Abi Gezunt: Health and the American Jewish Dream 9781618115379

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Abi Gezunt Explorations into the Role of Health and the American Jewish Dream

Jewish Identities in Post-Modern Society Series Editor Roberta Rosenberg Farber (Yeshiva University) Editorial Board Sara Abosch (University of Memphis) Geoffrey Alderman (University of Buckingham) Yoram Bilu (Hebrew University) Steven M. Cohen (Hebrew Union College – Jewish Institute of Religion) Bryan Daves (Yeshiva University) Sergio Della Pergola (Hebrew University) Simcha Fishbane (Touro College) Deborah Dash Moore (University of Michigan) Uzi Rebhun (Hebrew University) Reeva Simon (Yeshiva University) Chaim I. Waxman (Rutgers University)

Abi Gezunt Explorations into the Role of Health and the American Jewish Dream

Jacob Jay Lindenthal

Boston 2017

Library of Congress Cataloging-in-Publication DataNames: Lindenthal, Jacob Jay, author. Title: Abi gezunt: explorations into the role of health and the American Jewish dream / Jacob Jay Lindenthal, PhD, Dr PH. Description: Boston: Academic Studies Press, 2016. | Series: Jewish identities in post-modern society | Includes bibliographical references and index. Identifiers: LCCN 2016037754 (print) | LCCN 2016038131 (ebook) | ISBN 9781618115362 (hardback) | ISBN 9781618115379 (e-book) Subjects: LCSH: Jews—Health and hygiene—History. | Jews, East European—­ Health and hygiene—United States—History. | Jews, East European—United States—Social conditions—19th century. | Jews, East European—United States—Social conditions—­20th century. | Immigrants—Health and hygiene—United States—History. | United States—Ethnic relations. | BISAC: SOCIAL SCIENCE / Emigration & Immigration. | SOCIAL SCIENCE / Social Classes. | SOCIAL SCIENCE / Disease & Health Issues. Classification: LCC RA561. L56 2016 (print) | LCC RA561 (ebook) | DDC 610.89/924073—dc23LC record available at https://lccn.loc.gov/2016037754 © Academic Studies Press, 2017 All rights reserved ISBN 9781618115362 (hardback) ISBN 9781618115379 (e-book) Book design by Kryon Publishing, www.kryonpublishing.com Academic Studies Press 28 Montfern Avenue Brighton MA 02135 USA [email protected] www.academicstudiespress.com

Table of Contents

Foreword Preface Acknowledgements

viii xi xviii

Introduction Chapter 1.  Halakha—The Foundation of Jewish Law and Life Chapter 2.  Education and Literacy: The Path to Good Health

xix 1 13

Social Support Chapter 3. Charity—Das Jüdische Herz Chapter 4.  Family First

47 62

Health-Related Behaviors Chapter 5.  Childrearing Practices and Attitudes Chapter 6.  Alcoholism among the Jews

81 93

Human Capital Chapter 7.  Housing and Jobs in the New World—Health Against All Odds 107 Implications Chapter 8.  Socioeconomic Status and Health Chapter 9.  Health, Culture, and Wealth

135 150

Appendix I Woodbury Data on Neonatal and Infant Mortality Maternal Mortality and Maternal Age Birth Intervals Breastfeeding and Infant Mortality

169 169 171 172 173

vi

Table of Contents

Housing Congestion and Neonatal Survival Maternal Employment During Pregnancy Mortality in Later Ages Pulmonary Data

173 174 174 175

Appendix II Sources Corroborating Comparatively Low Rates of Tuberculosis among Jews in Eastern Europe Sources Corroborating Comparatively Low Rates of Infection among Jews Sources Corroborating Comparatively Low Rates of Influenza among Jews Sources Corroborating Comparatively Low Rates of Typhoid Fever among Jews Sources Corroborating Comparatively Low Rates of Mortality Associated with Whooping Cough, Scarlet Fever, and Measles among Jews Sources Corroborating Comparatively Low Rates of Syphilis among Jews Sources Corroborating Alcohol Consumption Among Jews

177

Appendix III Additional Reading Index

177 178 178 178

179 179 180 181 181 185

A Personal Note My reading of the literature of Jewish history and law served as the seedbed for the hypothesis of this work. Two important factors served to motivate the writing of this book: completion of the Lindex project, a National Library of Medicine-supported, Internet-based review of the disease experience of American Jews from 1874 until 1903, and the rising number of large-scale quality prospective studies pointing to the positive economic value of good health. The time was propitious several years ago to begin assembling this volume. It is quite possible that some of my readers may misinterpret this work as an exercise in ethnocentrism. There is, indeed, a joy I take in the accomplishments of my co-ethnics, coupled with a sense of sadness upon learning of their misdeeds. Nevertheless, as a member of the social science academic community, it is incumbent, once a topic is chosen, to assemble and offer the facts with as much impartiality as possible.

Jacob Jay Lindenthal, PhD, Dr PH

Foreword

The late American Jewish journalist and humorist Harry Golden entitled one of his last books, published in 1970, So Long As You’re Healthy (Abee Gezundt). He knew that the Yiddish phrase, usually transliterated as abi gezunt, resonated with Jews and, for a time, with the larger American community beyond. On the Lower East Side of New York, he recalled, “if the livelihood was not so good, and even if the shopkeeper went bankrupt, his relatives and friends” would say, consolingly, abi gezunt, “so long as you’re healthy.”1 Back in 1938, Molly Picon’s signature song in the Yiddish film Mamele (“Little Mama”) did much to popularize the expression abi gezunt. The song’s Depression-era message—“abi gezunt ken men gliklekh zayn,” (so long as you’re healthy you can be happy)—offered a timely rebuke to those who linked happiness to the pursuit of power and money. What was truly important, the song insisted, was good health, the basis for everything else.2 A year later, Cab Calloway, the great African American jazz singer and band leader, likewise penned a song entitled “Abi Gezunt” (“If You’ve Got Your Health, You Can Be Happy”). Drawing upon his acquaintance with his Jewish manager, Irving Mills, and clearly influenced by the lyrics of Molly Picon’s popular Yiddish song, he mischievously combined African American (“Hepster”) slang with the funny-sounding Yiddish phrase , and crooned, “I’m hip de dip, a 1 Harry Golden, So Long as You’re Healthy (Abee Gezundt) (New York: G. P. Putnam’s Sons, 1970), 19–20; see Kimberly Marlowe Hartnett, Carolina Israelite: How Harry Golden Made Us Care About Jews, the South, and Civil Rights (Chapel Hill: University of North Carolina Press, 2015), esp. 257. 2 Neil Levin, “Abi Gezunt,” The Milken Archive of Jewish Music, accessed January 24, 2016, http://www.milkenarchive.org/works/view/547#/works/view/547/full. Molly Picon wrote the lyrics; Abraham Ellstein composed the music.

Foreword

solid sender, a very close friend to Mrs. Bender, Bender, shmender, abi gezunt, I’m the cat that’s in the know!” As Hankus Netsky has observed, Calloway “knew one of the sweetest secrets of life: that a ‘cat’ that knows the meaning of Abi Gezunt is a cat that’s in the know.”3 Dr. Jacob Jay Lindenthal has spent a lifetime exploring this same secret of life. As an accomplished sociologist and highly respected health educator, Dr. Lindenthal has dedicated a lifetime to exploring social relationships. Indeed, he has personally worked to restore countless people to health and happiness, and he has trained legions of medical students to do the same. His interest in abi gezunt, however, goes far beyond his own medical practice. In this book, he seeks to understand how health shaped the destiny of the American Jewish community as a whole. American Jews’ rapid socioeconomic rise, he argues, is connected to their abiding concern with health. Knowledge of risk and protective factors—some mandated by Jewish law, others learned from books, still others passed down mimetically from parents to children—resulted in healthful behaviors. In particular, the high value that Jews placed upon “health, education, cohesive family life and communal social support,” he shows, “played a particularly important role in helping immunize the Jews against . . . the deterioration of their health status.” Better health, in turn, led to the formation of capital and ultimately to the community’s overall socioeconomic rise. Dr. Lindenthal’s study rests upon a mountain of medical evidence, much of it buried in obscure medical journals rarely consulted by historians. The footnotes and bibliography alone open up a world of long-forgotten articles detailing diverse aspects of immigrant Jewish health. Invaluable data are also found in the appendices. Nobody, to my knowledge, knows this medical literature better than Dr. Lindenthal.4 Fortunately, he has now created a database and index to this literature—what he calls The Lindex, the “first ethnic database of disease”—so that others may follow in his tracks and build upon his extraordinary contribution. Hundreds of studies relating to the diseases and 3 His rendition of the song, translated as “A Bee Gezindt,” can be viewed on https://www. youtube.com/watch?v=_-ca4HbD7hY; see Hankus Netsky, “Cab Calloway: On the Yiddish Side of the Street,” JBooks.com, accessed January 24, 2016, http://www.jbooks.com/ secularculture/Netsky.htm#. 4 For an important earlier survey, see Deborah Dwork, “Health Conditions of Immigrant Jews on the Lower East Side of New York: 1800–1914,” Medical History 25 (1981): 1–40.

ix

x Foreword

health conditions of Jews (1874-2000) are found in The Lindex. Historians of medicine will forever be grateful for his assiduous collection of this primary material. The question that lies at the heart of this book—how American Jews rose from rags to riches—has long captivated scholars and policy-makers alike. Some, influenced by Max Weber’s The Protestant Ethic and the Spirit of Capitalism,5 point to Jewish values and culture, particularly the Jewish proclivity for education, as the engine of their success.6 Others credit America, observing that Jews did not enjoy the same rapid rise in less hospitable countries. Still others point to freedom and free-market capitalism, which Jews were able to exploit more than some of their peers. Luck, timing, history, even Jews’ sexual habits have likewise been adduced to explain their rise. Nor has the last word on this subject likely been written.7 Thanks to this book, historians will henceforward also need to consider the vital importance of health in explaining American Jewish success. Knowledge about health, healthy behaviors (“protective factors”), and the avoidance of unhealthy, risky habits and ways have, readers will see, prolonged Jewish lives and increased Jewish wealth. Abi gezunt encapsulates one of the sweetest secrets of American Jewish life. Jonathan D. Sarna Joseph H. & Belle R. Braun Professor of American Jewish History Brandeis University

5 Max Weber, The Protestant Ethic and the Spirit of Capitalism, trans. Talcott Parsons (New York: Routledge, 2001 [orig. 1903]). 6 For a recent controversial discussion of “How Education Shaped Jewish History,” see Maristella Botticini and Zvi Eckstein, The Chosen Few (Princeton: Princeton University Press, 2012), and the critique by Shaul Stampfer in Jewish History 29 (December 2015): 373–379. 7 See Nathan Glazer’s pioneering discussion in “Social Characteristics of American Jews, 1654–1954,” American Jewish Year Book 56 (1955): 3–41. Recent discussions may be found in Jerry Z. Muller, Capitalism and the Jews (Princeton: Princeton University Press, 2010); Rebecca Kobrin (ed.), Chosen Capital: The Jewish Encounter with American Capitalism (New Brunswick: Rutgers, 2012); Adam D. Mendelsohn, The Rag Race: How Jews Sewed Their Way to Success in America and the British Empire (New York: New York University Press, 2015); and Rebecca Kobrin and Adam Teller, eds., Purchasing Power: The Economics of Modern Jewish History (Philadelphia: University of Pennsylvania, 2015).

Preface

A review of American Jewish history reveals two salient facts. The first is that great attention has been paid to the rapid socioeconomic rise of the Jews in America. Some have attributed this rise to a variety of factors, principally the Jews’ drive toward education and literacy, the comparatively skilled nature of their occupations upon arrival, and their relatively small family size. The second is that health and disease among the Jewish immigrants—although rarely touched upon in scholarly works—are often treated from the viewpoint of Jewish contributions to the development of the hospital system in America.1 Lacking, however, is a comprehensive review of the health of the immigrants themselves. This is strange when we consider the high value placed on health brought to these shores by succeeding waves of immigrants and the very many ways it has been manifested. Two well-thumbed studies2 deserve our   1 See also Alan M. Kraut and Deborah A. Kraut, Covenant of Care: Newark Beth Israel and the Jewish Hospital in America (New Brunswick: Rutgers University Press, 2007); Mary Ann Fitzharris and Jeanne E. Abrams, A Place to Heal: The History of National Jewish Medical and Research Center; Global Leader in Lung, Allergic and Immune Diseases (Denver: National Jewish Medical and Research Center, 1997); Dorothy Levenson, Montefiore: The Hospital As Social Instrument, 1884–1984 (New York: Farrar, Straus & Giroux, 1984); Arthur H. Aufses, Jr. and Barbara J. Niss, This House of Noble Deeds: The Mount Sinai Hospital, 1852– 2002 (New York: New York University Press, 2002). Others have contributed to our understanding of cultural differences in childhood healthcare among Italians and Jews, including Alice Goldstein Susan Cotts Watkins, and Ann Rosen Spector, “Childhood Health-care Practices Among Italians and Jews in the United States, 1910–1940,” Health Transition Review 40 (1994): 45–61.   2 One by Alan M. Kraut, Silent Travelers: Germs, Genes and the “Immigrant Menace” (New York: Basic Books, 1994), and the other by Howard Markel, Quarantine! East European Jewish Immigrants and the New York City Epidemics of 1892 (Baltimore: Johns Hopkins University Press, 1997).

xii Preface

attention for their observations on the role of infectious diseases as being largely responsible for inflaming anti-immigrant sentiment. Fifty years before the migrations of Eastern Europeans, the American East Coast groaned under the weight of poor Irish immigrants, bringing with them cholera. There was no question that the disease posed a serious threat: “. . . it raised long-term questions about the origin of disease, the adequacy of public health institutions to protect urban populations being suddenly and rapidly swelled by the foreignborn, and immigrants’ need for healthcare institutions tailored to their unique cultural perspectives.”3 American Protestants blamed the hierarchy of the Roman Catholic Church for fostering poverty, oppression, and misgovernment, all conducing to the disease. Bias against the Irish immigrants was reflected in officially sanctioned inflated rates of illness and hospitalization, while acknowledging that these immigrants might have been more susceptible to illness than others. Alan Kraut notes that the Catholic Church met the stigmatization of the Irish with an institutional response: the Catholic hospital not only saved souls from the Protestant menace, but also greatly expanded the availability of medical care and resources to impoverished urban masses. In Quarantine, Howard Markel crystallized the perspectives of the historian, the clinician, the epidemiologist, and the sociologist of two epidemics—typhus and cholera—in New York City in 1892: “Public health, after all, begins with the public, and issues that concern large numbers of people’s health become political almost by definition.”4 Those opposed to immigration knew that linking a deadly illness to an undesirable group of peoples and quarantining them would further flame anti-immigration sentiments. “It was . . . a period marked by bouts of economic depression and the closing of the western frontier. It was also a period of social upheaval in the form of urbanization, industrialization, rapid transportation, and labor unrest. For many Americans, the personification of all these social evils was the foreign, impoverished, and unkempt immigrant from Russia, Italy, Austria-Hungary, and other European nations. . . . Widespread nativistic and hostile sentiments that cut across lines of class and geographic location were expressed by both

  3 Kraut, Silent Travelers, 31.   4 Howard Markel, Quarantine! East European Jewish Immigrants and the New York City Epidemics of 1892 (Baltimore: Johns Hopkins University Press, 1997), 104.

Preface xiii

native-born and well-assimilated foreign-born Americans.”5 Markel demonstrated how class and national origin played a significantly larger role than did bacteriology in determining how the brief cholera epidemic was managed. The Jewish immigrant himself posed a minimal risk of carrying diseases from Europe. Disease was more a function of the conditions on the vessels that carried the Jews to America and served as an infectious substrate. Cultural factors have surely played a role in shaping the health experiences of the American Jew, particularly from the time of the great migration beginning in the 1880s through the post-World War II era. The Berkman-Glass paradigm describes how the social environment influences health, beginning with broad sociostructural conditions, such as cultural norms, values, social cohesion, and socioeconomic status, which molds social networks having a direct bearing on psychosocial mechanisms.6 These mechanisms have a direct effect on individual health pathways. L. F. Berkman and T. Glass further offered that the key to health is found in cultural factors that serve as the foundation for developing and maintaining social networks. Their theory supports what the author sought to demonstrate in this book: that the Jews enjoyed relatively good health owing in part to a strong social network. We further suggest a relationship between economic success and the relative health of the American Jew from the late nineteenth century through the outbreak of the Second World War—the period that set the stage for the economic rise of the American Jew. Those looking for direct causal links will be disappointed until such time as scholars design controlled, prospective studies of Jewish and non-Jewish immigrants, where both initial health and socioeconomic status can be thoroughly assessed. The best we can do at this time is to provide a conjectural analysis drawn from American Jewish history and studies that point to a relationship between health and the formation of capital. With an eye to the above, we trolled for trends in Jewish history, stopping to examine some of these factors in varying degrees of detail. This examination began more than 20 years ago in an effort that led to the development of the The Lindex, the second volume of this set and the first ethnic database of disease. The Lindex offers a comprehensive view of the health status of American Jews in   5 Markel, Quarantine, 3.   6 L. F. Berkman, T. Glass, I. Brissette, and T. E. Seeman, “From Social Integration to Health: Durkheim in the New Millennium,” Social Science & Medicine 51 (2000): 843–857.

xiv Preface

the medical literature from 1874 through 2000. Over a period of more than 30 years, we collected and reviewed studies dealing with diseases experienced by American and Canadian Jews (95 percent of whom are Ashkenazi, that is, of German or East European origin). As technology permitted, the information we amassed was entered into a searchable database with more than 2,400 entries and approximately 550 diseases/disorders related to American Jews between 1894 and 2003. Additional information on our motivation for developing The Lindex7 is provided in the introduction to that volume. Suffice it to say that our work on The Lindex led to the development of this volume to support our understanding of how socioeconomic factors and education—that is, knowledge of risk and protective factors—resulted in healthful behaviors. The Lindex was designed to collect and organize the literature involving the recorded experience of American Jews. Its purpose is to supplement standard search engines by focusing on one ethnic group residing in North America. It can therefore be considered the first ethnic database of disease. It makes no claim to covering the universe of data available, nor would we have the temerity of even suggesting that the Lindex comes close to including more than a significant sample of the data. Neither PubMed nor Medline, however, categorize articles by ethnicity. There is no comparable database for any ethnic group that covers this array of diseases in this detail over a 129-year period. Data drawn from studies forming the basis for The Lindex are based on what is referred to as “risk-factor epidemiology,” a perspective that focuses on individual behavioral and biologically based risks for disease. Limitations of this approach became apparent in the late twentieth century, when it became evident that this line of thinking could not explain the relationship between gradients in morbidity and mortality and socioeconomic status.8 More consideration needed to be given to both multiple levels of causation and associations between populations and their respective health profiles. Enter socioeconomic status, a very significant antecedent variable in the “social causes” model in the chain of causes of disease. Bruce Link and Jo Phelan   7 The grant number for "The Lindex Study: An Ethnic Database" is 1 G13 LM06902-01A1. Readers may access The Lindex at https://research.njms.rutgers.edu/m/lindex/.   8 P. M. Lantz, J. S. House, J. M. Lepkowski, et al., “Results from a Nationally Representative Prospective Study of U.S. Adults,” Journal of the American Medical Association 279 (1998): 1703–1708; M. G. Marmot, G. Davey Smith, S. Stansfield, et al., “Health Inequalities Among British Civil Servants: The Whitehall II Study,” Lancet 337 (1991): 1387–1393.

Preface xv

observed that the relationship between socioeconomic status and disease prevalence has been a constant at least over the last two centuries regardless of the specific disease pattern of a specific era.9 In the words of the originators of this concept, “. . . the essential feature of fundamental social causes is that they involve access to resources that can be used to avoid risks or to minimize the consequences of disease once it occurs.”10 The importance of such resources is that they define individual health behaviors. Thus, knowledge about risk and protective factors ranks as the single most significant determinant of health.11 Jews have been variously described as a group defined by religious tenets and an ethnic group united by a system of values and associated behavioral patterns. Whichever definition is emphasized, there can be agreement that the Jews share an articulated set of values, beliefs, traditions, attitudes, and behavioral patterns, many of which bear on the management of health and disease. A SPECIAL NOTE TO MY READERS After years of trolling through the literature, it was becoming evident that the time was drawing near to share the evidence for the working hypothesis of a relationship between health and wealth among American Jews. Chapters in this brief volume should be considered points of departure and as seedbeds for future research and discussion. Students of American history, ethnicity, medical   9 Bruce G. Link and Jo C. Phelan, “Controlling Disease and Creating Disparities: A Fundamental Cause Perspective,” The Journals of Gerontology: Series B Psychological Sciences and Social Sciences 60 (2005): 27–33; Bruce G. Link and Jo C. Phelan, “Social Conditions as Fundamental Causes of Disease,” Journal of Health and Social Behavior 35 (1995): 80–94. 10 Link and Phelan, “Social Conditions,” 87. 11 Historians and social scientists harbor their own unique perspectives when considering the sources and consequences of health. In arguing on behalf of the historical perspective, Stephen Kunitz stressed that: “Accurate prediction is unlikely to rest upon deductive science and more likely to result from stitching together all that one can know about the context— institutional, cultural, political, epidemiological—in which particular populations live and work. . . . When [social epidemiology] is successfully predicted, it is not likely to be because it is based upon deductions from scientifically valid generalizations that are true across time and place, but because analysts understand more or less intimately the people and places with which they are concerned, and because they can extrapolate sensibly from relevant experiences and groups elsewhere” (Stephen L. Kunitz, “Sex, Race and Social Role— History and the Social Determinants of Health,” International Journal of Epidemiology 36 [2007]: 10). Readers should remain alert to the historical perspective and of the possibility that the strength of the relationships of some variables may vary in time and place.

xvi Preface

sociology, and public health among other disciplines, may choose to devote more attention to specific chapters and some may understandably argue for a difference in their ordering leading to the suggested hypothesis of the economic value of health. I elected to begin with an all too brief review of the halakha, a massive compendium of Jewish religious laws derived from the written and oral Torah involving rules and practices affecting every aspect of life and in this case, those dealing with the promotion of health and prevention of disease. I then examined the premium placed on specific values brought to these shores by late nineteenthcentury Jewish immigrants, including education and literacy, as well as those involving social support, strong family ties, and the health-conducing behaviors of breast-feeding and child spacing. The following three chapters discuss implications for the promotion of health by the low incidence of alcoholism followed by the management of risks associated with a poor housing environment and employment profile during the latter part of the nineteenth and early twentieth centuries. The journey continues with the suggested hypothesis, of an as-yet-to-be quantified contribution of a health culture to the social and economic rise of American Jews, and ends with some of the implications for the future for more recent immigrants to this country.

