Psychological distress is independently associated with physical inactivity in Israeli adults.

OBJECTIVES: Limited data exist on the link between psychological distress and regular physical activity in the general population. We examined the association of psychological distress with physical inactivity, independently of sociodemographic and behavioral factors in a large community sample. We also examined whether psychological distress is related to limitations in day-to-day activities due to emotional problems. METHODS: Information on physical activity, sociodemographic, and behavioral factors was obtained through telephone interviews of 5708 subjects aged > or = 21 years from a cross-sectional study-the first Israeli National Health Interview Survey (2003-2004). Psychological distress and limitations due to emotional problems were measured using the five-item Mental Health scale (MHI-5) and role emotional scales derived from the SF-36 questionnaire. RESULTS: In multivariate analyses, high psychological distress level was associated with increased odds of physical inactivity among both men (adjusted OR=1.30, 95% CI=1.09-1.55) and women (adjusted OR=1.31, 95% CI=1.11-1.53). Psychological distress was strongly associated with limitations in day-to-day activities due to emotional problems. CONCLUSIONS: In this cross-sectional study of adult men and women, psychological distress was independently associated with physical inactivity. Psychological distress may limit day-to-day activities in general and reduce the success of health promotion activities. These findings could help in identifying subjects facing difficulties in initiation and adherence to these activities.

Body weight dissatisfaction among Israeli Jewish and Arab women with normal or overweight-obese body mass index, Israeli INHIS-1, 2003-2004.

INTRODUCTION: In Israel, 58.9% of Jewish and Arab Israeli women aged 25 to 64 years are overweight or obese (body mass index >or=25 kg/m(2)). The objective of this analysis is to describe body weight dissatisfaction differences between Jewish and Arab Israeli women with normal or overweight-obese body mass index. METHODS: This analysis included 1,393 Jewish and Arab women who participated in the Israeli National Health Interview Survey, 2003-2004. The survey covered a random sample of the Israeli general population aged 21 years or older. All variables were based on self-report. Body weight dissatisfaction was a multiple-choice question in the survey that offered the following responses: very satisfied, satisfied, reasonably satisfied, not satisfied, or very unsatisfied. Univariate and multivariate analyses were conducted. RESULTS: Overall, 39.1% of Jewish women reported body weight dissatisfaction, compared with 29.1% of Arab women. Older overweight-obese Arab women had a lower prevalence of body weight dissatisfaction than Jewish women of the same age group, which indicates cultural differences in body weight dissatisfaction among older overweight-obese women. However, cultural differences do not appear to influence body weight dissatisfaction among younger Jewish and Arab women of normal weight. CONCLUSION: This study suggests that Jewish and Arab women differ in their perceptions of body weight. Interventions tailored to each group are needed to promote healthy dietary and physical activity behaviors.

Individual-level analysis of social capital and health: a comparison of Arab and Jewish Israelis.

Discrepancies exist in existing research regarding the association between social capital and self-rated health, most of which has been undertaken in the developed world. The aim of this study is first to assess the levels of the various variables describing individual social capital in Jews and Arab residing in Israel, and second to assess the association between individual social capital and self-rated health in these two population groups. The data were obtained from an Israeli health interview survey (knowledge, attitudes and practices (KAP)) conducted during 2004-2005, which is based on 3,365 interviews with adult Jews and 985 adult Arabs. Social capital measures included social trust, neighborhood safety, perceived helpfulness, trust in local and national authorities and social support. Data were also obtained on self-rated health and socioeconomic and demographic variables. Multivariate logistic regression revealed that Jews reported higher levels of social trust, perceived helpfulness, trust in authorities, and social support compared to Arabs, after adjusting for demographic and socioeconomic variables. Social contacts, however, were reported more frequently in the Arab population. Neighborhood safety was similar in the two population groups. Among Jews, those reporting higher levels of individual social capital reported better self-rated health after adjusting for demographic and socioeconomic variables. Among Arabs, only those reporting higher levels of social support reported better self-rated health. In Israel, individual levels of social capital seem to be lower in the Arab minority than in the Jewish majority. Individual social capital was associated with better self-rated health mainly in the Jewish population and less so in the Arab population. Social capital factors may be associated with health to a higher extent in affluent populations with relatively high social capital and less so in low social capital and more traditional communities. More research is needed to verify these differences.

