Cancer burden in four countries of the Middle East Cancer Consortium (Cyprus; Jordan; Israel; Izmir (Turkey)) with comparison to the United States surveillance; epidemiology and end results program

It is important that population-based cancer registries provide accurate and reliable data for public health purposes. These data are essential data for planning of cancer control and prevention. In this study, we examined cancer incidence rates (year 2005–2010) in four MECC registries (Cyprus, Jordan, Israel, Izmir (Turkey)) and compared with the rates in the US. The overall age-standardized incidence rates for males were highest in the US followed by Israeli Jews, Izmir (Turkey), Cyprus, Israeli Arabs, and lowest in Jordan. In women the rates of cancer of all sites were also highest in US women followed by Israeli Jews, Cyprus, Israeli Arabs, Izmir (Turkey), and lowest in Jordan. It is of interest that although site-specific cancer rates differ between the countries studied, prostate, lung and colorectal cancers are within the five most common cancers males in all countries studied. In females, breast colorectal and endometrium cancers are three of the five most common cancers in females in all countries studied. The results presented in this paper can have implications for opportunities in cancer control and prevention in these countries. Future studies on individual cancer sites with highest rates in these Countries are currently underway.     

Medicine Among New Immigrants and Arab Minorities in Israel

The reaction to modern medicine and the general health of the new immigrants and Arab populations of Israel are described. The material was gathered during a threemonth visit to Israel where the author participated in the medical care of these persons. While these peoples still share many of the traditional medical superstitions and practices, the new immigrants have progressed much more during the 16 years of Israel''s existence. At present over 99% of Jewish women give birth in hospital, whereas only 65% of Israeli Arabs do. The infant mortality rate among the Jews in 1963 was about 21 deaths per 1000 live births, about one-half the rate for Arabs. The importance of understanding the cultural background and social conflicts of these people as a preliminary to the provision of proper medical care is stressed.     

Renal cell cancer in Israel: Sex and ethnic differences in incidence and mortality, 1980–2004

Background: The causes of renal cell cancer (RCC) remain largely unexplained. While the incidence is generally higher in men than in women, little has been reported on ethnic differences. We examine trends in RCC incidence and mortality rates among Israeli Arab and Jewish populations and compared with the rates in other countries. Methods: Age-adjusted RCC incidence and mortality rates in Israel, during 1980–2004, were calculated by sex and population group, using the National Cancer Registry. They were compared with the United States based on the Surveillance Epidemiology and End Results [SEER] program and the IARC database for international comparisons. Results: While RCC incidence rates in Israel are similar to the United States and the European average, the rates are significantly higher among Israeli Jews than Arabs. Men are affected more than women. Incidence rates over the last 24 years have increased among all men and Jewish women, but not among Arab women. Among men, the incidence rate ratio for Jews to Arabs declined from 3.96 in 1980–1982 to 2.34 in 2001–2004, whereas for women there was no change. The mortality rates were higher among Jews than Arab and among men than women. There were no significant change in the mortality rates and rate ratios. Conclusions: Our findings demonstrate marked ethnic differences in RCC in Israel. The lower incidence among Arabs stands in contrast to the higher prevalence of potential risk factors for RCC in this population group. Genetic factors, diet and other lifestyle factors could play protective roles.     

Genotypic Differences of Candida albicans and C. dubliniensis Isolates Related to Ethnic/Racial Differences within the Same Geographic Area

Candida albicans and C. dubliniensis genotype differences among Israeli ethnic groups were assessed. Isolates from Jews (51), Arabs (35) and Druze (25) were genotyped. The distributions among ethnic groups were not different, however they differed (p = 0.002) from global populations. Therefore, C. albicans and C. dubliniensis genotype distribution differences in Israel are related to changes in all ethnic groups.     

