Mortality In Israel Research Articles

Infant mortality in Israel during 1950–2000: rates, causes, demographic characteristics and trends

We evaluated the trends and risk factors in infant mortality in Israel over five decades (1950-2000), based on data obtained from the official notifications of live births, and death certificates. Until the 1960s the main cause of infant mortality was infectious disease; this was replaced by congenital anomalies in Moslems and Druzes, and preterm birth in Jews and Christians. In 2000, there were 746 infant deaths, and the national infant mortality rate (IMR) was 5.4 per 1000 live births (Jews 3.9; [95% CI 3.5, 4.3]; Moslems 9.2 [8.3, 10.3]; Christians 3.6 [1.4, 5.8]; Druzes 6.3 [3.6, 9.0]). Between 1955 and 2000 the overall IMR declined sevenfold (absolute declines of 56.8, 56.3, 45.0 and 28.3 per 1000 live births, in Moslems, Druzes, Christians and Jews, respectively). The reduction in IMRs between 1990 and 2000 in all religious groups (>45%) exceeded the goal set by the World Summit for Children in 1990 of 33%. In 2000, the main risk factors were birthweight < 1500 g [relative risk (RR) = 69], major congenital malformations (RR = 22.0 [18.8, 25.7], and multiple births (RR of 9.3 and 4.2 in triplets and twins respectively). We conclude that the marked decline in IMRs in Israel over five decades reflects a major improvement in population health. Today, infant mortality in Israel represents a unique combination of high rate of congenital malformations among Moslems, where consanguineous marriages are common, and medical termination of pregnancy of malformed fetuses are infrequent; and relatively high IMRs from preterm birth in Jews, associated with high rates of assisted reproduction.

Educational differentials in mortality from cardiovascular disease among men and women: the Israel Longitudinal Mortality Study.

While socioeconomic inequalities in cardiovascular disease have been observed in most industrialized countries, available information in Israel centers on ethnic variations and the role of education has yet to be investigated. This study examines educational differentials in cardiovascular mortality in Israel for both men and women aged 45 to 69 and 70 to 89 years. Data are based on a linkage of records from a 20% sample of the 1983 census with the records of deaths occurring until the end of 1992. The study population includes 152,150 individuals and the number of cardiovascular deaths was 14,651. Educational differentials were assessed for mortality of diseases of the circulatory system, ischemic heart diseases, cerebrovascular diseases, hypertensive diseases, and sudden death. Substantial mortality differentials were found among individuals aged 45 to 69 years, with larger inequalities among women. The age-adjusted relative risk for mortality of cardiovascular diseases among those with elementary education (< or =8 years) compared with those with high education (> or=13 years) was 1.46 (95% CI: 1.32-1.61) for men and 2.06 (95% CI: 1.76-2.41) for women. Differentials among the elderly were markedly narrower than those for younger adults. Similar trends were observed for mortality of subgroups of causes including cerebrovascular diseases and ischemic heart diseases. Educational differentials were not affected by adjustment for ethnic origin and car ownership. Those with 8 years of education or less suffer higher risk of cardiovascular mortality compared with adults with 13 or more years of education. Young, less educated women are more vulnerable, and health and social policies oriented towards this group are needed.

Population group differences in trends in stroke mortality in Israel.

In Israel, stroke is the third most common cause of death. In 1997 stroke accounted for 2905 deaths (8.1% of total), 1390 of them among men (7.5% of total; crude mortality rate of 48.3/100 000) and 1515 among women (8.6% of total; crude rate of 51.7/100 000). This report presents trends on stroke mortality by population group and estimates of morbidity in Israel. Data on stroke mortality in Israel during 1969-1997 were obtained from the Israel Central Bureau of Statistics. Age-specific and age-adjusted mortality rates were calculated for the 2 main population groups. Data on morbidity were obtained form the 1996/1997 National Health Survey. Hospitalization rates due to stroke are based on the national hospitalization data. A monotonic decrease in stroke mortality is evident in Jews during 1969-1997 in both sexes. Age-adjusted mortality rates declined by 62.5% for Jewish men and by 73.4% for Jewish women during 1969-1997. Among Arabs, there was a general decreasing trend in the mortality for both sexes during 1973-1997. The main difference in population group mortality trends was found in the group aged >/=75 years: a statistically significant decrease in mortality rates for Jews is evident, while no decrease is apparent for Arabs. On the basis of available data for 1990, an estimated 13 000 patients with stroke were hospitalized during 1997. During the last 25 years, age-adjusted stroke mortality in Israel has declined substantially, but the decline has been much greater among Jews than Arabs. The group aged >/=75 years shows the greatest difference in trends between Jews and Arabs. This finding may be explained by differences in risk factor distribution and case fatality rates.

