Israel Journal of Health Policy Research最新文献

{"title":"Tailoring care, advancing justice: predictors of forensic and legal engagement in survivors of sexual violence.","authors":"Shani Yaakobi-Zelnik, Maya Peled Raz, Ateret Gewirtz-Meydan","doi":"10.1186/s13584-025-00697-1","DOIUrl":"10.1186/s13584-025-00697-1","url":null,"abstract":"<p><strong>Background: </strong>One of the primary challenges faced by survivors of sexual abuse and assault is the fragmented nature of care. This begins immediately after the assault and continues throughout their recovery journey. To address this, specialized sexual assault referral centers (SARC) were established in Israel, providing comprehensive medical, legal, and emotional support. This study examines the association between these centers and survivors' consent to forensic examination and filing of police complaints.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed data from 616 cases of sexual abuse and assault reported at the SARC at Bnai Zion Medical Center between January 2016 and May 2022. Data included demographic information, assault characteristics, treatment details, and survivors' consent to forensic examination and police complaint filing.</p><p><strong>Results: </strong>Four distinct profiles of sexual assault survivors were identified. The first profile included survivors who consented to both forensic examination and police complaints. This group was characterized by shorter intervals between the assault and arrival at the center, being accompanied by friends or family, more often agreeing to receive medication and experiencing more incidents involving more than one attacker. The second profile included survivors who consented to forensic examination only, and it consisted mainly of young women who arrived unaccompanied, later after the assault, expressed more willingness to receive medications and often involved single perpetrator assaults with alcohol use. The third profile involved survivors who filed only a police complaint and were characterized by lower rates of alcohol use during the assault and less frequent receipt of medication. The fourth profile comprised survivors who refused both forensic examination and police complaint, primarily young females who arrived unaccompanied and often reported experiencing forced vaginal or anal penetration. Key predictors of group membership included time since the assault, biological sex, assault type, alcohol use, medication, presence of an informal escort, and multiple perpetrators.</p><p><strong>Conclusions: </strong>The study underscores the importance of a victim-centered, trauma-informed approach to care, highlighting the need for tailored interventions to address the specific needs and barriers of each survivor profile. The findings suggest that timely access to medical care and supportive services is significantly associated with survivors' decisions to consent to forensic examinations and file police complaints.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"38"},"PeriodicalIF":3.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of WHO and CDC growth charts for defining weight status in the young population in Israel: a population-based cross-sectional study.","authors":"Michal Yackobovitch-Gavan, Moshe Phillip, Shlomit Shalitin","doi":"10.1186/s13584-025-00699-z","DOIUrl":"10.1186/s13584-025-00699-z","url":null,"abstract":"<p><strong>Background: </strong>In Israel, the absence of national growth charts leads to the use of CDC or WHO growth charts to assess pediatric growth indices. This population-based cross-sectional study compared BMI z-scores and weight classifications using CDC and WHO charts in children insured by Clalit Health Services (CHS).</p><p><strong>Methods: </strong>The study analyzed the CHS electronic database for patients aged 2-18 years with at least one recorded BMI measurement from January 2017 to December 2023. Exclusion criteria included improbable BMI measurements (> 60 kg/m² or < 10 kg/m²). Demographic data, height, and weight were collected, and BMI z-scores were calculated using both CDC and WHO growth charts. Results were stratified by sex and age groups (2-5 years and > 5-18 years).</p><p><strong>Results: </strong>The cohort included 1,475,543 children: 488,008 aged 2-5 years (52% male) and 987,535 aged > 5-18 years (51% male). In the younger group, the median CDC BMI z-scores were below 0 (< 50th percentile), while the median WHO BMI z-scores were above 0 for both sexes, with significant differences between methods (P < 0.001). BMI z-scores were lower in males than in females across both methods (P < 0.001). In the older group, for both methods, the median BMI z-scores were above 0. WHO z-scores had higher medians in males compared to CDC z-scores (P < 0.001), while in females, z-scores were similar between methods (P = 0.210). CDC showed lower median z-scores for males compared to females (P < 0.001), whereas WHO results were comparable between sexes (P = 0.337). There were significant discrepancies in weight classification, particularly in the 2-5 age group. Overweight rates were over 4% higher using CDC charts compared to WHO (P < 0.001), with minimal agreement (Kappa = 0.06 for males, 0.01 for females). In the older group, WHO classified 4% more children as overweight than CDC (P < 0.001), with moderate agreement in males (Kappa = 0.74) and strong agreement in females (Kappa = 0.81).