Ethnic differences in preventive medicine: the example of Jewish Ethiopian women in Israel.
BACKGROUND
Studies have found ethno-cultural disparities in health care delivery in different countries. Minority populations may receive lower standards of care.


OBJECTIVE
To test a hypothesis that Jewish Ethiopian women may be receiving fewer preventive recommendations than other women in Israel.


METHODS
A telephone survey was conducted using a structured questionnaire designed specifically for this study in Hebrew, Russian and Amharic (Semitic language of Ethiopia). The study group included 51 post-menopausal women of Ethiopian origin, aged 50-75. The control group included 226 non-Ethiopians matched for age, some of whom were immigrants from the former Soviet Union. The questionnaire dealt with osteoporosis and breast cancer screening and prevention.


RESULTS
All the parameters measured showed that the general population received more preventive recommendations and treatment than did Jewish Ethiopian women, including manual breast examination, mammography, osteoporosis prevention, bone density scans, and recommendations for a calcium-rich diet, calcium supplementation, hormone replacement therapy, biphosphonates and raloxifen. On a logistic regression model the level of knowledge of the Hebrew language, age, ethnicity and not visiting the gynecologist were significantly related to not having received any preventive medicine recommendations.


CONCLUSIONS
Differences in cultural backgrounds and language between physicians and their patients may obstruct the performance of screening and preventive medicine. Recognizing this potential for inequity and using methods to overcome these barriers may prevent it in the future.
Tandeter
Howard
H
Department of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. howard@bgu.ac.il
Masandilov
Iana
I
Kemerly
Irena
I
Biderman
Aya
A
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D003142:Communication; D003469:Culture; D005002:Ethiopia / Q000208:ethnology; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007557:Israel; D007585:Jews / Q000208:ethnology*; D007802:Language; D008403:Mass Screening; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000208:ethnology*; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011315:Preventive Medicine / Q000592:standards*; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires