Report: Health Care Inequality Between Center and ‘Periphery’ Areas

Despite efforts that have ranged from providing incentives to imposing sanctions, the Israeli government has failed to persuade doctors to move to peripheral areas of the far north and south of the country. A Health Ministry report on “Inequality in Health and Ways to Deal With It” is to be presented Monday at a conference called to deal with such inequalities.

Tel Aviv and the Dan region are by far the best places for Israelis to live if they want to remain healthy, according to the report, which cites a wide range of statistics, from infant death rates through cancer treatment to the number of hospital beds available.

There are 4.7 doctors per 1,000 residents in the Tel Aviv area, comparable to the numbers in advanced European countries with well-developed medical systems, like Norway and France. In northern Israel, however, there are only 2.3 doctors of all kinds per 1,000 residents, and in southern Israel that number is 3.0. The south also has a relatively low number of nurses per 1,000 residents – 3.4 – compared to 6.1 in Tel Aviv, and 7.0 in Haifa. Yerushalayim also experienced a reduction over the past several years in the numbers of doctors and nurses per 1,000 residents.

Access to medical services is also a major problem in far-flung areas of the Negev and Galilee. In many towns in far northern and southern Israel, there are no pharmacies – and residents have to travel ten miles or more out of town to reach one. “Peripheral” relates not just to location, but populations as well; in all categories of disease – except for colon cancer rates – Arabs fared worse than Jews. The infant mortality rate for Jews in Israel stands at 2.9 per thousand births, compared to 11 per thousand for Arabs.

Some of the work the ministry has put in in recent years to correct these long-standing discrepancies has paid off, the report showed. In the center of the country, the utilization rate for Tipat Chalav mother and child clinic services is much higher – with chareidi areas of the center of the country holding the record for the most use of these services – while in the north the utilization rate is lower, due to a spate of establishments of these clinics in the area in recent years.

In the report, the ministry said that it would continue to try to reduce inequalities, by measures including recruiting more Arabic-speaking doctors, training programs for medical personnel from among Ethiopian immigrants, and developing digital health platforms to bring information and services closer to peripheral populations.