Death rests a while: holy day and Sabbath effects on Jewish mortality in Israel

The purpose of this study was to replicate and expand previous research examining the association between holy days and the timing of death. We analysed daily numbers of deaths of Jewish men and women aged 35 and above in Israel from 1983 to 1992, controlling for long term and seasonal trends. For all men, and for younger women (ages 35–74) there was a clear and significant dip–peak pattern in the number of deaths around the Sabbath (Saturday), but no consistent dip–peak pattern around other holy days. This pattern was found for all causes of death (particularly cerebro-vascular causes), was stronger for men than for women, and was not found among young Jewish children, or among the non-Jewish population.

Thank God it's Friday: The weekly cycle of mortality in Israel

The purpose of this study was to explore the weeklycycle of mortality among Jews in Israel. Drawing onprevious research on the association between holy-daysand the timing of death, we hypothesized thatmortality of Jews declines on Sabbath (Saturday), andrises to a peak on Sundays. We analysed daily numbersof deaths of Jewish men and women aged 5 and above inIsrael from 1983 to 1992, and found a clear andsignificant dip-peak pattern in the number of deathsaround the Sabbath. This pattern was found for allcauses of death, was stronger for men than for women,and was not found among young Jewish children, oramong the non-Jewish population.

27 Decrease in asthma mortality in Israel 1991–1995; Is it related to increased use of inhaled cortocosteroids?

27 Decrease in asthma mortality in Israel 1991–1995; Is it related to increased use of inhaled cortocosteroids?

Trends in blood pressure levels over time in middle-aged and elderly Jerusalem residents.

Change in blood pressure levels over time was investigated in Jerusalem, in two cross-sectional surveys in 1970 and in 1986 among residents of a neighbourhood aged 50 years and more. The study population comprised 1397 individuals in 1970 and 1858 in the 1986. Age-adjusted mean systolic and diastolic blood pressure levels were lower in 1986 than in 1970 by 6.9 mmHg and 4.7 mmHg, respectively. The prevalence of blood pressure levels above 160 and/or 95 mmHg in 1986 was lower by 50% and there was a twofold increase in current treatment for hypertension. The reduction in blood pressure in both sexes remained evident upon control for confounding effects of age, ethnic group, education, body mass index and reported treatment for hypertension. The proportion of people who had blood pressure levels below 140/90 and did not report being under treatment, increased. The possibility of methodological problems inherent in this type of study were considered. More effective antihypertensive treatment in 1986 can explain only part of the reduction. The decrease in levels of blood pressure as revealed by this study may reflect a real reduction in the population that could explain part of the striking decline in cardiovascular mortality in Israel.

