NIHP Survey

NIHP

To further understand and serve our community, Beit Natan conducted the first national survey of the health habits of Orthodox women and the quality, usage and efficacy of health services by the Haredi community" (2001, the Israel National Institute for Health Policy and Health Services Research).

The aim of the study was to collect data to document perceptions and utilization of health services and health care practices, preventive health care behaviors and mental health status and levels of health awareness within the haredi community. The objective was to enable a two-tiered analysis providing  (1) a comparison to the general population as reported in the 1999 National Brookdale Survey of Women’s Health and Social Welfare and the First Israeli National Health and Nutrition Survey (Mabat Survey) and  (2) an internal comparison of various aspects of health awareness and practices among different haredi subgroups.

Telephone interviews were completed with a national sample of haredi women. A final number of 459 interviews constituted a response rate of 73.9%. Voting patterns served as a proxy indicator of the location of haredi residents. The survey instrument was an adapted version of the Brookdale Survey of Women’s Health and Social Welfare with the addition of select items from the Mabat Survey of Health and Nutrition. The objective was to compare the utilization of health and health care practices, preventive health care behaviors of mental health status within the haredi community with those found in the general population and to provide an internal comparison among different haredi subgroups. Significant differences were found in demographic characteristics, health fund membership, the impact of financial factors on health care, sources of health and nutritional information and individual health profiles. Policy implications were suggested and a follow up research agenda presented.

OBJECTIVES:

The aim of the study was to collect data to document perceptions and utilization of health services and health care practices, preventive health care behaviors and mental health status and levels of health awareness within the haredi community. The objective was to enable a two-tiered analysis providing  (1) a comparison to the general population as reported in the 1999 National Brookdale Survey of Women’s Health and Social Welfare and the First Israeli National Health and Nutrition Survey (Mabat Survey) and  (2) an internal comparison of various aspects of health awareness and practices among different haredi subgroups.

The study sought to provide information that heretofore had not been available about an important demographic sector of Israeli society to the health ministry and health funds.

METHODOLOGY:

The survey instrument was an adapted version of the Brookdale Survey with select items from the Mabat Survey. A number of unique questions of special relevance to the haredi community were also included. The questionnaire was administered to a representative national sample of haredi women by telephone. The sample was drawn from urban, rural and semi-urban communities in the 3 major geographic regions of the country: North, South and Central. For each of the communities, sampling sectors were selected on the basis of Knesset voting records. The sample consisted of Hebrew speaking women, 22 years or older with telephones living on streets in electoral districts with 90% or higher percentages of voters for haredi political parties. The final number of useable interviews was 459 which constituted a response rate of 73.9%.

FINDINGS:

In comparison to the Brookdale Sample, the haredi respondents were significantly younger, overwhelmingly likely to be married, native born Israelis with a significantly larger family size. The haredi respondents were more evenly distributed among the four health funds. Haredi women were less likely to have a female permanent medical provider except when that provider was a gynecologist. Haredi women were nearly twice as likely as women in the Brookdale sample to have a female gynecologist and nearly twice as likely to prefer one. Haredi women were less likely to report that their permanent physician understood whether or not they understood their medical problems and medications. Haredi respondents also were likely to report that they did not obtain needed medical care or drugs in the last year and could not purchase certain foods. They relied most heavily on health fund publications and community newspapers for health and nutrition information.

In spite of being almost 3 times as likely to describe their overall well-being as excellent, the haredi respondents indicated higher rates of anemia, diabetes and overweight. The haredi women also evidenced a low level of awareness of the benefits of early detection of breast cancer and poor compliance to the current medical protocol of clinical examination and mammography.

The study findings suggest the following policy implications:

POLICY IMPLICATIONS:

A number of policy implications are suggested by the study findings.

1.    More female medical providers should be made available to female health fund members in general and haredi members in particular.

2.    The impact of financial constraints on health status should be systematically assessed.

3.    As a general health policy and particularly in the light of the foregoing of medical services and medications because of financial limitations, increased emphasis should be placed on preventive medicine.

4.    Increased use should be made of health fund publications and haredi newspapers as means of disseminating information about health and nutrition.

5.    Health funds should increase the level of nutritional counseling to counter the higher rates of anemia, diabetes and overweight in the haredi sector and the impact of the economic situation on dietary practices.

6.    Medical providers should be sensitized to the haredi tendency to report overall well-being and their perception that physicians do not adequately ascertain patient understanding of the medical situation and/or medications.

7.    Research should be directed to scientifically determining the relationship between religious outlook and mental health status.