Phosphoglycolate phosphatase in several population groups in Israel

The genetic polymorphism of phosphoglycolate phosphatase (PGP) found in red blood cells has been investigated in several population groups in Israel: Ashkenazi Jews, non-Ashkenazi Jews from Iraq, Yemen, Turkey, Iran, Balkan, North Africa and Arabs. The distribution of the PGP genes was not homogeneous (chi 2 = 40.545; d.f. = 20; p less than 0.005). The PGP2 gene frequency varied between 0.0185 in the Yemenite and 0.0688 in the Iranian Jews. PGP3 gene frequency ranged between 0.0062 in the Iranian and 0.0547 in the Moroccan Jews. Depsite this heterogeneity all the Israeli population groups showed some unifying characteristics which differentiated them from a random European population sample, namely higher frequencies of PGP1 gene (92-97% as opposed to 82% in th European sample) and lower frequencies of PGP2 gene (1.8-6.8% compared to 12.9% among Europeans).     

The Jewish Advantage and Household Security: Life Expectancy among 19th Century Sephardim of Gibraltar

Using the historical population of Gibraltar to examine the pattern of mortality of Jews and Roman Catholics revealed that: (1) the Jews exhibited a significantly better health status as measured by life expectancy at birth (47.66 and 47.56 for Jewish males and females vs. 38.10 and 40.89 for Catholics males and females, respectively), (2) most of the disparity is found in the very young age categories and (3) the significantly lower rates of deaths could be attributed to the diarrheal and nutritional complex. Stage two of the research involved the linkage of deaths over a 7-year period relative to their household context as of 1878. Being Jewish, having a servant, having access to a water well in the tenement and residing in a tenement only with other Jews, were all factors that contributed to a higher life expectancy. Our explanation for the enhanced survivorship among the Jews is grounded in economics as well as in an established welfare system, in religious precepts and in secular knowledge of health. One of the more notable and hitherto unobserved findings is that Roman Catholics residing in the same tenements with Jews enjoyed a distinct health advantage. This suggests that a positive amplification effect arose from their co-residence with the Jews.     

21-Hydroxylase deficiency: screening and incidence in Israel

BACKGROUND: Neonatal screening for congenital adrenal hyperplasia was introduced in 1977. However, even today only a few national screening programs exist and their cost effectiveness is still debatable. This study was conducted in order to evaluate the advisability of a national or regional screening program in Israel. METHODS: From June 1987 until December 1992 we screened a countrywide random sample of 113,846 newborns for 21-hydroxylase (21-OH) deficiency measuring 17alpha-OH progesterone (17-OHP) from blood spotted on filter paper. Between January 1993 and August 1995 we continued the screening program concentrating on the population of northern Israel. A total of 56,958 newborns were screened. We compared these findings with the incidence of 21-OH deficiency in the total population born in Israel during the years 1986-1991. RESULTS: In the countrywide screening program, 4 newborns (2 Arabs and 2 Jews) were found to have levels of 17-OHP between 409 and 2,049 nmol/l (2 males and 2 females). This constitutes a low incidence of 1 in 28,462 live births. In the north-Israel screening program 4 newborns (all Arabs) were detected (2 males and 2 females) constituting a much higher incidence of 1 in 14,240 live births. The data obtained from the archives revealed that the incidence of 21-OH deficiency nationwide during the years 1986-1991 was 1:19,000 live births, 1:30,000 for Jews and 1:8,000 for Arabs. The incidence of 21-OH deficiency among Arab newborns in the northern part of the country was as high as 1:5,000 (14:71,130). The female to male (F:M) ratio was 2.6:1 and the ratio of the salt-losing to the simple virilizing variant was 5:1. Two male patients were diagnosed prenatally, 21 patients (17 F and 4 M) during the first month after birth and 6 others subsequently. CONCLUSIONS: The high F:M ratio of 21-OH deficiency in the total population compared to a 1:1 ratio in our random screening programs suggests that 21-OH-deficient male patients in the general population might have been missed or died early due to a salt-losing crisis. The high incidence of this disease in the northern part of the country and especially among the Arabs, suggests that screening in this part of the country, especially among the Arab population, is warranted and might save the lives of some male patients.     

