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Arbel Y, Bar-El R. Cesarean Sections and Family Planning Among Ultra-Orthodox Israeli Jews. JOURNAL OF RELIGION AND HEALTH 2024; 63:2599-2632. [PMID: 38662024 DOI: 10.1007/s10943-024-02026-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/26/2024]
Abstract
The elevated frequency of Cesarean sections (C-sections) in OECD countries not only burdens health systems financially but also heightens the risks for mothers and infants. This study explores the feasibility of reducing C-section rates by examining the Israeli ultra-Orthodox population, noted for its large families and low C-section rates. We analyze birth data from an Israeli hospital, focusing on ultra-Orthodox mothers with husbands who are yeshiva students compared to other mothers. Our findings reveal that all else being equal, mothers married to yeshiva students exhibit a lower likelihood of undergoing a C-section and a higher propensity to seek private medical services to avoid this procedure. This behavior is attributed to their preference for large families and the desire to minimize C-sections, which may restrict the number of possible future pregnancies. These insights underscore the potential effectiveness of initiatives encouraging mothers to opt for vaginal deliveries, thereby reducing healthcare costs and maternal-infant risks.
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Affiliation(s)
- Yuval Arbel
- Sir Harry Solomon School of Economics and Management, Western Galilee College, 2412101, Acre, Israel.
| | - Ronen Bar-El
- Department of Management and Economics, The Open University of Israel, Ra'anana, Israel
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Trivedi MS, Manley H, Yi H, Silverman T, Chung WK, Appelbaum PS, Starck R, Schecter I, Kukafka R, Crew KD. Pilot study of a decision aid on BRCA1/2 genetic testing among Orthodox Jewish women. Fam Cancer 2024:10.1007/s10689-024-00371-6. [PMID: 38609522 DOI: 10.1007/s10689-024-00371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/05/2024] [Indexed: 04/14/2024]
Abstract
INTRODUCTION Orthodox Jewish women face unique social, cultural, and religious factors that may influence uptake of BRCA1/2 genetic testing. We examined the impact of a web-based decision aid (DA) on BRCA1/2 genetic testing intention/completion among Orthodox Jewish women. We conducted a single-arm pilot study among 50 Orthodox Jewish women who were given access to a web-based DA entitled RealRisks and administered serial surveys at baseline and 1 and 6 months after exposure to the DA. Descriptive statistics were conducted for baseline characteristics and study measures. Comparisons were made to assess changes in study measures over time. Fifty Orthodox Jewish women enrolled in the study with a mean age of 43.9 years (standard deviation [SD] 14.6), 70% Modern Orthodox, 2% with personal history of breast cancer, and 68% and 16% with a family history of breast or ovarian cancer, respectively. At baseline, 27 (54%) participants intended to complete genetic testing. Forty-three participants (86%) completed RealRisks and the 1-month survey and 38 (76%) completed the 6-month survey. There was a significant improvement in BRCA1/2 genetic testing knowledge and decrease in decisional conflict after exposure to the DA. At 1 month, only 20 (46.5%) completed or intended to complete genetic testing (p = 0.473 compared to baseline). While the DA improved genetic testing knowledge and reduced decisional conflict, genetic testing intention/completion did not increase over time. Future interventions should directly address barriers to BRCA1/2 genetic testing uptake and include input from leaders in the Orthodox Jewish community. CLINICALTRIALS GOV ID NCT03624088 (8/7/18).
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Affiliation(s)
- Meghna S Trivedi
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, 161 Fort Washington Avenue HIP 10, New York, NY, 10032, USA.
| | - Haley Manley
- College of Law, DePaul University, Chicago, IL, USA
| | - Haeseung Yi
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Thomas Silverman
- Department of Biomedical Informatics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Wendy K Chung
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Paul S Appelbaum
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Rebecca Starck
- Institute for Applied Research and Community Collaboration (ARCC), Spring Valley, NY, USA
| | - Isaac Schecter
- Institute for Applied Research and Community Collaboration (ARCC), Spring Valley, NY, USA
- Achieve Behavioral Health, Monsey, NY, USA
| | - Rita Kukafka
- Department of Biomedical Informatics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Katherine D Crew
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, 161 Fort Washington Avenue HIP 10, New York, NY, 10032, USA
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Taragin-Zeller L, Berenblum T, Brasil E, Rozenblum Y, Baram-Tsabari A. Religious diversity and public health: Lessons from COVID-19. PLoS One 2023; 18:e0290107. [PMID: 37619233 PMCID: PMC10449469 DOI: 10.1371/journal.pone.0290107] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
Scholars have identified a range of variables that predict public health compliance during COVID-19, including: psychological, institutional and situational variables as well as demographic characteristics, such as gender, location and age. In this paper, we argue that religious affiliation is also a clear predictor for compliance with public health guidelines. Based on a sample representative survey (N = 800) of Haredi Jews in Israel, we found that Haredi Jews mostly followed COVID-19 health regulations. Among the respondents who were non-compliant, however, we found large divergences which mostly reflected religious affiliation. While members of Lithuanian and Sephardi communities reported following guidelines, Hasidim, a more charismatic sub-group, were 12% and 14% more likely to flout public health guidelines than their Lithuanian and Sephardi counterparts, respectively. Despite this inner diversity, all Haredim were portrayed in Israeli media as one homogeneous group that was blamed for flouting public health guidelines and spreading COVID-19. Based on these findings, we argue for the importance of public health messaging that attends to diverse aspects of religious dogma, practice and observance by creating partnerships and sustainable relationships between different actors and stakeholders. In addition, we found that compliance was also shaped by knowledge about COVID-19 and public concern. Taking these findings together, health communication that acknowledges religious diversity while providing critical knowledge about the pandemic is key to developing and implementing community-focused interventions and public health programs. Practically, these insights help to improve pandemic governance as well as contributing theoretically to the study of public health relations and religion by highlighting how discourses around health vary and how differently positioned actors shape representations of responsiveness and health compliance.