Acknowledgements

This manuscript includes the contribution of many individuals representing different intellectual disciplines. My first debt of gratitude is to those whom I would almost certainly fail to acknowledge with sufficient respect and gratitude. Identifying an appropriate editor can be long and arduous until one finds a competent wordsmith, who is fluent in the subject matter and willing to treat it as a learning experience. My search ended on the first try in 2003, when I was introduced to Ms. Sandy Paton, President of Caduceus PA, LLC, while in the process of creating The Lindex, which led to her editing The Lindex and subsequently this book. It was apparent immediately that Ms. Paton possessed the necessary editorial skills and ability to cohere all-too-often inchoate thoughts into the desired message. And to my unending admiration and appreciation, Ms. Paton took it upon herself to become familiar with primary source esoterica. I was indeed very fortunate having Sandy at my side. This manuscript has been reviewed by a diverse group of individuals representing a broad range of interests and competencies. Each made unique and much appreciated comments. The list includes, but is not limited to, in alphabetical order, Rabbi Saul Berman, JD, adjunct professor and Rotter Fellow, Columbia University School of Law and chairman of the Judaic Studies Department, Stern College for Women of Yeshiva University; Stanley Cohen, MD, emeritus professor and former chairman, Department of Pathology and Laboratory Science, Rutgers–New Jersey Medical School; Lisa Jacobs, MD, MBA, Department of Psychiatry, the University of Pennsylvania; Kenneth M. Klein, MD, professor, Department of Pathology and Laboratory Science, Rutgers–New Jersey Medical School; Lorelle N. Michelson, MD, clinical associate professor of plastic and reconstructive surgery, Department of Surgery, Rutgers–New Jersey Medical School; Rabbi Elazar Hurvitz, PhD, of Yeshiva University and Samuel Belkin, PhD, professor of biblical studies and Talmudic

xviii Acknowledgements

literature, Yeshiva University; Stanley J. Robboy, MD, Department of Pathology, Duke University School of Medicine; Jonathan Sarna, PhD, The Joseph H. & Belle R. Braun Professor of American Jewish History, Brandeis University, and chief historian of the National Museum of American Jewish History; and Claudewell S. Thomas, MD, MPH, professor emeritus of psychiatry and biobehavioral sciences at the Geffen School of Medicine UCLA. I have long wished to acknowledge a long overdue debt to my professors whose teaching both within and out of the classroom have served as a great source of inspiration. Most are long gone, but not forgotten, and their efforts in my behalf suffuse every page of this manuscript. At the Columbia University Mailman School of Public Health, they include the late Lowell Eliezer Bellin, MD, MPH, professor and head of the Division of Health Administration, and Harold Fruchtbaum, PhD, adjunct associate professor of the history and philosophy of public health. At the Rutgers–New Jersey Medical School, Neil S. Cherniack, MD, professor of medicine and physiology; at Yeshiva University, Nathan Goldberg, PhD, professor of sociology, and Hyman B. Grinstein, PhD, professor of American Jewish history; at Yale University, August de B. Hollingshead, PhD, Sumner Professor of Sociology, and Jerome K. Myers, PhD, professor of sociology. It is impossible to recompense them. The skills and devoted assistance of many research librarians were required in the writing of this manuscript and assembling The Lindex. Immediately coming to mind is the late Dina Abramowicz, longtime doyen of Yiddish literature and distinguished librarian at the YIVO Institute for Jewish Research, a division of the Center for Jewish History in New York City; Judy S. Cohn, MLS, assistant vice president for Information Services and director of Health Sciences Libraries, Rutgers; Roberta Bronson Fitzpatrick, MSLIS, associate director of the George F. Smith Library of the Health Sciences and capable staff members; Barbara Robey, MLS, retired, Columbia University, and the competent librarians of the New York Academy of Medicine, and Columbia University (and my many colleagues and medical students who reviewed this manuscript, as well as many generations of medical students at the Rutgers–New Jersey Medical School. Special thanks are owed to the anonymous reviewers for their helpful comments).

Introduction

Some readers will recall the ever-popular Yiddish song, “Abi Gezunt,” featured in the film Mamele. The music by Abraham Ellstein may be familiar; however, the lyrics by Molly Picon were to prove prescient. Words in the first stanza, A bisl zun a bisl regn; a ruig ort dem kop tzu legn; abi gezunt ken men gliklakh zayn, translate loosely as, “a little sun, a little rain; a quiet place to lay one’s head; so long as you are healthy, good fortune will follow.” The lyrics of this song address a relationship between health and fortune that underlies the theme of this book. Consonant with sustained upward mobility, but deserving far more attention, has been Jewish interest and concern for health—whether on the personal or community level. Achieving a state of health involves a partnership between providers and consumers. A century ago, infectious diseases, such as diphtheria, influenza, and tuberculosis, were the scourge of the time, only to be followed by chronic diseases, such as heart disease, hypertension, and stroke. Steady innovations and influences outside the field of health sciences and medicine have provided continued impetus for improvements in health. Public health professionals have long pointed to increases in longevity preceding the advent of effective medical treatment from a variety of means, including advances in nutritional science and sanitary engineering, education, and increased income.1 A review of material on the Jews of Middletown, Connecticut, which involved a comparative retrospective cohort analysis of birth, death, and marriage certificates belonging to Jews and non-Jews for the years 1873-1935, revealed that the Jews were far more likely to travel to the Grace New Haven   1 R. G. Evans, M. L. Barer, and T. R. Marmor, Why Are Some People Healthy and Others Not? (Hawthorne: Aldine de Gruyter, 1994); J. B. McKinlay and S. M. McKinlay, “The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century,” Milbank Memorial Fund Quarterly 55 (1977): 405–428; T. McKeown, “The Direction of Medical Research,” Lancet 2 (1979): 1281–1284; Leonard. A. Sagan, The Health of Nations: True Causes of Sickness and Well-Being (New York: Basic, 1987); John Mirowsky and Catherine E. Ross, Education, Social Status, and Health (Hawthorne: Walter de Gruyter, Inc., 2003).

xx Introduction

Hospital, the major hospital of the Yale University School of Medicine to seek optimal care, rather than care at local hospitals or with local physicians.2 Today, the 25-mile plus journey takes about 45 minutes on the highway. A century ago, it might have involved several hours on much narrower and more treacherous roads. But the Jews of Middletown, when faced with serious illness, sought the New Haven Yale specialists. Education and economic well-being have been shown to be predictors of improved mortality among diseases amenable to medical intervention. A century ago, Elias Auerbach demonstrated that the Jews of Budapest were less likely to die as a result of such diseases.3 Similarly, when these diseases occurred in America, the Jews took immediate action to eliminate them. Today, epidemiologists differentiate between diseases that are potentially avoidable through appropriate medical attention and those that are not.4 The relationship between social class and mortality associated with diseases amenable to care has been widely substantiated with at least one study crediting education as “a slightly better indicator of avoidable mortality than income.”5 This was corroborated in a study by Marshall and colleagues, who found that the death rate attributed to amenable causes of mortality among men in New Zealand among the lowest socioeconomic group was 3.5 times higher than it was among men in the highest socioeconomic group.6 In a meta-analysis by Sandro Galea and colleagues that examined the causal impact of mortality in the United States for the years 1980 through 2007, deaths attributed to factors such as low education and poverty were comparable to the number of deaths related to pathophysiologic conditions,   2 Jacob Jay Lindenthal, “Early History of the Jews of Middletown, Connecticut” (PhD diss., Yeshiva University, 1973).   3 Elias Auerbach, “Die Sterblichkeit der Juden in Budapest 1901–1905,” Zeitschrift für Demographie und Statistik der Juden 11 (1908): 161–168.   4 D. D. Rutstein, W. Berenberg, T. C. Chalmers, et al., “Measuring the Quality of Medical Care: A Clinical Method,” New England Journal of Medicine 294 (1976): 582–588; D. D. Rutstein, W. Berenberg, T. C. Chalmers, et al., “Measuring the Quality of Medical Care: Revision of Tables and Indexes,” New England Journal of Medicine 302 (1980): 1146–1150.   5 E. Wood, A. M. Sallar, M. B. Schechter, and R. S. Hogg, “Social Inequalities in Male Mortality Amenable to Medical Intervention in British Columbia,” Social Science & Medicine 48 (1999): 1751–1758.   6 S. W. Marshall, I. Kawachi, N. Pearce, B. Boorman, “Social Class Differences in Mortality from Diseases Amenable to Medical Intervention in New Zealand,” International Journal of Epidemiology 22 (1993): 255–261.

Introduction xxi

such as cancer and heart disease and behavioral diseases, including those resulting from smoking and alcohol abuse.7 The leading social cause of death in the year 2000 was low education, harvesting approximately 245,000 individuals, followed by racial segregation, which took 176,000 lives. Other social causes of death included low social support (162,000), individual-level poverty (133,000), income inequality (119,000), and area-level poverty (39,000). Galea and colleagues further noted that the number of deaths attributable to low education in 2000 was similar to the number associated with fatal acute myocardial infarction (192,898); whereas the number of deaths attributable to lung cancer (155,521) was similar to the number associated with low social support.8 Many of my readers will recall the work of Edwin Chadwick and William Farr, who documented health conditions in mid-nineteenth-century England. Their work drew attention to the wide disparity in morbidity and mortality among different segments of the British population and subsequently laid the foundation for succeeding generations of public health students. It is appropriate that we devote space to their contributions, as scholars have since drawn upon their analyses to examine public health issues. By contrasting mortality rates in healthy and unhealthy districts of England in 1846, Farr observed a relationship between poor public health conditions and increased mortality.9 The disparity in life expectancy between the educated and uneducated was remarkable. Those in the professional classes lived an average of 35 years, while tradesmen and their families lived 22 years, and laborers, mechanics, and servants lived 15 years. Sixty-two percent of deaths occurred among children younger than 5 years of age. Chadwick delved into factors known to influence health, including alcohol abuse, personal hygiene, and family solidarity in poverty-ridden areas. There, whiskey shops outnumbered bakeries 79 to 12. When a poor resident of   7 Sandro Galea, Melissa Tracy, Katherine J. Hoggatt, C. DiMaggio, and A. Karpati, “Estimated Deaths Attributable to Social Factors in the United States,” American Journal of Public Health 101 (2011): 1456–1465.   8 Galea et al., “Estimated Deaths Attributable to Social Factors in the United States,” 1464.   9 Ninth Annual Report of the Registrar General (London: HMSO, 1846); J. M. Eyler, Victorian Social Medicine: Ideas and Methods of William Farr (Baltimore: Johns Hopkins University Press, 1979); S. Halliday, “William Farr: Campaigning Statistician,” Journal of Medical Biography 8/4 (2000): 220–227.

xxii Introduction

Edinburgh was asked when he was last washed, he responded, “When I was last in prison.”10 Chadwick took pains to evaluate the economic burdens posed by preventable illness, an issue of considerable relevance to the underlying hypothesis of this book. He suggested that improving the working conditions of tailors would extend their lives by ten years, and improving sanitary conditions in the worst districts would reduce sickness by at least one-third. He found that society cast burdens on even the most industrious survivors. “Widowhood most often remains permanent . . . even when the children are by good training and education fitted for productive industry. When they marry, the early familiarity with the parochial relief makes them improvident.”11 Education and health were not priorities among the poor in Liverpool and Edinburgh. And even when education offered a promise, it was not kept. Without social support, little could be done to move a man from a path bound toward destruction. Although much has been written about the role of education in the rise of American Jews, the contribution of the supremely held value of health to that mobility has not been adequately reviewed. This volume inquires into the value of health and education and other social variables that might have operated together, particularly in the early part of the twentieth century, and that contributed to raising the socioeconomic status of American Jews. It further offers that the rise of this ethnic group can be attributed at least in part to their paramount regard for health, education, and other social variables that helped propel their upward social mobility. Health has always been of the utmost importance to Jews. Discussions at bar mitzvah celebrations often begin with talk about children and other family members in medical or dental schools. As fatigue sets in, the discussion turns to personal health problems and assorted remedies. Is there a relationship between the rise of American Jews and their concern for health-related matters? We suggest that such an association exists and on the following pages aim to begin a discussion of that relationship. The relationship between the rise of American Jews and their concern with human capital, in this case health, is the hypothesis.

10 Edwin Chadwick, The Sanitary Condition of the Labouring Population of Gt. Britain (Scotland: Edinburgh University Press, 1842). 11 Chadwick, The Sanitary Condition, 21.

Introduction xxiii

We further suggest that a deeply ingrained attitude toward health may have contributed to the economic welfare and subsequent rise of Jews in America. One cannot fail also to be impressed with the largesse of American Jews as it relates to their support of health-related research, education, care-giving institutions, and each other. This is examined in greater detail in Chapter 3, Charity—Das Jüdische Herz. Although a plethora of medical studies involving American Jews have been published since the latter part of the nineteenth century, very little attention was paid to the maintenance of health and the prevention of disease. This is somewhat surprising in view of the central place preventive medicine has played in the Jewish culture, the alacrity with which Jews have traditionally sought medical care, and the powerful intellectual contributions they have made to the field of health and medicine. Irving Howe, in World of Our Fathers, devotes a scant two pages to disease, focusing primarily on the ravages of tuberculosis and concluding that “the immigrant Jews seem to have ended with a better health record than did other immigrant groups.”12 Similarly, Frederick L. Hoffman concluded, “The Jews in this country, as well as abroad, enjoy a longevity superior to that of the Christians.”13 The World Health Organization defines health as “a state of complete mental and social well-being and not merely the absence of disease or infirmity.”14 This definition has remained unaltered since 1948, but was further elaborated in 1984 as follows: “The extent to which an individual or group is able to realize aspirations and satisfy needs, and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources as well as physical capabilities.” Implicit in this definition is a culture of health, including a constellation of attitudes and health-promoting behaviors that ward off disease and

12 Irving Howe, World of Our Fathers: The Journey of the East European Jews to America and the Life They Found and Made (New York: Harcourt Brace Jovanovich, 1976), 150. 13 Frederick L. Hoffman, “Expectation of Life,” Jewish Encyclopedia 5 (1903): 308. 14 World Health Organization, WHO Definition of Health, accessed April 19, 2010, http:// www.who.int/about/definition/en/print.html. [From the preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June, 1946; signed on 22 July 1946 by the representatives of 61 States and entered into force on 7 April 1948.]

xxiv Introduction

disability in their earliest possible stages—in other words, prevention: “Pay homage to the physician before you need him” (Shemot Rabbah, 21:7). Thus, embedded in the early history of American Jews were a value system and behavioral patterns that placed a high premium on the promotion of health and the prevention of disease. This system and these patterns inherent in the Jewish immigrant proved especially valuable and help explain what has become known as the “epidemiologic paradox” surrounding immigrants and contributing to their declining health. Alejandro Portes and Min Zhou argue that recent immigrants are more likely to be influenced by native-born groups, which challenge their attitudes and behaviors.15 Shared circumstances and residential propinquity lead naturally to a second generation that is more similar to native-born minorities rather than to the middle-class majority.16 New immigrants can be adversely affected by chronic poverty, neighborhood disorganization, eroding social support systems, and the loss of accustomed norms and other factors that would have protected them against deterioration of health. We suggest, however, that the high value placed on health, education, cohesive family life, and communal social support played a particularly important role in helping immunize the Jews against the “epidemiologic paradox,” or more specifically, the deterioration of their health status. Katholiki Georgiades and colleagues, using a nationally representative sample of 13,460 children (aged 4 to 11 years) from the Canadian National Longitudinal Survey of Children and Youth, examined influences on school performance and mental health, as well as the moderating effects of family immigrant status and processes.17 Areas with higher concentrations of immigrants conferred a protective effect on their children, especially with regard to mental health. Parental authority and enhanced social support further protected children against negative influences from surrounding society.18 Furthermore, recent 15 Alejandro Portes, Min Zhou, “The New Second Generation: Segmented Assimilation and Its Variants,” Annals of American Academic Political and Social Studies 530 (1993): 74–96. 16 N. S. Landale, R. S. Oropesa, D. Llanes, B. K. Gorman, “Does Americanization have Adverse Effects on Health? Stress, Health Habits, and Infant Health Outcomes Among Puerto Ricans,” Social Forces 78 (1999): 613–642. 17 Katholiki Georgiades, Michael H. Boyle, and Eric Duku, “Contextual Influences on Children’s Mental Health and School Performance: The Moderating Effects of Family Immigrant Status,” Child Development 78 (2007): 1572–1591. 18 G. Coll and L. A. Szalazha, “The Multiple Contexts of Middle Childhood,” Future Children 14 (2004): 81–97.

Introduction xxv

immigrant parents were more likely to stress the value of educational achievement and success than were nonimmigrant citizens. Among the Jewish immigrants at the turn of the century, however, this effect was magnified. In the chapters that follow, the reader will observe how the Jews, more than any other group, availed themselves of every opportunity to learn and gain a strong foothold in their new home. At the Adult Free Lectures, provided by the New York City Board of Education in the latter part of the nineteenth century, 34 percent of the Yiddish lectures dealt with health and hygiene.19 A variety of philanthropic funds, such as those available through the Baron Maurice de Hirsch Fund, provided resources to help socialize the immigrants and, in particular, teach them English, giving them the tools and know-how they would eventually use to the fullest to reap an income in various crafts and promote their financial independence.20 As noted, it takes a web of variables to promote health and prevent the onset of disease as well as its effective management when disease does occur. Some of the requisites described include the importance of placing a premium on good health, encompassed by literacy, education, a supportive social environment, and the low incidence of alcoholism. (The low incidence of alcoholism among Jews, despite the low incidence of abstinence, was well recognized and is examined in Chapter 6, Alcoholism Among the Jews.) Just how much good health is determined by wealth, good genes, or happenstance remains to be determined. It has been argued that low socioeconomic status leads to stress and anxiety and ultimately to disease. Seligman suggests that low socioeconomic status is generally associated with health illiteracy, that is, the inability to prevent or avoid disease or even understand and follow prescriptions or medical advice. Indeed, unhealthful habits, such as smoking, alcoholism, and sedentary living, are more prevalent among persons with low socioeconomic status. 21 At the very least, American Jews were unwilling to settle for the status quo, when doing so promised anything less than what they felt they were capable of. By the middle of the twentieth century, 20 percent of Jewish males were 19 Stephen F. Brumberg, Going to America, Going to School: The Jewish Immigrant Public School Encounter in Turn-of-the-Century New York City (New York: Praeger Publishers, 1986), 169. 20 Benjamin Rabinowitz, The Young Men’s Hebrew Associations (1854–1913) (New York: American Jewish Historical Society, 1947). 21 Dan Seligman, “Why the Rich Live Longer,” Forbes ( June 7, 2004): 113–114.

xxvi Introduction

professionals (double the national average), and 35 percent of them were proprietors (compared with 13 percent for the US population as a whole).22 Jews’ interest in medicine was manifested from the earliest days of American Jewish history. And one way to ensure good health was to become a healthcare giver, since interest in the promotion of health and prevention of disease was not limited to consumers but extended to practitioners. By the early part of the twentieth century, a large number of practicing physicians were of Jewish origin.23 The Lower East Side of New York City eventually had developed its own medical world, with its own medical societies, medical economic leagues, and even medical journals. When immigrant Jews first came to these shores, they turned to Irish and German physicians. Eventually, they were able to rely on their own countrymen, who developed reputations for treating certain afflictions. Moses Rischin observed that the “more bitter the concoction, the more it was appreciated. Doses before and after each meal, and a pill or two, preferably silveror gold-coated, before retiring were especially prized.”24 Sociomedical sciences have illuminated many of the factors associated with the prevention of disease and the promotion of health. Healthcare clinicians, policy makers, and administrators have come to appreciate that “. . . the goals of public health are set by the knowledge and values of society.”25 The notion that careful study of an ethnic group’s response to the preservation of health and the management of disease should include the social sciences was enunciated by Salomon Neumann in 1847, who suggested that “. . . medical science is intrinsically and essentially a social science, and as long as this is not recognized in practice, we shall not be able to enjoy its benefits.”26 A century later, John Alfred Ryle observed, “We no longer believe that medical truths are only or chiefly to be discovered under the microscope, by means of the test tube, and the animal experiment, or by clinical examination and increasingly elaborate pathological studies at the bedside. Psychological and sociological 22 Thomas Sowell, Ethnic America: A History (New York: Basic Books, Inc., 1981), 88. 23 Moses Rischin, The Promised City: New York’s Jews, 1870–1914 (Cambridge, MA: Harvard University Press, 1977); M. M. Davis, Jr, Immigrant Health and the Community (New York: Harper and Brothers Co., 1921). 24 Rischin, The Promised City, 72. 25 Geoffrey Vickers, “What Sets the Goals of Public Health?” Lancet 1 (1958): 599–604. 26 Salomon Neumann, Die Öffentliche Gesundheitspflege und das Eigenthum. Kritisches und Positives mit Bezug auf die Preussische Medizinalverfassungs—Frage (Berlin: Adolph Riess, 1847), 64.

