Sex, ethnicity, and socioeconomic status affect israeli pediatric lipid testing despite equality in National Healthcare Services

Hagar Interator, Avivit Brener, Moshe Hoshen, Inbar Safra, Ran Balicer, Moshe Leshno, Raanan Shamir, Yael Lebenthal

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In Israel, coronary heart disease mortality rates are significantly higher among the Arab population than the Jewish population. Dyslipidemia prevention should begin in childhood. Objectives: To identify sociodemographic disparities in the preventive health measurement of lipid profile testing and lipoprotein levels among Israeli children and adolescents. Methods: A cross-sectional analysis of 1.2 million children and adolescents insured by Clalit Health Services between 2007 and 2011 was conducted using sociodemographic data and serum lipid concentrations. Results: Overall, 10.1% individuals had undergone lipid testing. Those with male sex (odds ratio [OR] = 0.813,95% confidence interval [95%CI] 0.809-0.816), Arab ethnicity (OR = 0.952, 95%CI 0.941-0.963), and low socioeconomic status (SES) (OR = 0.740,95%CI 0.728-0.752) were less likely to be tested. By 2010, differences among economic sectors narrowed and Arab children were more likely to be tested (OR = 1.039,95%C11.035- 1.044). Girls had higher total cholesterol, triglyceride, low-density lipoprotein-cholesterol, and non-high-density lipoproteincholesterol levels compared to boys (P < 0.001). Jewish children had higher cholesterol and low-density and high-density lipoprotein-cholesterol, as well as lower triglyceride levels than Arabs (P < 0.001). Children with low SES had lower cholesterol, low-density and high-density lipoprotein-cholesterol, and nonhigh- density lipoprotein-cholesterol levels (P < 0.001). Conclusions: We found that boys, Arab children, and those with low SES were less likely to be tested. Over time there was a gradual reduction in these disparities. Publicly sponsored healthcare services can diminish disparities in the provision of preventive health among diverse socioeconomic groups that comprise the national population.

Original languageEnglish
Pages (from-to)369-375
Number of pages7
JournalIsrael Medical Association Journal
Volume21
Issue number6
StatePublished - Jun 2019

Keywords

  • Healthcare disparities
  • Lipid profile testing
  • Lipoprotein levels
  • Pediatric healthcare
  • Socioeconomic status

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