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Affiliation(s)
- Lea Taragin-Zeller
- Federmann School of Public Policy and Governance and the Program in Cultural Studies, The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | | | - Yael Rozenblum
- Faculty of Education in Science and Technology, Technion – Israel Institute of Technology, Haifa, Israel
| | - Ayelet Baram-Tsabari
- Faculty of Education in Science and Technology, Technion – Israel Institute of Technology, Haifa, Israel
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Bilu Y, Flaks-Manov N, Bivas-Benita M, Akiva P, Kalkstein N, Yehezkelli Y, Mizrahi-Reuveni M, Ekka-Zohar A, Shapiro Ben David S, Lerner U, Bodenheimer G, Greenfeld S. Data-Driven Assessment of Adolescents' Mental Health During the COVID-19 Pandemic. J Am Acad Child Adolesc Psychiatry 2023:S0890-8567(23)00053-9. [PMID: 36764609 PMCID: PMC9904823 DOI: 10.1016/j.jaac.2022.12.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 12/21/2022] [Accepted: 02/01/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE Adolescents' mental health was severely compromised during the COVID-19 pandemic. Longitudinal real-world studies on changes in the mental health of adolescents during the later phase of the pandemic are limited. We aimed to quantify the effect of COVID-19 pandemic on adolescents' mental health outcomes based on electronic health records. METHOD This was a retrospective cohort study using the computerized database of a 2.5 million members, state-mandated health organization in Israel. Rates of mental health diagnoses and psychiatric drug dispensations were measured among adolescents 12 to 17 years of age with and without pre-existing mental history, for the years 2017 to 2021. Relative risks were computed between the years, and interrupted time series (ITS) analyses evaluated changes in monthly incidence rates of psychiatric outcomes. RESULTS The average population size was 218,146 in 2021. During the COVID-19 period, a 36% increase was observed in the incidence of depression (95% CI = 25-47), 31% in anxiety (95% CI = 23-39), 20% in stress (95% CI = 13-27), 50% in eating disorders (95% CI = 35-67), 25% in antidepressant use (95% CI = 25-33), and 28% in antipsychotic use (95% CI = 18-40). A decreased rate of 26% (95% CI = 0.80-0.88) was observed in ADHD diagnoses. The increase of the examined outcomes was most prominent among youth without psychiatric history, female youth, general secular Jewish population, youth with medium-high socioeconomic status, and those 14 to 15 years of age. ITS analysis confirmed a significantly higher growth in the incidence of psychiatric outcomes during the COVID-19 period, compared to those in previous years. CONCLUSION This real-world study highlights the deterioration of adolescents' mental health during the COVID-19 pandemic and suggests that youth mental health should be considered during health policy decision making. DIVERSITY & INCLUSION STATEMENT We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
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Affiliation(s)
| | | | | | | | | | - Yoav Yehezkelli
- KI Research Institute, Kfar-Malal, Israel; Maccabi Healthcare Services, Tel-Aviv, Israel
| | | | | | | | - Uri Lerner
- Maccabi Healthcare Services, Tel-Aviv, Israel
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Zalcberg Block S, Zalcberg S. Religious Minorities' Perceptions of Official COVID-19 Health Guidelines: The Case of Ultra-Orthodox Society in Israel. JOURNAL OF RELIGION AND HEALTH 2023; 62:408-427. [PMID: 36115890 PMCID: PMC9483401 DOI: 10.1007/s10943-022-01662-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 05/11/2023]
Abstract
This article focuses on perceptions of the Jewish ultra-Orthodox population in Israel-a religious minority-regarding guidelines enacted by the Israeli Ministry of Health (MOH) during the country's second wave of COVID-19, and ways the community coped with the pandemic. Semi-structured interviews with 30 ultra-Orthodox individuals revealed five major discourses reflecting participants' perceptions. Three discourses objected to MOH guidelines, while the other two aligned with them. The study's findings also indicate a lack of cooperation between the ultra-Orthodox population and state health authorities, emphasizing the need to implement culturally adapted health interventions. Study limitations are discussed, and future research recommendations are provided.
