Jewish men in Israel have one of the highest life expectancies in the world. In 2017, they could expect to live to 81 years on average; women – to 85 years
Dr Daniel Staetsky
Jews are ‘long-lifers’. Everywhere in the world Jews live longer than the non-Jews around them. Jewish men in Israel have one of the highest life expectancies in the world. In 2017, they could expect to live to 81 years, on average; women – to 85 years. In terms of life expectancy, Israeli Jews, and especially men, surpass almost all other high-income countries: the average life expectancy for men in OECD countries is 78 years, and 83 years for women.
This distinction between Jews and others is not new. The situation in the past, for example in the 1950s, was no different. Nor is it unique to Jews in Israel. Jews in the Diaspora live longer than the non-Jews around them in all places where records are kept. The only exceptions to this rule were newly formed immigrant Jewish communities from low-income countries (e.g. the Russian Empire) moving to high income countries (e.g. the USA and the UK). But even in these instances, the longevity advantage of Jews resurfaced quickly as immigrant communities integrated into their new lives.
The Jewish longevity advantage is not due to biology in the strict sense of that word. What kills Jews less than others is what epidemiologists call ‘avoidable mortality’ – quite literally, mortality that can be avoided if people behave in a health-conscious way: exercising, not overeating or undereating, consulting doctors, avoiding substance abuse, not smoking, not drinking excessively, not engaging in antisocial behaviour and violence, indeed, not taking unnecessary risks in general. Jews are, on average, more health-aware than non-Jews, so much so that it was noted even before there were statistics to prove it. Philosophers and physicians in the past commented that, relative to non-Jews, Jewish behaviour is more reserved and less prone to risk. Indeed, in a series of lectures in the late eighteenth century (later to become a book entitled Anthropology from a Pragmatic Point of View), Immanuel Kant pointed out that “women, priests and Jews do not get drunk, as a rule – at least they carefully avoid all appearances of it – because their civic position is weak and they need to be reserved.” For Kant then, it was the political vulnerability and weakness of Jews that stood behind the phenomenon of their greater sobriety. Jews did not get drunk because they were wary of entering an uninhibited state in their already insecure social position. People who are insecure are people who are afraid – of appearing themselves, of being judged by others, of punishment.
What is the link between this and coronavirus? There are many ways to destroy one’s health and typically, Jews are less prone to be health destructive with respect to many of them. For our purposes now, the most important behaviour is smoking. Jewish populations, both in Israel and in the Diaspora, are less profoundly affected by smoking than others, which gives Jews a strong advantage in dealing with various diseases affecting lungs and the respiratory system. Smoking damages health by causing or worsening the course of a wide range of cancers, as well as cardiovascular and respiratory diseases. Of all organs, lungs and the organs of the upper aerodigestive system are most severely assaulted by smoking. According to the American Cancer Society’s Second Cancer Prevention Study (which provided the evidence base for subsequent anti-smoking public health measures), the cardiovascular mortality of smokers is two to three times as high as the mortality of non-smokers, and mortality from lung cancer and chronic obstructive pulmonary disease among smokers is 14-24 times higher than among non-smokers. In short, smoking weakens the lungs. Coronavirus also assaults the lungs, so when it infects lungs that have already been weakened by something else, the result may be much worse than an assault on completely healthy lungs. Because, in general, Jewish populations have been less affected by smoking than others, we can be reasonably optimistic as to the effects of coronavirus on Jews.
I wish I could explain exactly why and how Jews are less affected by smoking. As explained above, it may be that Jews are comparatively more moderate in their health destructive behaviours. But it may also be more complex than that. Europeans and Americans took up smoking in very significant numbers in the first half of the twentieth century. The reality of the damage caused by smoking remained contested for a long time. Smoking started as a fashion in high society, before spreading to all social classes. Initially, it was almost exclusively a male habit, before spreading to women. The adverse effects of smoking took decades to demonstrate, and anti-smoking policies took decades to implement. The epidemic of diseases related to smoking ravaged the world particularly between the 1960s and the 1980s. This is an important point to grasp about the way in which smoking kills: its full effects on the health of the population are delayed by about 20-30 years. Smokers start developing smoking-related illnesses when they age, not in their youth. So, the increase in smoking-related mortality in the late twentieth century happened when the actual prevalence of smoking was already going down. Indeed, smoking is still the number one public health risk, and the consequences of mass smoking will continue to be felt at the level of population health for some years to come.
Importantly, however, no matter where one looks, the rates of mortality from smoking-related diseases have been considerably lower among Jews than non-Jews. A study published in Population Studies, a prominent demographic journal, indicated that in the 1970s-1990s, about 13% of all deaths among Israeli Jewish men aged 45 years and over were attributable to smoking. During the same period in English-speaking countries, the proportion of smoking-related deaths was about 30% of all male deaths, while in Southern Europe (Greece, Italy and Spain), it was about 20%. The most recent data indicate that Israelis are still at a considerable advantage when it comes to smoking-related mortality: today, death rates from cancer of the trachea, bronchus and lungs among men aged 65 years and over in the European Union are about 1.5 times as high as among men in Israel. The situation of Jews in the Diaspora is much the same.
The coronavirus pandemic is sometimes compared to the 1918 Spanish flu pandemic. Just how far the comparison is appropriate in biological terms is beyond the scope of this article, but there is something particular about the Spanish flu pandemic that can help make sense of the impact of coronavirus on Jews today. The ferociousness of the Spanish flu is partly explained by the fact that in 1918, the flu virus did not act alone. It attacked people whose lungs were already weakened – not by smoking (it was too early for that), but by tuberculosis. Tuberculosis was genuinely endemic at that time in the West, with a large pool of people with the clinical disease and another large pool with a latent infection. In 1917 mortality from tuberculosis in the USA, for example, was higher than mortality from a stroke and only slightly lower than mortality from heart disease, which is another way of saying that in the early twentieth century, tuberculosis was a central feature of life and a major cause of death. Thus, when Spanish flu attacked, it was particularly potent among populations with weakened lungs. The death march of Spanish flu would not have been as damaging as it turned out to be without some interaction with tuberculosis. Incidentally, mortality from tuberculosis declined sharply after the Spanish flu pandemic. Spanish flu killed off many people with tuberculosis and reduced the size of the pool of infected individuals in the community.
The critical point in this context though, is that the health profile of Jews, in Israel and elsewhere, makes them relatively resilient to coronavirus. That said, others have correctly indicated that additional factors should be taken into consideration in assessing the potential impact of coronavirus on Jews. For example, the age profile of some Diaspora Jewish communities is above average, and age is a notorious risk factor with respect to coronavirus. In addition, certain subgroups among Jews (e.g. the Orthodox) live intense, interconnected religious lives which, epidemiologically speaking, translate into the frequenting of – and crowding in – places of worship and religious study. Moreover, Strictly Orthodox Jews have large families: the average household size in this sector is five, compared to three in Israel as a whole and about two in other Western countries. Contagious agents, such as coronavirus, love crowds. So the impact of these factors may offset the impact of the generally wholesome Jewish population health profile, to some extent. However, the importance of healthy lungs, at a population level, would be very difficult to neutralise. Positivity and optimism with respect to the outcome of the encounter of coronavirus with Jews are not unwarranted. Quite the contrary.
Dr Daniel Staetsky
Senior Research Fellow and Director of JPR's European Demography Unit
Dr Daniel Staetsky
Senior Research Fellow and Director of JPR's European Demography Unit
Daniel holds a PhD in Social Statistics and Demography from the University of Southampton and a Master’s degree in Population Studies from the Hebrew University...
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