Arab-Jewish gap in life expectancy in Israel

Background: Studies about the health status of ethnic minorities in the Middle East are rare. This article examines changes in the life expectancy gap during 1970-2010 between the Arab-Palestinian minority and the Jewish majority in Israel, a persistent gap that has widened over the last 20 years. It examines the gap in a period over which the minority group was undergoing an epidemiological transition and demonstrates consequences of the transition on changes in the main causes of death contributing to the life expectancy gap. Methods: Decomposition methods estimate the contribution of specific age groups and causes of death to the total gap in life expectancy at any given year and changes in these contributions over the studied period. Results: The contribution of mortality differentials at ages < 45 years to the Arab-Jewish gap in life expectancy declined while that of differentials at ages > 45 has been gradually growing reaching > 70% of the total gap. For both males and females, trends in cancer and diabetes mortality differentials contributed to widening the gap among the elderly. Trends in heart mortality lead to increasing the gap among males but to decreasing it among females. Conclusions: While differences in infant and child mortality have declined, old-age (> 45) mortality differentials have emerged and have been gradually widening. These findings calls for a special attention to the various factors responsible for the widening mortality gap including social inequality between Arabs and Jews and higher levels of smoking and obesity among the Arab population.