Correlates of generalized anxiety disorder: independent of co-morbidity with depression: findings from the first Israeli National Health Interview Survey (2003-2004).

BACKGROUND: Generalized anxiety disorder (GAD) is a prevalent psychiatric disorder with chronic symptoms and is commonly comorbid with depression. OBJECTIVES: To identify correlates of GAD among adults and to describe treatment patterns and functional limitations among individuals with this disorder. METHODS: Data for 2,082 subjects aged >or=21 years from the first Israeli national health interview survey (INHIS-1) (2003-2004) were analyzed. Information on GAD was collected using the short form of the Composite International Diagnostic Interview. Data were also obtained on socio-demographic, physical health characteristics, history of life threatening events, treatment seeking behaviors, use of medication and functional impairment. RESULTS: The prevalence of GAD was highest among people aged 40-59 years, in those with asthma, hypertension and in those with osteoporosis. Regular exercise was associated with reduced prevalence for GAD (adjusted OR 0.46, 95% CI 0.22-0.95). The exclusion of individuals with major depression from analysis strengthened the association with age (adjusted OR 5.7, 95% CI 1.7, 19.7), weakened the association between GAD and osteoporosis (adjusted OR 3.4, 95% CI 1.2, 9.8), asthma (adjusted OR 3.4, 95% CI 1.2, 9.5) and regular exercise (adjusted OR 0.47 95% CI 0.2, 1.14). In this sub-sample, hypertension was no longer associated with GAD, and a significant association was found between GAD and past experience of life threatening events (adjusted OR 2.3, 95% CI 1.1-4.9). Psychiatric and psychological consultations were low among people with GAD (11.5% and 26.4% for those without and with comorbid depression, respectively), concurrent with a high degree of functional limitation. CONCLUSIONS: Middle age, history of traumatic life events, and certain chronic medical diseases (e.g., asthma and osteoporosis) are important risk factors for GAD. They could be used to help identify and treat people with GAD.

[Patterns of utilization of healthcare services among immigrants to Israel from the former Soviet Union].

BACKGROUND: Contradictory evidence exists as to the rate of use of healthcare services by Israeli immigrants from the former Soviet Union (fSU). OBJECTIVES: The aim of this study was to compare the rates of utilization of healthcare services in veteran Israeli Jews and immigrants a decade and a half after immigration. METHODS: The data was obtained from the Israel National Health Interview Survey (INHIS) during 2003-2004, which is based on 6,756 interviews with veteran Israeli Jews and 953 interviews with immigrants from the fSU, of them 835 arrived in Israel during the years 1990-1998, and 118 arrived after 1998. Questions included use of healthcare services, health status and socioeconomic factors. RESULTS: The immigrants from the fSU reported similar rates of visiting a family physician and specialist and lower hospitalization rates after adjustment for socioeconomic variables compared to veteran Jews. However, the rate of use of preventive tests such as serum cholesterol tests, mammography and Pap smear tests was lower in immigrants. There was no significant difference in use of healthcare services between recent immigrants and those living in Israel more than 5 years, except for mammography performance. CONCLUSIONS: The use of community healthcare services among immigrants is similar to the use among veteran Jews. However, the immigrant population in Israel utilizes preventive services less often than the veteran Jewish population.

Who uses complementary and alternative medicine in Israel?

OBJECTIVE: To describe the Israeli complementary and alternative medicine users and examine whether they are the same or different from non-users. DESIGN: This analysis was conducted on data collected from the use of health services module (n=2,365) of the Israeli National Health Interview Survey conducted 2003-2004. The questionnaire was based on the European Health Interview Survey and was administered over the telephone by trained interviewers. SUBJECTS: This survey was conducted on a random sample of the Israel general population age 21 years or more. OUTCOME MEASURES: Chi-square tests and logistic regression analyses were conducted. Complementary and alternative medicine was defined as self-reported use of homeopath, acupuncturist, chiropractor/osteopath, naturopath, or other complementary and alternative provider services for the subjects' own health needs in the last 12 months. RESULTS: Almost 6 percent of Israelis reported using complementary and alternative medicine. Use increased with income. Users were more likely to visit any doctor or a specialist in the prior 4 weeks to the survey compared to nonusers. Users self-reported similar use of pain medications compared to nonusers. CONCLUSIONS: These findings inform the international debate regarding if and how complementary and alternative medicine services should be covered by national health insurance.