title: Anemia among Muslim Bedouin and Jewish women of childbearing age in Southern Israel.
abstract: There are inequalities in health indicators among different ethnic groups living in the same region and receiving the same medical services. Anemia is a global problem. Although the prevalence of anemia is not high in Israel, differences among ethnic groups have not been studied. Our objective was to assess anemia among Bedouin and Jewish women of childbearing age in southern Israel. A retrospective observational study was conducted based on data from computerized medical records. Seven thousand eight hundred seventy-one women in the study clinics underwent complete blood counts and had blood hemoglobin levels of 11 g/dl or below. The Jewish patients were older (31.7 vs. 29.7 years, P < 0.001), practiced birth control more (24.2 vs. 9.9 %, P < 0.001), and adhered to it more (81.1 vs. 61.9 %, P < 0.001). Bedouin women had more children (3.7 vs. 1.9, P < 0.001), and more Bedouin women were pregnant during the study period (49.3 vs. 35.0 %, P < 0.001). The most prevalent types of anemia were iron deficiency and anemia of chronic disease. Two types of anemia were proportionally higher among Jewish women, anemia of chronic disease (18.1 vs. 9.7 %, P < 0.001) and folic acid deficiency (3.3 vs. 2.2 %, P > 0.001). The adherence rates for treatment were very low. Three factors associated with severe anemia (hemoglobin below 8 g/dl) were being Bedouin (odds ratio (OR) = 1.295, P < 0.001), use of birth control (OR = 0.419, P < 0.001), and pregnancy (OR = 0.447, P < 0.001). Being a Bedouin woman is a risk factor for severe anemia, and adherence to treatment for anemia is very low in both groups. These findings should be addressed in a national program to reduce health inequalities.
authors.affiliation: The Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva and Clalit Health Services, POB 653, Beer-Sheva, 84105, Southern District, Israel. yuliatr@walla.com.
authors.forename: Yulia
authors.initials: Y
authors.lastname: Treister-Goltzman
authors.affiliation: The Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva and Clalit Health Services, POB 653, Beer-Sheva, 84105, Southern District, Israel.
authors.forename: Roni
authors.initials: R
authors.lastname: Peleg
authors.affiliation: The Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva and Clalit Health Services, POB 653, Beer-Sheva, 84105, Southern District, Israel.
authors.forename: Aya
authors.initials: A
authors.lastname: Biderman
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology / Q000208:ethnology*; D018912:Arabs / Q000706:statistics & numerical data*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007585:Jews / Q000706:statistics & numerical data*; D008875:Middle Aged; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000208:ethnology; D015995:Prevalence; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Anemia; Anemia of chronic disease; Bedouin; Compliance; Ethnicity; Iron deficiency; Jew