Genetic polymorphism of delta-aminolevulinate dehydrase in several population groups in Israel

The genetic polymorphism of red cell delta aminolevulinate dehydrase (ALADH) has been investigated in several population groups in Israel: Ashkenazi Jews, non-Ashkenazi Jews from North Africa, Egypt, Turkey, Iraq, Iran, Yemen and the Balkans, and Arabs. The distribution of the ALADH genes was not homogeneous (chi 2 = 36.83; d.f. = 8; p less than 0.0005). A significantly higher frequency of the ALADH2 gene was observed among the Ashkenazi Jews (0.2021) than among the non-Ashkenazi Jews and Arabs (gene frequencies 0.0825-0.1290) or all the other population samples so far studied (Liberia, Japan, Italy, Germany and Spain).     

Perceived threat and exclusionary attitudes towards foreign workers in Israel

The present article focuses on determinants of attitudes towards granting social rights to overseas labour migrants in Israeli society. The analysis is based on a national representative sample of the adult population in Israel. The findings reveal that a substantial number of respondents (both Jews and Arabs) oppose granting equal social rights (i.e. education, welfare, health, housing) to foreign workers. These attitudes can partially be explained as resulting from perceived threat to social and economic well-being of individuals as well as threat to national identity and Jewish character of the state. Part of the exclusionary attitudes that cannot be attributed to threats, are explained by individuals’ socio-economic characteristics, ethnicity and political orientation. The findings are discussed within the context of Israel as an ethno-national state.     

The frequency of the ΔF508 mutation on cystic fibrosis chromosomes in Israeli families: correlation to CF haplotypes in Jewish communities and Arabs

Summary We have analysed the distribution of the ΔF508 mutation and the haplotypes of cystic fibrosis (CF) bearing chromosomes among the Israeli CF population. The population was classified according to its ethnic origin and included 3 groups, Ashkenazi Jews, Sephardic/Oriental Jews and Arabs. Haplotype B (KM19 allele 2, XV2c allele 1) was found to be the predominant haplotype in all groups but in each of them the haplotype distribution was different. The ΔF508 mutation was present in all groups and accounts for 32% of the CF mutations. It was mainly associated with the B haplotype but only one third of the CF chromosomes with this haplotype carry the ΔF508 mutation. This work is dedicated to Dr. Ruth Voss who initiated the CF study in Israel and was tragically killed in a car accident on 7 August 1988     

Participatory destigmatization strategies among Palestinian citizens,Ethiopian Jews and Mizrahi Jews in Israel

Abstract

This study examines how members of minority groups in Israel cope with stigmatization in everyday life. It focuses on working-class members of three minority groups: Palestinian Arabs or Palestinian citizens of Israel, Mizrahim (Jews of Middle Eastern and North African origin) and Ethiopian Jews. It reveals the use of racial, ethnic and national markers in daily processes of social inclusion and exclusion in one sociopolitical context. Palestinians, a group with a fixed external identity and a limited sphere of participation, were found to use the language of race and racism when describing stigmatizing encounters. Ethiopian Jews, the most phenotypically marked group, strictly avoided this language. For their part, Mizrahi Jews perceived the very discussion of stigmatization as stigmatizing, while often using ‘contingent detachment’ to distance themselves from negative group identities. Despite differences between the communities and the powerful role of the state in establishing symbolic and social boundaries, members of all three groups expressed their intention to achieve or retain avenues for participation in the larger society.     

High-resolution Y chromosome haplotypes of Israeli and Palestinian Arabs reveal geographic substructure and substantial overlap with haplotypes of Jews

High-resolution Y chromosome haplotype analysis was performed in 143 paternally unrelated Israeli and Palestinian Moslem Arabs (I&P Arabs) by screening for 11 binary polymorphisms and six microsatellite loci. Two frequent haplotypes were found among the 83 detected: the modal haplotype of the I&P Arabs (approximately 14%) was spread throughout the region, while its one-step microsatellite neighbor, the modal haplotype of the Galilee sample (approximately 8%), was mainly restricted to the north. Geographic substructuring within the Arabs was observed in the highlands of Samaria and Judea. Y chromosome variation in the I&P Arabs was compared to that of Ashkenazi and Sephardic Jews, and to that of North Welsh individuals. At the haplogroup level, defined by the binary polymorphisms only, the Y chromosome distribution in Arabs and Jews was similar but not identical. At the haplotype level, determined by both binary and microsatellite markers, a more detailed pattern was observed. Single-step microsatellite networks of Arab and Jewish haplotypes revealed a common pool for a large portion of Y chromosomes, suggesting a relatively recent common ancestry. The two modal haplotypes in the I&P Arabs were closely related to the most frequent haplotype of Jews (the Cohen modal haplotype). However, the I&P Arab clade that includes the two Arab modal haplotypes (and makes up 32% of Arab chromosomes) is found at only very low frequency among Jews, reflecting divergence and/or admixture from other populations.     

