Population Groups In Israel Research Articles

Pediatric injury attendances in different population groups in Israel before, during, and after COVID-19 lockdowns: a descriptive study, 2018–2022

BackgroundLockdowns and quarantines during the COVID-19 pandemic influenced healthcare services’ usage patterns such as emergency department (ED) attendance. During the pandemic, Israel issued three lockdowns (March–May 2020, September–October 2020, and December 2020–February 2021) to mitigate the spread of COVID-19. Little is known about the impact of these lockdowns on ED attendance for injuries in the diverse population of Northern Israel.MethodsWe described patterns of ED attendance before, during, and after COVID-19 lockdowns. We extracted data from medical records of all northern Israeli children aged 0–17 years old who attended Ziv Medical Center (ZMC) emergency department (ED) due to injury, between 01/01/2018 and 10/02/2022. We compared the volume and characteristics of ED attendance during lockdown periods to the same time periods in the 2 years before the pandemic and 1 year after the lockdowns, using chi-square tests.ResultsSeven thousand six hundred nineteen northern children attended ZMC ED during the time periods of the study for injuries and were analyzed. Mean attendance numbers during lockdowns decreased compared to previous years, with an increase in injuries proportion (67.8% (1502/2216) vs. 52.7% (2038/3868) p < 0.001). The proportion of 0–4-year-olds attending for injuries during the lockdown increased compared to pre-pandemic (39.68% vs. 30.7%, p < 0.0001). Minority population attendance decreased (27.47% vs. 30.71% p = 0.02). Hospitalization rates increased (13.21% vs. 10.65% p = 0.01). Post-lockdown periods saw a return to the pre-pandemic age and ethnicity distribution.ConclusionsCompared to previous years, the volume of injuries was lower during lockdowns for all ages, with a relative increase in the proportion of injuries among younger children attending the ED. A lower proportion of attendance from minority groups suggests different health-seeking behavior patterns during emergencies compared to the general population. Understanding these differences will help better plan for future emergencies.

Screening and Colonoscopy Quality Measures: Ethnic Disparities and Impact on Patients' Outcome.

Recent reports have confirmed the improving trends in colorectal cancer (CRC) incidence and outcomes. Still, disparities in incidence and mortality in CRC continue to persist between major ethnic groups despite the provision of widespread screening and improved care. We aimed to outline, from an endoscopic point of view, ethnic disparities in major endoscopic measures concerned with CRC screening and detection and track their impact on patients' outcomes. We reviewed electronic reports of patients referred for colonoscopy procedures over 20 years. We compared demographic, clinical, and endoscopic findings between major ethnic population groups in Israel. In addition, trends of screening utilization, bowel preparation, and polyp detection rates were tracked, and the incidence of CRC diagnosis was followed. A total of 51307 patients had undergone colonoscopies, of whom 16% were Arabs, and 84% were Jewish. The procedures performed for CRC screening throughout the study period were significantly lower in Arabs (5% vs. 13.1%; P < 0.0001). In parallel, for most of the follow-up period, the Arab patients had higher rates of inadequate bowel preparation (overall: 19.9% vs. 12%; P < 0.001) and a lower polyp detection rate (16.7% vs. 22.5%; P < 0.0001). Expectedly, the incidence of CRC has steadily decreased in the Jewish group, while an adverse pattern of increasing incidence was documented in the Arab patient during the follow-up period. Characterized by lower screening utilization and poor bowel preparation, the incidence of CRC development in Arab patients is increasing, while improving trends of CRC were observed in their Jewish counterparts.

The COVID-19 Israeli tapestry: the intersectionality health equity challenge

BackgroundCOVID-19 is disproportionately affecting disadvantaged populations, with greater representation and worse outcomes in low socioeconomic and minority populations, and in persons from marginalized groups. General health care system approaches to inequity reduction (i.e., the minimization of differences in health and health care which are considered unfair or unjust), address the major social determinants of health, such as low income, ethnic affiliation or remote place of residents. Yet, to effectively reduce inequity there is a need for a multifactorial consideration of the aspects that intersect and generate significant barriers to effective care that can address the unique situations that people face due to their gender, ethnicity and socioeconomic situation.Main bodyTo address the health equity challenges of diverse population groups in Israel, we propose to adopt an intersectional approach, allowing to better identify the needs and then better tailor the infection prevention and control modalities to those who need them the most. We focus on the two main ethnic – cultural—religious minority groups, that of Arab Palestinian citizens of Israel and Jewish ultra-orthodox (Haredi) communities. Additionally, we address the unique needs of persons with severe mental illness who often experience an intersection of clinical and sociodemographic risks.ConclusionsThis perspective highlights the need for responses to COVID-19, and future pandemic or global disasters, that adopt the unique lens of intersectionality and equity. This requires that the government and health system create multiple messages, interventions and policies which ensure a person and community tailored approach to meet the needs of persons from diverse linguistic, ethnic, religious, socioeconomic and cultural backgrounds. Under-investment in intersectional responses will lead to widening of gaps and a disproportionate disease and mortality burden on societies’ most vulnerable groups.

