Going by the numbers
CBS, which crunches figures on a daily basis, can offer insight on changes in health behaviors, demography, the medical system.
Prof. Orly Manor. Photo: Judy Siegel-Itzkovich
You are being watched, and there’s no escaping it. From birth to death, the
folks at the Central Bureau of Statistics (CBS) are saving and processing your
information – anonymously, so one’s rights to privacy are not violated – so they
can glean information for official records, decipher trends and help decision
makers set policy.
The amount of information they collect is huge,
ranging from demography, household income, economic indicators and road
accidents to disabilities, educational levels, manufacturing, sport, culture,
education, tourism, taxes, foreign trade and health.
Huge amounts of data
are available free to the public at www.cbs.gov.il – also translated into
English – while some government offices order and pay for special studies
cross-matching and comparing a variety of data.
The bureau not only puts
data online but also produces nicely illustrated booklets, including one called
“Women and Men, 1990-2009,” which includes a collection of various health data.
The CBS has many women among its professional employees, for some reason, and
it’s not always pleasant work. (Can you imagine handing out business cards
stating you’re in charge of the CBS unit specializing in data on the causes of
death?) The bureau recently held an unusual seminar on “Health and Fertility” at
its headquarters in Jerusalem’s Givat Shaul quarter, attended by over 100
outsiders interested in the specific field, and it even invited the
Deputy chief statistician Yoel Finkel told the audience that even
before the founding of the state, information was collected by the British. Data
on the causes of death were first provided during 1938. Data on births have been
provided since the early 1950s. Recently, he continued, the government
established a forum for strategic planning in various state offices because
cooperation on data-sharing was very important.
Na’ama Rotem, of the
bureau’s health and vital statistics sector, said the bureau’s health data are
only a small part of what it provides, but very important for setting policy.
Among the information collected are births, chronic diseases, disability,
accidents, absenteeism from work due to disease or accident, smoking, physical
activity, obesity, exposure to the sun, use of medical services, health
manpower, hospitalization, queues for surgery, prescription drug expenses,
dentists, household health expenses, private medical services and supplementary
“Among our sources of data are forms filled out by the
public, birth and death certificates, reports at district health offices on
stillbirths and aborted babies, and also ongoing surveys we conduct every few
years. Censuses conducted every decade also provide information,” she
Shoshi Einhorn-Gerberchik said that every new baby must be reported
with 10 days of birth, whether delivery was in a hospital or
“Connections between types of information, such as pregnancies
according to the level of religious observance, have also been ordered. We
receive some 40,000 different pieces of paper relating to births and deaths from
the Interior Ministry, Health Ministry, National Insurance Institute, Israel
Police and other authorities and have to coordinate them,” she said.
after more than six decades, one of the major innovations at the CBS is that an
increasing amount of data is digitized and collected on paper instead of forms
filled out by hand or typed in. This, she said, is more accurate and even allows
some data to be provided in real time using a special icon on the CBS
AS THE Israeli population has been growing by leaps and bounds
over the past four decades, there are more deaths than before, said the bureau’s
leading “causes of death” expert, Dafna Hartal, but it is clear that death rates
are declining. During this period, death rates have declined by 17 percent.
There are today fewer than 700 deaths per 100,000 residents. The most common
cause is cancer (10,300 people), while heart disease – which for decades was the
most common common cause of death – has been reduced by an astounding 76% due to
prevention, improved less-invasive treatments, better surgical approaches,
medications and rehabilitation.
Following that are complications of
diabetes, strokes, pneumonia, external causes such as accidents, kidney
diseases, lung disorders and congenital diseases.
Compared to the other
OECD countries, Israeli men are ranked two in longevity and women somewhat lower
but at an average of over 82, they still live longer than men, whose average
life expectancy is now around 80. Residents of Ra’anana live the longest on
average, while residents of Rahat and other Beduin towns have the shortest life
Information about health behaviors, said Olga Litinsky, is
self-reported by those queried, rather than based on scientific data, so when
people claim to exercise regularly or to go to complementary medicine
practitioners, one cannot be sure the figures are absolutely accurate even
though the answers are anonymous.
Hypertension is the most common medical
condition to have been diagnosed in individuals over the age of 65 (55%);
followed by diabetes (23% of this age group); heart attack (14%); and cancer (9%
of Jews and only 3% of Arabs). The average Israeli visited a doctor six times –
or a record 45 million visits – a year. Women go to doctors more frequently than
men, partly because of their “obstetrical duties.”
Sixty-seven percent of
women 50 years and older went for a mammography scan during the past two years,
and the rate among Arab women has risen impressively, thanks to Israeli Cancer
Society information efforts and the work of the four health funds.
statistics provided show that it’s very worthwhile to get a good education, and
not only due to higher income. The better educated, said Litinsky, are more
likely to exercise and get a mammogram, while they are less likely to suffer
from disability or to smoke.
As for fertility, some 166,000 babies are
born annually, said CBS statistician Dvorit Angel; this compared to only 56,000
in 1965 and 94,000 in 1980. The average Israeli woman gives birth to three
children, which gives Israel one of the highest fertility rates in the OECD
countries, some of which are below replacement rates. Ten percent of babies born
in Israel are the fourth in the family or more, way beyond the average OECD
Many Muslim women in Israel used to have 10 children or more, but
their fertility in recent years has declined significantly due to improved
education, use of contraception and their available level of health care. At 4.6
live births per Muslim woman, the fertility rate among them is still higher than
among their counterparts in surrounding Middle Eastern countries, said Angel.
There are no separate statistics on in-vitro fertilization for
The influence of haredi (ultra-Orthodox) women has made its
impact on statistics, as the rate of women giving birth after the age of 40 has
doubled since 1995 and totaled 6,877 last year.
DR. AHMED Khliel,
another bureau statistician, provided a very interesting presentation on
differences between Jewish and Arab families.
“Haredi women have the
highest birth rate, while secular Jewish women have the lowest. Birth rates
among Muslim women are declining. But we found no connection between religiosity
and fertility; there is no effect of religiosity on fertility rates among
Muslims,” he said.
When compared on socioeconomic matters, there is a
major difference between religiosity and educational level among Jewish women:
Haredi women have lower (secular) educations than their modern Orthodox or
secular counterparts. But, noted Khliel, there is no real difference between the
levels of religiosity and education among Muslim women.
Jews believe that
religiosity has a major effect on how many children one has, while Muslims
believe it is a socioeconomic matter and depends on the desire of the couples
Social structure among Muslims is very difference than among
Jews, said Khliel.
Jews generally stick to segregation of residence and
lifestyle according to the level of religiosity. Haredi Jews, modern Orthodox
and secular Jews usually live in different places and always go to separate
schools. Ninety-seven percent of haredi women have haredi husbands. What they
get from their own media is different.
On the other hand, Muslims all
live according to family or tribe.
A single Muslim family, he
continued, c a n include women with head covers and without, people
who fast during Ramadan and relatives who don’t, and they go to the same
Decisions about family size, birth control and abortion are
influenced by families and not religious leadership among Muslims, while it
works completely differently among Jews, he noted.
PROF. ORLY Manor, head
of the Braun School of Public Health and Community of the Hebrew
University-Hadassah Faculty of Medicine said that children play a major role in
the health of their parents.
While healthy individuals are more likely to
procreate than people with disease, there are other factors, such as social
relationships reducing stress and anxiety and promoting healthy behaviors, she
But at the same time, financial stress resulting from having a
large family can also create psychosocial, physical and emotion
“Families are changing,” said Manor.
“There’s a decline
of fertility in OECD countries – but not in Israel. Fifteen percent of American
women in their fertile years are childless, but it is much lower in Israel at
about five percent.”
According to the latest statistics, mortality rates
among Israelis are lowest among couples with two, three or four children, while
there is a higher rate if one has no children at all and in those with eight
children and more. “It’s an upside-down U-curve.”
She reported, however,
that the rate of reproductive cancer is lower in women who have had more
children, but it also means more obesity and heart disease among the parents.
But while there is a connection, it doesn’t mean that one causes the other,
Haredi women who give birth after age 45 seem to have a
“different expression of genes” than women who have their last child by the age
of 35; their genes apparently make it more possible for them to conceive and
give birth after 45, and it is not just due to the fact that they do not use
Figures are disparaged in the phrase “Lies, damned lies
and statistics,” which describes the persuasive power of numbers, particularly
the use of statistics to bolster weak arguments or to cast doubt on an
opponent’s point. But while working as a statistician could be considered by
some to be a tiresome profession, looking at the numbers can reveal interesting
trends and conclusions. They are necessary for senior people in government to
change courses and policies – if they indeed study them carefully.