Researchers: Ofra Kalter-Leibovici^1,2, Michal Benderly^1,2, Gershon Alpert³, Uri Goldbourt²

Background: Arabs in Israel have high rates of cardiovascular (CV) risk factors, CV morbidity and mortality. There are no data on the association between CV risk factors awareness and risk score, and health services utilization and CV morbidity and mortality among Arabs and Jews in Israel.

Objectives: To study the associations between baseline CV risk factor awareness and Framingham CV risk score, and health services utilization, incident CV morbidity and mortality during follow-up among Arabs and Jews.

Method: This is a cohort study of 1,100 Arab and Jews, 25-74 years of age, residents of the Hadera District, who have been interviewed between 2002-2007. Information on health services utilization, CV events and mortality updated till 2012 was received from all 4 sick funds.

Findings: Higher baseline CV risk factors awareness was associated with a greater number of visits to the family physician during follow-up. Participants with lower educational level had fewer visits to specialists for the management of diabetes and hypertension. Arabs had a higher frequency of visits to the family physician and specialists for CV risk factors management. Adherence to medical treatment of CV risk factors did not differ by ethnicity. Arabs had 2-times greater risk for incident CV morbidity, adjusted for baseline CV risk score, education and sick fund. Evidence-based treatment for CV risk factors and active lifestyle were protected participants from incident CV morbidity and all-cause mortality during follow-up.

Conclusions and policy implications /Recommendations: : The study results showed a positive association between baseline CV risk factors awareness and visits to the family physician during follow-up. We did not find evidence for ethnic-disparities in access to health services. Special efforts should be directed at risk assessment and primary and secondary prevention to reduce health-related disparities due to CV disease among Arabs and Jews in Israel.

Research end date: 04/2017