Older Persons’ Perceptions concerning Climate Activism and Pro-Environmental Behaviors: Results from a Qualitative Study of Diverse Population Groups of Older Israelis

Older people are under-represented in the climate change movement yet are highly susceptible to the negative effects of climate change. This study’s objectives were to identify possible barriers faced by older persons to increase their pro-environmental behaviors and participation in the climate movement. Relying on in-depth qualitative interviews and focus groups with 50 older persons from four different population groups in Israel, we identified three themes. The first theme concerned assigning responsibility for the current climate situation. This theme addressed the question of who is seen as responsible for the current situation. The second theme covered actions taken by older persons to address the current situation. Finally, older persons view governments/municipalities, industry, and individuals as responsible for the changing climate, with a more traditional segment of the population also viewing God as responsible. Moreover, although governments were identified as important institutions with relevance to the current climate challenge, respondents mainly acknowledged the relevance of pro-environmental behaviors rather than climate change activism. In conclusion, the findings highlight the need to increase environmental activism among older persons. It is also important to increase the breadth of possible pro-environmental behaviors older persons can engage with.

IQOS and cigarette advertising across regulatory periods and population groups in Israel: a longitudinal analysis

BackgroundTobacco regulation recently changed in Israel, including a partial advertisement ban. We assessed the impact of regulatory changes on Philip Morris International’s (PMI) IQOS and cigarette advertisements.MethodsWeekly number of ads...

Inequalities in initiation of COVID19 vaccination by age and population group in Israel- December 2020-July 2021.

SummaryBackgroundCOVID19 vaccination coverage in Israel varies among population groups. Comparing crude coverage between groups is misleading because of different age structures and socio-economic differences. To describe inequalities in COVID19 vaccine initiation in Israel we analysed the interaction of age and population groups in terms of dose 1 vaccine coverageMethodsWe calculated cumulative age-specific first COVID19 vaccine coverage by population group (Ultra-Orthodox Jewish, Arab, General Jewish). We calculated the relative differences in vaccine coverage between population groups within each age group, and between age groups within each population, using ANOVA and binomial regression after adjusting for socio-economic statusFindings8,507,723 individuals in 268 cities were included. Compared with the general Jewish population, coverage was lowest in the Ultra-Orthodox population in all age groups (range -12% among 60+ to -52.8% among 10-19 years olds, p<0.001). In all groups, the proportion of vaccinated individuals in younger age groups relative to those aged 60+ decreased with decreasing age and were smallest in the Ultra-Orthodox groups. For example, within the general Jewish population, people aged 20-29 were 14% less likely to be vaccinated than those aged 60+ while within the Ultra-Orthodox population it was 34.5%InterpretationIn all age groups, the Ultra-Orthodox population had the lowest vaccine coverage. Differences persisted after adjusting for socio-economic status. The younger the age group, the more Ultra-Orthodox Jews were diverging from age peers in terms of initiating COVID19 vaccination, suggesting a generational effect. Tailored approaches are urgently required to encourage vaccination among under-immunized groups in IsraelFundingNo specific funding was received

Associations of psychosocial factors, knowledge, attitudes and practices with hospitalizations in internal medicine divisions in different population groups in Israel