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Affiliation(s)
| | - Sara Zalcberg
- Hadassah Academic College, Jerusalem, Israel
- Religion Studies Tel Aviv University, Tel Aviv, Israel
- Shandong-Tel Aviv Joint Institute for Jewish and Israel Studies, Tel Aviv, Israel
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Arbel Y, Fialkoff C, Kerner A. Do Ultra-Orthodox Israeli Jews Suffer more than Secular Israeli Jews from Obesity? Gender, Cohort Effect and the Yule-Simpson Paradox. JOURNAL OF RELIGION AND HEALTH 2023; 62:255-267. [PMID: 36208353 DOI: 10.1007/s10943-022-01666-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
The Yule-Simpson paradox indicates contradicting statistical outcomes for the pooled sample and for each stratified group separately. The objective of the current study is to demonstrate this paradox. The sample is based on a 2015-2016 longitudinal survey carried out by the Israeli Central Bureau of Statistics. The sample includes 1194 individuals, where the responses of 1140 individuals were assessed twice (in 2015 and 2016) and the responses of 54 individuals were recorded only once. This gives a total sample of 2334 observations × years. The sample includes 609 females and 585 males. We use the limited dependent binary probit regression model. The dependent variable is a dummy variable that equals 1 if the individual is obese (BMI ≥ 30, where BMI = WEIGHT ÷ (HEIGHT2), WEIGHT is measured in kilograms and HEIGHT is measured in meters) and zero otherwise. The independent variables are the denomination (secular vs. ultra-Orthodox) and age in years. Findings suggest that on the one hand, for the pooled sample of 21-50-year-old females and males, results clearly support the conclusion that compared with secular Israeli Jews, projected probability of obesity (BMI ≥ 30) among ultra-Orthodox Israeli Jews is higher (p = 0.0128). On the other hand, when stratified by gender, one cannot reject the opposite conclusion, according to which projected probability of obesity is equal for all cohorts among ultra-Orthodox and secular Israeli Jews. Research findings thus stress the importance of cautious and rigorous statistical analysis and robustness tests prior to statistical inference.
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Affiliation(s)
- Yuval Arbel
- Sir Harry Solomon School of Economics and Management, Western Galilee College, 2412101, Acre, Israel.
| | - Chaim Fialkoff
- Institute of Urban and Regional Studies, Hebrew University of Jerusalem, Mt. Scopus, 9190501, Jerusalem, Israel
| | - Amichai Kerner
- School of Real Estate, Netanya Academic College, 1 University Street, 4223587, Netanya, Israel
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Levitan F, Frei-Landau R, Sabar-Ben-Yehoshua N. "I Just Needed a Hug": Culturally-Based Disenfranchised Grief of Jewish Ultraorthodox Women Following Pregnancy Loss. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221133864. [PMID: 36227857 DOI: 10.1177/00302228221133864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pregnancy loss (PL) often results in disenfranchised grief. Although much is known about women's experience of PL in general, less is known about PL among women from different backgrounds, particularly the Ultraorthodox community, where the woman's role is often defined by childbearing, but fertility is not openly discussed. The study's goal was to explore PL experiences among this unique sociocultural group: Jewish Ultraorthodox women. Employing a qualitative approach, we interviewed 14 women about their PL. Analysis revealed five themes denoting Ultraorthodox women's struggles post-PL, within two arenas: religiously-based marital struggle (restricted physical support, challenged emotional support) and social struggle/conflict regarding sharing (due to PL as a taboo, perceived failure to fulfill the woman's fertility role, and yearning for "room to grieve"). The findings highlight that PL-grief may be disenfranchised for religious reasons, underscoring the need for a culturally-sensitive inquiry of PL and disenfranchised grief. Therapeutically, clinicians' additional awareness is required.