The Y chromosome pool of Jews as part of the genetic landscape of the Middle East

A sample of 526 Y chromosomes representing six Middle Eastern populations (Ashkenazi, Sephardic, and Kurdish Jews from Israel; Muslim Kurds; Muslim Arabs from Israel and the Palestinian Authority Area; and Bedouin from the Negev) was analyzed for 13 binary polymorphisms and six microsatellite loci. The investigation of the genetic relationship among three Jewish communities revealed that Kurdish and Sephardic Jews were indistinguishable from one another, whereas both differed slightly, yet significantly, from Ashkenazi Jews. The differences among Ashkenazim may be a result of low-level gene flow from European populations and/or genetic drift during isolation. Admixture between Kurdish Jews and their former Muslim host population in Kurdistan appeared to be negligible. In comparison with data available from other relevant populations in the region, Jews were found to be more closely related to groups in the north of the Fertile Crescent (Kurds, Turks, and Armenians) than to their Arab neighbors. The two haplogroups Eu 9 and Eu 10 constitute a major part of the Y chromosome pool in the analyzed sample. Our data suggest that Eu 9 originated in the northern part, and Eu 10 in the southern part of the Fertile Crescent. Genetic dating yielded estimates of the expansion of both haplogroups that cover the Neolithic period in the region. Palestinian Arabs and Bedouin differed from the other Middle Eastern populations studied here, mainly in specific high-frequency Eu 10 haplotypes not found in the non-Arab groups. These chromosomes might have been introduced through migrations from the Arabian Peninsula during the last two millennia. The present study contributes to the elucidation of the complex demographic history that shaped the present-day genetic landscape in the region.     

Ethnic differences in the frequency of the C677T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene in healthy Israeli populations

Hyperhomocysteinemia is an independent risk factor for arteriosclerotic vascular disease. It can result from deficiencies of co-factors required for homocysteine metabolism and/or from genetic disorders of its metabolism. The association between the C677T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene and vascular disease is controversial, and may be affected by ethnic origin. A unique feature of the Israeli population is its ethnic diversity. The aim of this study was to study the frequency of the C677T MTHFR mutation in healthy Israeli ethnic groups. The frequency of the mutation was determined in 897 young healthy Jewish and Muslim Arab Israelis of eight different ethnic groups. Marked ethnic differences in the frequency of mutant homozygotes were found, ranging from 2% in Yemenite Jews, 4% in Sephardic Jews, 9% in Oriental Jews, 10% in Muslim Arabs, 16% in North African Jews, and 19% in Ashkenazi Jews. The frequency of mutant homozygotes was significantly higher in Ashkenazi Jews compared to Yemenites Oriental Jews, Sephardic Jews, and Muslim Arabs (chi2 = 12.35p < 0.001, chi2 = 8.17p = 0.004, chi2 = 6.04p = 0.01, chi2 = 6.54 p = 0.01, respectively). Our findings demonstrate the need for matching ethnic background in patients and controls when studying the association between the C677T MTHFR mutation and any disease.     

Changes in Jewish mortality and survival, 1963–1987

Abstract

From information on mortality of Jews obtained from individual death certificates and population data from surveys of the Jewish population undertaken in 1963 and 1987, age‐specific death rates and life expectancy of the Jewish population of Rhode Island are compared with those of the total white population for 1963 and 1987 to assess changing differentials. The Jewish mortality experience continues to differ from that of the larger population even while both groups have experienced noticeable improvements. For males, the age standardized rates have widened in favor of Jews as have the life expectancies at birth and the percentage surviving to old age. By contrast, for females, the standardized death rate has widened considerably in favor of whites, while life expectancy has improved almost identically for both groups and therefore remained about equal, as it was in 1963. Reasons for these patterns are explored through attention to differences between Jews and the general white population in death rates at particular stages of the life cycle. Jews tend to be more advantaged at all but the most advanced ages, age groups in which proportionally more of the Jewish population and Jewish deaths are concentrated.     