BackgroundInequalities in healthcare utilization exist across ethnic groups; however, the contributions of health-related knowledge and psychosocial factors to these inequalities remain unclear. We examined associations of social determinants of health, psychological factors, knowledge, attitudes and health practices, with hospitalizations in internal medicine divisions, among Israeli adults, Jews and Arabs, with non-communicable diseases, in a setting of universal health insurance.MethodsA retrospective study was undertaken among 520 Jews and Arabs aged 40 years or older with non-communicable diseases, members of a large health maintenance organization. Hospitalization (at least once during 2008) in an internal medicine division was determined based on documentation in electronic health records. Participants were randomly selected in strata of sex, population-group and hospitalization status (yes/no). Data were collected from medical records and via face-to-face interviews using a structured questionnaire. Main independent variables included comorbidity burden, health behaviors, mental health wellbeing and self-rated health. Scales measuring health knowledge and attitudes/beliefs were constructed using factor analysis.ResultsComorbidity burden (OR 1.41 [95% CI 1.24–1.61]) and self-rated health (not good vs. good) (OR 1.88 [95% CI 1.13–3.12]) were positively associated with hospitalizations in an internal medicine division, while an inverse association was found with better mental health wellbeing (OR 0.98 [95% CI 0.96–0.99, for each 1-point score increase). Among Jewish participants, positive associations were found of the number of offspring, comorbidity burden and perceived difficulty, with hospitalizations. No significant associations were found with hospitalizations of other sociodemographics, health behaviors, knowledge and attitudes/beliefs.ConclusionsComorbidity burden was the main risk factor of hospitalizations in internal medicine divisions. Psychosocial factors, such as self-rated health, a complex variable affected by social capital, mental wellbeing, the number of offspring, and perceived burden and difficulty, seem also to contribute. These findings suggest the involvement of broad family and social factors, beyond individual level characteristics and medical needs, in hospitalizations in internal medicine divisions. Interventions to reduce hospitalizations should be comprehensive and integrate aspects of mental health wellbeing; they should build on familial characteristics (e.g., number of offspring), factors related to social capital such as self-rated health, and perceived burden and difficulty.

Presence of Antibodies against Sindbis Virus in the Israeli Population: A Nationwide Cross-Sectional Study.

Sindbis virus (SINV) is a mosquito-borne alphavirus circulating globally. SINV outbreaks have been mainly reported in North-European countries. In Israel, SINV was detected in 6.3% of mosquito pools; however, SINV infection in humans has rarely been diagnosed. A serologic survey to detect SINV IgG antibodies was conducted to evaluate the seroprevalence of SINV in the Israeli population. In total, 3145 serum samples collected in 2011–2014, representing all age and population groups in Israel, were assessed using an indirect ELISA assay, and a neutralization assay was performed on all ELISA-positive samples. The prevalence rates of SINV IgG antibodies were calculated. Logistic regressions models were applied to assess the association between demographic characteristics and SINV seropositivity. Overall, 113 (3.6%) and 59 (1.9%) samples were positive for ELISA and neutralization SINV IgG, respectively. Multivariable analysis demonstrated that SINV seropositivity was significantly associated with older age and residence outside metropolitan areas. These results demonstrate that, despite no outbreaks or clinical presentation, SINV infects the human population in Israel. Seropositivity is countrywide, more frequent in people of older age, and less diffuse in Israel’s metropolitan areas. Seroprevalence studies from other countries will add to our understanding of the global burden of SINV and the risk for potential SINV outbreaks.

Factors affecting oral examinations and dental treatments among older adults in Israel

BackgroundRoutine dental examinations are important for early diagnosis and treatment of dental problems among older adults in order to improve their quality of life and avoid costly future treatments. In Israel, a significant percentage of adults do not seek dental care.MethodsThe study is based on a 2017 telephone survey conducted among people aged 50–75 from different population groups in Israel to examine their health beliefs and attitudes toward dental treatments.ResultsThe results show that among older adults the decision to undergo routine dental checkups is affected by socio-demographic status and health beliefs regarding dental health. Lower age, higher income levels, and Jewish religion predicted higher chances of frequent checkups. In addition, those who saw the benefits of routine checkups, believed that dentists were readily available, and had higher levels of health motivation were more likely to seek out routine dental care.ConclusionsAccording to the recent dental reform in Israel, people aged 75 and over are eligible for subsidized dental treatments. To enhance the frequency of dental checkups among older adults, it is recommended to provide this subsidized coverage for adults under age 75. In addition, planning dental health services for individuals in this age group should be based upon their accepted beliefs and values. Moreover, systematic health education through the media and health maintenance organizations should specifically target this population group to encourage them to undergo dental checkups more frequently.