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Affiliation(s)
- Fayga Levitan
- The Culturally-Sensitive Clinical Psychology Program, School of Advance Studies, Achva Academic College, Shikmim, Israel
| | - Rivi Frei-Landau
- The Culturally-Sensitive Clinical Psychology Program, School of Advance Studies, Achva Academic College, Shikmim, Israel
| | - Na'ama Sabar-Ben-Yehoshua
- The Israel's Culture and Instruction Program, School of Advance Studies, Achva Academic College, Shikmim, Israel
- School of Advance Studies, Tel-Aviv University, Israel
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Burstein O, Shamir A, Abramovitz N, Doron R. Patients' attitudes toward conventional and herbal treatments for depression and anxiety: A cross-sectional Israeli survey. Int J Soc Psychiatry 2022; 68:589-599. [PMID: 33530827 PMCID: PMC8938990 DOI: 10.1177/0020764021992385] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND As many patients view conventional antidepressants and anxiolytics negatively, it is not surprising that the willingness to apply these treatments is far from ideal, thus posing a critical barrier in promoting an effective and durable treatment. AIM The present study aimed to explore patients' attitudes toward conventional and herbal treatments for depression and anxiety, while considering cultural and demographic factors, to further elucidate the antecedes that putatively determine the treatment's outcome. METHODS During June 2017, a cross-sectional survey was conducted using stratified sampling from a large-scale Israeli volunteer online panel. The final sample included 591 Jewish Israeli adults that reported they were suffering from depression or anxiety. RESULTS A heterogeneous range of attitudes toward treatment was found: for example, a large group of patients did not utilize prescription medications (39%), a professional consultation (12.9%), or any form of treatment (17.4%). Interestingly, these patients were significantly more likely to support naturally-derived treatments and were less concerned with scientific proof. Further, adverse effects were demonstrated as a prominent factor in the choice of treatment. A higher incidence of adverse effects was associated with an increased willingness to consider an alternative herbal treatment. Noteworthy attitudes were found in orthodox-Jewish individuals, who showed similar consultation rates, but utilized more psychological, rather than pharmacological treatments. CONCLUSIONS It is proposed that patients' perspectives and cultural backgrounds are needed to be taken into consideration during the clinical assessment and choice of treatment. The findings imply that a particular emphasis should be placed on patients that discard conventional pharmacological options and on distinct cultural aspects. Several recommendations for revising the current policy are advocated to promote more culturally-informed and patient-oriented care.
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Affiliation(s)
- Or Burstein
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Alon Shamir
- Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.,Mazor Mental Health Center, Akko, Israel
| | | | - Ravid Doron
- School of Behavioral Science, The Academic College Tel-Aviv-Yaffo, Yaffo, Israel.,Department of Education and Psychology, The Open University, Raanana, Israel
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Arbel Y, Fialkoff C, Kerner A. The “battle of sexes” construct among ultra-Orthodox Jews: what is the optimal number of children for a minimal BMI? J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01354-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Pinchas-Mizrachi R, Velan B. The Effects of Sociocultural Transitioning on Accessibility to Healthcare: The Case of Haredi Jews Who Leave Their Communities. CONTEMPORARY JEWRY 2022; 42:139-156. [PMID: 35496659 PMCID: PMC9040699 DOI: 10.1007/s12397-022-09433-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/11/2022] [Indexed: 11/29/2022]
Abstract
Minority groups and immigrants encounter complex issues when attempting to access healthcare. This study examines factors affecting access to healthcare by a group of individuals in Israel who decided to leave their Haredi Jewish communities. We conducted 23 semi-structured interviews with individuals disaffiliating from Haredi communities in Israel in order to identify hurdles encountered during the process of seeking healthcare. We focused on specific steps in this process, including recognizing the need for help, deciding to actually turn to the health system, interaction with the system, and behavior after referring to the health system. We identified approximately 20 factors which can be either barriers or catalysts affecting healthcare access at the various stages. These were then traced to religious upbringing, hurdles of sociocultural transition, and unique characteristics of individuals reshaping their lives. The findings can be instrumental in designing culturally adapted health programs for individuals leaving the Haredi community. Moreover, the methodology that we are proposing can serve other investigations studying access to healthcare among various groups undergoing sociocultural transitions.
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Affiliation(s)
- Ronit Pinchas-Mizrachi
- The Israel Academic College in Ramat Gan, Ramat Gan, Israel
- Jerusalem College of Technology, Jerusalem, Israel
| | - Baruch Velan
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
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A Comparative Analysis of Smoking Rates by Sex and Socioeconomic Status Among Ultra-Orthodox City Residents and Non-Ultra-Orthodox City Residents in Israel. CONTEMPORARY JEWRY 2022; 42:451-471. [PMID: 36105370 PMCID: PMC9463507 DOI: 10.1007/s12397-022-09459-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 07/25/2022] [Indexed: 10/28/2022]
Abstract
The aim of this cross-sectional study is to examine the differences in smoking rates between ultra-Orthodox Jews and non-ultra-Orthodox Jews and to understand the role of sex and socioeconomic status (SES) in predicting smoking among the two populations. The study population included all Maccabi Healthcare Services members aged 50 or older (N = 30,170) who lived in two cities in the center of Israel: Bnei Brak-a city with a high concentration of ultra-Orthodox, and Ramat Gan-a non-ultra-Orthodox city. After adjusting for age, sex, and SES, the prevalence of smoking in the ultra-Orthodox city was significantly lower than that in the non-ultra-Orthodox city. A significant interaction was found between sex and degree of religiosity in predicting smoking. The smoking differences between men and women in the ultra-Orthodox city were high compared with those in the non-ultra-Orthodox city. Similarly, a significant interaction was found between SES and degree of religiosity in predicting smoking. These results in the effects of sex and SES in predicting smoking between ultra-Orthodox Jews and non-ultra-Orthodox Jews require further research to better understand these differences and plan intervention programs tailored to different populations accordingly.
