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Family Practice—an international journal
non-Jewish populations (total 171, 2%), and attendance
Method
at diabetic clinics was not statistically different between
Jewish patients with diabetes (43%) and non-Jewish
patients (59%).
Analysis of annual consultation rates for one practice,
for the period 1993–1994, showed that the average num-
ber of consultations for orthodox Jewish patients was
higher (3.96) than for the non-Jewish population (3.08).
The rate of daytime home visits was markedly higher in
the orthodox Jewish population (1.19) than for their
non-Jewish counterparts (0.41).
Two general practices in Gateshead serve the majority of
the Jewish Community. Registration and claims data
from the then South of Tyne Health Commission were
used, together with encounter data from computerized
and manual practice records. Ethical and rabbinical
approval was obtained for the study. For each data set,
Jewish patients were identified (by two members of the
community). Where appropriate, comparisons were
made with an age- and sex-matched population of non-
Jewish patients from the same practices.
Conclusion
Results
The strictly orthodox Jewish community in Gateshead
has particular primary care health needs related to reli-
gious beliefs, the age distribution of the population,
health risks and use of services. The high percentage of
young people and children reflects the very high value
that is placed on having children within the orthodox
community. Generally, Jewish law permits contraception
At the time of the study, one practice had 1414 Jewish
patients and the other had 620 patients (total 2034).
These practices had 3603 and 6714 non-Jewish patients,
respectively (total 10 317). The orthodox Jewish popu-
lation was predominantly young (Table 1).
The birth rate in 1993–1994 for women aged 20–44
years was much higher amongst Jewish women (294 per
3
only when medically necessary.
1
000) than non-Jewish women (76 per 1000) registered
The ways in which primary care services are accessed
differ from the non-Jewish population. Consultation
rates are higher than for non-Jewish patients. Yet the use
of certain health promotion and preventative services is
lower than for the non-Jewish population. The low
cervical screening rate may be attributed to a perceived
lower level of risk within the community. The high birth
rate, and the need to observe a period of abstinence
followed by a ritual bath (niddah) after any vaginal
bleeding, may also contribute to the observed difference
in cervical screening uptake.
with the two practices. The cervical screening rate for
Jewish women (60%) was significantly lower than for
non-Jewish women registered with the practices (83%)
(
(
chi-square P Ͻ 0.001), and in Gateshead in general
83%), over the period 1989–1994.
Rates of uptake of all childhood immunizations in
994 (diphtheria, Pertussis, tetanus, polio, Haemo-
1
philus influenzae and measles/MMR) were lower for
children from appropriate age groups in the orthodox
Jewish community. Rates for Pertussis (Jewish 63%,
non-Jewish 81%; chi-square P Ͻ 0.001), H.influenzae
Rates of uptake of childhood immunizations were
consistently lower in orthodox Jewish children, despite
attendance at the same practices as the non-Jewish
children with which they were compared. This may be
attributable in part to the practicalities of keeping up
with the immunization status of several closely spaced
young children in a family. Rates of uptake in other
strictly orthodox communities in the UK have been
(
Jewish 54%, non-Jewish 87%; chi-square P Ͻ 0.001)
and measles (measles and MMR Jewish 66%, non-
Jewish 79%; chi-square P Ͻ 0.001) were markedly
lower. The rate of uptake of breast screening among
orthodox Jewish women in the three and a half years
prior to December 1993 (69%) was not statistically
significantly different compared with non-Jewish
women (76%).
4
,5
shown to be variable. However, the low uptake of
preventative health care did not extend to attendance
for breast screening. This may be attributable to the
The prevalence of diabetes (those receiving medica-
tion for diabetes) was similar in Jewish (total 14, 1%) and
TABLE 1 Demographic characteristics
Age band
years)
Practice population
orthodox Jewish
Practice population
non-Jewish
Gateshead population
(FHSA data 1993)
(
0
2
6
–19
1405 (69%)
579 (28.5%)
50 (2.5%)
2305 (22.3%)
6067 (58.8%)
1945 (18.9%)
10 317 (100%)
24%
60%
0–64
5 and over
17%
Total
2034 (100%)
100%