Introduction xxvii

studies have as important a part to play. Even so, it is not yet appreciated how intimately disease and social circumstances are interrelated.”27 Leo Srole and colleagues, authors of the 1961 Midtown Manhattan study concluded, albeit with some reservation, that the proclivity of the Jews for psychiatric intervention was in large part rooted in Jewish family and religious tradition that emphasized the mobilization of family to support sick family members and seek healthcare resources outside the family when necessary.28 They concluded that the Jews were a “culture mobilized for the prevention and, that failing, for the healing of the ailments of body and mind.”29 By the mid-1970s, accumulating evidence pointed to diminishing distinctiveness of the American Jew in the medical and health orientations as a function of social changes in the orientation of other ethnic groups.30 Nonetheless, no evidence has been brought forth to support a weakening of the positive orientation toward health among Jews. One of the most important observations in the study of the disease experience of ethnic groups and the responses to them is the significant variation among them.31 The medical sociologist Renée Fox noted that health, illness, and medicine involve and affect every major aspect of a society—from the biological, to the social, to the psychological.32 Differences between individuals and groups can be attributed to genetic and cultural responses to the stresses of life within different cultures around the world. These variations in response can either confer protection against specific diseases or contribute to a heightened susceptibility to them. And while these responses might be beneficial to individuals in their own homelands, they might not prove as effective in newly adopted countries. The challenge for us is to review health conditions and responses to disease in the past and attempt to learn how these factors may have been influenced by the immigration of Jews to the United States. 27 John A. Ryle, Changing Disciplines (London: Oxford University Press, 1948), xlv. 28 Leo Srole, Thomas S. Langner, Marvin K. Michael, et al., Mental Health in the Metropolis: The Midtown Manhattan Study (New York: McGraw-Hill, 1962), 319–320. 29 Ibid., 320. 30 J. Greenblum, “Medical and Health Orientations of American Jews: A Case of Diminishing Distinctiveness,” Social Science & Medicine 8 (1974): 127–134. 31 Mark Nathan Cohen, Health and the Rise of Civilization (New Haven: Yale University Press, 1989). 32 Renée Fox, The Medicalization and De-Medicalization of American Society (Minneapolis: Daedalus Press, 1977).

xxviii Introduction

The time is propitious to explore the role of culture in the health and disease experience of specific ethnic groups. One reason is that since World War II, there has been a veritable explosion in research into the relationship of values and attitudes in the management of health and disease. It is now possible with these findings to review with greater insight than ever before those cultural factors that were conducive to health status. The myriad insights in our armamentarium allow us to re-examine ethnic history with an eye to furthering our understanding of the role that social and cultural factors play in the prevention of disease and the promotion of health. A metaphor for this activity would be the reentering of an abandoned gold mine thought to contain the precious metal that had been deemed inaccessible owing to the technological inadequacies of a previous era. To this end, we will examine social and cultural factors, including religious and philosophical orientation, educational status, social support, family values, and child rearing practices as they were expressed before and subsequent to the great migrations into the United States. Climbing the ladder of success requires a measure of strength. The Jews demonstrated their ability to overcome serious odds. Two important facts must be brought to bear at this point: (1) Other ethnic groups have also placed a premium on health and reaped rewards accordingly, and (2) groups with attitudes and behavioral patterns thought to induce negative health consequences—such as excessive alcohol consumption or drug abuse—have probably been hampered economically. The New York State Conference of Charities and Correction appointed a committee to investigate the cost of a normal standard of living in New York State. Of interest is that while the Russian and Italian immigrants in the lowest category spent proportionally the same amount of money on health, the Russians in the upper income brackets devoted twice the proportion of their income on health than did their Italian peers.33 It is no accident that one humorist could capitalize on this near obsession with health by portraying various different ethnic responses to fatigue and thirst as follows: Italians say, “I’m tired and thirsty. I must have wine.” Frenchmen say, “I’m tired and thirsty. I must have cognac.” 33 Robert Coit Chapin, The Standard of Living Among Workingmen’s Families in New York City (New York: Arno Press and The New York Times, 1971).

Introduction xxix

Mexicans say, “I’m tired and thirsty. I must have tequila.” Scots say, “I’m tired and thirsty. I must have whiskey.” Swedes say, “I’m tired and thirsty. I must have aquavit.” Japanese say, “I’m tired and thirsty. I must have sake.” Russians say, “I’m tired and thirsty. I must have vodka ” Germans say, “I’m tired and thirsty. I must have beer.” Greeks say, “I’m tired and thirsty. I must have ouzo.” Jews say, “I’m tired and thirsty. I must have diabetes.”

We will describe the relatively healthy status of the Jews and review some of the historical, cultural, and sociologic conditions that contributed to their health. In the nature of a broad hypothesis, it should be considered that a deeply ingrained attitude toward health might have provided one of the strongest contributions to the economic welfare and subsequent rise of Jews in America. In the pages that follow, data will be adduced in favor of primary prevention and the fostering of a population whose attentions have been riveted on health, a preoccupation that catapulted the majority of its people toward prosperity. The relationship between American Jewish concerns with health and their upward mobility remains speculative at this point. We view as our challenge the uncovering of some of the foundations for this deeply ingrained interest as well as some of the socioeconomic facts that support this assumption. The task for our successors lies in securing more direct data necessary to confirm our hypothesis.

CHAPTER 1

Halakha—The Foundation of Jewish Law and Life If the Bible is the cornerstone of Judaism, then the Talmud is the central pillar, soaring up from the foundations and supporting the entire spiritual and intellectual edifice. In many ways the Talmud is the most important book in Jewish culture, the backbone of creativity and of national life. No other work has had a comparable influence on the theory and practice of Jewish life, shaping spiritual content and serving as a guide to conduct. The Jewish people have always been keenly aware that their continued survival and development depend on the study of the Talmud, and those hostile to Judaism have also been cognizant of this fact. Adin Steinsaltz, The Essential Talmud1

T

raditional Jewish theology continually forms Jewish attitudes about what is considered right and wrong, including attitudes on health and learning. All Jewish laws have as their basis the maintenance of life. If life can be extended, even for a short time, then the route to do so must be taken (Shulchan Arukh, Orach Chaim 329:3). The foundation of Judaism is the halakha, the collective body of Jewish religious law, whose roots are found in both the written law (Torah/Pentateuch) and the oral law. The oral law was included in the 63 tractates of the Mishna, which were redacted by Rabbi Yehuda ha-Nasi around 200 CE. Before Rabbi Yehuda’s time, it was forbidden to record Jewish oral law in a written text. It was thought that because they lacked texts, students of the law would be compelled   1 Adin Steinsaltz, The Essential Talmud (Boulder: Perseus Publishing, 2006), 3.

2 Abi Gezunt

to maintain close relationships with their teachers. With the death of many of the best teachers in failed revolts, Rabbi Yehuda was moved to preserve the written word. The Talmud is the compilation of Jewish law. It comprises two components: the Mishna, a code of Jewish law written in Hebrew, and the commentary on the Mishna, known as the Gemara. Palestinian Aramaic was the spoken language, while Mishnaic Hebrew was the literary language. The Gemara was a combination of both Hebrew and Babylonian Aramaic. The oral law tradition continues to serve as an evolving vehicle of interpretation in every generation. There are three major denominations of American Jewry: Orthodox, Conservative, and Reform. Orthodox Jews profess an immutable faith in the law as recorded in the Torah and the Talmud. Interpreting the Talmud depends on precedent and principle: Orthodox rabbis aid in its transmission by interpreting when making judicial decisions (responsa), but may not directly alter it (Deuteronomy 4:2). Conservative Jewry, founded in America in l875, sought to meld orthodoxy to modern American life. Conservative Jews offer progressively more liberal interpretations of halakha. While acknowledging halakha, Conservative Jews emphasize that legislation is required at times when a consensus cannot be reached.2 Members of Reform Judaism, founded in Germany in l824, believe that the Pentateuch is inspired, and such inspirations can occur in every age and for all mankind. They stress the notion of progressive development in religion and believe that each age encourages the interpretation of and adaptation to the teaching of the Torah and the Talmud. Nonetheless, for all Jews halakha provides the same social and cultural framework that has guided them through the millennia as they sought to promote health and adapt to disease. This chapter will examine selected aspects of the approach taken by Judaism toward health care as reflected in ancient texts and further explicated and defined by contemporary students. THE SACREDNESS OF LIFE The Jewish view of medicine negates a causal sequence in the etiology of illness, but rather subscribes to a system-oriented scheme. Illness is seen as a reflection   2 Jacob Neusner, Judaism in the Secular Age: Essays in Fellowship, Community and Freedom (New York: K’Tav Publishing House, Inc., 1970).

Halakha—The Foundation of Jewish Law and Life 3

of one’s way of life: “If you listen to the voice of the Lord and you do what is right in His eyes and give ear to His commandments and keep all of his statutes, I will put none of the diseases upon you which I put upon Egyptians, for I am the Lord that heals you” (Exodus 15:26). All life, including that of lower animal forms, is regarded as sacred in Judaism: “The righteous man regardeth the life of his beast” (Proverbs 12:10). The Talmud insists upon equal treatment of all peoples: “Thou shalt not abhor an Edomite, for he is thy brother; thou shalt not abhor an Egyptian, because thou wert a stranger in his land” (Deuteronomy 23:8). The sanctity of life is paramount in Jewish thinking. Although Jewish law generally prohibits abortion, it is certainly permitted when there is a threat to the mother’s life. The Talmud states, “If a woman is in hard travail and her life cannot otherwise be saved, one cuts up the child within her womb and extracts it, member by member, because her life comes before that of the child. But if the greater part of the head is delivered, that it be born, one may not touch it, for one may not set aside one person’s life for the sake of another” (Mishna, Oholot 7:6). According to some decisions of Jewish law, abortion is permissible based on maternal health interests, but not on the condition of the fetus. Many Conservative and most Reform rabbis would agree to abortion where there is a probability of severe physical deformity or profound retardation. Abortion is also allowed in pregnancies resulting from sexual crimes, such as rape, statutory rape, and incest.3 In Deuteronomy (30:15), man is told to “choose life” and to preserve it over other biblical injunctions, with—according to the Talmud—the exception of incest, idolatry, and murder. It is equally important to promote physical and psychological well-being and to uphold each individual life to prevent destroying the moral fabric of society (Exodus 21:19). The Sanhedrin 37a, in a discussion of Adam as a single entity, equates the destruction of one man with that of the entire human race. Thus, to save the life of one person is to save an entire world (Sanhedrin 4:5). The respect for life is reflected in the dignity afforded the dead. A biblical injunction enjoins the disgrace of the dead, even of executed criminals (Deuteronomy 21:23); however, life always takes precedence over death. Even the   3 Solomon B. Freehof, “Abortion,” Central Conference of American Rabbis (1958): 118.

4 Abi Gezunt

Sabbath may be desecrated if a life can be prolonged (Shabbat, 151b), and thus a marriage procession takes precedence over a funeral cortege, should both meet at an intersection (Ketubot 17a, Yoreh Deah 360:1). The work of Maimonides, the great twelfth century rabbi, physician, ethicist, and philosopher, represents the rabbinical attitudes toward health unlike any other. Referred to by William Osler as “the Prince of Physicians,”4 Maimonides, who served as the physician to the ruler of Islam, King Saladin, wrote ten medical treatises. While his writings often reflect Aristotelian ideas as well as the medical thinking of eight centuries ago, which appear naïve when viewed through a contemporary lens, many practitioners of holistic medicine and naturopathy today take a more welcoming attitude. For Maimonides, the practice of preventive medicine and the preservation of health are mandatory in the service of the Almighty. In his Mishneh Torah Hilchot De’ot, The Laws of Personality Development, Maimonides encourages maintaining a healthy and sound body as living among the “ways of God” and avoiding anything that will harm the body: “. . . a person should never eat unless he is hungry, nor drink unless thirsty . . . never put off relieving himself . . . should engage his body and exert himself in a sweat-producing task each morning. . . .”5 Maimonides was well aware of the relationship between mental health and physical well-being. He acknowledged different types of mental anguish and mental distress and weakness of mental faculties and their role in diminishing the appetite for food owing to “anguish and fear and grief and distress.”6 Conversely, he noted, “rejoicing and happiness have the opposite effect by gladdening the heart and promoting movement of the blood and the spirit. . . .”7 Maimonides’ insights, although written eight centuries ago, could well serve as an introduction to the study of public health, in that he compared the poor air of the cities with narrow streets thick with the waste of their inhabitants to that of the air of the open fields. He recommended living on the   4 William Osler, “Remarks Made at the Dinner Commemorating the Twenty-Fifth Anniversary of the Jewish Historical Society, London, April 27, 1914,” Canadian Medical Association Journal 4 (1914): 729–733.   5 Rabbi Za’ev Abramson and Rabbi Eliyahu Touger, trans., Mishneh Torah Hilchot De’ot, The Laws of Personality Development (New York/Jerusalem: Moznaim Publishing Corporation, 1989).   6 Fred Rosner, trans., Moses Maimonides Medical Writings Treatise on Asthma (Haifa: Maimonides Research Institute, 1994), 73.   7 Ibid., 74.

Halakha—The Foundation of Jewish Law and Life 5

outskirts of a city or in a city with “wide horizons” if one cannot escape living in the city, and choosing living quarters with a sufficient flow of air and rooms where the sun is permitted to shine in as “the regime for preserving the health of one’s body and soul.”8 SICKNESS AND HUMAN INTERVENTION God is considered The Physician: “I the Lord am your healer” (Exodus 15:26). One could thus conclude that Judaism called for no role on the part of the physician, who was enjoined to trust in and diligently pursue God’s precepts alone to heal mankind: “If thou wilt diligently hearken to the voice of the Lord thy God, and wilt do that which is right in His eyes, and wilt give ear to His commandments, and keep all His statutes, I will put none of the diseases upon thee, which I have put upon the Egyptians; for I am the Lord that healeth thee” (Exodus 15:26). One, however, is enjoined to seek the services of a physician in times of need: “Who is in pain let him go to the physician” (Baba Kamma, 46b). God then shares the role of healer with man (Exodus 21:19; Talmud, Berahot). Ancient Jews, 450 years before Hippocrates, were probably the first to extrapolate the field of medicine from religion, as seen in the life of King Asa (915-875 BCE): “And in the thirty and ninth year of his reign, Asa was diseased in his feet; his disease was exceedingly great; yet for his disease he sought not to the Lord, but to the physicians.” With rare exception (I Kings 13:4,6; I Kings 17:11, 22; II Kings 4:17, II Kings 207:7), the management of disease was given over to secularly trained individuals. A significant number of ancient Jewish leaders and rabbis practiced medicine in varying degrees. Moses and Elisha had involved themselves with medical care. Their knowledge was based on tradition, clinical observation, and animal experimentation. Jewish physicians often bore extreme persecution, but were also held in very high esteem in many quarters. In the mid-sixteenth century, Christians were forbidden to read Hebrew books, with the exception of those dealing with medicine. Francis I of France requested the Holy Roman Emperor, Charles V, to provide him with a Jewish physician. This doctor met with such a degree of anti-Semitism from Francis I that he denied his Judaism, claiming to   8 Ibid., 109.

6 Abi Gezunt

have been converted to the one true faith. The King consequently dismissed the physician and asked to be provided with a genuine Jewish physician.9 Such was the image of the Jewish doctor—one of excellence. The Talmud placed physicians on a high pedestal (Baba Metzia, 85b; Hullinn, 7b; Sanhedrin, 17b). Although there are examples in the Talmud of physicians treating the poor for no fee (Ta’anit, 20b), the Talmud in fact requires physicians to charge for their services, arguing that “a healing for nothing is worth nothing” (Baba Kamma, 85a). So highly esteemed are physicians that the Talmud forbids anyone to live in a town where there is no medical doctor (Sanhedrin, Kiddushin, Mishneh 12). Maimonides further exhorted the Jewish people not to live in towns without a physician, surgeon, or bathhouse (Mishneh Torah, Hilchot De’ot, 4:1). The role of Hebrew scholars in the Middle Ages has been well acknowledged. In an address in 1894 before the International Medical Congress in Rome, Giovanni Battista Morgagni observed that in early medieval times, the Jews and the Arabs both contributed to the progress of medical science.10 Hebrew manuscripts have elucidated today how learned Jewish physicians of those times preserved and advanced the science of medicine. In Judaism, the physician does not have an absolute right to refuse treating a patient who is not yet under his care, a right granted under American Law. In the Jewish tradition, the physician acts not only on behalf of the patient, but also in the service of God and, accordingly, must go beyond American Medical Association code of ethics that declares, “a physician may choose whom he will serve.” The Jewish position in this regard is reflected in the oath of Maimonides that requires a testimony of belief in one God as Creator and the need to be subservient to Him as well as to request assistance from Him when dealing with patients. Halakhic reasoning may also be applied to other problems. For example, in vitro and in vivo fertilization are both permitted, since no earlier source forbids them. Rabbi J. David Bleich observed that, although in the case of the former experimentation with the technique would be forbidden because of the   9 L. Wallerstein, “Behind the Pioneer Role of Jews in Medicine: The Traditional ‘Jewish Doctor’ Explained,” Commentary 19 (1955): 244–250. 10 Harry Friedenwald, “The Relation of the Jews and of Judaism to the Medical Art,” American Medicine 23 (1917): 615–619.

Halakha—The Foundation of Jewish Law and Life 7

prohibition against spilling seed, there is no natural law that undermines the technique.11 Genetic counseling is both permissible and encouraged to prevent tragedy. But even after a couple has conceived a defective child, Rabbi Bleich stresses that subsequent “failure to bear children is not a halakhically viable alternative.”12 Rosenfeld and Rosner argued that modifying genetic material may be halakhically permissible on several grounds.13 First, genes are submicroscopic and would have been unknown to early thinkers; therefore, tampering with them would not have been forbidden. Second, since genetic surgery does not destroy the ovum or sperm, it cannot be considered spilled. Finally, if surgery is permitted on a person, it can certainly be permitted on an ovum or a sperm. PREVENTIVE MEDICINE Prevention is preferred to treatment: “. . . it is better for man that he avoid becoming ill than that he become ill and be cured.” According to the Midrash (Leviticus Rabbah 16:8), “A man can protect himself from illness by wholesome living.” The anthropologist Franz Boas highlighted this when he wrote that the Jews might be considered the “creators of the science of public hygiene.”14 It should come as no surprise to learn that very few Jewish women have been against vaccinating their children.15 Jews have long differentiated between the pure and the impure. Moral and physical purity are one and the same. The Israelites referred to themselves as a priestly and holy people, a mamlechet kohanim (Exodus 19:6). They were accordingly charged with high standards of sacerdotal hygiene, as befitting a priest. This helped to forge a way of life involving adherence to clearly prescribed 11 J. David Bleich, Judaism and Healing: Halakhic Perspectives (New York: K’Tav Publishing House, Inc., 1981). 12 Ibid., 123. 13 Azriel Rosenfeld, “Judaism and Gene Design,” in Jewish Bioethics, ed. F. Rosner and J. D. Bleich (New York: Sanhedrin Press, 1979), 401–408; F. Rosner, “Genetic Engineering and Judaism,” in Jewish Bioethics, ed. F. Rosner and J. D. Bleich (New York: Sanhedrin Press, 1979), 409–420. 14 Harry A. Savitz, “The Role of the Jewish Physician in the Progress of his People,” Annals of Medical History 10 (1938): 107–116. 15 Michael Marks Davis, Jr., Immigrant Health and the Community (New York: Harper and Brothers Co., 1921).

8 Abi Gezunt

hygienic practices.16 Greater direct attention to health and medicaments will not be found in any other sacred literature. Individuals are exhorted not only to be ethical for their own well-being, but also with regard to the social ramifications of their behavior. The practice of hygiene, both on the personal and social levels, was considered paramount. Food was to be pure and uncontaminated (Leviticus 20:25; Yoreh Deah 161:6), and contaminated vessels were required to be destroyed (Leviticus 11:33, Numbers 19:15). Special attention is given to meat (Exodus 22:31, Leviticus 7:15-17, 19:6; Deuteronomy 14:21, 16:4, Ezekiel 4:14). The Roman dictum mens sana en corpore sano (a healthy mind in a healthy body) has its spiritual analogy in the Talmudic notion of bodily cleanliness being conducive to spiritual cleanliness (Avoda Zara, 206; Jer. Shabbat 1:3, 3b) (see also Chapter 7, section entitled “A Culture of Health”). It is therefore not surprising that the erection of a ritual bath or mikvah took precedence over the building of a Synagogue.17 COMMUNICABLE DISEASE In 1873, John Hough described the history of the Jewish experience with disease based on figures accumulated by an insurance company.18 He noted then that the Jews were less susceptible to the plagues of 1346, 1505, 1624, 1691, and 1736 than were their non-Jewish counterparts. He further noted that the average lifespan of Jews was 37 years, compared with 26 years for non-Jews, writing that as prescribed in Mosaic laws, Jews should take every precaution to save all lives.19 The Talmud describes two major means for transmitting communicable diseases: directly from person to person and indirectly from lower animals to man through vectors, such as air water, food, and secretion. Kagan notes that ancient scholars were very aware of the necessity of practicing good hygiene to maintain health, admonishing people to wash face, hands, legs, eyes, and 16 Arturo Castiglioni, “The Evolution of Medicine Among the Jews,” Medical Leaves 5 (1943): 10–17. 17 Mordecai Etziony, “Medicine in the Hebrew Daily Prayer,” Canadian Medical Association Journal 71 (1954): 396–398. 18 John S. Hough, “Longevity and Other Biostatistic Peculiarities of the Jewish Race,” Medical Record 8 (1873): 241–244. 19 Ibid., 243.

Halakha—The Foundation of Jewish Law and Life 9

clothing daily and to change clothing daily. Drinking from unclean glasses or putting coins in the mouth were noted to cause harm. Spitting in public baths and tasting soup and putting the spoon back in the pot were known to spread infection. Bathing more frequently was suggested for inhabitants of large cities, since the air in large cities was known to contain larger quantities of foreign matter than found in the country.20 Chapter 13 of the Book of Leviticus provides a detailed discussion of dermatologic conditions, which were generally classified into Shkhin and Zora’ath. The diagnosis of these diseases was left to the priest, and sophisticated distinctions were made between lepromatous leprosy and vitiligo. Noah Aronstam suggests that these two classifications also probably included Aleppo or Delhi boils, framboesia, furunculosis, granulomata, impetigo, scabies, and trichophytide.21 Although there is no mention of treatment, great detail is provided for hygiene, quarantine, and burning of contaminated garments. Some of the principle causes, pathology, and prognosis of diseases in the early Hebrew literature have been reviewed by Solomon Kagan.22 The Babylonian Talmud includes among them uncleanliness, heredity, trauma, worry, and fear. Rabbi Samuel cautioned against “uncleanliness of the head, leading to infection of the scalp and eyes; uncleanliness of clothes, leading to discomfort and nervousness; and uncleanliness of the body causing skin diseases and disability” (Nedorim, 81). Cold, heat, and neglect are noted in the Palestinian Talmud as causes of death (Sabbath, 19: Baba Bathra, 8: Leviticus Rabbah, 16; Derech Eretz Rabbah, 10). Poor environmental conditions, including lack of sunshine, dampness, drafts, and abrupt changes in temperature were considered conducive to ill health (Yerushalmi Shekolim, 5; Niddah, 8; Zohar vol. 3, 227; Ketubot, 30). Ingesting unripe fruits and contaminated water as well as experiencing sudden changes in the environment would result in intestinal illnesses, while insufficiently boiled beef was known or suspected to be a cause of tapeworm infes­tation (Pesiktah Rabati, 37; Sanhedrin, 27; Shabbat, 109; Genesis Rabbah, 37). Excessive exercise or eating, lack of exercise, anxiety, fear, travel, and sin were associated with heart 20 Solomon R. Kagan, “Hygiene Among the Ancient Hebrews,” American Medicine 39 (1933): 26–30. 21 Noah E. Aronstam, “A Dermatologic Galaxy,” Medical Leaves 3 (1940): 193–198. 22 Solomon R. Kagan, “Etiology, Pathology and Prognosis According to the Ancient Hebrew Literature,” New England Journal of Medicine 202 (1930): 333–336.

