Living life to the full

Israelis, despite facing the slings and arrows, live longer than just about everyone else.

Elderly_521 (photo credit: Illustrative photo: MCT)
Elderly_521
(photo credit: Illustrative photo: MCT)

The humorist Ephraim Kishon once quipped that Israel is the only country in the world surrounded by enemies on all sides, but whose people get an ulcer from the upstairs neighbor. Yet that same “upstairs neighbor” may be one of the factors responsible for Israel’s longevity rate, which is the fifth highest in the world.

Despite sporadic wars, stress, the threat of a nuclear Iran and the high cost of living, Israelis live longer on the average than just about anybody else. Israel precedes rich welfare states, including Norway, Canada and Germany, on this important criterion measuring quality of life. And according to experts, Israel’s profound social solidarity – the fact that the upstairs neighbor is likely to be there for you when you need him or her – is one of the main factors contributing to Israel’s long life expectancy.

A recently released report by the Organization of Economic Cooperation and Development (OECD) reveals that Israelis live to the age of 81.6, which is two years longer than the average in other OECD member countries. Japan has the highest longevity rate at 83 years, followed by Switzerland at 82.3 and Spain and Italy both at 81.8.

Even more surprising is the fact that Israeli men take the title of the world’s highest life expectancy – a fact that should certainly silence any misogynist jokes about Israeli wives, Polish or otherwise. Israeli men live on average to the age of 80.2, closely followed by Switzerland with 80. In all other countries in the Western world,including Japan, men die, on average, in their 70s.

These statistics are even more astounding when you take into account that just 20 years ago the average longevity for both men and women in Israel was 78.8.

Yet Israel places among the lowest of the OECD countries when it comes to physical resources, infrastructure and expenditure allocated to medical care. For example, in 2009, Israel had two hospital beds per 1,000 people, in contrast to the OECD average of 3.5 per 1,000. Israel spent 7.9 percent of its GDP on medical needs, in contrast with the OECD’s average of 9.6 percent. The United States ranks first in medical expenditures, with an allocation of 17.4 percent of its GDP, but its life expectancy ranks 27th, comparable to Cuba and near the bottom of the OECD nations.

Israel has a universal health system with four highly competitive, major health maintenance organizations (HMOs) that provide inexpensive medical care to all Israeli citizens and residents.

Well before the OECD began compiling statistics, longevity in Israel was much higher. According to the Torah, the Patriarchs, Abraham, Isaac and Jacob, lived to be 175, 189 and 140, respectively. And Methuselah, according to Genesis, died at the ripe old age of 969.

Modern Israelis can’t compete. Yet, even though, according to the recent survey, nearly half of the Jewish public lives with a feeling of existential threat and doesn’t believe there will ever be peace, most of them report feeling good and live long lives.

Why? Different disciplines provide different explanations.

The Longevity Genetics Researcher:

Nir Barzilai, professor of medicine and genetics and director of the Institute for Aging Research at New York’s Albert Einstein College of Medicine, isn’t at all surprised by the statistic.

“The good news is that Israel, with all its worries, is not a place to worry about aging,” he tells The Jerusalem Report in a telephone interview from his office in New York. Barzilaiʼs team is conducting genetic research on more than 500 healthy American Ashkenazi Jews between the ages of 95 and 112 in an attempt to identify the longevity genes. The researchers hope to develop new drug therapies to help people live longer and delay age-related diseases.

“Israelis, who are not genetically prone to live longer than anyone else, are interacting better with the environment than people in the majority of the other countries, and that has to do with all aspects, including preventive medicine, water quality, nutrition, immunizations, early child medical care and access to medical care,” he explains.

The capacity to live over age 100 is determined genetically and only one out of 5,000 people have the genetic capacity to do so, says Barzilai, who studied medicine in Israel before moving to the US . Life span, he explains, is determined by the equal interaction of genes and the environment.

But why does the stress of living in Israel – which Israelis themselves identify in the survey – not adversely affect longevity? “Research on animals shows that stress, if it is intermittent, upgrades the biological capacity for resilience and makes us stronger for the next interaction,” he says.

“So maybe periods of stress on the biological system can influence longevity in a good way. Besides, the quality of life in Israel is one of the best in the world. Preventive medicine in Israel is terrific.”

The Sociologist:

Or perhaps sociology provides the answers to these questions? Professor Gad Yair at the Hebrew University in Jerusalem recently published a book, “The Code of Israeliness,” which is a study on what makes Israelis tick.

“It’s one of the basic codes that we care for each other a lot and we’re speaking about total strangers who might express concern for people they don’t know,” he tells The Report in a telephone interview. “There is a sense of shared fate, shared history, as if we are all in it together.

This was expressed significantly in the case of Gilad Shalit. It’s just a symbol of this basic code that we were willing to give 1,000 to get this one soldier back because we care.

“This reflects a society where kids never part ways from parents,” Yair continues. “They come and eat Friday dinner. Some Americans are shocked by the fact that Israeli kids at age 30 still have economic and emotional ties to their parents. There are also significant grandparent-grandchildren relationships and the daily, or four-times-aday, phone call.”

According to World Health Organization statistics, the suicide rate in Israel is the lowest among Western countries, 6 per 100,000, less than half the rate in countries such as Sweden, France and Germany. In explaining this, Yair refers to French intellectual Emile Durkheim, who wrote the first book of sociology in 1893 and a classic text on suicide in 1897.

“Durkheim concluded that the more connections you have in life, the less prone you are to commit suicide. The best predictor of longevity is the number of connections you have, and in Israel we have ‘social capital,’ family relationships, friends and frameworks for the elderly, which are maintained by voluntary and semivoluntary organizations.”

