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Visualizing health disparities in war and peace: Israel vs Palestine

Palestinian women sit on the rubble of their home in Beit Hanoun, Gaza Strip, Friday, Aug. 1, 2014. AP

Conflict between Israel and Palestine has resumed, with Israeli airstrikes killing top Hamas leaders and Hamas executing Palestinians they suspected of collaborating with Israel. The deadly cycle begins again, with civilian casualties mounting in Gaza as leaders on both sides blame each other for the breakdown in negotiations.

To date, more than 2,000 Palestinians and more than 60 Israelis have been killed, according to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). The UN says that most of the Palestinians killed, 1,444, were civilians, including 475 children and 246 women. On the Israel side, most of those killed, 64, were soldiers.

But when it comes to the health situation in Israel and Palestine, the lopsided death tolls during periods of conflict are only the tip of the iceberg.

Take, for example, child mortality. The following graphic (using IHME’s online visualization tool) shows child deaths per 1,000 live births in Palestine compared to those in Israel between 1990 and 2013. The gap between the two has diminished over time, but child mortality in Palestine was still nearly five times larger than it was in Israel in 2013.

Child deaths per 1,000 live births in Israel and Palestine, 1990-2013

Israel Palestine IHME

For maternal mortality, levels in Palestine are more than double the levels in Israel (see illustration below).

Maternal deaths per 100,000 live births in Israel and Palestine, 1990-2013

Israel Palestine IHME 2

Diseases primarily affecting children and child-bearing women (communicable, maternal, newborn, and nutritional disorders) account for 28% of all the years lost to early death and disability in Palestine. Non-communicable diseases are to blame for the majority of healthy years lost (62%) in Palestine.

Compared to Israel, Palestine has higher rates of early death and disability from certain non-communicable diseases, as illustrated in the next screen grab.

Certain causes stand out: cardio and circulatory diseases; mental and behavioral disorders, diabetes, urogenital, blood, and endocrine disorders; and other non-communicable diseases. Rates of early death and disability from diseases associated with poverty, such as nutritional deficiencies; neonatal disorders; and diarrhea, lower respiratory infections, and other infectious diseases, were also higher in Palestine than in Israel.

Rates of premature death and disability by cause in Israel and Palestine, 2010

Israel Palestine IHME 4

Israel’s health outcomes are more similar to those seen in Western European countries.

The graphic below shows how rates of premature death and disability in Israel, adjusted for differences in ages, are more similar to rates seen in Italy and Spain. Although its outcomes compare favorably to Western European countries, the US, Canada, and Australia, one area where Israel stands out is its high rates of diabetes, urogenital, blood, and endocrine disorders. Overall, the health of the Israeli people is among the best in the world, based on the Global Burden of Disease study.

Rates of premature death and disability by cause in the US, Australia, Western European countries, and Israel, 2010

Israe Palestine IHME 3

These data show how, despite being embedded within Israel’s borders, health outcomes among the Palestinian people are starkly different. Israel also has more advanced medical facilities than Palestine. For Palestinians, seeking medical treatment in more advanced facilities within Palestine or in Israel or Jordan can be a challenge.

A study published in The Lancet found that permission for 19% of patients and their companions applying for Israeli permits for hospital access in 2011 was denied or delayed. Israel restricts the movement of Palestinians between the West Bank and the Gaza Strip and to areas outside Palestine.

In addition to more widely publicized sources of tension between Israel and Palestine, extreme health disparities between the two areas are likely to add to the conflict for years to come.

Katie Leach-Kemon, a weekly contributor of global health visual information posts for Humanosphere, is a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation.


About Author

Katie Leach-Kemon

Katherine (Katie) Leach-Kemon is a policy translation specialist at the Institute for Health Metrics and Evaluation (IHME). Katie specializes in two of IHME's research areas, the Global Burden of Disease and health financing. Katie has helped produce IHME's Financing Global Health report since it was first published in 2009. She received an MPH from the University of Washington and served as a Peace Corps volunteer in Niger. Her work has been published in The Lancet, Health Affairs, and the Journal of the American Medical Association. You can follow her on Twitter @kleachkemon.