of suburbs, where the price of land is relatively cheap. Moreover, the natural evolution theory of suburbanization process explains the correlation between construction age, type, income level, and location in central cities. Results of our study give rise to the possibility that for the Jewish female and male populations, health considerations may influence housing choice, but not vice versa. For other populations (i.e., Arab females and males), and with one exception, no correlation between BMI and housing choice is found. Public policy implications of our study suggest that health-related considerations might be employed to promote return to denser urban areas/central cities (reverse suburbanization) particularly among the Jewish population group.

Trust in health care systems Arab minority, Jewish immigrant and non-immigrant

Abstract Background The objective of this study was to examine the level of trust towards Israel’s health care services (HCS) among Palestinian-Arab minority, Jewish immigrant, and non-immigrant Jewish citizens. Previous studies have shown that minorities and immigrants have less trust in health care system (HCSys), which might represent a barrier in access to, and utilization of HCS. Methods We obtained cross-sectional nationwide census data from the 2017 Social Survey of the Israel Central Bureau of Statistics. We studied levels of trust in the HCSys based on a survey question: ’Do you have trust in the healthcare system?” We conducted logistic regression analysis within and between the study groups to compare levels of trust, after adjustment for different relevant covariates in different models. Results Compared to non-immigrant Jews, Arabs had higher trust in the HCS (odds ratio (OR)=3.08, 95% confidence intervals (CI)=3.06,3.10) and compared to non-immigrant Jews, immigrant Jews had more trust (OR = 1.96, 95% CI = 1.94,1.98), even after adjusting for gender, age, education level, religiosity level, perceived discrimination, self-rated health status, HCS use, and having private health insurance. The variables that predicted trust in the HCSys were different in each ethnic group. Conclusions Contrary to our hypothesis and to previous research, Arab and immigrant Jewish respondents in our study had greater trust in the HCS compared to non-immigrant Jews. This might relate to different expectations among our study groupsof the patient-caregiver relations which might affect the access to and utilization of HCS and finally might affect the quality of care. Key messages Exceptionally, in Israel, the Arab minority and Jewish immigrants have more trust in the health care system compared with non-immigrant Jews. More research is needed to understand how trust among minority groups relates to the patterns of utilization of HCS and raises question regarding the quality of care.

Epidemiology and Clinical Management of Early Childhood Caries in Israel.

Aim: The aim of the present review is to describe the current status of early childhood caries (ECC) in Israel in aspects of epidemiology, prevention, and management.Methods: PubMed search was performed using the words caries, children, Israel. Demographic data was collected from the Israeli Central Bureau of Statistics.Results: The decayed, missing, and filled teeth index was 2.72 in 1992 and 2.56 in 2016. The proportion of restored teeth has increased. A number of preventive programs are ongoing but a general preventive program is lacking at the national level. From 2010, every child in Israel is eligible to receive free dental treatment.Conclusion: The gaps in understanding of the epidemiological profile of ECC in Israel is a call for more research conduct on ECC in the country.

The number of acute cerebrovascular events in Israel: a forecast until 2040

BackgroundAcute cerebrovascular event is one of the leading causes of death in Israel and is the primary cause of neurological disability in adults. Although some evidence indicates that the incidence rate of acute cerebrovascular events in developed countries is stable or has been decreasing over the past decades, the number of events is expected to increase in these countries due to projected changes in size and composition of the population. The purpose of this study was to provide a forecast of the number of acute cerebrovascular events in Israel for the coming decades.MethodsWe used data from the National Stroke Registry at the Israel Center for Disease Control and data from the long-term population forecasts of the Israeli Central Bureau of Statistics. We generated forecasts of the annual number of acute cerebrovascular events based on the mean annual incidence rates during 2014–2016 within population subgroups defined by gender, age, and ethnicity, and on the projected population size of these subgroups for 2015–2040. The forecasts were generated for various assumptions as to trends in the incidence rate and for alternatives as to the projected population growth.ResultsBased on the intermediate population growth alternative, the annual number of acute cerebrovascular events is expected to increase from 18,400 to 38,500, 34,800 or 26,400 events, assuming constant annual incidence rates, decreasing annual incidence rates at a rate of 2% every 5 years, or decreasing annual incidence rates at a rate of 7.25% every 5 years, respectively. Whereas, presently, events affecting Arab patients account for 15% of acute cerebrovascular events and events affecting patients over 80 account for 33% of acute cerebrovascular events, by 2040 events affecting Arab patients will account for more than 21% of the events and events affecting patients over 80 will account for 42% of the events.ConclusionsIn view of the expected increase in the number of acute cerebrovascular events and the changes in the demographic composition of adults suffering from such events, and in order to allow for optimal care and equity, it is imperative to evaluate the preparedness of care provision and the geographical deployment of treatment services in the short and long term.

