Israel's Health Ministry takes aim at rise in health-care gaps

“Health inequality is no different from diseases. It harms the health of the residents of the State of Israel. We must take the necessary steps to address this phenomenon.”

Doctor consultation at hospital. (illustrative) (photo credit: INGIMAGE)
Doctor consultation at hospital. (illustrative)
(photo credit: INGIMAGE)
Israel leads the OECD countries in the high rates of poverty both among the general population and among children, according to a new Health Ministry annual report titled “The Health System Confronts Inequality.” A conference to discuss the report will be held on Monday in Shefayim.
Written by Dr. Emma Averbuch and Dr. Shlomit Avni of the Health Ministry’s strategic and economic planning department, the document reveals health gap data for 2017. It finds that life expectancy increased in the general population among both Jews and Arabs. Life expectancy rose by 0.3 years for Jewish and Arab women; it also rose among Jewish men by 0.2 years, compared with an increase of 0.6 years among Arab men.
The gaps in life expectancy according to one’s place of residence expanded. The difference in life expectancy between Beersheba and Ramat Gan is 3.7 years, with the figure in the capital of the Negev 80.7 years and 84.4 in Ramat Gan.
By district, it was found that the highest adjusted mortality rates were recorded this year in the Beersheba and Acre districts (apparently due to the lower life expectancy among Beduin) and the lowest in Petah Tikva and Rehovot and Jewish settlements in Judea and Samaria. The most significant increase in mortality was recorded in the Golan subdistrict, from 5.0 per 1,000 live births in 2015 to 5.4 in 2016, while in the Judea and Samaria subdistrict there was a significant decrease from 4.2 to 3.8 in the same period.
Commenting on the report, ministry director-general Moshe Bar Siman Tov noted: “Health inequality is no different from diseases. It harms the health of the residents of the State of Israel. We must take the necessary steps to address this phenomenon.”
The report, he said, “indicates significant gaps in health outcomes in Israel among different population groups. I am pleased to see that our efforts are bearing fruit, and in some areas, there is a narrowing of gaps. However, more efforts and resources are needed to reduce the gaps. It is important to note that most of the gaps in health outcomes are caused by socioeconomic gaps originating outside the health system. The health system works to reduce the gaps created outside [of] it.”
A combination of infant mortality data by district with data by population group creates a complex picture. Among Jews, an examination of mortality rates at three points in time shows a consistent decline in the Haifa, Central and Tel Aviv districts. Haifa recorded a significant decrease of 0.5 between the two periods of time. In the northern and southern districts, however, there was a slight increase in the last measurement period, and they show the highest mortality rates in the Jewish sector (three per 1,000 live births).
In the Arab sector, there was a decrease in the infant mortality rates in the Northern, Haifa and Central districts, whereas in the Jerusalem district the downward trend was reversed, and the death rate reached 6.0 per 1,000 live births. In the Southern district, there has been no change between the two periods of time in recent years; it remains the highest rate among the districts.
The Health Ministry supports the health funds through the use of “support tests” designed to reward the insurers for activity in specific areas that are not included in the basket of national health services. The subsidies are intended to encourage new activity in the health system, thereby expanding the type and scope of services, improving their quality, focusing on the target group and more.
The tests, applicable for the years 2015 and 2016, may lead to financial grants for health funds that conduct weight-loss workshops for the treatment of diabetes and for parents and overweight children. This is done in an effort to conduct activities in low socioeconomic regions in the Jewish sector and in the Arab sector.
Only 13% of participants participated in workshops in Arabic, less than their percentage in the population. Participants in the Arabic courses tend to persevere more and attend more meetings than the participants in the Hebrew-language courses.
Leumit Health Services and Meuhedet Health Services (the smallest and next smallest of the four health insurers) stood out, compared with Clalit Health Services and Maccabi Health Services, in their ability to recruit members from low-income organizations to attend workshops.