Are Israelis becoming healthier? Trends in self-rated health, 2002-2018

Abstract

Background: Life expectancy at birth in Israel is steadily increasing. This raises the question whether Israelis are becoming healthier. The purpose of this study is to estimate trends in morbidity and to try to explain what causes morbidity levels to change.

Methods: We used 17 years of repeated cross-sectional data from the Social Survey to estimate trends in self-rated health. We used regression models to explain the trends in self-rated health that were observed from 2002 to 2018.

Results: Four major findings emerged. First, morbidity as measured by self-rated health has declined. Second, gains in educational attainment do not explain the decline in morbidity. Third, the rise in national expenditure on health per capita is strongly correlated with the decline in morbidity. And fourth, the effect of the national expenditure on health per capita appears to be stronger among women and among those without an academic degree.

Conclusions: Self-rated health has improved. However, it has not improved to the same extent for all Israelis. The results of this study show that the health of women has improved more than that of men and that the health of non-academics has improved more than that of academics. The latter suggests that the progressive effect of public financing has offset the regressive effect of out-of-pocket payments on self-rated health.

Keywords: Education; National expenditure on health; Self-rated health.

Fig. 1

Trends in self-rated health and in the percentage of respondents with a health problem that greatly interferes with daily functioning, Israel 2002–2018. Note: Self-rated health follows an ordinal scale: 1 = “not at all good”; 2 = “not so good”; 3 = “good”; and 4 = “very good.” Source: Israel Social Survey

Fig. 2

Age-standardized trends in self-rated health by gender, Israel 2002–2018. Note: Self-rated health follows an ordinal scale: 1 = “not at all good”; 2 = “not so good”; 3 = “good”; and 4 = “very good.” The standard population used for age-standardization is Israel in 2002

Fig. 3

Trends in self-rated health by selected age groups, Israel 2002–2018. Note: Self-rated health follows an ordinal scale: 1 = “not at all good”; 2 = “not so good”; 3 = “good”; and 4 = “very good”

Fig. 4

Observed trends in self-rated health and those predicted by a regression model with individual characteristics only and a model with individual characteristics and the national expenditure on health per capita, Israel 2002–2018. Source: Social Survey and coefficients reported in Table 1