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Israel's prevention programs and screening policies for cardiovascular disease
Insights
Mortality from ischemic heart disease (IHD) and cerebrovascular disease (CVD) declined in Israel across ethnic groups. However, specific groups like North African-born individuals face higher risks, highlighting the need for targeted prevention strategies.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Disease Research
Background:
- Ischemic heart disease (IHD) and cerebrovascular disease (CVD) are leading causes of death in Israel.
- Mortality trends and ethnic disparities in IHD and CVD require investigation for effective public health interventions.
Purpose of the Study:
- To analyze mortality trends for IHD and CVD across major ethnic groups in Israel over the past decade.
- To identify specific ethnic and sex-based disparities in IHD and CVD mortality.
- To assess the feasibility and optimal delivery systems for preventive interventions within Israel's healthcare framework.
Main Methods:
- Analysis of national mortality data for ischemic heart disease (IHD) and cerebrovascular disease (CVD) across four broad ethnic groups in Israel.
- Examination of male to female mortality ratios and identification of high-risk populations.
- Review of existing preventive intervention studies and healthcare system capabilities.
Main Results:
- Mortality rates for IHD and CVD have declined across all four ethnic groups in Israel over the last decade.
- Significant disparities exist, with North African-born individuals exhibiting higher mortality rates for both IHD and CVD.
- A low male to female mortality ratio for IHD and a female predominance for CVD were observed.
- Morbidity data, particularly incidence for CVD and IHD in females, remain scarce.
Conclusions:
- While overall mortality for IHD and CVD is declining in Israel, ethnic and sex-based disparities persist, necessitating targeted public health strategies.
- The primary healthcare system, with its broad access, is identified as the most suitable platform for implementing preventive interventions.
- Further research and resource allocation are crucial for developing and testing effective primary prevention services, particularly for underrepresented morbidity data areas.
Abstract:
For all four broad ethnic groups in Israel, mortality rates declined over the last decade for both ischemic heart disease (IHD) and cerebrovascular disease (CVD), the first and third most important causes of death in the country. The four broad ethnic groups consist of persons born in Israel, Asia, North Africa, and Europe. Mortality data also indicate a low male to female ratio in mortality from IHD, a definite female predominance in mortality from CVD, and high mortality rates for IHD and CVD in males and females born in North Africa. Morbidity data, especially incidence, are scarce for CVD in both sexes and IHD in females. The feasibility of preventive intervention needs to be tested under the specific conditions of Israel. Although a multiple risk factor trial in Jerusalem showed that such a program can be conducted in a primary care framework, it clearly still needs to be tested in clinics rather than in a model teaching institution. The best place for intervention would seem to be the primary health care system, which has almost complete access to the country's population. Kupat Holim (the Health Insurance Institute of the General Federation of Labour) is attempting systematically to identify and manage hypertension patients. To date, management of acute coronary disease has been emphasized in Israel. Although additional resources are needed for primary prevention services, other options are suggested for obtaining those services.