</p><p><strong>Conclusions: </strong>The study underscores the risk of misclassifying childhood overweight and obesity depending on the growth standard used, particularly in younger children. Policymakers should carefully choose appropriate standards and consider developing national growth charts tailored to the local pediatric population, while allocate resources for early interventions addressing both undernutrition and overnutrition.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"37"},"PeriodicalIF":3.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laboratory-confirmed respiratory syncytial virus (RSV) hospitalizations: a national all ages cross-section evaluation, 2020-2024.","authors":"Aharona Glatman-Freedman, Lea Gur-Arie, Rita Dichtiar, Lital Keinan-Boker, Michal Bromberg","doi":"10.1186/s13584-025-00693-5","DOIUrl":"10.1186/s13584-025-00693-5","url":null,"abstract":"<p><strong>Background: </strong>New vaccines and monoclonal antibody (mAb) against respiratory syncytial virus (RSV) were recently approved for adults and infants, respectively. However, their inclusion in national vaccination programs has been slow. Accurate assessment of RSV disease burden among all ages is essential for the global introduction of these agents.</p><p><strong>Methods: </strong>We evaluated all-ages burden of RSV hospitalizations, from 2020 to 2024, based on data collected by a new national laboratory-based hospital surveillance system. RSV-positive respiratory samples from patients hospitalized in general hospitals nationwide were reported. Data were analyzed by RSV circulation periods and age-group to determine hospitalization rates and 30-day mortality (30-DM) rates. We compared the laboratory-confirmed hospitalization rates with rates previously calculated based on ICD-9 codes.</p><p><strong>Results: </strong>RSV-confirmed hospitalizations were reported for all age-groups. The highest RSV hospitalization rates were found among patients < 1 year old. Patients ≥ 60 years old had the highest RSV hospitalization rates among ≥ 5 years old patients, and their 30-DM rates reached 14.7%, exceeding those of influenza. During the COVID-19 pandemic, lower rates of RSV-confirmed hospitalizations were reported among ≥ 60 years old patients, probably due to higher adherence to social distancing measures. We found higher numbers and rates of laboratory-confirmed hospitalizations among all age-groups ≥ 1 year old, than those previously reported by our group, based on ICD-9 codes.</p><p><strong>Conclusions: </strong>Laboratory-confirmation of RSV is paramount for optimal assessment of RSV hospitalization burden, particularly beyond infancy, and for the global adoption of newly developed vaccines and mAb.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"36"},"PeriodicalIF":3.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Providing food security in Gaza for the \"day after\".","authors":"Elliot M Berry, Dorit Nitzan, Martin Kussmann","doi":"10.1186/s13584-025-00700-9","DOIUrl":"10.1186/s13584-025-00700-9","url":null,"abstract":"<p><p>Poverty, conflict and war are the most prominent reasons for food insecurity worldwide including for the population of Gaza since October 7, 2023. It has been shown that at least during the seven-month period between January and July, 2024, an adequate supply of food was delivered to Gaza. However, a distinction must be made between food availability (entering Gaza), and food accessibility (food supply actually reached at the household level). The latter was apparently controlled by Hamas; and there are no reliable data available on the actual distribution of food. A prerequisite for achieving a better \"day after\" for the population of Gaza depends on achieving a permanent end to the hostilities between Hamas and other Gazan militants with Israel. That must be a top priority for policymakers. Nonetheless, understanding the elements involved in the planning for a successful \"day after\" can begin now. We know that most of the population needs housing, as well as sufficient, adequate and accessible food, water, energy sources, adequate health services for acute and chronic medical and surgical conditions, mental health, and preventive care. In this article, we focus on planning for food and nutrition security for the \"day after,\" a process that will require actions along the six dimensions of food security- availability, accessibility, utilization, stability, sustainability, and agency. We outline these dimensions and their necessary components.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"34"},"PeriodicalIF":3.