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Podolsky-Krupper C, Goldner L. "God is a painter": How Jewish Ultra-Orthodox art therapists and clients perceive mental health treatment. Transcult Psychiatry 2021; 58:731-744. [PMID: 33092485 DOI: 10.1177/1363461520944742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The current study examined the ways in which 14 art therapists and adult clients from the Ultra-Orthodox sector in Israel perceive mental health and mental health treatment. Semi-structured interviews were subjected to an interpretative phenomenological analysis to capture the meaning ascribed to the treatment and its challenges. Four themes emerged: the perception of mental health as related to the centrality of functioning, purposefulness, and emotional balance; the specific challenges of therapy, in terms of suspicion regarding treatment and difficulties in establishing intimacy and self-disclosure; the interplay between the worlds of therapy and religion; and the intersection of art and religion. The discussion centers on an interpretation of the findings in light of the ontological typology of individualism versus collectivism.
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Affiliation(s)
| | - Limor Goldner
- Graduate School of Creative Arts Therapies, University of Haifa, Haifa, Israel
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Levkovich I, Rodin D, Shinan-Altman S, Alperin M, Stein H. Perceptions among diabetic patients in the ultra-orthodox Jewish community regarding medication adherence: a qualitative study. BMC Public Health 2021; 21:1559. [PMID: 34404385 PMCID: PMC8369440 DOI: 10.1186/s12889-021-11619-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Promoting a healthy lifestyle and achieving strict adherence to medical treatment among patients with diabetes are key objectives in public health. Yet health behaviors are often culturally driven, especially in closed religious communities. This study seeks to reveal key cultural-religious factors, attitudes and behaviors characterizing the lifestyle in one such closed community-the ultra-Orthodox Jewish community-by understanding the attitudes of ultra-Orthodox patients with diabetes toward coping with their illness and the factors impacting their adherence to medicinal treatment. METHOD Qualitative interviews were conducted with 16 ultra-Orthodox patients with diabetes using a semi-structured, in-depth questionnaire. RESULTS Three main themes emerged: 1) "The disease as a secret": Hiding the disease among patients with diabetes in ultra-Orthodox society; 2) "Distinguishing between sacred and secular occasions": ultra-Orthodox diabetes patients distinguish between treatment adherence on weekdays and treatment adherence on holidays or special occasions; 3) "Ask the rabbi": In cases of dilemmas that involved conflicts between halakhic rulings and doctors' instructions, the rabbi's decision was usually the final one. CONCLUSIONS The findings of this study may help provide an in-depth understanding of the obstacles and motives of ultra-Orthodox patients in adhering to medicinal treatment of diabetes in particular and to medicinal treatment in general, thus helping family physicians who treat this population provide optimal and appropriate treatment.
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Affiliation(s)
- Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Haifa, Israel.
| | - David Rodin
- Department of Family Medicine, The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Clalit Health Services, Haifa and Western Galilee District, 36006, Kiryat Tivon, Israel
| | - Shiri Shinan-Altman
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, 52900, Ramat-Gan, Israel
| | - Mordechai Alperin
- Department of Family Medicine, The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Clalit Health Services, Haifa and Western Galilee District, 36006, Kiryat Tivon, Israel
| | - Hodaya Stein
- Department of Family Medicine, The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Clalit Health Services, Haifa and Western Galilee District, 36006, Kiryat Tivon, Israel
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COVID-19 Amongst the Ultra-Orthodox Population in Israel: An Inside Look into the Causes of the High Morbidity Rates. ACTA ACUST UNITED AC 2021; 41:99-121. [PMID: 34305203 PMCID: PMC8290384 DOI: 10.1007/s12397-021-09368-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/15/2021] [Indexed: 11/11/2022]
Abstract
The current paper focuses on the circumstances that have led to the high COVID-19 infection rates amongst the ultra-Orthodox population in Israel. The current study utilizes a qualitative design and is based on in-depth interviews, email correspondence and online records of 25 ultra-Orthodox individuals who either tested positive for COVID-19 or had contact with a verified COVID-19 patient. The data were analyzed through identification of main themes and an interpretation of their meanings. The findings showed that a wide range of causes led to the high infection rate, including aspects that derive from a structural element, a religious element and a social-ideological element—all of which are directly or indirectly connected to religion. These findings demonstrate the central role of religion in health outcomes among the ultra-Orthodox community in general and during pandemics in particular, and they shed light on the central role of religion in health outcomes among closed-religious communities. The findings further reveal the importance of cooperation between the state authorities and the religious ones, and of providing culturally adapted health service solutions in the fight against COVID-19 and promoting health more generally. Study limitations are discussed and recommendations for future research are provided.
