Population group differences in trends in stroke mortality in Israel

Background and Purpose-In Israel, stroke is the third most common cause of death. In 1997 stroke accounted for 2905 deaths (8.1% of total), 1390 of th em among men (7.5% of total; crude mortality rate of 48.3/100 000) and 1515 among women (8.6% of total; crude rate of 51.7/100 000). This report prese nts trends on stroke mortality by population group and estimates of morbidi ty in Israel. Methods-Data on stroke mortality in Israel during 1969-1997 were obtained f rom the Israel Central Bureau of Statistics. Ag-specific and age-adjusted m ortality rates were calculated for the 2 main population groups. Data on mo rbidity were obtained form the 1996/1997 National Health Survey. Hospitaliz ation rates due to stroke are based on the national hospitalization data. Results-A monotonic decrease in stroke mortality is evident in Jews during 1969-1997 in both sexes. Age-adjusted mortality rates declined by 62.5% for Jewish men and by 73.4% for Jewish women during 1969-1997. Among Arabs, th ere was a general decreasing trend in the mortality for both sexes during 1 973-1997. The main difference in population group mortality trends was foun d in the group aged +/- 75 years: a statistically significant decrease in m ortality rates for Jews is evident, while no decrease is apparent for Arabs . On the basis of available data for 1990, an estimated 13 000 patients wit h stroke were hospitalized during 1997. Conclusions-During the last 25 years, age-adjusted stroke mortality in Isra el has declined substantially, but the decline has been much greater among Jews than Arabs. The group aged greater than or equal to 75 years shows the greatest difference in trends between Jews and Arabs. This finding may be explained by differences in risk factor distribution and case fatality rate s.