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary healthcare delivery adaptations in war-induced population displacement.","authors":"Assi Cicurel, Yael Wolff Sagy, Ilan Feldhamer, Shlomit Yaron, Shani Caspi-Regev, Doron Netzer, Ronen Arbel, Gil Lavie","doi":"10.1186/s13584-025-00698-0","DOIUrl":"10.1186/s13584-025-00698-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Impact of war on civilians in high-income countries has been relatively underexplored in research. Internal displacement of populations within a country during war challenges healthcare universal access, utilization, and continuity of care. Healthcare systems can prepare and adjust to mitigate detrimental effects. Therefore, our objective was to examine primary healthcare delivery adaptations during war-induced population displacement and the effects on primary healthcare utilization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Observational, repeated cross-sectional study based on Clalit Health Services (CHS) electronic medical records (EMR) data. Outcomes were the rates of visits in primary care during five months following the war, compared to the previous year, by population group. All CHS members were included, 4.86 million, classified into four groups: (1) evacuated municipalities in the South (ES); (2) evacuated municipalities in the North (EN); (3) areas of restricted activity (RA) (4) rest of the Country (RC). The considered exposures were the state of war and internal displacement of populations, extended periods of restricted activities for areas under threat, and primary healthcare delivery adaptation measures. The main outcomes and measures were primary care visit rates grouped into four consecutive weeks clusters. Visits were further classified as in-person or telehealth visits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Healthcare delivery adaptation measures included fast set-up of pop-up primary clinics in evacuated population concentrations, services expansion (online visits 24/7, medication delivery range), and expanded services for internally displaced persons (designated call center lines and text-based nursing service). During the initial weeks following the outbreak of war overall visits declined, mainly in displaced populations (by 43.9% (95% CI: 42.2-45.6%) and 19.1% (95% CI: 17.1 - 21.1%) in the first month in ES and EN, respectively). Visits rates gradually recovered in all population groups, returning to baseline within 12 weeks. This was driven by a sharp initial decline of in-person visits, and attenuated by increased usage of telehealth, mainly observed in displaced populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The outbreak of war and population displacement was associated with decreased primary care visits, while telehealth service utilization increased significantly. This increase was partly facilitated by telehealth consultations provided by patients' regular primary care physicians, often themselves displaced, thereby preserving continuity of care through existing trust and rapport. Healthcare systems should proactively integrate telehealth solutions into emergency preparedness plans, prioritizing continuity of patient-provider relationships even during displacement. Future research is needed to evaluate the quality and equity implications of telehealth adaptations and their impact on long-term healt","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"35"},"PeriodicalIF":3.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Policy interventions for improving hospital-to-home transitions of care for older adults and informal caregivers: a qualitative study.","authors":"Opeyemi Rashidat Kolade, Joshua Porat-Dahlerbruch, Theo van Achterberg, Moriah Esther Ellen","doi":"10.1186/s13584-025-00692-6","DOIUrl":"10.1186/s13584-025-00692-6","url":null,"abstract":"<p><strong>Background: </strong>Efficient hospital-to-home transitions for older adults and their informal caregivers are hampered by current fragmented care systems, resulting in communication and coordination lapses when people move between hospital-to-home settings. Such fragmentation often leads to suboptimal hand-overs of information and care, medication errors, and overlooked follow-up appointments, which, in turn, contribute to adverse health outcomes for the elderly population. This study aims to answer the question: \"What policy interventions can improve the transitions from hospital to home for older adults and their informal caregivers\" Thus the study focuses on delineating policy recommendations at the micro, meso, and macro levels to facilitate smoother and more beneficial hospital-to-home transitions for older adults and their informal caregivers.</p><p><strong>Methods: </strong>As part of the European Union Transitional Care Program (TRANS-SENIOR), this qualitative descriptive study leverages a multiple perspectives approach through in-depth interviews with older adults and informal caregivers. The goal is to pinpoint critical intervention zones of policy recommendations based on a holistic understanding of older adult and caregiver recommendations for improving hospital-to-home transitions.