Yair also discusses another related aspect of the Israeli code that may have some effect on longevity, which he refers to as “Immediate Intimacy.” “Even strangers become best friends in Israel. You can move to a new apartment and within days and weeks you will have good neighbors. We break barriers quickly which in other societies take years to break,” he says.

The Immunologist:

Dr. Doron Melamed researches aging in the department of immunology at the Technion School of Medicine in Haifa. His team is trying to come up with a novel approach to rejuvenate the immune system in the elderly.

“Israel is a place where immigrants came from all over the world and brought with them many different genes that have mixed to form a diversity that contributes to this extended life span,” he says.

“Clearly, the function of the immune system is affected by genetics and the genetic mix makes us more resistant to disease. From my perspective, longevity in Israel might have to do with better functioning of the immune system, which is supported by genes.”

The Social Scientist:

Professor Sam Lehman-Wilzig is associate professor in the Department of Political Studies at Bar-Ilan University in Ramat Gan and has written on the subject of Israeli longevity. “It occurs to me that almost everyone in this country has a reason for being here. Collectively, we have a sense of purpose,” he tells The Report.

“We’re in a country where everyone is continuing a national project, which gives us a reason for living. Having a reason to get up in the morning is important for staying healthy.” Lehman-Wilzig echoes Yair’s words regarding the social capital in Israel.

“Research around the world shows that one of the most important factors in longevity is not biological, but social,” he says. “Isolation, loneliness, lack of social interaction can cause depression that leads to physiological problems. Israel is an extremely family and socially oriented society. There is no such thing as someone falling down in the street without someone immediately coming to help. Very few people really feel alone.”

Lehman-Wilzig posits that Israel’s weather may also have an effect on the long life span. “Very hot or very cold weather can kill and we don’t have that. We have lots of sunshine and people don’t get the sad symptoms that come with winter that can affect not just the suicide rate, but also physical health.”

The Nutritionist:

But Dr. Olga Raz, head of the nutrition department in the Ariel University Center on the West Bank, sounds a different note.

She is not happy with the Israeli diet despite the fact that Israelis eat lots of tasty fresh vegetables and fruits and very little red meat, yet connects this with their longevity.

“Israelis love sweets,” she says. “When the Ethiopians first came they didn’t have any diabetes. Now they have 20 percent diabetes because they were exposed to food that is unhealthy.” The many Jewish holidays where food plays an important role, and food plays a role in all of them except for Yom Kippur, are a catastrophe, she says, referring to the “they persecuted us, let’s eat” syndrome.

Raz brings up another point best illustrated by a joke. A Frenchman, a German and a Jew walk into a bar. “I’m tired and thirsty,” says the Frenchman.

“I must have wine.” “I’m tired and thirsty,” says the German. “I must have beer.” “I’m tired and thirsty,” says the Jew. “I must have diabetes.”

“Jews like to go to the doctor and if the doctor doesn’t order a CT exam then it’s a scandal,” says Raz. “With the public health system it’s much easier to go to a doctor than in those countries where you have to pay for every single thing.”

And so Israelis may not take good care of their diets, but do take care of the ills that they bring upon themselves. The Demographer: Jona Schellekens is a professor in the department of sociology at Hebrew University who specializes in fertility, marriage and mortality.

“It’s the men who are the remarkable aspect in this story,” he says. “The interesting question is why the gap in longevity between Israeli men and women is so small [unlike in other countries].

Research seems to suggest that the difference between men and women is mostly the result of behavior.

“Men take more risks, smoke more and drink more alcohol. In Israel, Jews drink less alcohol. Israeli men marry more than non-Jewish men abroad and it has been shown that marriage protects both men and women, but especially men.”

The Historian and Sociologist:

Oz Almog, sociologist and historian at the University of Haifa, specializes in semiotics, the sociological history of Israeli society, and Israeli popular culture and lifestyles. He has written a book entitled The Sabra: The Creation of the New Jew.

“Most of the Jews living in Israel don’t see themselves as regular citizens, but rather as part of an ancient nation that has been given a historic mission. This feeling, common to both religious and secular Jews, fills people’s lives with meaning and prolongs it,” he tells The Report.

Almog points out that Jews have lots of holidays, which means lots of time off from work. “The saying goes that whoever doesn’t work dies quickly, and whoever works too much also dies quickly. Israelis get plenty of time to rest.”

Furthermore, says Almog, Israeli patients tend to be proactive. “Jews kvetch [complain persistently]. In fact we invented the kvetch. In Israel, they tend to believe in the doctor but always like to get a second opinion, and thus they increase the chances for getting better and living longer.

“There are those who say that the muscle most needed for survival is the brain,” says Almog. “Jews tend to pursue intellectual activities, which keeps the elderly here active and vital. Israelis are also dugri [forthright]. They let off steam and don’t keep emotions bottled up, which is good for health. And finally, Jews are known for their sense of humor. We laugh when things are bad and that is good for a long, healthy life.”

The Comedian:

And since laughter, does, indeed, seem to be good medicine, The Report turned to popular stand-up comedian, Avi Nussbaum for explanations of Israeli longevity. But Nussbaum begs to differ with the premise. “You call this living?” he asks.

“Everyone who lives here knows that it’s not really a life. If you take off the time spent in aggravation, reserve duty, waiting in line and dealing with bureaucracy, you end up with a net life of only 30 years.”

Finally, The Report would like to offer its own possible explanation. Israelis are well-known for their contrariness. Perhaps Israel has one of the highest longevity rates just to tick off those who would destroy it. Iran ranks number 107 in the world by the United Nations with a life expectancy of 71.