Holocaust survivors sicker but outlive other Israelis, study reveals

The overall mortality rate among Holocaust survivors was considerably lower (25.3%) compared with the general Israeli population (41.1%).

The hands of Shalom Shtamberg, a 93-year old Holocaust survivor, are seen during his bar mitzvah ceremony, a Jewish coming-of-age celebration traditionally marked by boys at the age of 13, in Haifa, Israel August 31, 2017 (photo credit: AMIR COHEN/REUTERS)
The hands of Shalom Shtamberg, a 93-year old Holocaust survivor, are seen during his bar mitzvah ceremony, a Jewish coming-of-age celebration traditionally marked by boys at the age of 13, in Haifa, Israel August 31, 2017
(photo credit: AMIR COHEN/REUTERS)
Holocaust survivors experience more chronic illness but outlive the general Israeli population by an average of seven years, a new study published in the Journal of the American Medical Association has revealed.
Led by the Tel Aviv-based Maccabi Kahn Institute for Research and Innovation, the study revealed that while excessive rates of chronic comorbidities were reported among Holocaust survivors, their overall mortality rate was considerably lower compared to the general Israeli population.
This may be associated, researchers said, by “improved health literacy and unique resilience characteristics among Holocaust survivors,” including more favorable genetic, physical and emotional characteristics.
The study evaluated approximately 38,500 survivors born between 1911 and 1945 in Europe and 35,000 control individuals born in pre-state Israel between the same years, all insured by Maccabi Healthcare Services.
Holocaust survivors had significantly higher rates of chronic illnesses including hypertension, obesity, chronic kidney disease, cancer and dementia. Yet the overall mortality rate among Holocaust survivors was considerably lower (25.3%) compared with the general Israeli population (41.1%).
When comparing the mean age of death, Holocaust survivors lived on average until 84.8 years old, almost seven years longer than the general population average of 77.7 years old.
The higher rate of chronic illness among survivors follows the broad medical understanding that a genocide experience sustained for five years would have a seriously detrimental effect on the “psychological and physical well-being of individuals because of psycho-social trauma, post-traumatic injury, poor hygiene, prolonged malnutrition, and sub-optimal preventive means.”
The apparent paradox between higher rates of illness but lower levels of morbidity may partially be explained, researchers suggested, by greater health literacy among Holocaust survivors.
An October 2018 study led by Dr. Roni Elran-Barak of the University of Haifa found that more Holocaust survivors (39%) cited “maintaining good health” as a method to maintaining the best possible life in old age than other postwar (27.9%) and prewar (21.6%) immigrants to Israel.
Individuals with higher health literacy levels are more likely, research shows, to use preventive methods and participate in medical screenings, leading to earlier diagnosis and treatment and, subsequently, higher life expectancy.
Researchers said that it is also conceivable that “the Darwinist ability to survive among Holocaust survivors who reached Israel was associated with favorable resilience despite the enduring consequences of serious comorbidities.”
This favorable resilience, the study said, may be due to coping abilities that led them to survive the extreme conditions faced during the Holocaust.
Coping abilities could include different stress responses making Holocaust survivors less sensitive to the consequences of some comorbidities, as well as optimism, cognitive flexibility, maintaining a supportive social network, attending to personal physical well-being and embracing a personal moral compass.