Disparities in the geography of serious mental illness in Israel

Christopher G. Hudson, Varda Soskolne

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objective: The aim of this research is to test and apply a model of the disparities and variations in serious mental illness (SMI) to estimating prevalence in local areas throughout Israel. Methods: This study employs a secondary analysis of data from the 2003/2004 Israel National Health Survey of 4859 adults aged 21 and over from the household population of legal residents and citizens. It uses small area estimation methods (SAE), specifically to: (i) estimate and test a multivariate logistic model of disparities in the risk of serious mental illness; (ii) use the foregoing model for computing estimates, using census data, for local areas; (iii) validate these estimates against the rate of psychiatric hospitalizations. Results: The model uses standard demographic and socioeconomic variables to successfully predict 92.5% of respondents' statuses as SMI, with a sensitivity of 26.9%, specificity of 95.9%, and an AUC index of .797. The resulting estimates of the percentage of adults with an SMI in the 16 subdistricts ranged between 3.7% and 7.7%, with a national mean of 5.0%. The estimates have a partial correlation of .63 with rates of psychiatric hospitalization in Jewish localities, but elevated rates have not been validated in Arab localities. Conclusion: The use of small area estimation methods demonstrated the capacity for deriving local prevalence rates of serious mental illness, ones that can be validated against psychiatric hospitalization for the majority population group in Israel.

Original languageEnglish
Pages (from-to)898-910
Number of pages13
JournalHealth and Place
Issue number4
StatePublished - Jul 2012

Bibliographical note

Funding Information:
The assistance of Professor Uri Aviram, Dr. Haim Belmaker, Dr. David Chinitz, and Dr. Alean Al-Krenawi, and the Israel Ministry of Health, Mental Health Division, the Central Bureau of Statistics, Hebrew University's Braun School of Public Health, and the Social Science Data Center are all acknowledged. In addition, the support and partial financial assistance provided by Salem State University's School of Graduate Studies (Salem, MA, USA) is also acknowledged. The contents of this article do not necessarily represent the viewpoints of any of the individuals or institutions acknowledged here. Portions of the text of this paper have been adapted from an earlier paper by the first author ( Hudson, 2009 ).


  • Israel
  • Mental health disparities
  • Needs assessment
  • Serious mental illness
  • Small area estimation


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