Does body fat change with car ownership rates? A longitudinal survey of gender differences

Durable goods provide conventional proxies for household wealth, which, in turn, may increase the tendency to consume healthier food products and engage in leisure-time physical exercise. Higher car ownership levels, on the other hand, may reduce the tendency to participate in utilitarian, non-exercise-related physical activities such as walking to work and biking to do errands. Based on a recent longitudinal two-year Israeli Central Bureau of Statistics (CBS) survey, we examine the correlation between the number of cars owned by households and household members' body mass index (BMI) for adult female and male respondents below the workforce retirement age. Results indicate that projected BMI of native Israeli Jewish females and Jewish immigrants from Asian-African countries drops significantly, while compared with baseline native Jewish Israelis, the projected BMI decrease among Arab females is attenuated significantly with increased car ownership levels. These outcomes suggest that programs aimed at alleviating poverty may have the additional benefit of promoting obesity-reducing activities, particularly among the population of native Jewish Israeli females and immigrants from Asian African countries.

The Association of Pension Income with the Incidence of Type I Obesity among Retired Israelis.

Previous studies have identified obesity and overweight as the fourth leading risk factor for global mortality. The objective of the current study is to investigate gender differences and the impact of wealth and income from pensions, sociodemographic variables, and self-assessment of health conditions on the projected probability to become obese in the postretirement age (67 years and older). We are unaware of previous studies, which explored the direct relationship between obesity, monetary income from pensions, wealth, and self-assessment of health conditions. To conduct this research, we make use of an extensive questionnaire concerning the economic and sociodemographic features and health and housing conditions of individuals administered within the framework of the 2015-2016 longitudinal survey conducted by the Israeli Central Bureau of Statistics (CBS). The survey is representative of the Israeli population and also includes information regarding the weight, height, gender, and age of each household member. Results of our study demonstrate that while for the female respondents older than 67, the projected probability of type I obesity (BMI ≥ 30) drops by 0.41% (p=0.0021) to 0.52% (p=0.0001) with an incremental 10,000 NIS (about $2,500) rise of gross annual income from a pension, for the male respondents above 67 years, the projected probability remains unchanged (p=0.4225). This outcome remains robust even when the 2015 BMI measurement of type I obesity (BMI ≥ 30) is controlled. This drop among women attenuates with a cutoff point increase from BMI ≥ 25 (overweight) to BMI ≥ 30 (type I obesity) to BMI ≥ 35 (type II obesity). Further results indicate that for both genders above 67 years and for men above 62 years, the projected BMI drop of one year decreases with income from a pension (p=0.013, p=0.039, and p=0.007, respectively), although the spread around the projection becomes wider. Compared with other martial status categories, for widowed females, the projected probability of obesity and self-reporting on improved health conditions drops by 6.58% (p=0.0419) to 11.28% (p=0.0048) and 6.55% (p=0.0190) to 7.47% (p=0.0036), respectively. For females older than 67, family status divorced drops the projected probability of obesity by 9.25% (p=0.0319). For males older than 67, results show a rise in projected obesity with car ownership by 6.10% (p=0.0897) to 6.41% (p=0.0469) and a drop in projected obesity with academic degree status by 9.93% (p=0.0106) to 10.14% (p=0.0118) and immigration status from American-European countries by 7.67% (p=0.0821) to 8.99% (p=0.0398) and Asian-African countries by 11.63% (p=0.0245) to 11.99% (p=0.02). Research findings stress the differences and similarities in male-female patterns of obesity after the retirement age of 67 years and may be of assistance to welfare and public health experts.

Work cessation after cancer diagnosis: a population-based study.