10 Abi Gezunt

palpitations (Sabbath, 33; Aboth R. Nathan 11; Eruvin, 56; Ketubo, 62t; Gitin, 70; Sifrei, Deuteronomy, 32). Hereditary diseases were distinguished from contagious diseases. Epilepsy and hemophilia were understood to be hereditary disorders (Yevamoth, 64), while food, utensils, and clothing were said to serve as vectors for contagious diseases (Midrash, Ruth 1; Taanith, 21; Siphra, 12; Yoma, 84; Gitin, 67; Chulin, 94). Hemophilia drew considerable attention, since it had resulted in an occasional death following circumcision. That it is transmitted from mother to son and that it is a disorder of the blood clotting system were also known (Yevamoth, 64) to the writers of the Talmud, as was the existence of microorganisms and insect-vector diseases (Berachot, 6; Pesikta Rabati Tanchuma, Mishpatim, 19; Genesis Rabbah, 12; Ta’anit, 21). LIVING BY THE LAW Basing findings and outcomes on religion presents challenges to many readers and researchers in deciphering the interrelationship of factors associated with any religion: socioeconomic issues, the definition of the religion, failure of study subjects to specify religious membership and participation (that is, beliefs and adherence), and failure of study subjects to claim denominational status. Membership in a religious group can originate either by birth or self-selection, making it difficult to measure the contribution of factors other than religion itself on health status. Finally, the degree of adherence to religious norms cannot be assessed in any standard manner.23 Nonetheless, we attempt to make the connection between health and those who have practiced a particular faith and adhered to the laws in some fashion. Harold Koenig cautions that it is important to distinguish between confounders and explanatory variables when seeking to arrive at conclusions based on the religion-health relationship.24 He observed that religious involvement offers social support, resulting in better mental health and better health behaviors. Citing epidemiologic evidence for the ameliorative effects of religion, particularly with regard to social support, 23 George K. Jarvis and Herbert C. Northcott, “Religions and Differences in Morbidity and Mortality,” Social Science & Medicine 25 (1987): 813–824. 24 Harold G. Koenig, Medicine, Religion, and Health: Where Science & Spirituality Meet (Pennsylvania: Templeton Foundation Press, 2008), 130–133.

Halakha—The Foundation of Jewish Law and Life 11

Koenig offered that the “weight of evidence today favors psychological, social, and behavioral factors being categorized as explanatory variables or mediators of the religion-health relationship, not as confounders.” Michael McCullough and colleagues observed an overall 29 percent increase in survival in those who were religiously involved, with effects stronger in women than in men, particularly in those who attended weekly religious services, conferring a 37 percent increase in survival.25 Evidence of outside influences in Judaism abound. In tractate Berachot, 6a, Genesis Rabbah states that “the evil spirits crowd the academies and are to be found by the side of the bride. They hide in the crumbs that we throw on the floor and in the water we drink; they are to be found in the diseases we contract, in the oil, in the vessels, and in the air. No mortal could survive if he saw their number, for they are like the earth that is thrown up around a bed that is sown.” One wonders with Angelo Rappoport,26 who observed that demons were thought to congregate in cemeteries, deserts, and other “gruesome” localities, whether rabbis of ancient times had some understanding of modern day microbiology. Although most rabbis were offended by the notion of a dybbuk or devil, there were others who invoked their powers for protection and health. Jewish law is a living one and all adherents to the law are exhorted to abide by the law in a reasonable way, that is, to ponder the halakhic implications and how they may be applied to the current era and the individual’s circumstances. It is faith and adherence to the Hebraic law, according to Mordecai Etziony, that paved the physician’s way and not the other way around.27 The tradition and consciousness of the Hebrew through the centuries determined good medicine and how the physician would apply it. God remains the Prime Healer; the physician His messenger.28 The laws regarding hygiene as recorded in the Pentateuch were incorporated into later writings, including the Talmud, Tosfot, and Midrashim, and into the daily life of the Jew. The effect was to confer a consciousness of medicine upon the family, deeply rooting the concept of God as Healer and the physician as His Shaliyah (messenger). Thus, faith and knowledge of 25 M. E. McCullough, W. T. Hoyt, D. B. Larson, H. G. Koenig, and C. Thoresen, “Religious Involvement and Mortality: A Meta-Analytic Review,” Health Psychology 19 (2000): 211–222. 26 Angelo S. Rappoport, The Folklore of the Jews (London: Soncino Press, 1937). 27 Etziony, “Medicine in the Hebrew Daily Prayer,” 396. 28 Ibid.

12 Abi Gezunt

sanitary laws and healthful practices were incorporated into the Jewish understanding of medicine.29 We have noted that the teachings for medical practices, such as abortion, amniotic testing, in vitro fertilization, and genetic counseling, are specific. Halakhic scholars might dispute the conditions under which these practices are performed depending upon their persuasion—Orthodox, Conservative, or Reform; however, every issue is weighed heavily and serves as testimony to the Jews’ belief in the sanctity of life. Many of the contributors of the halakhic literature were not only rabbis but also physicians, as in the case of Maimonides. Thus its tenets are rooted deeply in the preservation of life. The teachings from the Torah and the Oral Law, which form the basis of Jewish law known as the halakha, serve continually as a guide for the living and for living this life fully and well. We acknowledge that some of what we have stated remains subject to debate in Jewish law. Accordingly, our words should be considered an interesting orientation of Jewish law as it relates to health. Our readers are respectfully advised to direct any questions on a case-by-case basis to a qualified rabbinic authority. With this all too brief review of Jewish law as it relates to health, we turn our attention to the relative health status of immigrating Jews as reflected in comparative morbidity and mortality data from Europe. This is followed by challenges posed by the physical environment, more specifically, housing and work-related conditions.

29 Ibid., 396–398.

CHAPTER 2

Education and Literacy: The Path to Good Health . . . Those who are competent and have confidence in themselves and their ability to control their own lives will experience better health outcomes than those who do not. Leonard A. Sagan, The Health of Nations: True Causes of Sickness & Well-Being1

T

he underlying hypothesis of this ongoing work suggests that, among other factors, immigrant Jews to America placed a premium on both health and education that in turn conduced to upward social and economic mobility. The positive relationship between social status and morbidity, as gauged by levels of education, occupation, income, and housing, has long been documented.2 Although Jewish immigrants arrived on these shores as impoverished as members of other groups, there was one critically important difference between them and their fellow immigrants: they or their grandparents were far more likely to have derived from the middle class.3 High cultural values accounted in part for the rapid rise of Jews in occupational status and economic influence. In addition,

  1 Leonard Sagan, The Health of Nations: True Causes of Sickness & Well-Being (New York: Basic Books Inc., 1987), 190.   2 W. P. D. Logan, “Social Class Variations in Mortality,” Public Health Reports 69 (1954): 1217– 1223; A. B. Hollingshead and F. Redlich, Social Class and Mental Illness: A Community Study (New York: Wiley, 1958); A. Antonovsky, “Social Class, Life Expectancy and Overall Mortality,” Milbank Memorial Fund Quarterly 45 (1967): 31–73; E. M. Kitagawa and P. M. Hauser, Differential Mortality in the United States: A Study in Socioeconomic Epidemiology (Cambridge, MA: Harvard University Press, 1973).   3 U.S. Immigration Commission, Reports of the Immigration Commission (1907–1910) (Washington, D.C.: Government Printing Office, 1911).

14 Abi Gezunt

their emphasis on Talmudic learning led naturally to a desire for knowledge.4 Although more than one-quarter of Jewish immigrants were unable to read or write a secular language, a function of the restrictions placed upon them by Russian laws, a greater proportion of them could read Hebrew. Abraham Cahan noted that “the most ignorant man of the earth among our people can read the holy tongue [Hebrew], though he may not understand the meaning of the words.”5 Jacob Riis further observed that “the poorest Hebrew knows—the poorer he is, the better he knows it—that knowledge is power, and power is the means for getting on in this world that has spurned him so long.”6 The former Chief Rabbi of the British Empire, Rabbi Jonathan Sacks, has written, “Judaism is a faith whose passion is education, whose heroes are teachers, and whose citadels are schools and houses of study. To learn, to teach, to internalize God’s will, to join our minds with the great sages and scholars of the past—this is a supreme expression of Judaism, and the one from which all else flows.”7 We suggest that education played a very significant role in promoting health and preventing disease among American Jews. Let us first briefly review some of the health benefits associated with education. LONG-TERM HEALTH Education has a tremendous impact on long-term good health. It not only increases the receptivity of the population to the importance of health care, but also increases the demand for health services and improves the doctor-patient relationship. It furthermore also leads to a decline in fertility and better maternal care—two closely linked areas8 (see also Chapter 5). It has been suggested that health is a function of mastering one’s environment and being receptive to change. Although a person’s income level can have a positive impact on health status, the level of education a person has achieved has even greater predictive power. We suspect that the remarkable good health of Jews in the United States, particularly during their trying period of immigration at the turn of the century,          

4 5 6 7 8

Milton M. Gordon, Assimilation in American Life (New York: Oxford University Press, 1964). Abraham Cahan, The Rise of David Levinsky (New York: Harper & Bros, 1917), 88. Jacob A. Riis, The Children of the Poor (New York: Charles Scribner’s Sons, 1892), 47. Jonathan Sachs, The Koren Siddur ( Jerusalem: Koren Publishers, 2011), 56. Claudio Gonzalez-Vega, Health Improvements in Costa Rica: The Socioeconomic Background (Paper delivered at the Rockefeller Conference, Bellagio, Italy, 1985).

Education and Literacy: The Path to Good Health 15

might be attributed to their high regard for education in the Jewish tradition coupled with their overriding concern for health. Education also increases productivity; enhances the desire to find work; and increases income, allowing for the purchase of adequate food, housing, and medical care—all of which contribute to greater health.9 Educated parents are more likely to feed children adequately than are uneducated parents at the same income level and to provide appropriate care for their children when they are sick. They are more likely to be clean and insist upon hygienic conditions in their homes. Repeated evidence from studies has shown that parents, mothers in particular, with higher educational levels demand more efficient healthcare systems.10 INCREASED LONGEVITY Perhaps one of the more profound effects of education remains on increased longevity. The longer one remains in school, the greater the probability of a longer life, better health behaviors, such as engaging in vigorous physical activities and not smoking.11 In fact, disparities in mortality between well-educated and less-educated persons have been growing significantly over time, with the greatest increases being enjoyed by those more highly educated.12 Olshansky corroborated these findings in 2012, observing that men and women with fewer than 12 years of education fared worse than all adults in the middle of the twentieth century.13 The best correlate of adult health in populations is the number of years of schooling completed.14 The profound impact of education has been further highlighted by mortality gains in blacks and Hispanics with sixteen or more years of education compared with whites with less than a high school education.   9 R. N. Grosse and C. Auffrey, “Literacy and Health Status in Developing Countries,” Annual Revue of Public Health 10 (1989): 281–297. 10 J. Caldwell and P. McDonald, “Influence of Maternal Education on Infant and Child Mortality: Levels and Causes,” Health Policy Education 2 (1982): 211–384; 3:1–123. 11 Dana P. Goldman and James P. Smith, “The Increasing Value of Education to Health,” Social Science & Medicine 72 (2011): 1728–1737. 12 E. R. Meara, S. Richards, and D. M. Cutler, “The Gap Gets Bigger: Changes in Mortality and Life Expectancy, by Education, 1981–2000,” Health Affairs 27 (2008): 350–360. 13 S. J. Olshansky, T. Antonucci, L. Berkman, et al., “Differences in Life Expectancy Due to Race and Educational Differences Are Widening, And Many May Not Catch Up,” Health Affairs 31 (2012): 1803–1813. 14 M. Grossman, “Government and Health Outcomes,” American Economic Review 72 (1982): 191–195.

16 Abi Gezunt

Even though survival disparities within racial and ethnic groups persist at the highest levels of education, having four years of education beyond high school provides a profound advantage on longevity, which increases further with a postgraduate degree.15 ECONOMIC GROWTH AND STANDARD OF LIVING Health status is often directly related to economic growth—the greater the standard of living, the lower the morbidity and mortality; however, the relationship of life expectancy to economic development is not always sustained in developing countries.16 In 1985, the Rockefeller Foundation sponsored a conference in Bellagio, Italy, to identify factors associated with maintaining good health at a low cost.17 The focus was on China, Kerala, Sri Lanka, and Costa Rica, since they had succeeded in improving the health of their populations dramatically and at a remarkably low cost. The mortality levels in those countries approached those of industrialized countries following implementation of a series of health awareness programs and expansion of medical care facilities.18 In Kerala, despite low average annual per capita incomes, life expectancy had increased owing to prompt therapeutic attention to morbidities and improved nutrition and personal hygiene. Infant mortality had decreased thanks to adequate food supplementation during pregnancy and augmented postnatal care.19 MATERNAL EDUCATION These improvements were largely attributed to the level of maternal education and health consciousness. In 1817, Kerala offered free education, and in 1844, 15 R. G. Rogers, G. B. Everett, A. Zajocova, and R. A. Hummer, “Educational Degrees and Adult Mortality Risk in the United States,” Biodemography and Social Biology 56 (2010): 80–99. 16 D. Kingsley, “The Amazing Decline of Mortality in Underdeveloped Countries,” American Economic Review 46 (1956): 305–318. 17 S. B. Halstead, J. A. Walsh, and K. S. Warren, Good Health at Low Cost [Conference Report] (New York: Rockefeller Foundation, 1985), 147–158. 18 D. T. Jamison, “China’s Healthcare System: Policies, Organization, Inputs and Finance,” in Good Health at Low Cost, ed. S. B. Halstead, J. A. Walsh, and K. S. Warren (New York: Rockefeller Foundation, 1985), 21–32. 19 P. G. K. Panikar, “Healthcare System in Kerala and Its Impact on Infant Mortality,” in Good Health at Low Cost, ed. S. B. Halstead, J. A. Walsh, and K. S. Warren (New York: Rockefeller Foundation, 1985), 47–55.

Education and Literacy: The Path to Good Health 17

a royal proclamation established knowledge of English as a criterion for appointment to coveted positions in government service. Protestant missionaries eventually established the first school for girls in 1819 and for teacher training by 1887.20 By 1901, the continued establishment of schools and fostering of education had transformed the inhabitants (especially the women) of Travancore and Cochin in Kerala into the most literate in India. A comparison of the mortality rates in Kerala and West Bengal, two of the most densely populated areas in India, further demonstrated the effect of education on the populace.21 Although West Bengal was somewhat more advanced economically, Kerala had enjoyed significantly lower mortality rates. In a United Nations survey, higher female literacy was associated with lower infant mortality rates in several states in India (Table 1).22 Sri Lanka represents yet another nation that succeeded in increasing the life expectancy of its population dramatically despite a per capita income of $300 (US).23 Infant mortality rates per 1,000 live births declined from a high of 175 in 1930 to 34 in 1981, while maternal mortality rates dropped from 21 in 1930 to 0.8 in 1980. Increasing overall educational levels and gender equality in education accompanied these declines. Literacy of males 10 years of age and older in Sri Lanka rose 37 percentage points between 1921 and 1981 (54 to 91 percent); however, literacy for females rose 61 percentage points (21 to 82 percent). Increasing gender equality was particularly instrumental in the decline of perinatal mortality. The gap between male and female participation in education had virtually disappeared in the 1960s, guaranteeing better education for successive generations of mothers. This outcome was mirrored in Costa Rica. Despite a lower per capita income in Costa Rica in 1980 compared with the Latin American average, the life expectancy—attributed to reduced infant mortality rates—was higher, 20 John C. Caldwell, “Routes to Low Mortality in Poor Countries,” Population and Development Review 12 (1986): 171–220, 189. 21 Moni Nag, “The Impact of Social and Economic Development on Mortality: Comparative Study of Kerala and West Bengal,” in Good Health at Low Cost, ed. S. B. Halstead J. A. Walsh, and K. S. Warren (New York: Rockefeller Foundation, 1985), 57–78. 22 United Nations, State of the World’s Children (New York: Oxford University Press, 1984), 150. 23 Godfrey Gunatilleke, “Health and Development in Sri Lanka: An Overview,” in Good Health at Low Cost, ed. S. B. Halstead, J. A. Walsh, and K. S. Warren (New York: Rockefeller Foundation, 1985), 111–124.

18 Abi Gezunt

TABLE 1 Infant Mortality Rates, Female Literacy, and Output per Capita in Selected States in India State

Infant mortality per 1,000 births

Female literacy (% of population)

State domestic product per capita (U.S. dollars)

Kerala

52

64

96

Karnataka

81

28

99

Maharashtra

94

35

139

Punjab

104

34

162

Tamil Nadu

108

34

95

Haryana

113

22

145

Himachal Pradesh

114

31

111

Andhra Pradesh

123

21

86

Assam

128

–

81

Orissa

141

21

80

Gujarat

146

32

118

Rajasthan

146

11

83

Madhya Pradesh

151

16

76

Utter Pradesh

151

14

60

owing to a low illiteracy rate among women.24 Between 1930 and 1980, the proportion of women who completed primary education had increased more than fivefold. Costa Rica distinguished itself among Latin American countries by the continued high priority it gave to education. The Costa Rican Constitution assumed the responsibility for free compulsory education in 1869, and by 1892, approximately 28 percent of the population older than 10 years of age was literate. (In contrast, Mexico and many other small Central American countries failed to reach this level of literacy until the middle of the twentieth century.) By 1927, two-thirds of Costa Ricans older than 10 years of age were literate.25 Education in Costa Rica contributed to an explosion in communications, a decline in fertility, and increased labor productivity.26 That maternal education 24 L. Rosero-Bixby, “Infant Mortality Decline in Costa Rica,” in Good Health at Low Cost, ed. S. B. Halstead, J. A. Walsh, and K. S. Warren (New York: Rockefeller Foundation, 1985), 125–158. 25 Caldwell, “Routes to Low Mortality in Poor Countries,” 190. 26 Gonzalez-Vega, Health Improvements in Costa Rica.

Education and Literacy: The Path to Good Health 19

is important for adequate nutrition in her offspring was corroborated in a recent investigation of dietary habits of Flemish preschoolers by Carine Vereecken and Lea Maes (2009).27 Children of mothers with a low level of education, no job, three or more children, and who were themselves younger than 30 years of age did not meet the Flemish dietary guidelines for most food groups. HEALTH BEHAVIORS David Cutler and Adriana Lleras-Muney observed that education is also a key factor in modifying unhealthy behaviors.28 They found that mortality within five years of being interviewed as part of the National Health Interview Survey was significantly related to level of education among adults 25 years of age and older. The pattern for chronic disease morbidity paralleled that of mortality, the higher the level of education, the lower the rate of heart condition, stroke, ulcer (in the previous 12 months), hypertension, high cholesterol, emphysema, and diabetes. The better educated were less likely to report themselves in fair or poor health, lose days from work, and experience functional limitations. They were also more likely to score relatively well on scales measuring anxiety or depression. Thus, there appears to be a large salutary effect of education and the practice of health-related lifestyles, including lower rates of smoking, excessive alcohol intake, use of illegal drugs (while more likely to have tried illegal drugs, the educated are also more likely to give them up), greater involvement in weight control and exercise, and engagement in preventive medical care (flu vaccinations, mammograms, pap smears, colonoscopies) and in the management of hypertension and diabetes. The educated are also more likely to use seat belts and to install smoke detectors in their homes. Cutler and Lleras-Muney observed a 30 percent reduction in mortality when controlling for health-promoting behaviors, such as exercise, smoking, drinking, seat belt 27 Carine A. Vereecken and Lea Maes, “Young Children’s Dietary Habits and Associations with the Mothers’ Nutritional Knowledge and Attitudes,” Appetite 54 (2010): 44–51. 28 David M. Cutler and Adriana Lleras-Muney, “Education and Health: Evaluating Theories and Evidence,” in The Health Effects of Social and Economic Policy, ed. J. S. House, R. F. Schoeni, G. A. Kaplan, and H. Pollack (New York: Russell Sage Foundation, 2007); David M. Cutler and Adriana Lleras-Muney, “Understanding Differences in Health Behaviors by Education,” Journal of Health Economics 29 (2009): 1–28.

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use, and preventive care, and attributed this reduction to the powerful effect of education. IMPROVED SANITARY CONDITIONS Improving sanitary conditions alone, such as providing a healthy water supply in pre-modern communities, does not often result in health improvements.29 Such improvements can only come from understanding the concept of cleanliness and availing oneself of the entire package, that is, using soap and water, having clean hands, properly disposing of feces, and maintaining personal hygiene.30 In his study of six countries, Sagan judged education as a very powerful force and attributed the decline in infectious disease deaths to education, rather than improvements in sanitation. Without education, a clean water supply is useless. In Brazil, Thomas Merrick attributed the provision of a clean water supply to the decline of infant mortality rates between 1970 and 1976; however, having piped water proved only one-fifth as important as having an educated parent.31 Two schools of thought guide current research into the relationship of education, income, and health over time. Whereas demographers look at education and mortality across period and birth cohorts,32 medical sociologists 29 Sagan, The Health of Nations. 30 R. Schneider, M. Schiffman, and J. Faigenblum, “The Potential Effect of Water on Gastrointestinal Infections Prevalent in Developing Countries,” American Journal of Clinical Nutrition 31 (1978): 2089–2099. 31 Thomas W. Merrick, “The Effect of Piped Water in Early Childhood Mortality in Urban Brazil, 1970 to 1976,” Demography 22 (1985): 1–23, 12. 32 G. Pappas, S. Queen, W. Hadden, and G. Fisher, “The Increasing Disparity in Mortality Between Socioeconomic Groups in the United States, 1960 and 1986,” New England Journal of Medicine 329 (1993): 103–109; P. D. Sorlie, E. Backlund, and J. B. Keller, “US Mortality by Economic, Demographic, and Social Characteristics: The National Longitudinal Mortality Study,” American Journal of Public Health 85 (1995): 949–956; S. H. Preston and I. T. Elo, “Are Educational Differentials in Adult Mortality Increasing in the United States?,” Journal of Aging and Health 7 (1995): 476–495; I. T. Elo and S. H. Preston, “Educational Differentials in Mortality: United States, 1979–1985,” Social Science & Medicine 42 (1996): 47–57; K. G. Manton, E. Stallard, and L. Corder, “Changes in the Age Dependence of Mortality and Disability: Cohort and Other Determinants,” Demography 34 (1997): 135–157; V. A. Freedman and L. G. Martin, “Understanding Trends in Functional Limitations among Older Americans,” American Journal of Public Health 88 (1998): 1457–1462; S. M. Lynch, “Cohort and Life-Course Patterns in the Relationship Between Education and Health: A Hierarchical Approach,” Demography 40 (2003): 309–331.

