Advocacy Groups Call for Nat'l Plan to Tackle Health Care Gaps

A report released today by a coalition of socio-economic advocacy groups details the disparities in health services available to various population groups in Israel.

The study - which was jointly commissioned by the Association for Civil Rights in Israel, Physicians for Human Rights, The Adva Center, Tene-Briut, and the Galilee Society - found significant gaps in the morbidity rate as well as access to medical services available to divergent population groups. Specifically, the report compared incidences of diabetes, heart disease, breast cancer and mental health problems among different groups in Israel.

Higher incidences of diabetes were found among those population sectors with fewer financial means. According to the report, the illness is far more common among Ethiopian immigrants who have lived in Israel for over 10 years (16 percent ), while 14.8 percent of Israelis who receive unemployment benefits were diagnosed with the disease. In addition, the study found that 12.5 percent of Arab men and 11.5 percent of Arab women suffer from the illness. In contrast, just 7.1 percent of Jewish men and 5.3 percent of Jewish women were said to have diabetes.

The prevalence of diabetes found among immigrants from Ethiopia rose in proportion to the amount of time they have been in the country. While the illness reportedly affected just 0.4 percent of those shortly after their arrival in Israel, the rate jumped to 16 percent a decade later.

The study's findings also suggest Arab patients and Ethiopian immigrants have less access to medical treatment for diabetes.

In terms of heart disease, the incidence rate indicates gaps between Arab men (8.9 percent ) and Jewish men (7.8 percent ), as well as Arab women (4.4 percent ) and Jewish women (3.5 percent ). The study found that Arab men who suffered from heart disease tended to be younger and habitual smokers.

Disparities were also seen in mortality rates. In 1999, the mortality rate of Arab men with heart disease was 28.4 percent higher than that of Jewish men, and 66.5 percent higher among Arab women compared to Jewish women. The authors of the report set a goal to reduce the disparity in mortality rates between Jews and Arabs by 25 percent within five years.

As for breast cancer - the most common killer of Israeli women - the report cites a higher rate among Jewish women, but notes that Arab women are more likely to be diagnosed with the disease during its advanced stages.

According to Dr. Michael Zilberman, the chief executive officer of the Middle East Cancer Consortium, "In Arab and Muslim countries, 70 percent of the women who suffer from breast cancer, the most common form of cancer in the world, see the doctor for the first time only after the disease is incurable."

Recovery from cancer within five years of initial diagnosis was found to be more prevalent among Jews (86.6 percent ) than Arabs (77.8 percent ). There is also a disparity in the figures measuring early detection of breast cancer via mammography among women aged 50 to 74 in the last two years - 70.1 percent of Jews compared to just 47.5 percent of Arabs.

The report also points to disparities in mental health statistics. It cites a poll conducted by the Health Ministry which found that between 2003 and 2004, 21.1 percent of Arab women and 16.2 percent of Arab men suffered from higher levels of stress. The same poll concluded that, by comparison, 14.7 percent of Jewish women and 10 percent of Jewish men reported similar levels of stress.

According to that survey, 7.9 percent of Arab women and 4.5 percent of Arab men were afflicted with depression, in contrast to just 4.7 percent of Jewish women and 2.9 percent of Jewish men.

Israel has struggled to make psychiatric services available to its Arab population, which has access to few clinics - the most prominent of which are in Sakhnin and Umm al-Fahm. According to one poll, however, 51 percent of Arab youth seek psychological counseling from their schools, while just 30 percent of Jewish youth do the same.

Mohammad Khatib, the general director of the Galilee Society, says more efforts have been made among the Arab population to increase access to mental health facilities. The report released today calls on the government to double the amount of psychiatric health services available to the Arab population within the next five years.

"This report calls for a national program that will shrink the gaps," said Barbara Swirski, the executive director of Adva. "In the last five years, similar plans for narrowing gaps in health services were formulated in Britain, Finland, Norway, Canada, Australia and even the United States, which founded the National Institutes of Health two years ago."

"We are joining forces with a movement which began in developed countries that strive for equality," Swirski said. "In recent years, a number of projects were announced by the Health Ministry and health maintenance organizations, all aimed at narrowing these gaps. Now we must combine all of these efforts into one grand, serious plan."