Principal investigator

Dr. Ofra Kalter-Leibovici

Subinvestigators

Gertner Institute:

Cardiovascular Epidemiology Unit: Ms Flora Lubin, Ms. Angela Chetrit

Mental Health Epidemiology and Psychosocial Aspects of Illness Unit: Ms. Saralee Glasser, Mr. Giora Kaplan

Information and Computerization Unit: Ms Daphna Gofer

Biostatistics Unit: Dr. Havi Murad

Clalit Health Services, Samaria District: Dr. Ahmed Atamna, Dr. Gershon Alpert

Background

• The level of morbidity and mortality from diabetes and cardiovascular disease is high among Moslem Arabs in Israel, especially for women.
• There is no measurement-based data on the presence of classic and new risk-factors for cardiovascular disease among Jews and Arabs in the general population of Israel.
• There is no data about awareness of risk-factors for cardiovascular disease among Jews and Arabs.
• There is no data about the use of health services for the purpose of preventing cardiovascular disease among Jews and Arabs.

Objectives

To evaluate and quantify the following for Jews and Arabs in Israel:

1. Incidence of classic and new risk-factors for cardiovascular disease
2. Awareness of these risk-factors
3. Use of health services for the purpose of preventing cardiovascular disease

Implications

Identification of treatable risk-factors in different population groups will help plan effective knowledge-based interventions to reduce the burden of cardiovascular morbidity on the State and reduce costs for the healthcare system.

Type of Study

Prevalence in population survey

Method

Research population

Random sample of 1,100 people living in Jewish and Arab towns (with populations exceeding 2000) in the Hadera District.

The sample was divided into two equal groups for both gender and population sector (Jewish, Arab), and into five ten-year age groups, ages 25-74.

Research components

The study included:

1. Personal interviews in participants' homes
2. Fasting blood tests and the clinic tests

Information gathered during the interviews included:

• Socio-demographic traits
• Use of health services
• Life-style (diet, smoking and physical activity)
• Reported morbidity
• Reported morbidity of first-degree relatives

Information gathered during clinical tests and measurements included:

• Weight; circumference of waist, hips and arm
• Resting electrocardiogram
• Fasting blood sample, including risk-factors for the cardiovascular disease

Status

The collection of data is currently being completed.

Results

• There is a high incidence of risk-factors for cardiovascular disease in the Arab population.
• There is a higher incidence of obesity, metabolic syndrome and diabetes among Arab women than in Jewish women. Arab women rarely engage in leisure-time physical activity.
• The percentage of Arab men who smoke is higher than the percentage of Jewish men who smoke, and the amount of smoke exposure among Arab smokers higher than the exposure of Jewish smokers.
• There is a higher incidence of diabetes among Arab men and women, in comparison to Jews of the same gender.
• No differences were observed in the sectors' knowledge about risk-factors, but both populations attributed more importance to emotional factors and less importance to classical factors: obesity, hypertension and exceptional levels of blood lipids.
• No differences were observed between the population sectors' use of health services for the purpose of preventing cardiovascular disease. However, there were more unbalanced diabetes patients in the Arab population and more Arab participants with undiagnosed or untreated high levels of blood lipids than among Jewish participants.

Financing organization

1. The Israel National Institute for Health Policy and Health Services Research
2. The Chief Scientist, Ministry of Health
3. Inheritance Fund
4. Tnuva
5. Yad Levav
6. Israel Diabetes Research Association

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