Education and Literacy: The Path to Good Health 21

have focused on the differential effect of schooling on the course of life.33 A so-called age-as-leveler hypothesis suggests that the role of education weakens, as do other social factors, over the life course because of biological decrement.34 This contrasts with the hypothesis that stresses a cumulative advantage resulting from the increasing strength of the education/health relationship over the course of a lifetime.35 Epidemiologic transition theory corroborates findings by demographers that the influence of socioeconomic status was strong at the turn of the last century, reduced in the early part of the century, but strengthened again in the latter decades of the twentieth century.36 Fluctuations are viewed as a function of the transition from the preponderance of infectious diseases to chronic diseases. The relative impact of socioeconomic status was minimal during the first period, when the efficacy of medical care was limited. The highest socioeconomic groups were first to enjoy the benefits of an increased understanding of the treatment of infectious diseases, leading to widened gaps between the social groups. Medical science has, in recent decades, made remarkable advances in the prevention and management of chronic diseases, leading once again to a widening of the socioeconomic gap in health. LEVEL OF INCOME Education and income, two dominant predictors of health, rival each other in importance, yet each has an independent effect on health. Data amassed by John Mirowsky and Catherine Ross strongly suggest that education conduces to a sense of personal control and a decrease in vulnerability to life events that 33 James S. House, James M. Lepowski, Ann M. Kinney, et al., “The Social Stratification of Aging and Health,” Journal of Health and Social Behavior 35 (1994): 213–234; C. E. Ross and C. Wu, “Education, Age, and the Cumulative Advantage in Health,” Journal of Health and Social Behavior 37 (1996): 104–120; M. Becket, “Converging Inequalities in Later Life—An Artifact of Mortality Selection?” Journal of Health and Social Behavior 41 (2000): 106–119; John Mirowsky and Catherine E. Ross, Education, Social Status, and Health (Hawthorne: Walter de Gruyter, Inc., 2003). 34 House, et al., “The Social Stratification of Aging and Health.” 35 Scott M. Lynch, “Explaining Life Course and Cohort Variation in the Relationship between Education and Health: The Role of Income,” Journal of Health and Social Behavior 47 (2006): 324–338. 36 Ibid.

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can be deleterious to health.37 Loss of a sense of control is a well-known precursor to stress-related diseases, including heart disease, stroke, and a panoply of other disorders. Higher levels of education provide individuals with a potential array of coping strategies that confer a sense of control over seemingly uncontrollable events. Education plays a significant role by fortifying individuals against the deleterious consequences of life stresses, and increased income helps by lessening the sense of helplessness, powerlessness, and failure. While income level is well acknowledged as a predictor of morbidity and mortality, persistent poverty and income instability are strong predictors of poor health over a lifetime.38 It stands to reason that the wealthy might be able to more readily exploit medical technologies, such as mammography and Papanicolaou smear testing; however, others argue that the well-educated may be better informed about health, better able to take necessary precautions, and better able to make decisions regarding treatment options.39 Education further empowers individuals to evaluate the negative consequences of behaviors thought to be deleterious to health and to consult about health concerns among educated peers.40 An analysis by Scott M. Lynch (2006) of education, health, and income covering the years 1972 to 2001 corroborated findings in studies pointing to a strong direct effect of schooling on health compared with an indirect effect through income challenge. The steady decline in mortality from coronary heart disease, the leading cause of mortality since 1921, is an example of the powerful role of education. Two decades ago, education correlated highly with modifying risk factors, such as smoking, lack of exercise, and obesity.41 37 Mirowsky and Ross, Education, Social Status, and Health. 38 J. Schnittker, “Education and the Changing Shape of the Income Gradient in Health,” Journal of Health and Social Behavior 45 (2004): 286–305. 39 A. D. Foster and M. R. Rosenzweig, “Information, Learning, and Wage Rates in Low-Income Rural Areas,” Journal of Human Resources 28 (1993): 759–790; A. D. Foster, “Learning by Doing and Learning from Others: Human Capital and Technical Change in Agriculture,” Journal of Political Economy 103 (1995): 1176–1209. 40 Mirowsky and Ross, Education, Social Status, and Health; Schnittker, “Education and the Changing Shape of the Income Gradient in Health.” 41 R. J. Garrison, R. S. Gold, P. W. Wilson, and W. B. Kannel, “Educational Attainment and Coronary Heart Disease,” Preventive Medicine 22 (1993): 54–64; K. A. Matthews, S. F. Kelsey, E. L. Meilahn, et al., “Educational and Behavioral and Biologic Risk Factors for Coronary Heart Disease in Middle-Aged Women,” American Journal of Epidemiology 29 (1989): 1132–1144; S. Shea, A. D. Stein, R. Basch, et al., “Independent Associations of Educational Attainment and Ethnicity with Behavioral Risk Factors for Cardiovascular Disease,” American Journal of Epidemiology 134 (1991): 567–582.

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With the suspicion that level of education may help explain disparities between health and income, an analysis of data derived from the 1996–1997 Community Tracking Study and the 1972–2000 General Social Survey revealed a strong positive relationship between income and health by level of education.42 At the lower levels of income, education not only improves health, but also operates more strongly.43 In other words, as one descends the income gradient, the positive influence of education increases. Whereas both education and income contribute to health, the relationship favors education at all levels of income. Considering mean subjective health scores, impairment scores, and numbers of serious diagnoses by income level for those with no high school degree, a high school degree but not a four-year college degree, and a four-year college degree or higher, Mirowsky and Ross reported that at any level of income, a more favored state of health was reported by the more highly educated.44 Holding level of education constant revealed that those with the lowest incomes experienced the worst health. Differences in health were reduced at higher levels of education when income levels were controlled. These findings support what is referred to as resource substitution,45 or when one resource reduces the impact of another. More highly educated individuals at any given level of income are better equipped, by dint of information and reasoning skills, to reduce life’s risks and navigate life’s challenges. They are also are more capable of efficiently using their economic resources. EMOTIONAL SUPPORT More highly educated individuals are also more likely to provide emotional support to their partners in a marriage. Mirowsky and Ross46 observed that 42 P. Kemper, D. Blumenthal, and J. M. Corrigan, “The Design of the Community Tracking Study: A Longitudinal Study of Health System Change and Its Effects on People,” Inquiry 33 (1996): 195–206; R. Strouse, J. Hall, F. Potter, et al., Report on Survey Methods for the Community Tracking Study’s 1996–1997 Round One Household Survey: Report No. 8519–940 (Princeton: Mathematica Policy Research, Inc., 1998). 43 Schnittker, “Education and the Changing Shape of the Income Gradient in Health.” 44 Mirowsky and Ross, Education, Social Status, and Health. 45 John Mirowsky and P. N. Hu, “Physical Impairment and the Diminishing Effects of Income,” Social Forces 74 (1996): 1073–1096; John Mirowsky and C. E. Ross, “Economic Hardship Across the Life Course,” American Sociological Review 64 (1999): 548–569; C. E. Ross and J. Huber, “Hardship and Depression,” Journal of Health and Social Behavior 26 (1985): 312–327. 46 Mirowsky and Ross, Education, Social Status, and Health.

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education increases the stability of relationships. Marriage itself has been shown to be a protective factor, while general social support is associated with improved psychological well-being and improved physical health. Marriage further increases the prospect of good health by decreasing economic hardship. The authors opined that the “regulation married life produces” might have an ameliorative effect on health. Mirowsky and Ross further found that the level of physical impairment in a partner was a function of their level of education and the amount of support they could provide. When asked if someone in the family was available to help when a partner was ill or impaired, the higher the educational level of the family member, the more likely they were willing or able to help a partner. The implications of these findings for the role of education in the health and success of American Jews are intriguing. Achieving economic success in America may be partially explained by the fact that while arriving at these shores impoverished, the Jews harbored a zeal for education that acted synergistically on the premium they placed on good health. The rapid rise of American Jews into the professions and how this relates positively to health is instructive. Although income is very important, the ability to control one’s work environment and to work creatively conduces to the instinct of workmanship and contributes strongly to health and a sense of well-being. The Mirowsky and Ross study47 corroborated Thorstein Veblen’s observation that the most fundamental contribution to the well-being of the race and its biological success was “instinctive bias here spoken of as the institution of workmanship.”48 We can also expect increasing life spans for American Jews based upon scientific advances that favor the well educated. The longer we live, the greater are the chances of surviving yet another decade. Mirowsky and Ross compared the survival of white women over three sequential census intervals and observed that in all cases, education contributed to increased longevity, surpassing that of lesser educated peers of the same gender, in men and women aged 60 through 80. They concluded that the longer a person lives, the more important the role of education in survival: “Mortality eliminates the poorly educated more 47 Ibid. 48 Rick Tilman, A Veblen Treasury: From Leisure Class to War, Peace and Capitalism (Armonk and London: M. E .Sharpe, Inc., 1993), 189.

Education and Literacy: The Path to Good Health 25

severely at every step, and yet the correlation of education with the odds of making it to the next step grows.”49 INCIDENCE OF DISEASE The absence of attitudes and behaviors that prevent disease or promote health over a lifetime become apparent in later life. The number of years of schooling, as we have noted earlier, is related to a healthy lifestyle, which in turn is further negatively related to the incidence of life-threatening events, such as heart attacks, stroke, and respiratory arrest. Dana Goldman and James Smith documented disparities in health in non-Hispanic whites aged 40 to 64 years of age in a National Health Interview Survey.50 There was a clear disparity in health between respondents who had not graduated from high school and those with 16 or more years of education. Less educated respondents also had worse health outcomes and experienced more rapid disease progression, partially due to an earlier onset of disease and decreased efficacy in managing the course of their disease. Older individuals who have not exercised, who have stored considerable body fat, smoked, abused alcohol, and perhaps failed to accumulate desirable biologics that contribute to vital lung capacity and sensitivity of insulin receptors, court health-related disasters in later life.51 Similarly, behaviors over time that contribute to undesirable biological accumulators, such as high resting blood pressure, fatty arterial plaques, and a low ratio of high-density to low-density lipoprotein levels, place the aged at increased risk. Higher levels of education fortify individuals with a repertoire of skills that help reduce demands on the physiological system, otherwise known as the “allostatic load.” Excessive demands on allostasis can reduce the body’s ability to regulate the nervous and endocrine systems and are attenuated by socioeconomic variables, such as education.52

49 Mirowsky and Ross, Education, Social Status, and Health, 167. 50 Goldman and Smith, “The Increasing Value of Education to Health.” 51 World Health Organization, National Institute on Aging, National Institutes of Health, “Global Health and Aging” (NIH Publication no. 11–7737. October 2011), accessed May 4, 2014, http://www.who.int/ageing/publications/global_health.pdf. 52 Mirowsky and Ross, Education, Social Status, and Health.

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Threats to health in the elderly—particularly among blacks—are posed by accumulated environmental stress over a lifetime, which serve to accelerate biological aging.53 Accompanying aging are ever increasing challenges dealing with one’s own declining physiologic functioning. Mirowsky and Ross suggested that having a sense of control helps the elderly to cope with diminishing capacities that accompany increasing disease and disability.54 Younger individuals with low levels of education begin with high levels of impairment that often increase as they age, while the well educated begin with low rates of impairment that remain low through their forties, rising slowly until age seventy, after which the incidence of impairment rises significantly. Mirowsky and Ross attributed the differences to the respondents’ sense of control, which in turn is related to their educational status. They noted that the effects of education are cumulative. Higher levels of education not only help individuals avoid risky behavior (such as smoking and lack of exercise), but also help them acquire the skills to overcome stress and minimize the impact of risky behavior. COGNITIVE FUNCTIONING AND RESERVE Education also increases cognitive functioning throughout adult life and decreases cognitive decline, especially as it relates to Alzheimer’s disease. The Rotterdam Study followed 6,827 non-demented adults and found a significantly higher risk of dementia among the least educated women.55 De Ronchi and colleagues reported significantly higher rates of dementia among elderly subjects in Ravenna, Italy without any education during the first decade of life compared with others who had some education.56 Lack of education in the early years might thus suggest an increased presence of dementia later in life. This was also corroborated in a study by Jean-François Dartigues and colleagues, 53 B. A. McEwen and P. J. Gianaros, “Central Role of the Brain in Stress and Adaptation: Links to Socioeconomic Status, Health, and Diseases,” Annals of the New York Academy of Science 1186 (2010): 190–222. 54 Mirowsky and Ross, Education, Social Status, and Health. 55 A. Ott, C. T. M. van Rossum, F. van Harskamp, et al., “Education and the Incidence of Dementia in a Large Population-Based Study: The Rotterdam Study,” Neurology 52 (1999): 663–666. 56 D. De Ronchi, L. Fratiglioni, P. Rucci, et al., “The Effect of Education on Dementia Occurrence in an Italian Population with Middle to High Socioeconomic Status,” Neurology 50 (1998): 1231–1238.

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who drew subjects aged 65 and older from the general population of southwestern France, and found that the incidence of Alzheimer’s disease declined as the level of education increased—at least through high school.57 The highest level of Alzheimer’s disease was seen in persons with no education (5.4 per 100) compared with subjects who completed grade school (1.7 per 100) and subjects with high school and/or university degrees (0.4 per 100). Although much work is required to determine the contribution of education to the incidence of Alzheimer’s disease, data suggest that higher levels of education may confer cognitive reserve in the form of greater functioning capacity. This was further corroborated by John Chibnall and colleagues, who studied dementia among a group of elderly Jesuit priests and concluded that education increased the neural circuits required for cognition, resulting in the priests’ diminished vulnerability to pathology.58 Many studies and investigations have confirmed that decrements in education support a causal link between lower levels of education and a higher prevalence of dementia.59 MATERNAL LITERACY ON HEALTH Maternal literacy, defined as the mother’s ability to read and write a language, strongly correlates with the good health of the family. Increased income without 57 Jean-Françcois Dartigues, M. Gagnon, P. Michel, et al., “Le Programme de Recherché Paquid sur l’Épidémiologie de la Démence: Méthodes et Résultats Initiaux,” Review of Neurology 147 (1991): 225–230. 58 John T. Chibnall, Robin Eastwood, “Postsecondary Education and Dementia Risk in Older Jesuit Priests,” International Psychogeriatrics 10 (1998): 359–368. 59 D. A. Bennett, R. S. Wilson, J. A. Schneider, et al., “Education Modifies the Relation of AD Pathology to Level of Cognitive Function in Older Persons,” Neurology 60 (2003): 1909– 1915; B. Schmand, J. Smit, J. Lindeboom, et al., “Low Education Is a Genuine Risk Factor for Accelerated Memory Decline and Dementia,” Journal of Clinical Epidemiology 50 (1997): 1025–1033; M. E. Farmer, S. J. Kittner, D. S. Rae, et al., “Education and Change in Cognitive Function: The Epidemiologic Catchment Area Study,” Annals of Epidemiology 5 (1995): 1–71; S. Lee, I. Kawachi, L. Berkman, et al., “Education and Other Socioeconomic Indicators and Cognitive Function,” American Journal of Epidemiology 157 (2003): 712–720; J. Lindsay, D. Laurin, R. Verreault, et al., “Risk Factors for Alzheimer’s Disease: A Prospective Analysis from the Canadian Study of Health and Aging,” American Journal of Epidemiology 156 (2002): 445–453; K. F. Mortel, J. S. Meyer, B. Herod, and J. Thornby, “Education and Occupation as Risk Factors for Dementias of the Alzheimer and Ischemic Vascular Types,” Dementia 6 (1995): 55–62; M. Prencipe, A. R. Casini., C. Ferretti, et al., “Prevalence of Dementia in an Elderly Rural Population: Effects of Age, Sex, and Education,” Journal of Neurology 60 (1996): 628–633.

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maternal literacy has little bearing on the health of the family. Two culturally and geographically similar populations in the Ekiti Division of Nigeria’s Western State serve as one example.60 The two areas had no major social or economic differences except in the provision of medical care. Although both had equivalent water supplies and sanitation, one center had a rural hospital with the services of a physician for more than a decade, while the other did not even have a pharmacy within 10 kilometers. The dichotomy in the access to healthcare services was overcome by education: the greater the educational level of the parents, the more likely they were to avail themselves of extant healthcare facilities. As we have shown, neonatal survival is directly related to the educational status of the mother. When access to healthcare services alone was provided to illiterate mothers in Nigerian villages, the life expectancy of neonates increased 20 percent.61 When healthcare services were not available, but education was provided to mothers, life expectancy increased 33 percent. When both access and literacy were figured into the equation, life expectancy increased 80 percent. It was suggested that an educated mother would have sufficient self-confidence to urge doctors, nurses, and dispensers to provide urgent care for her sick children. At the same time, the healthcare practitioners would respect her demands, owing to her apparent degree of education and ability to understand the situation. While maternal literacy is generally important for reducing infant mortality,62 paternal literacy is a relatively more important factor in urban areas for reducing child mortality, since it is directly related to the purchase of food, clothing, shelter, sanitation, medical care, and other items related to health.63 Maternal education, however, promotes an equitable family structure and a system in which children’s complaints are more likely to be heard and the care of children becomes an important priority.64 An educated mother is more likely to have a child-centered household, one in which the net wealth flow no longer moved from the younger 60 I. O. Orubuloye and J. C. Caldwell, “The Impact of Public Health Service on Mortality Differentials in a Rural Area of Nigeria,” Population Studies 29 (1975): 259–272. 61 Ibid. 62 Caldwell and McDonald, “Influence of Maternal Education on Infant and Child Mortality”; Halstead, Walsh, and Warren, Good Health at Low Cost; J. N. Hobcraft, J. W. McDonald, and S. O. Rutstein, “Socioeconomic Factors in Infant and Child Mortality: A Cross-National Comparison,” Population Studies 38 (1984): 193–223. 63 Strouse et al., Report on Survey Methods for the Community Tracking Study’s Survey. 64 United Nations, Socioeconomic Differentials in Child Mortality in Developing Countries (New York: United Nations, 1985).

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to the older generation but from the older to the younger generation. Thus, more family resources are deployed for the children, who then face fewer risks. Educated women are generally better informed about the nutritional content of foods, the importance of nutrition, and nutritional options.65 They are more likely to employ a midwife, avail themselves and their families of immunizations, ensure their families followed a proper diet, and seek modern healthcare facilities. Maternal education surpasses type of marriage, socioeconomic area of residence within the city, the use of modern medical services at childbirth, the practice of birth control, and residence in an urban or rural area, when it comes to childhood survival.66 Education inclines mothers to adopt less fatalistic attitudes toward illness, enhances their receptivity to modern health care, and fortifies them to demand the attention of physicians and nurses and to use available facilities as “a right and not a boon.”67 Female autonomy is another important issue, since it is the parent with the least schooling who is likely to retard parental endeavors in keeping the children healthy. Greater female autonomy—as found among the Jews—encourages a woman to make her own decisions when caring for a sick child. A woman with autonomy will not fear seeking help outside the home or finding treatment for her child. She will also be able to understand the advice given by doctors and nurses and take responsibility for carrying it out.68 Higher education was particularly attractive to immigrant Jewish women.69 Their parents motivated them to study, and the mothers in turn motivated their children to plan for careers. They understood the power of being prepared, 65 S. H. Cochrane, J. Leslie, and D. J. O’Hara, “Parental Education and Child Health: Intracountry Evidence,” Health Policy and Education 2 (1982): 213–250; B. Tecke and F. C. Shorter, “Determinants of Child Mortality: A Study of Squatter Settlements in Jordan,” Population and Development Revue 10 (1984): 257–280; J. C. Caldwell, P. H. Reddy, and P. Caldwell, “The Social Component of Mortality Decline: An Investigation in South India Employing Alternative Methodologies,” Population Studies 37 (1983): 185–205; H. Behm, “Determinantes Socio-Economicos de la Mortalidad en America Latina,” Boletin de Poblacion de las Naciones Unidas 13 (1983): 1–16. 66 J. C. Caldwell, “Education as a Factor in Mortality Decline: An Examination of Nigerian Data,” Population Studies 33 (1979): 395–413. 67 Ibid. 68 J. C. Caldwell, “Routes to Low Mortality in Poor Countries,” Population and Development Review 12 (1986): 171–220. 69 U.S. Immigration Commission, Reports of the Immigration Commission (1907–1910) (Washington, D.C.: Government Printing Office, 1911).

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resulting in a larger proportion of Jewish girls attending high schools and commercial schools than any other ethnic group. Greater education also provided a healthier working environment for the Jewish women. Robert Woods and Albert Kennedy noted that work “has cultural value, awakens responsibility, develops character, and promotes standards of achievement.”70 RELIGION AND EDUCATION The receptivity of religious systems to education also has a bearing on the overall health of a society. During the sixteenth century, the Portuguese created church-affiliated schools. The Dutch followed with a system of parish schools in the mid-seventeenth century, while the British, nearly two hundred years ago, established both fee-paying schools in India where classes were conducted in English and free schools with classes taught in the native tongue.71 The remarkable health status enjoyed by the Sri Lankans, a largely Buddhist society, despite a very low per capita income is instructive.72 Traditionally, Buddhism has stressed enlightenment, which can be translated as a predilection for education. Fortunately, the value of education was recognized for more than 300 years by the colonial powers that held dominion over the Sri Lankans. One of the key values of the Buddhist revival of the late nineteenth century was education, and families were exhorted to do everything they could to educate their children. By the end of the nineteenth century, the colonial government re-enforced the local desire for universal compulsory schooling. The Sinhalese incorporated this value to the extent that by 1960, 95 percent of age-eligible youngsters were enrolled in elementary schools and 27 percent were studying in secondary schools.73 THE JEWISH QUEST FOR LITERACY Samuel Tenenbaum observed that when it came to education, no sacrifice was too great for the Jews to make, such that no other group valued learning more 70 Robert A. Woods and Albert J. Kennedy, Young Working Girls: A Summary of Evidence from Two Thousand Social Workers (Boston: Houghton Mifflin, 1913), 27. 71 Caldwell, “Routes to Low Morality.” 72 F. S. F. Dallas, “Health Statistics in Sri Lanka, 1921–80,” in Good Health at Low Cost, ed. S. B. Halstead, J. A. Walsh, and K. S.Warren (New York: Rockefeller Foundation, 1985), 79–92. 73 J. A. Caldwell, “Routes to Low Mortality.”

