INDICATORS OF MORTALITY
Editor Nurit Yaffe
Indicators of Mortality is the second in the series of public information pamphlets issued by the Israel Central Bureau of Statistics (the first was Women in Statistics). Additional data on the health of the Israeli population may be found in the various publications of the Bureauís Health Division, and on the ICBS internet site . To a large extent, the information in this pamphlet derives from Health of the Bureauís Jubilee series (in Hebrew; to be published).
We hope you will find these public information pamphlets useful.
Joseph A. Yahav
The Government Statistician
Note: In Order to View Graphs, Click on the Graph No.
1. Life expectancy (at birth) is an estimate of the number of years a baby born in a certain year will live, based on themortality rates measured in that year. Life expectancy is a major indicator in mortality research and is frequently used in comparisons of mortality patterns between countries, between population groups within countries, and between periods of time.
Since mortality is highly correlated with social and economic conditions, life expectancy is also widely used as an indicator of the social and economic levels of populations.
2. In 1996 the life expectancy of an Israelimale was 76.3 (Jewish - 76.6, Arab* 74.9), and that of a female - 79.9 (Jewish - 80.3, Arab* - 77.7).
*Note: The Arab population throughout the pamphlet includes a small number of persons who are neither Jews nor Arabs
3. Since the establishment of the State of Israel, the life expectancy of the Jewish population has risen by almost 12 years for males, and by almost 13 years for females (Graph no. 1). These data refer to the Jewish population only, due to problems of comparability and reliability for the Arab population in the period prior to the 1970s .
4. Data for the period prior to the establishment of the State of Israel show a 5 year increase in life expectancy in the 1930s and 1940s - from 60 to 65 years for Jewish males and from 63 to 68 years for Jewish females.
5. The rise in life expectancy in Israel, as in other countries, is due primarily to the major decrease in mortality from infectious diseases in the earlier decades, and from heart diseases, mainly acute myocardial infarction, in the later decades.
6. The rate of increase in life expectancy in Israel varies with time (Table 1): from a very high increase in the 1950s to almost no growth in the 1960s and a high increase since.
Table 1. Increase of life expectancy of Jews
7. Universally, life expectancy of females is higher than that of males and this is true for Israel as well.
Graph no. 2 (for males) and Graph no. 3 (for females) present life expectancy for a selection of 14 developed countries in the years 1994/1995. Among these countries, Israel ranks third for males, after Japan and Sweden, and ninth for females.
As for less developed countries, data (of low reliability) were selected for three Middle Eastern countries: in Jordan and Lebanon life expectancy of males in the period 1990-95 was 66 years and that of females - 70 years; in Egypt in 1991 the figures were 63 for males and 66 for females.
8. Mortality rates ofelderly women in Israel are about 60% higher than those of Japanese women, whose life expectancy is the highest in the world. For example, in 1995/96 the death rate (per 1,000) of women aged 70-74 was 15.1 in Japan whereas in Israel it was 27.3; at ages 80-84 the rates were 54.1 and 77.4, respectively.
9. Israel ranks last among the industrialized countries in respect to the gap between male and female life expectancy, with thesmallest (!) gap of less than 4 years (in favour of females). In most European countries the gap is 5 or 6 years and in some countries such as Finland and Portugal it is more than 7 years.
In some East European countries, such as Hungary, the gap exceeds 9 years.
10. As the life expectancy of females in Israel has increased more than that of males, the inter-sexgap is increasing. From a 3.3 year gap in the early 1970s it has risen to a 3.5-4.0 year gap in recent years. Internationally too, Israeli women have improved their ranking since the 1970s.
11. The life expectancy of Arabs is lower than that of Jews, mainly because of higher mortality among the former in the younger age groups. Amongmales aged 75+ mortality of Arabs is lower than that of Jews.
12. As infant mortality among Arabs in Israel decreases, the gap in life expectancy between them and Jews decreases too. In 1975, male life expectancy was 3.7 years higher for Jews than for Arabs;in 1996, the difference was only 1.7 years (76.6 for Jews and 74.9 for Arabs). Among females the gap narrowed from 3 years in 1975 to 2.6 years in 1996 (80.3 for Jews and 77.7 for Arabs).
13. From 1950 to 1995, theprobability of males to reach the age of 65 rose from 70% to almost 80%, and that of females rose from 75% to almost 90%.
14. In 1996 the number of infant (less than 1 year old) deaths in Israel was 767 -2% of all deaths during that year. In 1950, infant deaths numbered more than 2,000 and constituted 24% of all deaths.
15. In 1996 the infant mortality rate per 1,000 live births (IMR) was 6.3. The IMR of the Jewish population - 5.0 - was almosthalf the rate of the Arab population - 9.3.
16. In the early 1950s IMR was almost 40 among Jews and over 60 among Arabs. Thedecrease over time is presented in Graph no. 4.
17. Among the 14 countries presented earlier in Graph no.2 and Graph no.3,Israel ranks 11th in regard to IMR (Graph no. 5). The rate of the Jewish population (5.0) is identical to that of Switzerland (4th in the scale), while the rate of the Arab population (9.3) is higher than that of Greece (14th and last among the countries selected).
In underdeveloped countries IMR is still very high, with values of 100-150 frequently found in African countries. In the middle East there exists a wide range of IMRs. In Iraq IMR is 127, in Turkey 49, in Jordan 36 and in Lebanon 34.