</p><p><strong>Results: </strong>Findings show strategies that strengthen patient and caregiver engagement on the micro level. These include implementing personalized care plans and improving communication channels between healthcare providers and their recipients. The meso level targets healthcare organizations and systems, promoting the adoption of streamlined care coordination, enhanced discharge planning, and bolstered support services for caregivers. Such interventions are designed to smooth the transition process, ensuring that care continues seamlessly from hospital to home. At the macro level, our findings urge policy reforms to address broader systemic issues, such as the allocation of resources, the introduction of funding mechanisms, and the expansion of healthcare workforce capacity. These policy recommendations aim to create an enabling environment for effective care transitions, addressing underlying challenges that impede seamless care transitions.</p><p><strong>Conclusion: </strong>This paper presents a set of policy recommendations for policymakers, healthcare professionals, and stakeholders. These recommendations aim to tackle the multifaceted challenges associated with hospital-to-home transitions to enhance care experience and outcomes for older adults and their caregivers by addressing individual, organizational, and systemic issues.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"33"},"PeriodicalIF":3.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between hospital accreditation and healthcare providers' perceptions of patient safety culture: a longitudinal study in a healthcare network in Brazil.","authors":"Helidea de Oliveira Lima, Leopoldo Muniz da Silva, Leandro Reis Tavares, Ana Claudia Lopes Fernandes de Araújo, Laise Pereira Moreira, Vanessa de Melo Silva Torres, Fabiana Nogueira de Oliveira, Anthony M-H Ho, Deborah Simões, Glenio B Mizubuti, Joaquim Edson Vieira","doi":"10.1186/s13584-025-00690-8","DOIUrl":"10.1186/s13584-025-00690-8","url":null,"abstract":"<p><strong>Background: </strong>Enhancing security and dependability of health systems necessitates resource allocation, a well-defined infrastructure, and a steadfast commitment to ensuring its safety and stability over time. This study aimed to assess changes in patient safety culture over time (2014-2022) within a network of private hospitals in Brazil and to examine its association with the hospital accreditation process. The study utilized the Hospital Survey on Patient Safety Culture (HSOPSC) to measure healthcare professionals' perceptions of patient safety culture.</p><p><strong>Methods: </strong>The HSOPSC questionnaire was distributed to 71 hospitals between 2014 and 2022 with 259,268 responders. Hospitals were classified as accredited (AH) or non-accredited (NAH). A linear mixed-effects regression model was used to analyze the trend of dimension scores over time, accounting for both fixed and random effects to accommodate within-hospital correlations and variations across time points.</p><p><strong>Results: </strong>Out of 12 dimensions analysed, 11 significantly improved, and one (\"frequency of reported events\") remained unchanged over time (p = 0.84). Two dimensions had < 50% positive responses: \"communication openness\" (47.13% [38.19-58.73]) and \"nonpunitive response to errors\" (41.24% [34.13-51.98]). Safety culture improved among AH across all, but \"frequency of reported events\" (p = 0.12), dimensions. Among NAH, \"frequency of reported events\" decreased over time (p = 0.008) while other dimensions remained unchanged.</p><p><strong>Conclusion: </strong>Our results suggest an improvement in patient safety culture within this network of private hospitals in Brazil from 2014 to 2022. While accreditation appears to be associated with fostering a culture of safety over time, our study does not establish a causal relationship. Additionally, non-accredited hospitals tended to report fewer adverse events, which may indicate underreporting and missed opportunities for healthcare system improvement through adverse event analysis.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"27"},"PeriodicalIF":3.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Telemedicine on Preventive Medicine- A Case from Israel.","authors":"Limor Adler, Shiraz Vered, Menashe Meni Amran, Galya Zacay, Edna Bar-Ratson, Bar Cohen, Ilan Yehoshua","doi":"10.1186/s13584-025-00696-2","DOIUrl":"10.1186/s13584-025-00696-2","url":null,"abstract":"<p><strong>Background: </strong>Preventive medicine is one of the core elements of primary care physicians' (PCPs) work. This includes screening for cancer (such as Mammography and fecal occult blood test (FOBT) for breast and colon cancer) and also screening for chronic conditions (like bone density scans (DEXA scans) for osteoporosis). In recent years, especially since the COVID-19 pandemic, the use of telemedicine increased dramatically. This study aimed to identify the rate of preventative medicine referrals and performance in individuals who mostly had face-to-face encounters compared to those who mostly had remote encounters.</p><p><strong>Methods: </strong>This retrospective cohort study is based on the electronic medical records of one healthcare maintenance organization (HMO) in Israel. We followed all individuals eligible for at least one of the screening tests in 2020 and 2021 and evaluated whether they received referrals to screening tests (mammography, FOBT, and DEXA scans) and performed them. Each individual was assigned to the face-to-face group (more than 60% of their encounters were face-to-face), the remote group (more than 60% of their encounters were remote), and the mixed group, which included the rest of the cohort.