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than the Eastern European Jews.74 Parental support was uncompromising and often marked with a respect for modernity. Max Gewirtz, who entered P.S. 34 on the Lower East Side in 1897, spoke endearingly of his father, who had “the good sense to put me into an area in which I was going to live my life.” He noted that the Jewish children in public school became Anglicized sooner than non-Jewish children. The benefit was also realized by the parents who had to learn to speak English in order to keep up with their children.75 Seriousness of purpose distinguished the Jewish student from some of his Gentile peers. In the mid-1930s, Jewish students were often subjected to ethnic slurs and jokes, exclusion from honorary fraternities, and the segregation of female Jewish students from non-Jewish female students in dormitories. Non-Jewish students were warned not to associate with the Jewish students.76 Clearly there were differences in the ways Jews and non-Jews approached learning. Some non-Jews appeared to value their friendships, fraternities, and athletic teams over the course of study: “Life outside the classroom—the club room, the playing field . . . showed what stuff a fellow really was made of. . . .”77 A librarian of the time noted that the Jews sought “the best of the continental literature,” and that reading rooms were filled with young men preparing themselves for civil service examinations.78 The students demanded the best material to help them debate on “every conceivable public question.” Even toddlers were able to read paragraphs when put to the test. A piece in the New York Evening Post reported on the nature of the reading done by those in the disadvantaged districts of New York: “Hebrews form the best and largest class of readers among the foreign element.”79 In 1902, the Jewish Daily Forward editorialized this desire for learning, recounting a story in which a poor Jewish family refused to allow their son to work and leave school. The story reflected the capacity of the Jews to make sacrifices for their children, emphasizing their respect and love for education. 74 Samuel Tenenbaum, “Brownsville’s Age of Learning: When the Library Stayed Open All Week,” Commentary 6, 8 (1947): 174. 75 Annual Report of the Free Lectures to the People, Season 1900–1901 (New York: Department of Education, School Board for the Boroughs of Manhattan and the Bronx, 1901). 76 H. Broun and G. Britt, Christians Only: A Study in Prejudice (New York: Vanguard Press, 1931). 77 F. Rudolph, The Emergence of the American University (Chicago: University of Chicago Press, 1962), 289. 78 Tenenbaum, “Brownsville’s Age of Learning.” 79 Literary Digest, Letters and Art, Volume 22, No. 2 ( January 13, 1900).

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While some non-Jews were disdainful of the immigrant Jewish students, others, such as members of the Liberal Immigration League, were frankly commendatory, noting that the progress of the Russian Jew was “sure and constant, in spite of his poverty and distressful start.”80 The thirst of Jews for education could be gauged by the statistics describing the high proportions of youngsters who graduated from high schools and colleges. Ninety-two percent of Jewish boys who were members of the Brownsville Boys Club in the 1940s completed high school, and most of them did it in four years. Yet less than half of all those who entered high school in New York City at that time actually earned a diploma. Only 42 percent of students from white-collar homes and 20 percent of students from homes of manual laborers completed high school, and only one in ten African Americans finished high school in 1940. Some of this attrition was attributed to the impact of the war effort and the resulting shortage in manpower. Despite this, the Jewish Brownsville students remained in school.81 Jewish boys from the Brownsville district also finished college at higher rates than all New York City youths (Table 2).82 Heschel believed that the source of motivation for learning among Eastern European Jews was that it invited the transcendental, owing to their assiduous application to the study of the Torah, “the place where the Divine Glory listens to what Jews recreate anew.83 Study, after all, was commanded by the Almighty. It was a duty prescribed only by knowing the Torah thoroughly. Social ranking and mobility were determined largely by the amount of learning one acquired. Untutored members of Jewish society gained respect in the community when they showed deference to the more learned. The penchant Jews had for learning was portrayed in Abraham Jacob Paperna’s reminiscences of the shtetl (a small town with a large Jewish population) Kopyl, where he spent his youth. He noted that while the entire Christian 80 E. J. James, O. R. Flynn, and J. R. Paulding, The Immigrant Jew in America (New York: Benjamin F. Buck & Co., 1906), 411–412. 81 Gerald Sorin, The Nurturing Neighborhood: The Brownsville Boys Club and Jewish Community in Urban America, 1940–1990 (New York: New York University Press, 1990). 82 Andrew Greeley, Ethnicity, Denomination and Inequality (Beverley Hills: Sage Publications, 1976), 32. 83 Irving Howe, Voices from the Yiddish: Essays, Memoirs, Diaries, ed. Eliezer Greenberg (Ann Arbor: University of Michigan Press, 1972), 74.

Education and Literacy: The Path to Good Health 33

TABLE 2  Proportion of Jews and nonJews attending college by cohort Cohort

Jews (%)

All (%)

1900-1909

17

17

1910-1919

29

18

1920-1929

42

18

1930-1939

47

23

1949-1959

69

29

1959-1959

64

32

1960-1969

88

43

Adapted from Greeley, Ethnicity, Denomination and Inequality.

population was illiterate, the Jews—aged four through 13—were taught in heders (elementary schools). Even a poor man would sell “his last candlestick or pillow to pay the teacher.”84 The proportion of Jews attending the gymnasia in the Western Russian provinces rose steadily in the Jewish Pale.85 Jewish youngsters entered secondary schools whenever possible. In 1853, they represented 1.25 percent of the secondary school population. Two decades later, the proportion of Jewish male students rose to 13.2 percent.86 Although four in every five Russians could neither read nor write, almost all Jewish males and most females were literate in their own ethnic language of Yiddish. Three in every ten Jewish men and one in every six women could read Russian at the turn of the century.87 The Jews’ desire for literacy would serve them well in their new country. The enthusiasm for education among the immigrant Jews was impervious to time and aging. In a 1990 New York Times article, residents of the Beth Abraham Hebrew Home for the Aged, with an average age of 86 years, purportedly maintained the desire to continue learning.88 The residents maintained 84 Salo W. Baron, The Russian Jew under Tsars and Soviets (New York: Schocken Books, 1987), 117. 85 Lucy S. Dawidowicz, Golden Tradition: Jewish Life and Thought in Eastern Europe (Boston: Beacon Press, 1968). 86 Baron, The Russian Jew under Tsars and Soviets. 87 Zvi Y. Gitelman, Marshall I. Goldman, and Musya Glants, Jewish Life After the USSR (Bloomington: Indiana University Press, 2001). 88 D. Hevesi, “A Hospital That Calls to Ask How You’re Doing,” New York Times (March 10, 1990), 28.

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that saying “I am too old to learn” suggests giving up on life. Seeking continuous improvement suggests having a desire to live and implies looking forward to the future. Milton Gordon traced the immigrant Jews’ eagerness for learning to the Talmud, crediting traditional values and an especially high regard for Talmudic learning.89 S. Joseph Fauman echoed Gordon’s sentiments, noting that the Jew’s respect toward religious learning was easily transferred to the sphere of secular learning.90 The Jews brought with them to the New World their intellectual passion, which, in their former environment, had been the height of achievement. Intellectual distinction had replaced Talmudic learning.91 Samuel Joseph illustrated the force of Talmudic learning in Jewish life in the following dialogue between an admissions officer and an eleven-year-old Russian Jew who presented himself for admission to Hirsch-sponsored English classes.92 What is your name? Isaac Cooperschmidt. How old are you? Eleven years. Where were you born? Goverin. What have you learned? The Pentateuch with Rashi, the Prophets, the Psalms and Proverbs and Gemara. Which treatise of the Gemara have you learned? Gittin. Which section? Kol Hagget. I have no copy of the Gemara at hand, else I would examine you. Nisht Kosche! [No problem] I know it by heart. 89 Milton M. Gordon, Assimilation in American Life (New York: Oxford University Press, 1964). 90 Samuel Joseph Fauman, “Occupational Selection Among Detroit Jews,” in The Jews: Social Patterns of an American Group, ed. M. Sklare (Glencoe: The Free Press, 1958), 119–137. 91 Morris Raphael Cohen, A Dreamer’s Journey: The Autobiography of Morris Raphael Cohen (Glencoe: The Free Press, 1949). 92 Samuel Joseph, History of the Baron de Hirsch Fund: The Americanization of the Jewish Immigrant (Philadelphia: Jewish Publication Society of America, 1935), 256.

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THE JEWISH STUDENT In 1901, Jews had taken possession of the New York City public schools in all grades. The younger students were lauded for their “cleverness . . . , obedience, and general good conduct,” and the “vacation schools, night schools, social settlements, libraries, bathing places, parks and playgrounds of the East Side were fairly besieged with Jewish children eager to take advantage of every opportunity.”93 Teachers praised the natural ability and persistence of their Russian Jewish students and were awed at their ability to overcome the hardships of their existence for a good education.94 Female Jewish students, in particular, worked hard to make up for missed work.95 Schools were intent on keeping students in school and not returning sick children home. This was especially important since many youngsters failed to return to school after an illness because they were unable to catch up on their work. Working Girls in Evening Schools, a study conducted in New York City during 1910 and 1911 by Mary Van Kleeck under the auspices of the Russell Sage Foundation, offered some insight into what was going on among Jewish women during this period.96 Foreign-born Jewish women, accounting for 15 percent of the students, were exceeded in number only by American-born women. Yet only 25 percent of the American-born women were daughters of Jewish immigrants. Approximately 40 percent of women attending evening schools in New York were Jewish. Most of the courses were vocational or associated with evening trade schools. The willingness of a very high proportion of Jewish women to avail themselves of the evening school system was a testament to their eagerness to advance themselves economically and take advantage of educational opportunities available in America that had been denied them in the old country.97 Russian Jewish immigrant women were less eager than were their American peers to find dates and attend dances and preferred to spend time studying, 93 United States Industrial Commission, Reports on Immigration (Washington, D.C., 1901), 478. 94 Charles Seligman Bernheimer, The Russian Jew in the United States (Philadelphia: J. C. Winston Co., 1905). 95 Selma Cantor Berrol, “Immigrants at School: New York, City, 1898–1914” (PhD diss., City University of New York, 1967). 96 Mary Van Kleeck, Working Girls in Evening Schools: A Statistical Study (New York: Russell-Sage Foundation, 1914). 97 Ibid.

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reading, or pursuing other educational activities, such as attending the theater. Education was, of course, also important to Jewish men. Although Jews represented only two percent of the population, 8.5 percent of male students in 77 institutions of higher learning were either first- or second-generation Jews.98 Over the next 50 years, the number of Jews attending college continued to increase. THE YIDDISH PRESS Russian Jewish immigrants in America produced many publications, which, in addition to coalescing them as a group, also help them acculturate. Despite the presence of 5 million Jews in Czarist Russia, there was not a single Yiddish daily; however, in cities such as New York and Chicago, Yiddish daily, weekly, and monthly publications abounded. Some feared the Yiddish literature would serve as an impediment against the acquisition of English. In fact, the periodicals served to expedite the learning and promotion of English among the Jews. Yiddish lectures and literature, as well as the Jewish theater, served as “a stepping-stone to that English-speaking, self-educational society, composed of workingmen who have lived a few years in the country.”99 The Yiddish press proved to be a powerful Americanizing agency.100 Much of the writing dealt with accommodation to America.101 The Yiddish press “combined the functions of a journal of opinion, a literary magazine and a people’s college.”102 Morris Raphael Cohen wrote that the Yiddish press “. . . taught me to look at world news from a cosmopolitan instead of a local or   98 Nathan Glazer, “The American Jew and the Attainment of Middle-Class Rank,” in The Jews: Social Patterns of an American Group, ed. Marshall Sklare (Glencoe: Free Press, 1958).   99 Bernheimer, The Russian Jew in the United States, 34. 100 Ibid. 101 Robert Ezra Park, The Immigrant Press and Its Control (New York: Harper & Bros, 1922); Mordecai Soltes, The Yiddish Press: An Americanizing Agency (New York: Bloch Publishing Co., 1924), 173-178; Harold Silver, “Some Attitudes of the East European Jewish Immigrants towards Jewish Charity in the United States in the Years 1890-1900” (Master’s thesis, Graduate School of Jewish Social Work, 1934); Marjorie Gottlieb Wolfe, “The Bintel Brief of the Jewish Daily Forward as an Immigrant Institution and as a Research Source” (Master’s thesis, Graduate School of Jewish Social Work, 1937); Shmuel Niger, “Yiddish Culture,” in The Jewish People Past and Present IV (New York: Jewish Encyclopedic Handbooks and Central Yiddish Culture Organization, 1955), 264–307. 102 Melech Epstein, Jewish Labor in U.S.A.: An Industrial, Political, and Cultural History of the Jewish Labor Movement, Vol 1 (New York: KTAV, 1969), 274.

Education and Literacy: The Path to Good Health 37

provincial point of view, and it taught me to interpret politics realistically instead of being misled by empty praise.”103 Thus, the Yiddish press prepared millions of Jews to participate in American civilization while promoting self-respect. CULTURAL ASSIMILATION There was a growing sentiment in the late nineteenth and early twentieth centuries in the country that little was being done to help assimilate and socialize the new immigrants. It was held that bettering relations between the newcomers and their American neighbors could preserve the hold immigrant parents had over their children and amalgamate the better features of the various immigrant cultures with the native born. The answer was sought in social action and education in American ways. The key to this assimilation was understood as having a command over the English language to help the immigrant better understand American life, while sharing the same ideals and aspirations of the native born.104 In 1874, the Young Men’s Hebrew Association (YMHA), an educational and social institution, was founded.105 From the start, the YMHA was lauded for the good work it had accomplished among the Russian immigrants.106 In 1886, the libraries of the Hebrew Free School Association united with that of the YMHA.107 The combined YMHA and Hebrew Free School Association libraries contained more than 10,000 volumes, owing in large part to financial support from the Jewish community.108 The YMHA had created numerous classes in commercial and vocational subjects, including the study of Hebrew and English. The YMHA lobbied for and organized classes on behalf of the public evening school long after it could no longer assume this role. It was felt that the security of the community depended greatly on acquainting immigrants with the English language and governmental institutions. This was seen as a way to defend the poor from becoming pawns of agitators and demagogues 103 Cohen, A Dreamer’s Journey, 219. 104 Edward George Hartmann, The Movement to Americanize the Immigrant (New York: Columbia University Press, 1948). 105 Benjamin Rabinowitz, “The Young Men’s Hebrew Association (1854-1913),” Publications of the American Jewish Historical Society 37 (1947): 221-326. 106 Jewish Messenger, April 4, 1884: 1. 107 Jewish Messenger, June 4, 1886: 4. 108 Rabinowitz, “The Young Men’s Hebrew Association.”

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within their own communities.109 One of the outstanding figures in the struggle to acculturate immigrants was Henry M. Leipziger, who had written a doctoral dissertation at Columbia University in 1888, entitled The Philosophy of the New Education. The theme of his dissertation—practical skills and academic arts— would become the major basis of his educational philosophy.110 Leipziger held that the development of the American citizen must result from his education and “listening to expert men,” thus enabling him to think, inquire, and debate.111 Leipziger had lectured during the 1880s at various colleges and temples. His aim was to acculturate immigrants to the values and norms of the United States. Under Leipziger’s direction, the Adult Free Lecture attendance of the New York City Board of Education increased threefold in 1890 and 1891, from 23,600 to more than 78,000. A year later, enrollment increased to 122,000. By 1898, there were more than 500,000 attendees. In 1903 and 1904, when lectures were given in Yiddish and Italian, there were nearly 1,136,000 attendees. Between 1903 and 1917, more than 370,000 persons attended the Yiddish language lectures, accounting for more than 22 percent of all attendees. Persons attending the Italian lectures represented only six percent of all attendees.112 Lectures delivered in Yiddish during the academic year 1903-1904 in the Adult Free Lecture program included Comparison of Life and Customs in Russia and America and How to Study English. Other lectures examined the duties of the foreigner in the United States, American history, the history of New York, and the constitution and laws of the land. Ralph Waldo Emerson, Benjamin Franklin, George Washington, and Abraham Lincoln served as topics of other lectures, while the Holy Land served as another; however, more lectures were delivered on health than any other topic and covered the prevention of consumption, contagion, nutritional hygiene, care of the skin, digestion and indigestion, and first aid.113

109 Leipziger Papers, “Annual Report and Directory of the YMHA, 1886-1887,” Red Scrapbook 91 (1867): 14-15. 110 Ruth L. Frankel, Henry Leipziger, Educator and Idealist (New York: Macmillan, 1933). 111 Annual Report of Public Lectures, 1915-1916 (New York: Board of Education of the City of New York, 1916). 112 Stephan F. Brumberg, Going to America, Going to School: The Jewish Immigrant Public School Encounter in Turn-of-the-Century New York City (New York: Praeger Publishers, 1986). 113 Brumberg, Going to America, Going to School.

Education and Literacy: The Path to Good Health 39

The Baron Maurice de Hirsch Fund was highly instrumental in providing scarce resources to the agencies that attempted to socialize the immigrants.114 The Fund was endowed in 1891 with $2,400,000, used to provide classes in English for immigrant youngsters. A principal objective of the Fund was to promote financial independence. The Fund, however, also had a positive effect on the health of the immigrant, providing much needed relief and support of the immigrants, including training in a craft and the tools and implements necessary to earn a living; instruction in the English language and the obligations of citizenship in the United States; instruction in agricultural work and methods of farming; contributions toward the welfare of individuals and families while they awaited work; information on work opportunities, and contributions toward the education of the needy. The Fund also sought to determine the demographics, health, education, family composition, income, and living arrangements of newcomers. Impoverished students were provided carfare and nourishment, such as coffee or tea and a slice of bread and cheese to sustain them for classes. By 1893, the Baron de Hirsch Trade School offered courses in carpentry, joinery, and woodcarving; sign and house painting; artistic metal working; and machinist and mechanical drawing. Efforts were strongly directed at educating students in the English language, the required language for public schools. The school also offered a student loan to aid men who had already completed professional education in medicine, law, and other fields and who required a short period of time to qualify for work in this country. The Trustees of the Fund were especially sensitive to the health needs of the students and apprentices in the Trade School. By 1926, arrangements were made with the Committee of Health Service among Jews, under the direction of Dr. Jacob A. Goldberg, to provide medical examinations for all entering students and determine whether they were healthy enough to pursue their trade of choice. The year 1932 witnessed the screening of approximately 2,000 men under the supervision of the New York Tuberculosis and Health Association. Ailments were identified and advice was offered regarding remediation. Concern was also shown for the deaf. Through an agreement with the Deaf Mute Institute of New York, the Fund provided for the training of two 114 Joseph, History of the Baron de Hirsch Fund.

40 Abi Gezunt

deaf mutes in the sign painting and printing classes of the Trade School. Lectures were provided in Yiddish and English on such topics as The Responsibility of Immigrant Parents to their Children and The Children and the Streets. English language classes, the domestic arts, civics, and industrial opportunities were also provided. Higher education was made more hospitable to the immigrating Jew owing to the rapid expansion of colleges and universities. By 1924, higher educational institutions were capable of instructing five times the number of people as they were in 1890.115 Another factor was the move of education away from the classics and toward more practical subjects, which meshed well with the burgeoning interest in science and technology and the subsequent need for a managerial class. The Jewish immigrants, who far more than other immigrants had been engaged in middle-class occupations in the old country, were eager to recapture their middle-class status, and seized upon the opportunities before them.116 Their proclivity for education had long since prepared them to be on the alert for educational opportunities. William Thomas and Florian Znaniecki believed that material conditions played a strong role in the development of behavior, especially for the Jews, whose tendency for educational advancement had long been in place.117 Jews were eager to suppress traits that would reveal them as aliens. They sought to adopt quickly the knowledge, skills, attitudes, and values that would facilitate their participation in American society.118 HEALTH AND HYGIENE IN SCHOOLS Foremost in the minds of educational planners charged with socializing hundreds of thousands of immigrant children was the promotion of health. The most highly prized attribute held by those in education was strength. This was 115 Rudolph, The Emergence of the American University; Stephen Steinberg, The Academic Melting Pot: Catholics and Jews in American Higher Education (New York: McGraw-Hill, 1974). 116 Glazer, “The American Jew and the Attainment of Middle-Class Rank.” 117 William I. Thomas and Florian Znaniecki, The Polish Peasant in Europe and America, 2nd ed. (New York: Alfred A Knopf, 1927). 118 Robert E. Park and Herbert A. Miller, Old World Traits Transplanted (Chicago: Society of Social Research, University of Chicago, 1925).

Education and Literacy: The Path to Good Health 41

followed by using English well, acquiring an intellectual education, and knowing how to conduct oneself as an American citizen.119 The immigrants themselves gave short shrift to such matters as the physical accommodations of the schools that others might have considered important: the opportunity for education overshadowed all negative aspects of the slum schools, such as the darkness, noxious fumes from the gas jets, and the noise from adjacent factories and elevated trains. Despite all the drawbacks of the schools, they were in very high demand. Jewish parents never protested conditions, but did protest when their children were turned away owing to overcrowding. In 1897, Jewish parents nearly rioted when their children were turned away from school. The school had already filled 2,000 slots, even though the maximum capacity for the building was 1,500.120 As early as 1897, the schools became aware of the need to intervene on behalf of the health of the students. In his first annual report, Superintendent of Schools William Henry Maxwell recommended that a survey be undertaken to determine how many students were mentally and physically incapable of pursuing a normal education and subsequently suggested the formation of special classes for these youngsters.121 Between 1894 and 1897, physicians were hired by schools in major cities, including Boston, Chicago, and New York City. For $30 per day, the school physicians devoted one hour to the care of students. By 1902, physicians’ hours had increased to three hours per day.122 Children with contagious diseases were sent home.123 Another response came in the form of an experiment in school nursing. The Board of Education, in cooperation with the Henry Street Settlement and 119 William H. Maxwell, “Education of the Immigrant Child,” in Education of the Immigrant (from an abstract of papers read at a public conference under the auspices of the New York-New Jersey Committee of the North American Civic League for Immigrants, held at New York City, May 16 and 17, 1913) (Washington, D.C.: U.S. Bureau of Education, Bulletin no. 51, 1913), 18-19. 120 Diane Ravitch, The Great School Wars: A History of the New York City Public Schools (New York: Basic Books, 1988), 179-180. 121 William Henry Maxwell, First Annual Report of the City Superintendent of Schools (New York: Department of Education 1899), 130-132. 122 Caldwell, “Education as a Factor in Mortality Decline.” 123 First Annual Report of the City Superintendent of Schools; L. H. Gulick and L. P. Ayers, Medical Inspection of Schools (New York: New York Charities Publication Committee, 1910).

