Health Scan: The offspring factor

Study: If you have no kids, or 10, watch your health

Both women and men who have no children, and those who raised many, have shorter lifespans, according to new research at the Hebrew University-Hadassah Braun School of Public Health and Community Medicine, now celebrating its 50th anniversary. Biostatistician Prof. Orly Manor, who is dean of the school in Jerusalem’s Ein Kerem, said the epidemiological evidence does not mean people shouldn’t have many children (or none), but that such people should pay more attention to their health.
The team examined the Israel Longitudinal Mortality Study between 1995 and 2005 and death records to monitor 62,000 Jewish women and 71,000 Jewish men aged 45 to 89 living at home (and not in a kibbutz). Almost 20,000 died during the follow-up period. The group was controlled for age, origin, educational level and health habits. Deaths due to cardiovascular disease and other causes were found to be more common in childless couples and those with eight to 10 children than in those with fewer children.
Manor explained that there is not a single cause, and that the factors are conflicting. In women, sex hormones during pregnancy could minimize the resources of women, leaving those who bore many children with fewer resources. At the same time, having many pregnancies reduces the risk of breast and ovarian cancer. There may be a genetic predisposition to high fertility and mortality, she suggested, and the psychosocial effects of having many kids – such as chronic stress from raising and financing them – may take a toll on health, but having a wide social support network may ease the burden.
The team found no association in men and most women who had a large family to an increased or decreased risk of cancer (except for cancer of the reproductive system); such parents did, however, have a higher body mass index than those with no or many children. Being childless is associated with a higher risk of alcoholism, suicide and other risk-taking behavior which reduces longevity. The statistical study is not judgmental, Manor stresses, but those at higher risk should adopt health-promoting and disease-preventing behaviors to minimize the risk.
Meanwhile, non-Hodgkin’s lymphoma (NHL), a blood cancer that has doubled its prevalence in the past six decades, may be triggered  by infections and  is more common in people with autoimmune diseases or in people who undergo treatment to suppress their immune system, according to Braun School Prof. Ora Paltiel. Presenting her study at the same jubilee event in early June, Paltiel said the mortality rates from NHL have not doubled because treatments are better today than decades ago. Another possible cause may be occupational exposure to pesticides and other chemicals, and even obesity.
Her epidemiological study was based on the Jerusalem Perinatal Study of 92,000 children and the Israel Cancer Registry. The researchers found that babies who used to die of infections largely survive today, but may have a genetic susceptibility to infection which also may predispose them to NHL.
STATISTICS BUREAU TAKE ISRAELIS’ PULSEIsrael’s more than seven million residents made 45 million visits to physicians last year plus 4.5 million telephone consultations, according to the latest Health Survey of the Central Bureau of Statistics. The report is meant to be used by decision makers to set policy in healthcare and to be sent to the Organization of Economic Cooperation and Development (OECD), of which Israel has just become a member. The report, based on interviews of 29,000 people (living at home) in a representative sample and some data obtained from the Health Ministry, also stated that 8.3 million visits were made to paramedical workers and 2.7 million to complementary medicine practitioners offering acupuncture (one-quarter of visits), reflexology (16%) and shiatzu (13%).
About a fifth of Israelis 65 and over are not independently mobile and have difficulty coping alone with their daily routines. Over half suffer from hypertension and almost a quarter from diabetes. Women are more likely to make visits to doctors than men, except between birth to four years and over 75. During their fertile years, women are twice as likely to visit doctors than men. Israelis made an average of about six visits to a doctor in 2009 compared to 7.1 in 2000 – apparently due to the increase in phone and even e-mail consultations.
A total of 5.9% (or 424,000) were hospitalized at least once last year. The rate of hospitalization of Arabs, especially those aged 25 to 44, was higher than that of Jews, except over the age of 75. Sixty percent of women aged 50 and over said they underwent a mammogram during the previous two years, but the rate was higher among Jewish women (61%) than Arab women (51%).
Almost 2% of Israelis have undergone an MRI scan at least once, and more than half waited at least a month for it. Only 12% said they were vaccinated against the flu during the year prior to the interview, but over 65, half of them had gotten such a shot. It was an improvement over 2000, when 9% of the general population and 45% of those over 65 had been vaccinated.
Seventeen percent said they had been diagnosed with at least onechronic disease, including heart disease, stroke, hypertension, asthma,chronic respiratory problem, diabetes, cancer, depression or anxiety.Hypertension was the most common. Cancer is more common among Jews thanArabs. Asthma is twice as common among Jews. The rate of depressionreported among those over 25 was twice to five times higher among Jewsthan Arabs.
Three-quarters of the population said they hold a supplementary healthinsurance policy from their public health fund, and 23% have nursinginsurance. But among Jews, the supplementary health insurance rate was83% compared to 43% of Arabs.
Although the national smoking rate over the age of 21 is 22.8%, men aremuch more likely to be addicted to tobacco – 28% of men and 13% ofwomen smoke at least one cigarette daily. Fully 46% of Arab mencompared to 25% of Jewish men smoke cigarettes (hookahs were notincluded, even though it is no less dangerous than cigarettes). Amongwomen, 14% of the Jews and 4% of the Arabs smoke.