Holocaust Experience and Mortality Patterns: 4-Decade Follow-up in a Population-Based Cohort

Iaroslav Youssim*, Malka Gorfine, Ronit Calderon-Margalit, Orly Manor, Ora Paltiel, David S. Siscovick, Yechiel Friedlander, Hagit Hochner*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Research on mortality associated with exposure to the Holocaust is relevant for a better understanding of the effects of genocides on survivors. To our knowledge, previous studies have not investigated the long-term cause-specific mortality of Holocaust survivors. We compared mortality rates among Israelis born in European countries controlled by the Nazis during World War II with those among Israelis of European descent who did not have this exposure. Records of 22,671 people (45% women; 5,042 survivors) from the population-based Jerusalem Perinatal Study (1964-1976) were linked to the Israeli Population Registry, which was updated through 2016. Cox models were used for analysis, with 2-sided tests of statistical significance. Risk of all-cause mortality was higher among exposed women (hazard ratio (HR) = 1.15, 95% confidence interval (CI): 1.05, 1.27) than in unexposed women. No association was found between Holocaust exposure and male all-cause mortality. In both sexes, survivors had higher cancer-specific mortality (HR = 1.17 (95% CI: 1.01, 1.35) in women and HR = 1.14 (95% CI: 1.01, 1.28) in men). Exposed men also had excess mortality due to coronary heart disease (HR = 1.39, 95% CI: 1.09, 1.77) and lower mortality from other known causes combined (HR = 0.86, 95% CI: 0.75, 0.99). In summary, experiencing the Holocaust was associated with excess all-cause and cancer-specific mortality in women and cancer- and coronary heart disease-specific mortality in men.

Original languageAmerican English
Pages (from-to)1541-1549
Number of pages9
JournalAmerican Journal of Epidemiology
Volume190
Issue number8
DOIs
StatePublished - 1 Aug 2021

Bibliographical note

Publisher Copyright:
© 2021 The Author(s).

Keywords

  • Holocaust
  • cancer
  • cohort studies
  • coronary heart disease
  • genocide
  • mortality
  • survival analysis

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