Inequalities in health among Kibbutz elderly - effects of structural changes

Abstract

"Kibbutz elderly demonstrated in the past a high level of health, exceptional longevity, positive wellbeing, and strong evidence for successful aging. For instance, in 1995, life expectancy of females in kibbutzim was (at birth) 82.5 years and 78.1 years formales (compared to 79.8 and 75.9 for Israeli Jews). Research showed social arrangements (based on principles of solidarity, equality, social integration and social support) to be the prime factor responsible for these positive results. Social arrangements were translated to create social capital in both its principal forms: physical and social - to act for the health and well being of the kibbutz elderly. Yet, the importance of socioeconomic equality among members could not be positively ascertained, as there existed practically no differences in this regard among kibbutz communities. Since the end of the eighties, many kibbutzim experienced major structural and ideological changes with major impact upon their social arrangements and consequently upon health and well being of all members, the elderly in particular. The most significant structural changes are "privatization" of public budgets (so that each membergets what others get - rather than according to needs) and in arrangements of "differential salary" based on level of professional or managerial position at work (thus the principle of "equity" replaces both "mechanic equality" and "qualitative equality".) We compared two kibbutzim that moved to a structure based on the "equity" principles (rather than "equality") with two kibbutzim that keep to the "equality" principles in the distribution of budgetary remuneration (all four were roughly similar in their average economic standing). Respondents were members aged 55 or older. Analyzed were medical files as well as a questionnaire instrument that gauged kibbutz (perceived) social capital on various dimensions and respondents' self reported levels of health, wellbeing, and the existence of ill symptoms. The "equity" members showed lower levels of health. They also reported lower level of existence of social capital intheir kibbutzim. I discuss possible consequences for the kibbutz population, the importance of social arrangements for health and longevity, and the support this study gives to the theoretical model of relating socioeconomic inequality to health and life expectancy." (author's abstract)