Parents' perceptions of childhood immunization in Israel: Information and concerns

BackgroundImmunization has a significant impact in protecting from severe diseases. Various factors that could influence child immunization coverage and parents' decisions about vaccinating their children should be further explored in specific population groups. ObjectivesThe current study has two main objectives: to assess the main information sources that affect parental decisions to vaccinate their children and to measure the extent to which these factors differ demographically by exploring the opinions and attitudes within four main population groups in Israel: ultra-Orthodox Jews, all other Jews, non-Bedouin Arabs, and Bedouins. Methods1504 parents, with similar representation among four main population groups, participated in this study. A structured, anonymous, self-administered questionnaire was used. ResultsThe most influential source on parents' decisions to vaccinate their children was the nurse at Mother and Child Health Clinics (MCHCs). Positive attitudes were shown regarding the key role of immunization in preventing severe diseases, while the most important concern expressed was the potential pain to the child while being vaccinated (rather than the safety of the vaccine). Higher compliance rates were reported among participants with a non-academic education level (χ2 = 12.21, p <0.001), an average level of income (χ2 = 26.66, p <0.001), and a greater level of religiosity (χ2 = 5.13, p <0.01). Multivariate analysis showed that higher reliance on Ministry of Health publications (OR = 2.24, 95% CI = 1.49–3.35) and a belief that vaccinations prevent severe diseases (OR = 1.55, 95% CI = 1.06–2.25) predicted higher vaccination compliance. A concern about unsafe components of the vaccinations predicted lower compliance (OR = 0.41, 95% CI = 0.25–0.66). Bedouins demonstrated the highest compliance rate (99%), were most influenced by all information sources, and demonstrated the most pro-vaccination positions. ConclusionsThe factor that most influenced Israeli parents' decisions to vaccinate their children was their degree of trust in information sources about vaccinations, particularly the nurses at the MCHCs.

Risk and Protective Factors for Child Overweight/Obesity Among Low Socio-Economic Populations in Israel: A Cross Sectional Study.

Background and Aims: Scientific evidence regarding protective factors that contribute to healthy weight in childhood is limited and is particularly scarce in lower socio-economic populations in different ethnic groups. This study aimed to assess the prevalence of biological, behavioral and psychosocial factors for child overweight/obesity in Jewish and Arab population groups in Israel, and to compare their associations with child overweight/obesity in the two groups.Methods: Children aged 5–6 years were randomly selected from 20 Mother and Child Health clinics in towns and villages of lowest socio-economic ranking in Northern Israel. Children and mothers were invited for a special “One Stop Shop–Preparation for School” visit which included growth measurements. Questionnaires were distributed to mothers for self-report on biological, SES, psychological and lifestyle factors. Perinatal and early nutritional data were retrieved from clinic records. Multivariate analyses using logistic regression models predicting child overweight/obesity were conducted separately for Jewish (N = 371) and Arab (N = 575) children.Results: Overweight/obesity (BMI ≥85th centile) rates were higher in Jewish (25%) than Arab (19%) children. In both Jewish and Arab groups, respectively, maternal BMI (OR = 1.10 [95%CI = 1.04, 1.17]; OR = 1.08 [95%CI = 1.04, 1.13]), and child birthweight (OR = 1.33 [95%CI = 1.04, 1.71]; OR = 1.39 [95%CI = 1.11, 1.73]) were significant risk factors for overweight/obesity, and maternal self-efficacy regarding child's lifestyle was significantly protective (OR = 0.49 [95%CI = 0.28, 0.85]; OR = 0.54 [95%CI = 0.34, 0.85]). Additionally, four other maternal psychological and child behaviors were significantly associated with overweight/obesity in the Jewish group and two child lifestyle behavior factors in the Arab group. Moreover, significant interactions indicating moderation effects were found only in the Jewish group: maternal education and maternal age moderated the effect of maternal BMI on child overweight/obesity. No other moderation of risk factors was found.Discussion: In this study of children from low SES families, protective factors contributed to healthy child weight alongside risk factors for overweight/obesity. They differed between the population groups, and fewer variables explained overweight/obesity in Arab children. Although further expansion of these findings is required they point at the relevance of protective factors, maternal self-efficacy in particular, for understanding childhood obesity in specific ethnic contexts and for planning culturally adapted prevention programs in disadvantaged populations.