Cause-specific mortality among Israeli adolescents in the 1980s

Purpose: Considerable mortality occurs during adolescence despite it being a relatively healthy period of life. Nationwide analysis of adolescent mortality data helps identify those sub-groups with higlier-than-expected death rates, that may be amenable to preventive intervention programs. Methods: Adolescent mortality in Israel during 1981–1986 is examined by age (10–14, 15–19 years), sex, population group (Jews, non-Jews), and cause of death. Data were abstracted primarily from special publications for 1981–1986. Recently available mortality updates for 1987–1989 were inspected and significant changes in mortality during the latter period have been included. Results: Among an average of approximately 800,000 adolescents aged 10–19 years living in Israel during 1981–1986, the majority (77%) were Jews. Overall mortality was 36.7 per 100,000. Death rates were almost twice as high for males as for females, increased with age for all population subgroups, and were 63% higher for non-Jews compared with Jews. Accidents were the major cause of death among Israeli adolescents (37.7% of total mortality), with male-to-female rate ratio of 3.4. Mortality from all external causes, including accidents, suicide, homicide, and other external causes accounted for 50.6% of all deaths. Neoplasms were the next major cause of death. Israel and U.S. adolescent mortality rates were compared and showed similar trends. Conclusions: The non-Jewish minority adolescents, and most particularly the males, are at the highest risk of death. Preventive intervention programs should be targeted to the high-risk populations described.

Trends in coronary heart disease mortality and related factors in Israel.

Age-adjusted mortality from coronary heart disease (CHD) showed a striking decline in Jews living in Israel between 1974 and 1979. The decline was evident for both males (age-adjusted rate, age 25+, declining from 441 to 347/100,000) and females (declining from 303 to 205/100,000, respectively), and probably for each of the different immigrant groups. A similar decline in Arabs and Druse has not been identified and awaits further analysis. The decline has been associated with the presentation of coronary care units, coronary bypass surgery, improved emergency service and cardiopulmonary resuscitation procedures. The modernization of diagnostic procedures, discharge and rehabilitation, and possibly pharmacologic therapy may also have contributed, but available data do not provide unequivocal proof for the role of secondary prevention. In the realm of primary prevention, evidence for improved screening, treatment and control of hypertension is suggestive but not conclusive. Little, if any, change in serum cholesterol levels and cigarette smoking habits has been observed. A continuous increase of the percent of calories derived from fat has been apparent, while energy derived from carbohydrates, notably starch, has been declining. Thus, changes in CHD mortality were not accompanied by putatively anti-atherogenic trends in eating habits. The reasons behind the striking decline of CHD mortality in Israel are not clear, but so far there is very little in the available data to suggest a meaningful effect of life-style modifications on mortality trends.

Congenital malformations in Israel.

The interest in congenital malformations increases when the infant mortality rate declines. When the preventable cases decline and form only a small part of the total infant mortality, attention is directed towards the remaining hard-core of infant mortality. At this stage, congenital malformations (CM), which are still to a certain degree a terra incognita, gain in importance and are rated at high priority. Infant mortality in Israel declined from 51 -7 per 1,000 live births in 1949 to 23-7 in 1964. During these 16 years, the mortality in the second half of infancy (infants aged 6-11 months) diminished to about one-fifth of the 1949 figure; the mortality at the ages 1-5 months declined to less than one-third; even the late neonatal mortality (1-3 weeks) decreased to less than half; but in the first week of life the decrease amounted to only 16-4 per cent. This is the period in which intra-uterine developments influence the mortality rather more than environmental circum stances. Most causes of death showed a more or less regular tendency to decline. But the share of CM in the total infant mortality increased from 9 8 per cent, in 1950 to 21 -3 per cent, in 1963 and 20 0 per cent, in 1964. Further improvement in the infant mortality will depend on understanding the bio logical processes underlying congenital malforma tions.

Differential mortality in Israel by socioeconomic status.

Differential mortality in Israel by socioeconomic status.

Epidemiological Observations on Leukemia in Israel

As in other parts of the world, 1,2 we, in Israel, have been impressed by an apparent increase in the incidence of leukemia in recent years. The immigrant population of Israel, which came in well-defined waves from many different countries mainly after 1948, provides material for the study of the incidence of leukemia in different ethnic groups. Furthermore, the differences in medical sophistication of their countries of origin and the mass-treatment programs linked to specific groups of immigrants make it possible to investigate some of the etiologic factors involved in this disease. This communication presents observations based on a study of leukemia mortality in Israel during the years 1950-1958 and of 150 consecutive leukemia patients seen at a large central hospital. Material Information was obtained from the following 2 sources: All the certificates of the 718 registered leukemic deaths reported to the Central Bureau of Statistics * during the years