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Goldblat E, Rivkin D, Konstantinov V. Associations between ethnicity, place of residence, hearing status of family and habilitation of children with hearing impairment. Isr J Health Policy Res 2020; 9:36. [PMID: 32660547 PMCID: PMC7359005 DOI: 10.1186/s13584-020-00394-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/07/2020] [Indexed: 11/10/2022] Open
Abstract
Background Hearing parents tend to have a strong preference for their deaf and hard-of-hearing children to acquire adequate speech, as opposed to use of sign language. Research reports the contribution of many variables to speech acquisition by children with hearing loss (HL). Yet, little is known about the association between ethnicity, place of residence, and hearing status of family members and mode of communication of young people with HL. The purpose of the present study was to examine whether mode of communication of young people with HL is associated with ethnicity, place of residence, and hearing status of family members. Method Participants were young adults with sensory-neural severe to profound HL, either congenital or acquired prior to age 3. Only participants without additional disabilities were included. The data on participants were extracted from records of the Ministry of Labor, Social Affairs and Social Services in Israel. The data for each participant in the study included mode of communication, gender, use of assistive device, ethnicity, geographic place of residence, and presence of first-degree relatives with HL. Regarding participants with a cochlear implant (CI), age at implantation was documented as well. Results Chi-square tests revealed significant associations between mode of communication and all of the study variables. In addition, all the study variables made a significant contribution to mode of communication. Regarding ethnicity, most of the ultra-Orthodox participants used oral language, while the majority of Israeli-Arab participants used sign language. Regarding geographical place of residence, lower rates of oral language use were found in the northern and southern districts of Israel. Conclusions The findings of the present study underline the need for better monitoring of Israeli-Arab children with HL and children residing in peripheral areas in Israel and for improving access to habilitation services.
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Affiliation(s)
- Ester Goldblat
- Administration of Disabilities, Ministry of Labor, Social Affairs & Social Services, P.O.B 1260, Jerusalem, Israel.
| | - Dori Rivkin
- Family Group, Myers-JDC-Brookdale, Jerusalem, Israel
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Raghupathi V, Ren J, Raghupathi W. Studying Public Perception about Vaccination: A Sentiment Analysis of Tweets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3464. [PMID: 32429223 PMCID: PMC7277574 DOI: 10.3390/ijerph17103464] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 01/04/2023]
Abstract
Text analysis has been used by scholars to research attitudes toward vaccination and is particularly timely due to the rise of medical misinformation via social media. This study uses a sample of 9581 vaccine-related tweets in the period January 1, 2019 to April 5, 2019. The time period is of the essence because during this time, a measles outbreak was prevalent throughout the United States and a public debate was raging. Sentiment analysis is applied to the sample, clustering the data into topics using the term frequency-inverse document frequency (TF-IDF) technique. The analyses suggest that most (about 77%) of the tweets focused on the search for new/better vaccines for diseases such as the Ebola virus, human papillomavirus (HPV), and the flu. Of the remainder, about half concerned the recent measles outbreak in the United States, and about half were part of ongoing debates between supporters and opponents of vaccination against measles in particular. While these numbers currently suggest a relatively small role for vaccine misinformation, the concept of herd immunity puts that role in context. Nevertheless, going forward, health experts should consider the potential for the increasing spread of falsehoods that may get firmly entrenched in the public mind.
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Affiliation(s)
- Viju Raghupathi
- Koppelman School of Business, Brooklyn College of the City University of New York, Brooklyn, NY 11210, USA;
| | - Jie Ren
- Gabelli School of Business, Fordham University, New York, NY 10023, USA;
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17
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Trivedi MS, Colbeth H, Yi H, Vanegas A, Starck R, Chung WK, Appelbaum PS, Kukafka R, Schechter I, Crew KD. Understanding Factors Associated with Uptake of BRCA1/2 Genetic Testing among Orthodox Jewish Women in the USA Using a Mixed-Methods Approach. Public Health Genomics 2019; 21:186-196. [PMID: 31163445 DOI: 10.1159/000499852] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 03/23/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND/AIMS Ashkenazi Jews have a 1:40 prevalence of BRCA1/2 mutations. Orthodox Jews are an understudied population with unique cultural and religious factors that may influence BRCA1/2 genetic testing uptake. METHODS Using a mixed-methods approach, we conducted a cross-sectional survey and focus groups among Orthodox Jewish women in New York/New Jersey to explore factors affecting decision-making about BRCA1/2 genetic testing. RESULTS Among 321 evaluable survey participants, the median age was 47 years (range, 25-82); 56% were Modern Orthodox and 44% Yeshivish/Chassidish/other; 84% were married; 7% had a personal history of breast or ovarian cancer. Nearly 20% of the women had undergone BRCA1/2genetic testing. Predictors of genetic testing uptake included being Modern Orthodox (odds ratio [OR] = 2.31), married (OR = 3.49), and having a personal or family history of breast or ovarian cancer (OR = 9.74). Focus group participants (n = 31) confirmed the importance of rabbinic consultation in medical decision-making and revealed that stigma was a prominent factor in decisions about BRCA1/2 testing due to its potential impact on marriageability. CONCLUSION In order to increase the uptake of BRCA1/2 genetic testing among the Orthodox Jewish population, it is crucial to understand religious and cultural factors, such as stigma and effect on marriageability, and engage religious leaders in raising awareness within the community.