The seroprevalence of West Nile Virus in Israel: A nationwide cross sectional study

West Nile Virus (WNV) is endemic in Israel, affecting yearly 40–160 individuals. Israel is located on a central migratory path between Africa and Eurasia and most West Nile Fever (WNF) cases reported in recent years were among residents of the coastal plain. The aim of the study was to evaluate the seroprevalence of WNV among the Israeli population and to assess correlates for WNV infection. A cross-sectional nationwide serologic survey was conducted using 3,145 serum samples collected by the national Israeli serum bank during 2011–2014, representing all age and population groups in Israel. Prevalence rates of WNV IgG antibodies were determined. Logistic regressions models were applied to assess the associations between demographic characteristics and WNV seropositivity. 350 samples were positive to WNV (11.1%; 95%CI: 10.0–12.3%). In the multivariable analysis, there was a significant association between seropositivity and the Arab population group vs. Jews and others (OR = 1.86, 95%CI: 1.37–2.52), the time lived in Israel [50–59 years vs. 0–9 years; OR = 10.80 (95%CI: 1.03–113.46) and ≥60 years vs. 0–9 years; OR = 14.00 (1.32–148.31)] residence area] Coastal Plain, Inland Plain (Shfela) and Great Rift Valley vs. Upper Galilee; OR = 2.24 (95%CI: 1.37–3.65), OR = 2.18 (95%CI: 1.18–4.03), OR = 1.90 (95%CI: 1.10–3.30), respectively [and rural vs. urban settlement (OR = 1.65, 95%CI: 1.26–2.16). People, who reside in the Coastal Plain, Inland Plain and Great Rift Valley, should be aware of the risk of contracting WNV and reduce exposure to mosquito bites, using insect repellents, and wearing protective clothing. The Ministry of Environmental Protection should be active in reducing the mosquito population by eliminating sources of standing water, a breeding ground for mosquitoes.

Whole Exome Sequencing In Arab And Jewish Israeli Families Multiply Affected With Schizophrenia

Background Schizophrenia is a complex disorder that likely results from the impact of both common and rare susceptibility variants. The impact of common variants with small effect in schizophrenia has been widely investigated. After large scale sequencing studies in schizophrenia become feasible, multiple whole exome sequencing studies were performed, and found disruptive mutations distributed across many different genes. They also identified gene sets with enrichment of rare variants with large effect. Sequencing studies performed in large families have showed that candidate variants did not necessarily segregate within the families, and were different in each family. To search for inherited variants of large effect we performed whole exome sequencing in Arab and Jewish Israeli families multiply affected with schizophrenia. All the Jewish families were of non-Ashkenazi origin. The Arab families were drawn from an ethnically homogenous population with an unusually high level of consanguinity, and a low rate of intermarriage with other population groups in Israel. Methods Eight large families with multiple subjects affected with schizophrenia were selected, since in these families the genetic transmission appears to be most consistent with inheritance of highly-penetrant disease alleles. In total whole exome sequencing and data analysis of 32 family members were performed. Each family was analyzed separately, first according to the most appropriate single-gene mode of inheritance and second according to an oligogenic mode of inheritance looking for all variants shared between affected family members. Multiple variants found by applying the oligogenic mode of inheritance were prioritized by using the VarElect software. To assess enrichment of rare segregating variants in specific genes in the schizophrenia cases, we performed a gene-based collapsing dominant model analysis while correcting for population stratification. Permutation-based analyses were done to test for enrichment of previously detected de-novo variants and additional candidate gene sets. Results We were able to identify several interesting rare segregating functional variants. Single-gene inheritance candidates which are consistent with the most appropriate mode of inheritance in a given family were found in only 2 out of 8 analyzed families. These variants were found in DOCK8 and DRP2 genes. No gene reached genome-wide significance in the collapsing analysis. An enrichment of variants in candidate gene sets is currently under investigation. Discussion It seems that schizophrenia in most of these families arises from the combined effects of several different coding variants, even in ethnically homogenous consanguineous Arab Israeli families.

Access to higher education and its socio-economic impact among Bedouin Arabs in Southern Israel

This paper explores minority access to higher education in Israel in general, and among the Negev Bedouin Arabs, in particular. The Negev Bedouin community has undergone major changes during the past 60 years, and has the lowest socio-economic level of any population group in Israel. Higher education plays a prominent role in determining a community's competitiveness in the world marketplace. In most societies, it is also recognized as a major avenue to greater economic rewards and social mobility, making it of vital importance to those groups on the bottom of the socioeconomic ladder of society. The provision of public educational services to the Negev Bedouin, admissions procedures and standardized testing, financial assistance policies, and the socio-economic and political impact of higher education in Israel are examined in-depth. The paper concludes that the following structural and policy changes are needed to improve the access of the Negev Bedouin community to higher education: better quality elementary and secondary education, financial aid, removal of minimum age requirements, and culturally unbiased measures for admissions screening.