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with the blessings of its director, Lillian Wald, instituted a school nurse program at four schools on the Lower East Side. This plan was begun in 1902. Under this novel system, the school nurse was to treat students she was qualified to help and send more serious cases to physicians for further examination and treatment. School nurses paid home visits and acted as health educators, advising about the availability of the dispensary and the care of the child.124 The experiment improved attendance so greatly after one year that the Board of Estimate voted to expand it.125 The first nurse in charge of this experiment, Miss Lina L. Rogers, noted that there was no room set aside for a dispensary; rather the nurses worked in a corner of the playground. Their supplies were limited to cotton, small basins, scissors for cutting hair, spatulas for applying Vaseline, and an alcohol lamp for heating water. The most common medical problems included eczema, ringworm, and pediculosis. In 1902, personal hygiene as well as the fundamentals of nutrition and healthful leisure time activities became part of the curriculum, when the first citywide director of Health Education, Maxwell, was appointed.126 These innovations were very much in keeping with Superintendent Maxwell’s concern for the overall welfare of children. By the following decade, children were being taught how to prevent tuberculosis, how to combat vermin, and the rudiments of industrial hygiene. The vast number of immigrants magnified the problems related to the spread of contagious disease and absence from school. Schools were encouraged to address the cause of their students’ illnesses. Malnutrition was determined to be a major source of ill health among the immigrants. It became apparent that feeding youngsters or at least supplementing their diets with lunches was necessary.127 It was felt that many mothers were either ignorant of proper diet or too busy to prepare lunches. Many youngsters arrived at school without having eaten breakfast. In response to this situation, the Council of 124 Caldwell, “Education as a Factor in Mortality Decline”; Lillian Wald, The House on Henry Street (New York: H. Holt and Co, 1915). 125 F. Shaw, World’s Work: Fifty Years of Research in the New York City Board of Education, vol. VII (New York: 1963). 126 Harold McCormick, “The First Fifty Years,” Fiftieth Annual Report of the City Superintendent of Schools (New York: 1948). 127 Burton J. Hendrick and Paul Kennaday, “Three-Cent Lunches for School Children,” McClure’s Magazine 42 (1913): 120-128.

Education and Literacy: The Path to Good Health 43

Jewish Women developed what came to be known as the Penny Luncheons.128 Women involved in the suffrage movement at the time had also organized penny luncheons in schools and free extension courses for girls. A child’s inability to learn was often attributed to conditions beyond the control of the child. It was variously attributed to illness, poverty, and malnutrition. Rape by boarders was also implicated in impeding learning.129 Feeling powerless in this matter, the school sought the direction of professionals in social work.130 In a 1908 study of children aged ten through fourteen, investigators examined the connection between health and scholastic ability and school readiness.131 The more medical problems a child had, the longer it took him to complete school.132 Maxwell sought to address the needs of the whole child and noted that whenever a foreign parent was “compelled to do something for the improvement of his child’s health, he moves a step nearer the American standard of living.”133 Youngsters were soon learning in their required geography courses that it was the obligation of citizens to separate garbage from ashes; keep receptacles covered; refrain from throwing papers, fruit-skins, and other discarded matter into the street or sidewalk; refrain from throwing anything from windows, from obstructing sidewalks or thoroughfares, and from defacing walks, fences, or buildings.134 They were also taught that it was their responsibility to be personally clean, have clean clothing and homes, attend to the neighborhood and the streets and the proper disposal of garbage, report contagion immediately, and 128 Boris D. Bogen, Jewish Philanthropy: An Exposition of Principles and Methods of Jewish Social Service in the United States (New York: Macmillan Co., 1917). 129 Julia Richman, “A Social Need of the Public Schools,” The Forum 43 (February 1910): 166. 130 J. E. Robbins, “The Settlement and the Public Schools,” Outlook XCV (1910): 785-787; E. H. Johnson, “Social Service and Public Schools,” Survey 30 (May 3, 1913): 173-178; John Spargo, The Bitter Cry of the Children (New York: Macmillan Co, 1906); Robert Hunter, Poverty (New York: Macmillan Co., 1904), 216. 131 Gulick and Ayers, Medical Inspection of Schools. 132 Tecke and Shorter, “Determinants of Child Mortality”; A youngster with defective teeth required 8.5 years to complete the normal 8-year curriculum, while his peers with defective breathing needed 8.6 years; with hypertrophied tonsils, 8.7 years; with adenoids, 9.1 years; and with enlarged glands, 9.2 years. 133 William Henry Maxwell, Ninth Annual Report of the City Superintendent of Schools for the Year Ending July 31, 1907 (New York: Department of Education, 1907), 139. 134 Course of Study in Geography with a Syllabus (New York: Board of Education, October 1905).

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have respect for Health Board notices, anti-spitting laws, and child labor laws. Seventh and eighth grade girls were taught the art of housekeeping, including the management of such tasks as lighting a gas range; care of the sink, waste pipe, and trap; and dishwashing and laundry. Nursing care was taught in eighth grade, including the fittings and care of the sickroom and appropriate diet for the sick.135 The public schools assumed the responsibility of catering to the total person. After all, only a healthy person could fend for himself in the labor market. Schools were geared to cover every aspect of a student’s life. Vocational guidance was considered essential for helping students climb out of the ghetto. Great emphasis was placed on transforming the immigrant into a clean, wholesome individual, and much attention was paid accordingly to courses in physical training and hygiene. Lectures were provided daily on the importance of cleaning and caring for nails, hair, eyes, mouth, teeth, and nose; polishing shoes; and replacing and securing buttons to maintain a wholesome and clean appearance; having proper ventilation; getting sufficient sleep and having sufficient play; and maintaining good posture while standing, sitting, writing, sleeping, and walking.136 The handkerchief had become an important symbol of one’s concession to the new culture. Carrying a clean white handkerchief was a school “rule.” One student recalled having a teacher bring stacks of clean handkerchiefs to school. When necessary, she would call students to her desk, hand them a handkerchief, and have them blow their noses. The student remembered carrying a clean handkerchief to prevent having to be called up by the teacher.137 Teachers paid special attention to the needs of the immigrant populations, since they believed unhealthy physical conditions served as a source for poor scholastic performance. Visiting teachers would explore the causes of poor scholarship and attendance and attempt to remediate them.138 They took it upon themselves to facilitate eye, ear, dental, and orthopedic examinations.

135 Course of Study and Syllabuses in Drawing, Constructive Work, Sewing and Cooking for the Elementary Schools of the City of New York (New York: Board of Education, May 27, 1903). 136 Course of Study in Physical Training and Hygiene (New York: Board of Education, 1903; Board of Superintendents, 1905). 137 Brumberg, Going to America, Going to School. 138 Johnson, “Social Service and Public Schools.”

Education and Literacy: The Path to Good Health 45

At times, the school system challenged the authority of immigrant parents, particularly when it came to issues of health. Selma Cantor Berrol reported a situation in 1908 involving a misunderstanding between teachers and parents on the Lower East Side of Manhattan.139 Mental sluggishness was considered by medical authorities of the day to be caused by enlarged adenoids. Although teachers often took it upon themselves to arrange for the removal of adenoids, many parents remained averse to this practice. Despite objections, teachers arranged for physicians from the nearby Gouverneur Hospital to perform mass adenoidectomies at the school. When the parents heard of this plan, 80 mothers descended upon the school and dragged their children—adenoids intact—to the safety of their homes. Most of the parents had the wisdom to attribute their children’s lack of energy to the poverty and congestion of their home lives and not to the presence of adenoids. The Hebrew Educational Alliance also paid serious attention to the healthcare needs of their charges. Although many immigrants appreciated the importance of getting a good education, they did not always attribute importance to proper physical conditioning. The Alliance made participation in gym classes compulsory when possible and held periodic medical examinations of the students.140 In the summer, the Alliance’s roof garden was the scene of great activity designed to shelter children from their harsh neighborhood environments. During the summer, lectures on the principles of hygiene and sanitation were offered, and a trained nurse examined youngsters who took part in the roof-top activities. In addition, the Nathan Straus pasteurized milk depot provided three-cent lunches to poverty stricken youngsters. LITERACY: THE ROAD TO HEALTH, AND WEALTH As we have seen, the association between literacy, particularly maternal literacy, and health is undeniable. Factors such as place of residence (urban versus rural), religion, ethnic group, sanitation, and the proximity of healthcare facilities have had only a negligible effect on mortality compared with maternal education.141 139 Berrol, “Immigrants at School.” 140 S. P. Rudens, “A Half Century of Community Service: The Story of the New York Educational Alliance,” American Jewish Year Book 46 (1944): 73-99. 141 United Nations, Socioeconomic Differentials.

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Even the influence of income—although significant—did not exert as strong an effect on mortality as did literacy. Improvements in mortality appear to be linked less with economic improvement than with improvements in preventive medicine and public health.142 Leonard Sagan asserted, “Many people assume that the health benefits associated with education are but the consequence of a greater economic advantage—more education begets affluence, better nutrition, better medical care, and so forth—all those things that money can buy. But the evidence reviewed does not seem to support this view.”143 The determining factor in health, he maintained, is literacy and education of the parent, which serves as a predictor of infant mortality. Sagan also observed that educated people have higher levels of self-esteem, are more likely to take care of themselves, and also more likely to have developed the social skills necessary to participate in social activities that are a part of the educational process. In education lies the key to a better life.

142 E. Arriaga and K. Davis, “The Pattern of Mortality Change in Latin America,” Demography 6 (1969): 223–242. 143 Sagan, The Health of Nations, 177.

SOCIAL SUPPORT

CHAPTER 3

Charity—Das Jüdische Herz There are eight levels of tzedaka, each greater than the next. The greatest level, above which there is no other, is to strengthen the name of another Jew by giving him a present or loan, or making a partnership with him, or finding him a job in order to strengthen his hand until he needs no longer [beg from] people. For it is said, “You shall strengthen the stranger and the dweller in your midst and live with him,” [Leviticus XXV:35] that is to say, strengthen him until he needs no longer fall [upon the mercy of the community] or be in need. Moses Maimonides, Charity’s Eight Degrees1

A

core value taught by rabbis in the Yeshiva was “Az irh hat nit kein rachmones, kinderlach, farvos zeit irh idn”; that is, “If you don’t have compassion, children, why bother to be Jewish?” Charity has been one route by which to preserve the faith and the culture, while showing compassion and being faithful to religious tenets and cultural heritage. Das Jüdische Herz (the Jewish Heart) was more a function of responsibility placed upon the Jew by special circumstance rather than an inherited trait. This attitude was reflected recently in a front-page article published in The New York Times ( June 14, 2013), describing how decisions of Edward R. Korman, a United States district judge serving on the United States District Court for the Eastern District of New York, have been scorned by individuals on both sides of the political spectrum.2 He viewed himself as a “compassionate   1 Moses Maimonides, “Mishneh Torah, Eight Degrees of Charity: Rambam, Hilchot Mat’not Ani’im 10:17–14,” accessed June 18, 2009, http://www.panix.com/~jjbaker/rmbmzdkh.html.   2 Pam Belluck, “Judge in Contraceptive Case: Tough, but Hard to Pigeonhole,” New York Times ( June 14, 2013), A1, A3.

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conservative.” He explained that his compassion sprang from two deep wells of experience rarely discussed publicly: his upbringing as a son of Jewish immigrants from the shtetls of Ukraine and Poland, and rachmones, the Yiddish word for compassion. He had a 30-year-old daughter who was severely autistic. The profound nature of his daughter’s disturbance caused the judge to lament that he had never had a conversation with her. Thus, he was often moved to award increased damages in cases involving disabled children to help their families along and to eliminate the child being viewed as a burden. The Jew has always remained aware of the circumstances that led him and his family to his present state. The Jew sees as his primary responsibility the care of his family, followed by the problems of his compatriots. The good things of life must be shared and passed down during one’s lifetime, and it is considered a blessing to be of service to others. All giving is to be downward.3 Because the Jews had long embraced this philosophy, they thrived and prospered against what often seemed like overwhelming odds. TAKING CARE OF THEIR OWN The Jewish immigrant’s home was his castle. Since emotional security and social recognition were largely absent from the society in which they operated, family was the only place where words of encouragement and appreciation were plentiful. In turn, the Jew’s sense of responsibility to his family was sharpened. Occupations were chosen with an eye toward economic success. Not only was having a lucrative job a way to self-validation, but it was also a way to repay the family for their support and love.4 The social pattern of familism, that is, the ascendancy of family over individual interest, became prevalent among Jews, enabling and encouraging them to provide services to and receive services from relatives. Robert F. Winch and colleagues sought to determine the relationship between familism and migration,

  3 Natalie F. Joffe, “Non-Reciprocity Among East European Jews,” in The Study of Culture at a Distance, ed. M. Mead and R. Metraux (Chicago: University of Chicago Press, 1953), 386–387.   4 Nathan Goldberg, “Dynamics of the Economic Structure of the Jews in the United States,” in The Writing of American Jewish History, ed. M. Davis and I. S. Meyer (New York: American Jewish Historical Society, 1957), 33–256; 251–252.

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arguing that occupational status was a function of ethnic status.5 Certain types of employment would render the Jews geographically immobile, thus fostering conditions for familism among them. Significantly more Jews and Catholics than other ethnic or religious groups reported higher degrees of functional interaction, as determined by the number of times the term “relative” was employed by the respondent to denote a family member involved in either the giving or the receiving of aid, services, and loans. It was suggested that the Jews are not more familistic because they are less migratory, but rather that they are less migratory because they are more familistic.6 Social relief to Jews by Jews was a way of carrying out their earthly destiny. The Jews believed that charity was a necessary part of “taking care of their own” and never forgetting those who are suffering. Nowhere was this more clearly illustrated than in the creation of hundreds of Hebrew societies and associations established to care for their poor, ill, and uneducated. These societies grew up to support needy immigrants in the absence of other organizational structures. As early as 1892, 136 religious societies were listed on the Lower East Side of Manhattan, 93 of which were Russian/Polish.7 The notion of charity (or tzedakah), once an integral part of Jewish religious life, had extended beyond the synagogue. Jewish charitable organizations reflected the influence of American nonsectarian philanthropic philosophies; however, the Jews retained the “moral worth of charity.”8 While the belief in charity is strongly supported by the Talmud and is considered one of the Jews’ three highest duties, Jews are also averse to accepting charity, a function of exercising limits over charity.9 Although Jews lived as much as they could within their own communities and cooperated in the spirit of brotherhood, their aim was for independence: “Better is the life of a poor man under a shelter of logs than sumptuous fare in another man’s house.” In the   5 Robert F. Winch, Scott A. Greer, and Rae Lesser Blumberg, “Ethnicity and Extended Familism in an Upper-Middle-Class Suburb,” American Sociological Review 32 (1967): 265–272.   6 Ibid.   7 Rischin, The Promised City.   8 Deborah Dash Moore, At Home in America: Second Generation New York Jews (New York: Columbia University Press, 1981).   9 Naomi W. Cohen, “Responsibilities of Jewish Kinship: Jewish Defense and Philanthropy,” in Jewish Life in America—Historical Perspectives, ed. R. Rosen (New York: KTAV Publishing House, Inc., 1978), 126.

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daily prayer said at meals, the supplicants ask that they be spared having to accept gifts of flesh and blood. Being a beggar in the Jewish culture carries with it immense disrepute. Jews in the new country were determined not to become a burden or seek support from any place other than their own community. They were thus motivated to create their own Jewish philanthropic organizations and were firm in declining help from the government or non-Jewish charitable organizations. Economic circumstances and unrestricted migration eventually resulted in an oft-cited anomaly of motivating thousands of Jewish men to desert their families. As a result, deserted women and children constituted the second largest item on the cash relief budget of the United Hebrew Charities.10 In 1905, they accounted for 15 percent of the relief disbursed. In 1911, the National Desertion Bureau was established to locate missing Jewish husbands.11 Even after the Wall Street Crash of 1929, Jewish agencies initially held their own far better than did other family welfare services. Between 1930 and 1931, however, nearly 40 percent of Jews received aid from Jewish agencies, putting a strain on resources within their community. Although some Jews were forced to accept public welfare, they remained concerned about its effects upon the Jewish community.12 Kosher breadlines arose, but were denounced as inefficient and unnecessary. Independent Jewish charitable organizations were eventually created to meet the demand, and Yiddish newspapers sponsored relief campaigns. The New York Federation, a Jewish charitable organization founded in 1917, faced a budget deficit and had to launch an emergency fundraising effort. Sydney Stahl Weinberg noted that “taking care of their own” was becoming increasingly difficult.13 Solomon Lowenstein, executive director of the New York Federation and chairman of the coordinating committee on unemployment of the New York Welfare Council, observed that the work of the Hebrew Shelter and Immigrant Aid Society (HIAS), rendered kosher 10 Paula E. Hyman, “Gender and the Immigrant Jewish Experience in the United States,” in Jewish Women in Historical Perspective, ed. J. R. Baskin (Detroit: Wayne State University Press, 1991): 222–239, accessed February 29, 2016, faculty.history.umd.edu/BCooperman/ NewCity/JewishWomen.html. 11 Ibid. 12 Beth Wenger, New York Jews and the Great Depression—Uncertain Promise (New Haven: Yale University Press, 1996), 140. 13 Sydney Stahl Weinberg, The World of Our Mothers: The Lives of Jewish Immigrant Women (Chapel Hill: University of North Carolina Press, 1988), 229.

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breadlines and soup kitchens for the Jews unnecessary. HIAS announced that, over a period of four months, the Shelter Department had served 45,132 free meals and provided 6,129 nights of shelter at the headquarters; however, during Passover, the same department had served only 7,026 meals.14 As early as 1832, New York had a Jewish-sponsored orphanage. By 1909, Bogen documented “1,191 separate and distinct Jewish organizations, not including mutual benefit societies, cemeteries, burial societies, trade unions, Zionists, Territorialists, and other organizations doing work of an international character.”15 The organizations included relief societies, federated charities, educational institutions, institutes, settlements, and trade schools. There were also hospitals, dispensaries, orphan asylums, convalescent homes, sanitaria, and nurseries. A total of 809 Jewish philanthropic agencies conservatively spent $10 million annually. BIKUR CHOLIM AND HATZOLOH All ethnic and religious groups maintain organizations designed to support the sick. Well within the context of this discussion are two institutions: Bikur Cholim and Hatzoloh. Bikur Cholim is a moral obligation for all Jews, and translates loosely as visiting the sick and infirm. The concept derives from Genesis 17:26-18:1, where God visits Abraham after he is circumcised, reflecting a concern for the sick and for meaningful interpersonal relationships as reflected in the biblical commandment: “And ye shall love your neighbor as yourself ” (Leviticus 19:18). The practice can be performed by individuals or members of organized societies. Bikur Cholim societies were established in the Middle Ages and are still found today in Jewish communities throughout the world. The practice includes visiting the homebound and hospitalized infirm as well as the recitation of Psalms chosen to address their needs. The Talmud states, “He who visits a person who is ill takes away a sixtieth of his pain” (Nedarim 39b). 14 Harry Schneiderman, ed., for the American Jewish Committee, Review of the Year 5691. September 21, 1933 to September 9, 1934, American Jewish Year Book (Philadelphia: Jewish Publication Society of America, 1933), 39. 15 Boris Davis Bogen, Jewish Philanthropy: An Exposition of the Principles and Methods of Jewish Social Service in the United States (New York: Sage, 1917), 7–8.

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“Anyone who visits the sick causes him to live and anyone who does not visit the sick causes him to die” (Nedarim 40a). Many Bikur Cholim societies have expanded their services to address the changing needs of the community and now include social services; seeing to the needs of children; providing psychological counseling; feeding the hungry; counseling related to eligibility for government entitlements, health insurance options, and medical referrals; and offering services to seniors. Hatzolah (rescue), founded in the late 1960s, is the largest volunteer ambulance service in the world. In New York alone, there are more than 1,000 volunteer emergency medical technical personnel and paramedics who respond to more than 250,000 calls per year. Hatzolah organizations sponsor a wide array of community events. One distinguishing aspect of the Hatzolah is their willingness to remain in the hospital with patients and family members after bringing them to the emergency room to help guide them through the intricacies involved in such stressful events. Assistance often extends to patient advocacy, medical consultations, and patient transfer to other medical facilities. THE LANDSMANSCHAFTEN The Landsmanschaften were Jewish fraternal organizations that sought to provide health benefits, insurance, and medical assistance to their countrymen. The oldest such organization was established in 1843 and served the Union of German Jews.16 The word Landsman translates loosely in English as “compatriot,” but does little to convey the depth of the bond felt among the Jews and their co-religionists in these organizations. These organizations were often named after the hometowns of the Jews before their immigration to the United States. The Landsmanschaften helped the Jewish community provide what they could for members who were physically, financially, or emotionally distressed. While the Landsmanschaften allowed and encouraged full participation in the community life of their new home, the Jews remained bound to obligations remaining from their homelands. Whatever debt or care bound them to their 16 J. Finkelstein, “Brest Jews in the World: The Landsmanschafts and the Story of the United Brisker Relief,” accessed February 18, 2009, http://www.jewishgen.org/Yizkor/Brest2/ bre611.html.

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brother back in the old country was dealt with and satisfied even in the new country. The work of the Landsmanschaften extended to any unfortunate individual among them. For example, in 1890, money was collected for a fellow Brisker (a native of Brest, Belarus) who was unable to pay his rent. This simple effort led to the organization of the Brisker Benevolent Society in New York. The United Brisker Relief Committee, founded in 1915 in New York, was established to provide relief for cities and towns decimated by World War I. When the Jews left the city of Brest, it was argued that no one needed to send aid of any sort, since there would be no one in the town to receive the aid. The founders persisted and sought the Jews who had been expelled from their homes and provided aid through donations. This effort spread to Warsaw, where the Briskers themselves had organized a committee to help the Brest homeless. The Brest organizations were again called upon to assist their compatriots in Brest after the horrible May 13, 1937 pogrom.17 Branches arose throughout the United States, including Harlem, Brownsville, Newark, Cleveland, and Los Angeles. Each major Landsmanschaft federation sponsored a hospital or a social welfare institution and each responded directly to the needs of the Jewish community. When the supply of hospital beds in Manhattan proved inadequate, several groups joined to open additional facilities, including the Galician’s Har Moriah, the People’s Hospital, and the Jewish Maternity Hospital.18 The incentive to build new facilities was borne by feelings of mistrust of existing institutions among Jews, who considered the lack of Kosher food in some hospitals a matter of disrespect.19 In addition to being ridiculed for refusing non-Kosher food, some Jews were subjected to forced shavings of their religious beards, an act tantamount to desecration.20 The Landsmanschaften hospitals, on the other hand, sought to meet the cultural needs of their patients and help them avoid the disgrace associated with receiving charity.21 Activities of the Landsmanschaften continued throughout World War II to the current day. 17 Finkelstein, “Brest Jews in the World.” 18 Jewish Communal Register, “Die erefenung fun pipls hospital,” Tageblat 27 (1910). 19 Daniel Soyer, Jewish Immigration Associations and American Identity in New York, 1880–1939 (Cambridge, MA: Harvard University Press, 1997). 20 Jewish Communal Register, “Vos Men tut in a Idishn Hospital,” Tageblat 26 (1914). 21 Soyer, Jewish Immigration Associations.