Long-term work maintenance among cancer survivors is important for patients, their families and society. To assess the risk of work cessation among workers at baseline in cancer survivors at 2 and 4 years after diagnosis compared with a matched cancer-free control group. Baseline measurements for this historical prospective study were drawn from the Israeli Central Bureau of Statistics 1995 National Census, followed up until 2011. Patients who died before the end of 2011 were excluded from the study. Adjusted odds ratios (ORs) for the study outcome were assessed by binary logistic regression analyses, controlled for age, sex, ethnicity, years of education and socioeconomic position. Cancer was associated with not working at 2 years after diagnosis (adjusted OR = 1.71, 95% confidence interval [CI] 1.59-1.84, P < 0.001), while only mild attenuation was seen at 4 years after diagnosis (adjusted OR = 1.57, 95% CI 1.46-1.68, P < 0.001). Analysis by cancer type revealed that patients diagnosed with central nervous system (adjusted OR = 3.42, 95% CI 2.41-4.86, P < 0.001), renal (adjusted OR = 2.10, 95% CI 1.38-3.16, P < 0.001), breast (adjusted OR = 2.05, 95% CI 1.76-2.38, P < 0.001) and haematologic malignancies (adjusted OR = 2.04, 95% CI 1.59-2.61, P < 0.001) showed the greatest magnitude effect at 2 years. These results emphasize the need for tailored interventions in order to enhance work maintenance, even among patients who are working at baseline and with very long-term survivors.

Cohort Effect and the Impact of Environmental Characteristics on Obesity

Obesity and overweight have become the fourth leading risk factor for global mortality. They might be affected by a variety of different externalities, such as processed food, traffic noise, and other environmental factors. The objective of the current study is to examine the impact of cohort, gender and environmental characteristics of the residential unit on overweight and obesity. We make use of an extensive and unique set of questions concerning the environmental characteristics of the housing unit asked within the framework of the 2015-2016 longitudinal survey conducted by the Israeli Central Bureau of Statistics (CBS) via face-to-face interviews. The survey also includes information regarding the weight, height, gender and age of each household member. The opportunity to use the BMI measure, namely, WEIGHT÷(HEIGHT2), and estimate the probability to become overweight (BMI≥25) provides unique measures of the impacts of environmental externalities. The prominent public policy reprecussion from our study is that a reduction in traffic noise, may improve residents health, as they lead to a decrease in the prbability of overweight for both genders. Further implication is that positive environmental characteristics, particularly, number of exposures in the residential unit, tends to improve significantly the probabity of overweight among women.

Temporal trends of geographic variation in mortality following cancer diagnosis: a population-based study

BackgroundInequalities among the western population, combined with the introduction of new treatment options for cancer, have challenged endeavors to provide equal care to patients with cancer. Israel’s highly developed healthcare system and mandatory National Health Insurance afforded an opportunity to study geographic variation over time in mortality following cancer diagnosis.MethodsThis historical prospective cohort study included a nationally representative cohort that was assessed by the Israeli Central Bureau of Statistics 1995 census and followed until 2011. The cancer incidence (1995–2009) was ascertained by the Israel National Cancer Registry. We analyzed the effect on patient outcome of living in a given district, according to the Israeli Central Bureau of Statistics classification. Patients were stratified by the year of diagnosis (1995–1997, 1998–2000, etc.), and associations were adjusted for age, ethnicity, and districts. We excluded patients with malignancies associated with screening program (breast, prostate, colon, and cervical cancers).ResultsThis study included 26,173 patients living in 13 residential districts. During the last years (2007–2009) of the study, the hazard ratio (HR) for risk of death was high in 8/13 districts (61.5%), compared to 4/13 (30.7%) during 2004–2006, and 0/13 (0%) during 2001–2003. Districts that were less likely to be associated with increased risk of death were located in the center of Israel and in metropolitan areas, compared to the peripheral regions. Furthermore, HRs were substantially higher in the last years of the study (2007–2009, HRs rose to 1.69, 95%CI: 1.38–2.08) compared to the earlier years (2004–2006, HRs rose to 1.35, 95%CI: 1.13–1.62).ConclusionOur findings suggested that geographic variation for mortality following cancer diagnosis have increased over time. Our results provide policy makers with vital information regarding the need for targeted interventions, mainly in peripheral regions.