Workplace and family support and work–life balance: Implications for individual psychological availability and energy at work

This study presents three studies that explore the ways in which multiple support sources (workplace and family social support) help individuals to experience work–life balance (WLB) and thereby develop a sense psychological availability and positive energy at work. We examine this serial mediation model across three population groups in Israel using time-lagged data from part-time students (sample 1), as well cross-sectional data from workers in the industrial sector (sample 2) and physicians in public hospitals (sample 3). The results indicate a complex process in which workplace and family support augment employee positive energy through WLB and psychological availability. The findings shed light on the importance of support from work and nonwork sources for the pursuit of employees to achieve balance in the spheres of work and life and suggest that the WLB helps in the development of psychological availability and augmenting employee positive energy.

Disparities in the geography of serious mental illness in Israel

ObjectiveThe aim of this research is to test and apply a model of the disparities and variations in serious mental illness (SMI) to estimating prevalence in local areas throughout Israel. MethodsThis study employs a secondary analysis of data from the 2003/2004 Israel National Health Survey of 4859 adults aged 21 and over from the household population of legal residents and citizens. It uses small area estimation methods (SAE), specifically to: (i) estimate and test a multivariate logistic model of disparities in the risk of serious mental illness; (ii) use the foregoing model for computing estimates, using census data, for local areas; (iii) validate these estimates against the rate of psychiatric hospitalizations. ResultsThe model uses standard demographic and socioeconomic variables to successfully predict 92.5% of respondents’ statuses as SMI, with a sensitivity of 26.9%, specificity of 95.9%, and an AUC index of .797. The resulting estimates of the percentage of adults with an SMI in the 16 subdistricts ranged between 3.7% and 7.7%, with a national mean of 5.0%. The estimates have a partial correlation of .63 with rates of psychiatric hospitalization in Jewish localities, but elevated rates have not been validated in Arab localities. ConclusionThe use of small area estimation methods demonstrated the capacity for deriving local prevalence rates of serious mental illness, ones that can be validated against psychiatric hospitalization for the majority population group in Israel.

Perceived discrimination and health-related quality of life among Arabs and Jews in Israel: A population-based survey

BackgroundStudies have shown that perceived discrimination may be associated with impaired health. The aim of this study was to assess the levels of perceived discrimination on the basis of origin and ethnicity and measure the association with health in three population groups in Israel: non-immigrant Jews, immigrants from the former Soviet Union, and Arabs.MethodsA cross sectional random telephone survey was performed in 2006 covering 1,004 Israelis aged 35-65; of these, 404 were non-immigrant Jews, 200 were immigrants from the former Soviet Union and 400 were Arabs, the final number for regression analysis was 952. Respondents were asked about their perceived experiences with discrimination in seven different areas. Quality of life, both physical and mental were measured by the Short Form 12.ResultsPerceived discrimination on the basis of origin was highest among immigrants. About 30% of immigrants and 20% of Arabs reported feeling discriminated against in areas such as education and employment. After adjusting for socioeconomic variables, discrimination was associated with poor physical health among non-immigrant Jews (OR = 0.42, CI = 0.19, 0.91) and immigrants (OR = 0.51, CI = 0.27, 0.94), but not among Arabs. Poor mental health was significantly associated with discrimination only among non-immigrant Jews (OR = 0.42, CI = 0.18, 0.96).ConclusionsPerceived discrimination seemed high in both minority populations in Israel (Arabs and immigrants) and needs to be addressed as such. However, discrimination was associated with physical health only among Jews (non-immigrants and immigrants), and not among Arabs. These results may be due to measurement artifacts or may be a true phenomenon, further research is needed to ascertain the results.

Can subjective and objective socioeconomic status explain minority health disparities in Israel?

