Groups with special needs.

PositionIsrael

The Elderly

In 1996, there were 543,300 persons over the age of 65 in Israel, constituting 9.6% of the total population, and 219,300 persons over the age of 75 (3.85% of the total population) (CBS, 1997a: Table 2.10). In OECD countries, the average proportion of the 65+ cohort is 13%; in Sweden it is 17.6%, in the United Kingdom, 15.7% and in Switzerland, 14.2% (Ben-Nun and Ben-On, 1996: 3). It is well known that health problems increase with age, and that the average per capita outlay for persons over the age of 65 is about 4 times the average expenditure.

What is less well known is the fact that 58% of persons aged 75+ and 70% of elderly inpatients are women. Although Israel's population is young compared to that of most OECD countries, the 75+ cohort is growing, and, with it, the need for community services for the elderly and long-term geriatric beds.

Among immigrants from the former Soviet Union, the proportion of the elderly is higher than in the general population (14%, compared with 9.6%). Elderly immigrants report suffering more than veteran Israelis from hypertension, chest pains, shortness of breath and arthritis (Neon et al, 1993). However, a 1998 analysis of data from four national surveys found no difference between veteran and new Israelis in either the incidence or types of chronic diseases for which they reported actually receiving treatment (Niral et al, 1998: 104). Thus, either the difference is a subjective one, or elderly immigrants are not receiving (or not reporting on receiving) the treatment they need.

A 1990-91 study of 70-year olds in Jerusalem identified another group with special health care needs: women of African-Asian origin, whose rate of hypertension was found to be 63%, compared with 43% for women of European origin. Bursztyn et al suggest that this may be due to the higher body mass index in women of African-Asian origin (Bursztn et al, 1996: 632). While high levels of awareness and treatment were found, according to the authors, this awareness was not translated into adequate control of hypertension levels (ibid: 633).

In Israel - as elsewhere - services for the elderly suffer from fragmentation: The National Insurance Institute (Social Security) is responsible for home care, the Ministry of Labor and Social Affairs for placing physically frail elderly persons in homes for the aged or sheltered housing, and the Ministry of Health for care of mentally frail seniors or those in need of nursing homes.

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