18. The variation in IMR by geographical distribution(sub-districts) is presented in the map for the total Israeli population (1994-1996 averages). The lowest IMR is in the Rehovot s.d. (4.3) and the highest is in the Hadera s.d. (11.1).
19. Within the Jewish population IMR inrural localities (5.3 in 1994-1996) is lower than the rate for the whole country (5.5). The opposite is true of the Arab populaion: in Arab rural localities the rate (13.6) is higher in comparison with the rate for the whole country (10.1).
20.Among the 12 cities with a population of more than 100,000 inhabitants, the variation in IMR is from 3.0 (Petah Tiqwa) to 8.0 (Ashdod). In Jerusalem the rate is 7.6 (6.4 for Jews); in Tel Aviv - Yafo and in Haifa it is 6.0 (5.6 for Jews).
21. Infectious diseases, once the major cause of infant deaths in Israel among Jews and Arabs alike, cause only 5% of infant deaths today. Since the 1970s for Jews and somewhat later for Arabs, the two major causes of infant deaths arecongenital malformations (26% for Jews and 31% for Arabs in the early 1990s) and prematurity (29% and 13% respectively).
22. The main reason for the difference in IMR betweenJews and Arabs is the much higher prevalence of mortality from congenital malformations among the Arabs (rate of 3.4 in 1995) compared to Jews (rate of 1.5).
23. There are differences in IMRs, related both to biologicalcharacteristics (such as birth weight, age of mother and birth order) and to social characteristics (such as parentsí education). The differences in IMR by birth weight are outstanding as can be seen in the following examples (1990-1993 averages):
- IMR of babies weighing less than 1.5 kg. at birth is 303.4 whereas that of babies weighing 3.5-3.9 kg. is 2.8.
- IMR of babies whose mothers are younger than 20 is 16.2 whereas that of babies whose mothers are 25-29 is 8.0.
- IMR of babies whose mothers have 1-4 years of schooling is 14.4 whereas that of babies whose mothers have 16 or more years of schooling is 5.2.
24. In the late 1970s 120 out of 1,000 babies who weighed1.5-1.9 kg. at birth died during their first year. The rate declined to 40 per 1,000 by the early 1990s.
25. The target pertaining to infant mortality rate for theyear 2000, as defined by the Ministry of Health in 1989, is its reduction to a rate of 7.5. For the Jewish, Christian and Druze infants the goal was already achieved in 1995. It has not yet been achieved for Moslem infants.
CAUSES OF DEATH
26. In 1996 there were about35 thousand deaths* in Israel of which 89% were of Jews and 11% of Arabs. The percent of deaths of Arabs is smaller than the percent of Arabs in the population, since the Arab population is younger than the Jewish population.
27. The distribution of deathsby age was as follows: 2% were deaths of infants; 7% of persons aged 1-44; 14% of persons aged 45-64; 77% of persons aged 65+.
28. Over 7,000 items are included in the international list of causes of death. The determination of theleading causes depends also on the manner in which the various causes are aggregated. The inclusion of all heart diseases in one group makes them the major cause of death in Israel in recent years: 31% of the deaths in 1995 were caused by heart diseases and 23% were caused by cancer (also aggregated as a group of diseases). However, when the three sub-groups of heart diseases - acute myocardial infarction (9% of all deaths), other ischaemic heart diseases (13%) and other heart diseases (9%) - are categorized separately, then cancer becomes the leading cause.
29. There are differences in the frequency of causes of death associated withage. The main cause of death at ages 0-4 is congenital malformations, at ages 5-24 it is external causes, at ages 25-64 it is cancer and at age 65+ - heart diseases. External causes include mainly motor vehicle traffic accidents, accidental falls, suicide and homicide.
30. The distribution ofdeaths by cause for the Jewish and Arab populations is presented in Graph no. 6 and Graph no. 7. The proportions of deaths from cancer and from ischaemic heart disease are larger among the Jews; the proportion of deaths from external causes (mainly related to car accidents) is higher among the Arabs; the proportions of heart diseases other than ischaemic heart disease, of cerebrovascular disease and of infectious diseases are similar in the two groups. Partly the differences are related to differences in the age distribution: the Arabs are younger than the Jews.
31. While rates of mortality from cancer have been steady since the 1950s, the rates of mortality from the other major causes of death havedeclined during these years(age adjusted rates). Mortality from infectious diseases declined steeply in the 1950s and 1960s; mortality from ischaemic heart disease and from cerebrovascular disease has been declining since the mid 1970s (Graph no. 8 and Graph 9).
32. Mortality caused byheart diseases has decreased by about 30% in the last two decades (27% in females and 32% in males). The steepest decrease in mortality from the various heart diseases has been in acute myocardial infarction.
33. Out of the 1,967 deaths from external causes which occured in Israel in 1996 511 (26%) were caused by motorvehicle accidents. The highest number of deaths caused by motor vehicle accidents was in 1974 - 659. In the 1980s (and early 1990s) the figures decreased to around 400 per year and they have risen to over 500 in recent years (586 in 1995 and 511 in 1996).
The rate of deaths caused by car accidents decreased from the early 1970s (18 per 100,000 population) to the 1990s (8 per 100,000 in the early 1990s and 9 in the mid 1990s).