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Affiliation(s)
- Meghna S Trivedi
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, USA, .,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York, USA,
| | - Hilary Colbeth
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Haeseung Yi
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, New York, USA
| | - Alejandro Vanegas
- Department of Biomedical Informatics, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Rebecca Starck
- Institute for Applied Research and Community Collaboration (ARCC), Spring Valley, New York, USA
| | - Wendy K Chung
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York, USA.,Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Paul S Appelbaum
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Rita Kukafka
- Department of Biomedical Informatics, College of Physicians and Surgeons, Columbia University, New York, New York, USA.,Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Isaac Schechter
- Institute for Applied Research and Community Collaboration (ARCC), Spring Valley, New York, USA.,Achieve Behavioral Health, Monsey, New York, USA
| | - Katherine D Crew
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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18
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Brand D, Zaidman-Zait A, Most T. Parent Couples' Coping Resources and Involvement in their Children's Intervention Program. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2018; 23:189-199. [PMID: 29672722 DOI: 10.1093/deafed/eny011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/29/2018] [Indexed: 06/08/2023]
Abstract
Parental involvement is vital to the implementation of intervention programs for deaf and hard-of-hearing (DHH) children. The current study examined the dyadic relationships between mothers' and fathers' coping resources and their involvement in their child's intervention program. In addition, the moderating roles of parent's gender and family religiosity on the associations between coping resources and involvement were examined. Seventy Jewish couples of parents of DHH children, representing various levels of religiosity, completed questionnaires regarding involvement in their child's intervention program, child acceptance, parental self-efficacy, and perceived social support. Multilevel modeling analyses were used to test actor-partner interdependence. The findings indicated significant actor effects for child acceptance, parental self-efficacy, and social support. All were positively associated with parental involvement. Gender was found to moderate the actor effect of child acceptance. Partner effects were found only for mothers, for child acceptance, and social support. Fathers' child acceptance and social support were negatively associated with mothers' involvement. Religiosity did not moderate neither actor nor partner effects. These results have important implications for planning intervention programs that are sensitive to each of the parent's needs.
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Peles C, Rudolf M, Weingarten M, Bentwich ME. What Can Be Learned from Health-Related Tensions and Disparities in Ultra-Orthodox Jewish Families? JOURNAL OF RELIGION AND HEALTH 2018; 57:1133-1145. [PMID: 29511923 DOI: 10.1007/s10943-018-0590-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Promoting healthy lifestyle from early childhood is a key objective in public health, yet health behaviors are often culturally driven, especially in closed-religious communities. This study aims to reveal key cultural-religious aspects of attitudes and behaviors regarding lifestyle in one such closed community-the ultra-orthodox Jewish community. In-depth interviews were conducted with 20 participants: religious leaders, educational figures, psycho-medical professionals from two major ultra-orthodox communities in Israel. A thematic analysis was used to reveal key themes in the interviews. We found tensions between conflicting themes in the parenting, nutrition and physical activity domains, while the sleep domain illustrated cultural solution for a tension. By illuminating the perceptional components of lifestyle, the study contributes to better foundations of health promotion in closed-religious communities.
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Affiliation(s)
- Chagit Peles
- Faculty of Medicine, Bar-Ilan Unversity, Safed Campus, P.O. Box 1589, Safed, Israel
| | - Mary Rudolf
- Faculty of Medicine, Bar-Ilan Unversity, Safed Campus, P.O. Box 1589, Safed, Israel
| | - Michael Weingarten
- Faculty of Medicine, Bar-Ilan Unversity, Safed Campus, P.O. Box 1589, Safed, Israel
| | - Miriam Ethel Bentwich
- Faculty of Medicine, Bar-Ilan Unversity, Safed Campus, P.O. Box 1589, Safed, Israel.
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20
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Gabbay E, McCarthy MW, Fins JJ. The Care of the Ultra-Orthodox Jewish Patient. JOURNAL OF RELIGION AND HEALTH 2017; 56:545-560. [PMID: 28102466 DOI: 10.1007/s10943-017-0356-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The Ultra-Orthodox Jewish community embraces a system of values and a rigorous behavioral code that are deeply rooted in religious tradition and history. Here we describe some of the unique challenges that stem from the encounter between modern medical practice and the Ultra-Orthodox world. Through examples of clinical and ethical scenarios ranging from prenatal care to end-of-life decisions, we illustrate problems related to observance of age-old practices in a modern hospital setting, balancing acceptance of Divine will with standard risk assessment, reconciliation of patient autonomy with deference to rabbinic authority and fear of stigma associated with mental illness in a traditional society. We also offer a generalizable model where inquiry precedes pre-formulated judgment to help clinicians provide enhanced care for this population.