Disparities in health exist between the three main population groups in Israel, non-immigrant Jews, immigrants from the former Soviet Union (arriving in Israel since 1990) and Arabs. This study examines the relationship between health and socioeconomic status in this multicultural population and assesses to what extent subjective and objective socioeconomic measures may explain the disparities in health. A random cross sectional telephone survey of 1004 Israelis aged 35-65 was performed. The questionnaire measured physical and mental health-related quality of life using the Short Form 12. Information regarding subjective socioeconomic status (SSS) and objective socioeconomic status (SES) was collected. Arabs and immigrant women from the former Soviet Union had worse physical health compared to non-immigrant Jews. Immigrant and Arab men and women had worse mental health compared to non-immigrant Jews. Multivariable log-linear regression analysis adjusting for age, SSS or SES explained the disparities in physical health between Arab and non-immigrant Jewish men. However, SSS and SES did not explain the disparities in physical health between the three groups of women. The disparities in mental health between immigrants and non-immigrant Jews can be explained by SSS for both men and women, whereas the disparities between Arabs and Jews can be explained by objective SES only among women. Employed men reported better physical and mental health. Part of the disparities in mental health in Israel can be attributed to differences in SSS and SES in the different groups. However, there is a need to identify additional factors that may add to the disparities in both physical and mental health. The disparities due to socioeconomic status vary by health measure and population group.

Intergenerational Family Relations and Life Satisfaction Among Three Elderly Population Groups in Transition in the Israeli Multi-cultural Society

The study aims to illuminate the links between personal and familial resources and wellbeing of elders 65+ in three population groups in Israel: kibbutz members, new immigrants from the former Soviet Union and Arabs-all of whom are undergoing different types of personal, social and economic transitions. About 70 respondents in each group were interviewed regarding life satisfaction, familial relations based on the paradigm of intergenerational family solidarity and personal resources (socio-demographic and physical functioning). The main conclusions of this study are: the lives of the elderly immigrants are much more disruptive by the transitional migration processes they are undergoing and this affects their well-being which was much lower than the other two groups. Additionally they received more help from the family. Family solidarity, mainly opportunity structures and emotional bonds were especially strong among the Arabs, with the lowest level of conflict. The Arab elderly were also different from the other two groups in the lower level of help they provided to their adult children, probably due to their more limited level of personal resources and the differing social expectations. The majority of respondents acknowledged some degree of filial obligations, although much lower among kibbutz members. Personal resources (physical functioning and financial adequacy) had the strongest effect on life satisfaction in all three groups. The dimensions of family solidarity played a less dominant role. The discussion highlights the distinctive family culture of the three groups, the transition they face, and their differential resources with some policy recommendations.

Ethnicity and its significance in the pathobiology of prostatic carcinoma in Southern Israel

Background Several studies have noted ethnic differences in the natural history of prostatic carcinoma. Southern Israel has been regarded as a melting pot and, perhaps more than the rest of the country, has encouraged the ingathering of immigrants from several countries, as well as a large Bedouin community. Objectives In an attempt to determine any differences that may exist in population groups in Israel, we have examined clinical and biologic markers in patients diagnosed with prostatic cancer in Southern Israel in 1996–2000. We wanted to demonstrate differences in the incidence and features of prostate carcinoma among the population groups in Southern Israel, and to evaluate their possible biologic significance. Methods Clinical parameter features, including the ethnicity origin of patients with prostatic adenocarcinoma, were reviewed in a cohort of 189 patients seen between 1996 and 2000. Tissue sections from specimens in a subset of 40 of these patients who had undergone prostatectomy were studied by immunohistochemistry for TP53, Bcl-2, and chromogranin A using the ABC peroxidase method. These markers were chosen because of their suggested impact on the biology of this tumor. Clinical correlations were examined. Results We confirm the presence of ethnic differences in the features of prostatic adenocarcinoma in our geographic area. Notably, patients of North African origin were treated surgically at a younger age than immigrants from East Europe. Higher total prostate-specific antigen levels and more robust tumor cell Bcl-2 expression were detected in the East European patients. The number of Bedouin subjects in our cohort of patients with prostatic cancer was much more limited than expected. No immigrants from Ethiopia were included in our study diagnosed with prostate carcinoma during this period. Conclusions The proportion of patients of European, especially East European, origin was relatively high among the cohort of 189. Their older age and the lower proportion of subjects that underwent surgery, together with the tendency toward higher total prostate-specific antigen levels and higher Bcl-2 expression, suggest that this ethnic group may not differ significantly from the African-American group in the United States. The low representation of Bedouin and absence of Ethiopian immigrants among our patients with prostate cancer may point to a genuinely low incidence or it may be related to inadequate medical supervision in these population groups.