</p><p><strong>Results: </strong>For mammographies and FOBT, the referral rates were lower in the face-to-face group compared to remote and mixed groups (mammographies: 27.3% vs. 29.8% and 32.9%, p-value < 0.001; FOBT: 55.6% vs. 60.3% and 58.7%, p-value < 0.001, respectively). However, for all three tests, the performance rates were the lowest in the remote group compared to face-to-face and mixed (for mammographies, 68.2% vs. 76.3% vs. 78.1; for FOBT, 44% vs. 56.8% vs. 54.3%; for DEXA 9.2% vs. 22.9% vs. 20.7%, respectively). A referral from the PCP increased the odds of performing the test for mammographies OR-1.55, 95% CI 1.52-1.58, and for FOBT OR-1.96, 95% CI 1.93-1.99.</p><p><strong>Conclusion: </strong>Although PCPs referred their patients to screening tests in remote visits, the performance rate of individuals who mainly used telemedicine was lower than those who mostly had face-to-face visits. A referral for a screening test from the PCP increased the odds of performing it. Understanding individuals' health behaviors using telemedicine is crucial to maintaining adherence to preventing medicine.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"31"},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversifying the health workforce in Israel and the United States: a comparison.","authors":"Edward Salsberg","doi":"10.1186/s13584-025-00694-4","DOIUrl":"10.1186/s13584-025-00694-4","url":null,"abstract":"<p><p>Minority populations in many countries, including Israel and the US, experience significant health disparities compared to the majority population. A health workforce that reflects the characteristics of the population including race/ethnicity, language and socioeconomic backgrounds, can help address these disparities. Over the years, Isreal and the US have implemented a variety of programs and policies to promote greater representation of minority populations in medicine and other health professions. This paper compares some of the efforts and outcomes in the 2 countries to support a more diverse health workforce. While progress has been made in both countries, they now face significant challenges which are likely to put recent progress at risk.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"32"},"PeriodicalIF":2.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived neighborhood disadvantage and poor chronic health in Israel.","authors":"Sharon Stein Merkin, Kathleen Abu-Saad","doi":"10.1186/s13584-025-00695-3","DOIUrl":"10.1186/s13584-025-00695-3","url":null,"abstract":"<p><strong>Background: </strong>Social disparities in health persist in Israel despite universal health care. Few studies have focused on the impact of neighborhood disadvantage on health in a representative sample of the Israeli population while accounting for multiple socioeconomic factors. The objective of this study was to assess the independent association between perceived neighborhood disadvantage and self-reported poor chronic health.</p><p><strong>Methods: </strong>Self-reported poor chronic health was defined as (1) reported not very good/poor health, and (2) having a chronic health/physical problem for > = 6 months disrupting daily life activities. Neighborhood disadvantage was based on self-reported measures of residential environment (scale of dissatisfaction with transportation, parks, cleanliness, waste removal, noise, pollution, safety, and walkability) and social problems (dissatisfaction related to neighbors, and neighbors interacting to improve the environment). High levels of neighborhood problems were defined as top 25th percentile of dissatisfaction scales. Logistic regression models included incremental adjustment for sex, age, ethnicity/religion, immigration status, peripheral region and then income, education and employment status.</p><p><strong>Results: </strong>A total of n = 7,020 participants with non-missing data were included. High levels of neighborhood environmental and social problems were independently associated with poor chronic health even after adjustment for sex, age, ethnicity/religion, immigration status, and peripheral region, and remained statistically significant after additionally adjusting for income, education, employment and lifestyle factors (odds ratio (OR) 1.5, 95% confidence interval (CI) 1.2-1.9 for environmental problems; OR 1.3, 95% CI 1.1-1.6 for social problems).</p><p><strong>Conclusions: </strong>Living in areas of perceived disadvantage conferred health risks beyond those related to ethnicity or socioeconomic status. These findings suggest that neighborhood-level factors contribute significantly to health disparities in Israel and should be included in national efforts to evaluate and minimize these health disparities. Future research is needed to also consider objective measures of neighborhood disadvantage, in order to determine the more salient neighborhood measures with respect to health outcomes and to effectively develop targeted interventions to reduce area-level health disparities.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"30"},"PeriodicalIF":3.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}