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Affiliation(s)
- Ezra Gabbay
- Hospital Medicine Section, Division of General Internal Medicine, Department of Medicine, Weill-Cornell Medicine, 525 East 68th Street, Box 331, New York, NY, 10065, USA.
| | - Matthew W McCarthy
- Hospital Medicine Section, Division of General Internal Medicine, Department of Medicine, Weill-Cornell Medicine, 525 East 68th Street, Box 331, New York, NY, 10065, USA
| | - Joseph J Fins
- Division of Medical Ethics, Department of Medicine, Weill-Cornell Medicine, New York, NY, USA
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21
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Turner A. Chassidic Teachings and Modern Psychology: Toward a More Unified Approach. JOURNAL OF RELIGION AND HEALTH 2016; 55:973-985. [PMID: 26507951 DOI: 10.1007/s10943-015-0145-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article describes how many modern psychological constructs and theories exist in older as well as newer Chassidic and Jewish teachings, particularly those of Chabad Lubavitch. This exploration points toward a potential benefit for a unification of psychology and Chassidic teachings. Psychological theories and constructs explored are Freudian psychoanalysis, cognitive dissonance, cognitive restructuring/reframing, self-efficacy/planned behavior, and logotherapy/existentialism. The article then concludes with a discussion of possible implications of moving toward a unified approach for clinical practitioners.
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Affiliation(s)
- Akiva Turner
- Health Care Sciences Department, Nova Southeastern University, Fort Lauderdale, FL, USA.
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Tkatch R, Hudson J, Katz A, Berry-Bobovski L, Vichich J, Eggly S, Penner LA, Albrecht TL. Barriers to cancer screening among Orthodox Jewish women. J Community Health 2016; 39:1200-8. [PMID: 24845763 DOI: 10.1007/s10900-014-9879-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The increased risk of genetic cancer mutations for Ashkenazi Jews is well known. However, little is known about the cancer-related health behaviors of a subset of Ashkenazi Jews, Orthodox Jews, who are a very religious and insular group. This study partnered with Rabbinical leadership and community members in an Orthodox Jewish community to investigate barriers to cancer screening in this community. Orthodox Jewish women were recruited to participate in focus groups designed to elicit their perspectives on barriers to cancer screening. A total of five focus groups were conducted, consisting of 3-5 members per group, stratified by age and family history of cancer. Focus groups were audio recorded and transcribed. Transcripts were coded using conventional content analysis. The resulting themes identified as barriers to cancer screening were: preservation of hidden miracles, fate, cost, competing priorities, lack of culturally relevant programming, lack of information, and fear. These results provide a unique perspective on barriers to cancer screening in a high risk but understudied population. Findings from this study may serve to inform culturally appropriate cancer education programs to overcome barriers to screening in this and other similar communities.
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Affiliation(s)
- Rifky Tkatch
- Department of Oncology, Wayne State University School of Medicine/Karmanos Cancer Institute, 4100 John R, MM03BF, Detroit, MI, 48201, USA,
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Keshet Y, Liberman I. Coping with illness and threat: why non-religious Jews choose to consult rabbis on healthcare issues. JOURNAL OF RELIGION AND HEALTH 2014; 53:1146-60. [PMID: 23572239 DOI: 10.1007/s10943-013-9711-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Whereas modern and advanced medical services are available and accessible to all citizens of Israel, the phenomenon of consulting Orthodox rabbis (Jewish clerics) on healthcare issues is gaining ground among populations that do not identify themselves as religious. The objective of the research was to enquire why non-religious Jews choose to consult rabbis on medical issues. Fifty semi-structured open-ended interviews were conducted during 2009-2011 in northern Israel. The article presents the respondents' main motives, expectations, beliefs, and modes of consulting both physicians and rabbis. This study aims to contribute to discussion about conflating modern medicine with spiritual-religious beliefs in modern-secular society.
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Affiliation(s)
- Yael Keshet
- Department of Sociology and Anthropology, Western Galilee Academic College, P.O.B. 2125, Acre, 24121, Israel,
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Freund A, Cohen M, Azaiza F. The doctor is just a messenger: beliefs of ultraorthodox Jewish women in regard to breast cancer and screening. JOURNAL OF RELIGION AND HEALTH 2014; 53:1075-1090. [PMID: 23543095 DOI: 10.1007/s10943-013-9695-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Screenings for the early detection of breast cancer greatly improve survival odds. Studies of minority groups have shown lower attendance of screenings; however, these studies seldom focused on religious minorities. This study examines perceptions of cancer and cancer screening among healthy ultraorthodox women in order to gain insight about ways to promote screening. In this qualitative-phenomenological study of two focus groups, three main themes were found: faith in God; the Rabbi as a guide; one's relationship with the community. The study's findings point to the importance of studying the unique needs of members of certain religious groups.
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Affiliation(s)
- Anat Freund
- Faculty of Social Welfare & Health Sciences, School of Social Work, University of Haifa, 31905, Mount Carmel, Haifa, Israel,
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