Navajo tribal mortality: A life table analysis of the leading causes of death

Abstract

The five leading causes of death for Navajo males and females are analyzed by life table methods. Navajo male and female life expectancy at birth were 58.8 and 71.8 years, respectively. The greatest increase in Navajo male life expectancy would result from the elimination of motor vehicle accidents (5.17 years at birth, and 3.11 years for working ages 15–65). The life expectancy of Navajo females would be lengthened the most (3.70 years) by elimination of circulatory system disease. For working‐ages gains for both sexes, however, the greatest benefit would result from elimination of motor vehicle accidents. The implications of the results are discussed in relation to the various public health programs and health planning efforts for the Navajo Nation.     

Towards a redefinition of Jewish nationalism in Israel? The enigma of Shas

The electoral success of Shas, a mizrahi, religious political party in Israel is analysed with the help of the cultural division of labour model. Mizrahim (Jews originating in Muslim countries) are a semi-peripheral ethnic group in Israel, located between the dominant ashkenazim (Jews of European origin) and the Palestinians. While most mizrahim have been voting Likud for the past twenty-five years, increasingly the poorer among them have been shifting their vote to Shas. The key to Shas's success, where other efforts to organize mizrahi political parties have failed, is its integrative, rather than separatist, ideology. Shas seeks to replace secular Zionism with religious Judaism as the hegemonic ideology in Israeli society, and presents this as the remedy for both the socio-economic and the cultural grievances of its constituency. This integrative message, emphasizing the commonalities between mizrahim and ashkenazim, rather than their differences, is attractive to mizrahim because of their semi-peripheral position in the society.     

Minority status in an ethnic democracy: The status of the Arab minority in Israel

It is commonly assumed that democracy in deeply divided societies takes either a majoritarian or consociational form. While the state in both types is ethnically neutral, there are some countries that combine viable democratic institutions with institutionalized ethnic dominance. The article introduces this third, so far not recognized, general type of ‘ethnic democracy’ and demonstrates its utility for Israel in treating its Arab minority. The tensions and contradictions in Israel's dual character as a Jewish democratic state give rise to five Arab demands that the Jewish majority reject: making Israel non‐Jewish and non‐Zionist, accepting Palestinian nationalism, lifting all restrictions on Arab individual rights, granting Arabs certain national collective rights and incorporating Arabs into the national power structure. Each Arab demand is discussed in detail and the rationale for Jewish objections is spelled out. The problem can be reduced, but not resolved, by establishing a separate Palestinian state in the West Bank and Gaza Strip for the Palestinian people and by according Israeli Arabs the status of a Palestinian national minority within the Jewish state. These issues are not unique to Israel but rather common to ethnic democracies. It is concluded that the Israeli experience is becoming increasingly relevant to states which are democratizing but keeping appreciable ethnic dominance.     

Life expectancy,maximum longevity and lifetime reproductive success in female Thornicroft's giraffe in Zambia

Gestation and longevity scale with body mass across taxa, yet within size dimorphic taxa, males tend to have reduced lifespans compared with females. Testing life history models, and accounting for sex differences in longevity, requires obtaining accurate longitudinal data from wild populations. We provide the first report describing key life history parameters from a long‐term study of giraffes in Africa. We followed a population of Thornicroft's giraffe (Giraffa camelopardalis thornicrofti) in Zambia for over 40 years. Maximum longevity among females was approximately 28 years, with lifespan accounting for 81% of the variance in lifetime reproductive success. Average adult female life expectancy was no different than average adult male life expectancy. However, the breeding lifespan of males was about half that of females, while maximum lifespan of males was 75% that of females. Our findings support the suggestion that sex differences in maximum lifespan arise from stronger selection for lengthy lives in females than in males. Among females, longer lives are associated with greater reproductive output.