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Both secular and religious groups sought to support their constituents. The Laborers’ Union Benevolent Association was founded in 1843. By 1850, the association had between 2,500 and 4,000 members.22 Members paid minimal dues, for which they received sick benefits and funeral expenses. Cemetery privileges were also provided to members, who could not have secured such without synagogue membership.23 The Jews had a “strongly perceived” sense of obligation toward each other: “Jews hired Jews, gave charity to Jews, and yes, often exploited Jews.”24 But as Jews became prosperous and built businesses, their co-religionists also benefited and were given jobs. Jesse Eliphalet Pope captured the spirit of the Jews in his coverage of the New York clothing industry, noting that “among no other class of industrial workers do we find so much cooperation and organization, for mutual benefit, and among no other nationality do we find such sympathetic cooperation of the well-to-do classes in the attempt to raise those below them.”25 While Jews remained aware of their own needs, they were also aware of the needs of Jews abroad and gave assistance to persecuted Jews in Damascus, Palestine, Gibraltar, and Poland.26 Christian and Protestant immigrants, who were divided along national lines, were far less cohesive.27 JEWISH COMMUNITY LIFE When the Eastern European Jews arrived in America, they developed family circles and cousin’s clubs, particularly in large cities such as New York, Philadelphia, Pittsburgh, Chicago, and Detroit.28 Family clubs preceded the cousin’s clubs; 22 Robert Ernst, Immigrant Life in New York City, 1825–1863 (New York: King’s Crown Press, 1949). 23 Hyman Bogomolny Grinstein, The Rise of the Jewish Community in New York, 1654–1860 (Chapel Hill: University of North Carolina Press, 1948). 24 Edward C. Banfield, The Moral Basis of a Backward Society (New York: The Free Press, 1958). 25 Jesse Eliphalet Pope, The Clothing Industry in New York (Columbia: E.W. Stephens Publishing, 1905), 185. 26 Grinstein, The Rise of the Jewish Community in New York, 1654–1860. 27 Robert Ernst, Immigrant Life in New York City, 1825–1863 (New York: King’s Crown Press, 1949). 28 William E. Mitchell, Mishpokhe: A Study of New York City Jewish Family Clubs (New York: Mouton Publishers, 1980).

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however, being a first-generation descendent of a family club member ensured eligibility for membership in the cousin’s club. Membership entitled the needy, including the disabled and the ill, to aid in the form of loans and gifts. A costly illness became an occasion for charity. Jewish women in suburbia participated actively in the organizational life of the community and were often the leaders in the League of Women Voters, Community Fund, or Red Cross. Many Jewish women were instrumental in creating health societies for diseases, such as cerebral palsy, nephritis, and cancer, or for the blind. They strongly supported organizations and activities that would improve the quality of their lives and the lives of others in their community. The home bureau of the Hebrew Sheltering Guardian Society placed as many as 400 chronically ill children who had suffered from a variety of aliments, including childhood tuberculosis, asthma, skin diseases, polio and other crippling ailments, ear infections, endocrine conditions, and hypertension.29 Orphanages hosted fewer and fewer Jewish children over time. For the Jewish youngsters who were in orphanages, every attempt was made to foster continuing ties with the children’s original family. (At that time, orphans included children whose biological parents were living but could not keep them at home, as well as children whose parents had died.) Parents or other relatives, provided they were respectable, could see their children at any time when they were not at school.30 Mutual aid societies, in addition, abounded and many such institutions were visible in the Brownsville section of New York, where they did exhaustive work for the benefit of the Jews living there.31 The Jews in this country had a sense of transcendence—beyond the self and everyday problems. They called this the “flow” experience, “as if a stream of energy made it possible to balance their personal skills with environmental challenges.”32 The Jews were subdivided into communities and societies whose aim was to support every member as if they were a part of the family. The numerous testimonies of the help extended to immigrants are legendary. 29 Jacqueline Bernard, The Children You Gave Us: A History of 150 Years of Service to Children (New York: Bloch Publishing Co., 1972). 30 Ibid. 31 Gerald Sorin, The Nurturing Neighborhood: The Brownsville Boys Club and Jewish Community in Urban America, 1940–1990 (New York: New York University Press, 1992). 32 Ibid., 93.

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An investigation of records between 1908 and 1910 at Ellis Island revealed that 58 percent of the Jews had been helped by remittances or tickets, surpassing the Irish, the Germans, and the Scandinavians in this effort.33 Although the Jews who had settled in the United States were unable to devote themselves as fully to the study of the Torah and to worship as they had in their countries of origin, they spent considerably more time performing works of charity than they had in their former countries.34 The central point of all these efforts remained the “eternal life of the Jewish nation.” It wasn’t the immortality of the individual Jew that mattered, but that of the Jewish people; hence, the extraordinary attachment of life manifested by Jews to care for the sick and the poor and to increase the family to maintain the people for as long as possible.35 HEALTH AND CHARITY With the influx of immigrants into the United States in 1880, there rose great concern about disease and poverty in the ghetto. Conditions were seen as a menace to American Judaism.36 This concern gave rise to the Sanitary Aid Society of New York, which investigated health conditions and reported them to the New York City Health Department.37 In New York, Chicago, and Philadelphia, the United Hebrew Charities provided free medical care to Jews. In Denver, the National Jewish Hospital for Consumptives was opened in 1899 to help overcome tuberculosis. Medical institutions arose throughout the country to accommodate the influx of immigrant Jews and to provide training for Jewish physicians and nurses who were denied access to prevailing institutions.38 Jews’ Hospital 33 Philip Taylor, The Distant Magnet: European Emigration to the U.S.A. (London: Eyre and Spottiswoode, 1971). 34 Ben Zion Dinur, “American Jewish Historiography in the Light of Modern Jewish History,” in The Writing of American History, ed. M. Davis and I. Meyer (New York: American Jewish Historical Society, 1957), 202. 35 Salo W. Baron, A Social and Religious History of the Jews (New York: Columbia University Press, 1937). 36 Myron Berman, The Attitude of American Jewry towards East European Jewish Immigration, 1881–1914 (New York: Arno Press, 1980), 306. 37 Ibid. 38 Bogen, Jewish Philanthropy.

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(now Mount Sinai Hospital) and Beth Israel Hospital in New York were among the first to be organized. More hospitals arose in time to provide care for poor Jewish immigrants who had failed to gain admission to these hospitals owing to the limited number of beds. Special needs hospitals, such as the Bronx Lebanon Hospital (1890), the Austro-Hungarian Hospital (1901), and the Jewish Maternity Hospital (outpatient, 1906; inpatient, 1909) also arose.39 The hospitals became a training ground for Jewish physicians and nurses. By the late 1920s, more Jewish physicians had affiliations with hospital facilities than their non-Jewish colleagues. The number of hospital beds rose steadily to accommodate the Jewish community of greater New York and the increasing number of aged among the Jewish immigrants. By 1929, thirteen institutions had been established to provide care for chronic and incurable diseases.40 The Hospital for Joint Diseases, established by Dr. Henry Frauenthal, offered Jewish physicians an entrée into the field of orthopedic surgery. Although at first the Jews turned to Irish and German physicians, they were later more likely to rely on their own countrymen for more common illnesses and to seek out non-Jewish specialists as necessary.41 Medical practice was difficult for Jewish physicians. They worked long hours, making house calls between hospital duty and office hours. While women and children came to the office during the day, men were more likely to see physicians in the evening after work. Despite their large patient loads, Jewish physicians were beset by economic problems. Since medical positions in large industrial and financial corporations were closed to them, they were forced to rely largely on revenues from private practice.42 The penchant for charity among the physicians, however, never waned. Dr. Abraham Jacoby, who argued for compulsory vaccination against smallpox and researched diphtheria, served as attending physician at the Hebrew Orphan Society for more than 60 years and did so entirely without pay.43 Children at the Society were examined at least once a month and sometimes daily, or as often 39 A. J. Rongy, “Half a Century of Jewish Medical Activities in New York City,” Medical Leaves 1 (1937): 151–163. 40 Jewish Communal Survey of Greater New York, Report of the Executive Committee (October, 1929). 41 Rischin, The Promised City. 42 Rongy, “Half a Century of Jewish Medical Activities in New York City.” 43 Bernard, The Children You Gave Us.

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as warranted. Medical care and supervision was so meticulous that by 1922, only 62 of more than 13,500 children had died. The Jews also banded together and formed organizations to protect themselves and each other from the unknown elements of American society. Social organization of the Jews was instrumental to the growth of the New York ghetto. Despite their poverty and struggle for existence, the Jews strove together, not apart, to build a better life. Even as they formed organizations for their betterment, such as the Tailors’ Labor Union, some Jews suffered the loss of their jobs and literally went hungry and cold.44 For the benefit of their struggling brothers and to maintain the principles they felt to be at stake, the Jews would often contribute 15 to 20 percent of their wages. The established and successful Jewish worker was prepared to risk all—good wages, short hours, and good shop conditions—to help his less fortunate Jewish brother. By the time of the large immigrations, secular and social groups had already developed support systems. The Laborers’ Union Benevolent Association had between 2,500 and 4,000 members in 1850, only 7 years after it was founded. Christians, Protestants, Presbyterians, Lutherans, and Catholics were far less cohesive. Jews, although known for their individualism, never clung to this trait at the expense of another Jew.45 They met on common ground when those below their social class needed a helping hand. Social and economic resources have an ameliorative effect on mortality and morbidity. Individuals with little or no social support suffer higher rates of mortality compared with those who have support.46 Having greater support also improves self-management of chronic illnesses, such as diabetes, and improves outcomes associated with myocardial infarction and smoking cessation.47 High levels of social and emotional support and having a sense of 44 Ray Stannard Baker, McClure’s Magazine (Colliers, 1904). 45 Pope, The Clothing Industry in New York. 46 D. G. Blazer, “Social Support and Mortality in an Elderly Community Population,” American Journal of Epidemiology 115 (1982): 684–694; R. Fleming, A. Baum, M. N. Gisriel, et al., “Mediating Influences of Social Support on Stress at Three Mile Island,” Journal of Human Stress 8 (1982): 12–22; L. F. Berkman and S. L. Syme, “Social Networks, Host Resistance, and Mortality: A Nine-Year Follow-Up Study of Alameda County Residents,” American Journal of Epidemiology 109 (1979): 186–204; L. F. Berkman, L. Summers, and R. I. Horwitz, “Emotional Support and Survival after Myocardial Infarction,” Annals of Internal Medicine 117 (1996): 1003–1009. 47 Berkman and Syme, “Social Networks, Host Resistance, and Mortality”; Berkman et al., “Emotional Support and Survival after Myocardial Infarction”; C. E. Lloyd, R. R. Wing, T. J. Orchard, and D. J. Becker, “Psychosocial Correlates of Glycemic Control: The Pittsburgh

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connection have been shown to increase survival rates of patients with cancers,48 and heart disease,49 to reduce the risk of coronary artery disease (including lowering blood glucose values, smoking rates, and waist-hip ratios) hypertension, and diabetes,50 and to lessen the progression of coronary atherosclerosis.51 Mortality six months after myocardial infarction was also found to be significantly related to social support, independent of its severity and patients’ hypertension status, smoking habits, age, gender, race, education, or marital status.52 The degree of emotional support was also predictive of cognitive

48

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Epidemiology of Diabetes Complications (EDC) Study,” Diabetes Research and Clinical Practice 21 (1993): 187–195; L. Ruggiero, A. Spirito, D. Coustan, et al., “Self-Reported Compliance with Diabetes Self-Management During Pregnancy,” International Journal of Psychiatry in Medicine 23 (1993): 195–207; D. T. Pham, F. Fortin, and M. F. Thibaudeau, “The Role of Health Belief Model in Amputees’ Self-Evaluation of Adherence to Diabetes Self-Care Behaviors,” Diabetes Education 22 (1996): 126–132; L. M. Tillotson and M. S. Smith, “Locus of Control, Social Support, and Adherence to the Diabetes Regimen,” Diabetes Education 22 (1996): 133–139; R. Lo, “Correlates of Expected Success at Adherence to Health Regimens of People with IDDM,” Journal of Advanced Nursing 30 (1999): 418–424; V. J. Giannetti, J. Reynolds, and T. Rihn, “Factors Which Differentiate Smokers from Ex-Smokers Among Cardiovascular Patients: A Discriminant Analysis,” Social Science & Medicine 20 (1985): 241–245; W. Ruberman, E. Weinblatt, J. D. Goldberg, and B. S. Chaudhary, “Psychosocial Influences on Mortality After Myocardial Infarction,” New England Journal of Medicine 311 (1984): 552–559; R. B. Case, A. J. Moss, N. Case, et al., “Living Along After Myocardial Infarction: Impact On Prognosis,” Journal of the American Medical Association 267 (1992): 515–529; M. E. Garay-Sevilla, L. E. Nava, J. M. Malacara, et al., “Adherence to Treatment to Diabetes Self-care Behaviors,” Diabetes Education 22 (1995): 126–132. P. Reynolds and G. A. Kaplan, “Social Connections and Risk for Cancer: Prospective Evidence from the Alameda County Study,” Behavioral Medicine 16 (1990): 101–110; L. Welin, B. Larsson, K. Svärdsudd, B. Tibblin, and G. Tibblin, “Social Network and Activities in Relation to Mortality from Cardiovascular Diseases, Cancer and Other Causes: A 12-year Follow-Up of the Study of Men Born in 1913 and 1923,” Journal of Epidemiology and Community Health 46 (1992): 127–132; K. Ell, R. Nishimoto, L. Mediansky, J. Mantell, and M. Hamovitch, “Social Relations, Social Support and Survival Among Patients with Cancer,” Journal of Psychosomatic Research 36 (1992): 531–541; J. H. Hibbard and C. R. Pope, “The Quality of Social Roles as Predictors of Morbidity and Mortality,” Social Science & Medicine 36 (1993): 217–225. H. S. Lett, J. A. Blumenthal, M. A. Babyak, T. J. Strauman, C. Robins, and A. Sherwood, “Social Support and Coronary Heart Disease: Epidemiologic Evidence and Implications for Treatment,” Psychosomatic Medicine 67 (2005): 869–878. T. Rutledge, K. Matthews, L-Y Lui, K. L. Stone, and J. A. Cauley, “Social Networks and Marital Status Predict Mortality in Older Women: Prospective Evidence from the Study of Osteoporotic Fractures (SOF),” Psychosomatic Medicine 65 (2003): 688–694. H-X Wang, M. A. Mittleman, and K. Orth-Gomer, “Influence of Social Support on Progression of Coronary Artery Disease in Women,” Social Science & Medicine 60 (2005): 599–607. L. F. Berkman, L. Leo-Summers, and R. I. Horwitz, “Emotional Support and Survival after Myocardial Infarction,” Annals of Internal Medicine 117 (1992): 1003–1009.

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decline. T. E. Seeman and colleagues (2001) examined changes in cognitive functioning of subjects over a 7.5-year period.53 Respondents with good emotional support had better baseline cognition and cognition over time, independent of socio-demographic, behavioral, and psychological predictors of cognitive decline. Among persons with higher participation in social activities and greater numbers of social networks, there were significantly fewer cognitive declines, even after controlling for socioeconomic status, level of cognitive or physical activities, depression, or the presence of chronic medical conditions.54 These findings were corroborated in many other studies, suggesting that social integration might delay the onset of dementia.55 While it cannot be denied that social relationships can enhance self-esteem and provide a sense of belonging, they can also be sources of demands, conflict, embarrassment, envy, disappointment, and devaluation, as well as serving as models for risky or unhealthy behaviors.56 Medical sociologists have uncovered increasing evidence of the powerful relationship between social support and morbidity and mortality.57 Indeed, the quality of data supporting the relationship between social support and health has been significantly enhanced with more sophisticated prospective research designs that permit focus on the 53 T. E. Seeman and E. Crimmins, “Social Environment Effects on Health and Aging,” Annals of the New York Academy of Sciences 954 (2001): 85–117. 54 L. L. Barnes, C. F. Mendes de Leon, R. S. Wilson, J. L. Bienias, and D. A. Evans, “Social Resources and Cognitive Decline in a Population of Older African Americans and Whites,” Neurology 53 (2004): 2322–2366. 55 C. Fabrigoule, N. Lechevallier, L. Crasborn, J. F. Dartigues, and J. M. Orgogozo, “Inter-Rater Reliability of Scales and Tests Used to Measure Mild Cognitive Impairment by General Practitioners and Psychologists,” Current Medical Research and Opinion 19 (2003): 603–608; S. M. Albert, B. Gurland, G. Maestre, D. M. Jacobs, Y. Stern, and R. Mayeux, “APOE Genotype Influences Functional Status among Elderly without Dementia,” American Journal of Medical Genetics 60 (1995): 583–587; S. Evans, C. Katona, “Epidemiology of Depressive Symptoms in Elderly Primary Care Attenders,” Dementia 46 (1993): 327–333; L. Fratiglioni and H. X. Wang, “Smoking and Parkinson’s and Alzheimer’s Disease: Review of the Epidemiological Studies,” Behavioral Brain Research 113 (2000): 117–120; S. S. Bassuk, T. A. Glass, and L. F. Berkman, “Social Disengagement and Incident Cognitive Decline in Community-Dwelling Elderly Persons,” Annals of Internal Medicine 131 (1999): 165–173; D. A. Bennett, J. A. Schneider, and Y. Tang, et al., “The Effect of Social Networks on the Relation between Alzheimer’s Disease Pathology and Level of Cognitive Function in Old People: A Longitudinal Cohort Study,” Lancet 5 (2006): 406–412. 56 Seeman and Crimmins, “Social Environment Effects on Health and Aging.” 57 B. N. Uchino, “Social Support and Health: A Review of Physiological Processes Potentially Underlying Links to Disease Outcomes,” Journal of Behavioral Medicine 29 (2006): 377–387.

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relationship of social support to laboratory findings associated with specific diseases.58 Poverty has long been associated with an increased risk of morbidity and mortality. Low social support has been identified as a predictor of mortality in the first year of life, as have elevated cholesterol levels, tobacco use, and hypertension.59 While social programs help promote health and hospitals provide care, a neighborhood or religious organization or familial group offers emotional support and a form of aid independent of formal agencies. The relationship between social support and health is complex. According to Debra Umberson, it involves at least four processes.60 The first involves individual attributes, including personality, coping strategies, and psychological factors that influence how an individual will react to stress, deal with health concerns, and assess stressful life events, and estimate social resources. The second focuses on the positive influence of social ties that deter health-compromising behavior and encourage compliance with health-promoting medical regimens. The third addresses the role of biology with a focus on physiological and biochemical mechanisms, including responses to others. The fourth addresses mechanisms used to buffer stresses. How each of these orientations operates—either individually or in concert—to promote health in specific ethnic populations will hopefully occupy future generations of scholars. We can, however, point to the immigrant Jew as an example of social support, however broad our choice of brushes. Driven largely by their moral obligation to provide for and assume responsibility for their own, lest their poor burden the rest of society, American Jews have remained active in providing charity for sectarian and nonsectarian causes. Their charity was structured by their religious brotherhood and historic identity.61 Consequently, the immigrant culture was not a culture of poverty,62 but one that gave largely from the heart to foster self-sufficiency and resulted in the improved health and eventual wealth of their people. 58 J. S. House, K. R. Landis, and D. Umberson, “Social Relationships and Health,” Science 241 (1988): 540–545. 59 F. Mookadam and H. M. Arthur, “Social Support and Its Relationship to Morbidity and Mortality after Acute Myocardial Infarction,” Archives of Internal Medicine 164 (2004): 1514–1518. 60 Debra Umberson, “Family Status and Health Behaviors: Social Control as a Dimension of Social Integration,” Journal of Health and Social Behavior 28 (1987): 306–319. 61 Bogen, Jewish Philanthropy. 62 A. Y. Kahan, A Basic Guide to Jewish Laws and Heritage: Based on the Classical Yiddish Sefer (New York: Keser Torah Publications, 1984).

SOCIAL SUPPORT

CHAPTER 4

Family First The continuing act of creation requires that we mortals shall utilize our God-given talents, our knowledge and our strength toward the end that the world shall be improved and perfected. Albert Isaac Gordon, Jews in Suburbia1

A

lthough the main social unit for the Jews was the entire shtetl (community), relatives were still more important than friends. But in the end, all Jews remained bound to each other. Samuel Joseph had noted that, unlike the immigration of other groups, Jewish immigration was a “family movement,” unequaled by any other group and attested to by the great proportion of women and children among the immigrants.2 It was the Jewish family’s approach to health and hygiene that played the premier role in the promotion of good health and the prevention of disease among members. The energy devoted by parents to solving their own healthcare needs served also to support their children. A respondent in an interview of attitudes toward child health care among immigrant Jews and Italians said that the “Jews would dig ditches in order to take their children to the doctor.”3 One Jewish pediatrician reportedly received an early morning call from an anxious mother, seeking advice on how to dress her child. She asked the physician to go outside to see how cold it was. Jewish mothers were far less   1 Albert Isaac Gordon, Jews in Suburbia (Boston: Beacon Press, 1959), 217–218.   2 Samuel Joseph, “Jewish Immigration from the United States from 1881 to 1910” (PhD diss., Columbia University, 1914).   3 Goldstein et al., “Childhood Health-Care Practices among Italians and Jews in the United States.

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likely than were non-Jewish mothers to let nature take its course and to put off seeking professional assistance for health care. Jewish women favored seeking the advice of their pediatricians over reading advice proffered by the public health literature. As early as the 1920s and 1930s, Jewish women were making the switch from home to hospital births, preceding Italian women in this practice.4 The resulting tightly-knit Jewish family structure usually precluded total neglect of health, resulting in long-term optimism, as illustrated in the following story. On Friday, November 9, 1990, Michael Winerip, in the “Our Towns” section of The New York Times, wrote a story that reflected the optimism of a 100-year-old Jewish man, who in turn reflected many of the values of his co-ethnics.5 The man was born in Russia and came to this country in 1907, having spurned his father, who wished to educate him for the rabbinate. Instead, he attended YMCA College in Springfield, Massachusetts, but in his senior year (1917), he was denied a degree because he was Jewish. Springfield College, obviously embarrassed by this, conferred our protagonist with an honorary degree in 1989. He holds basic values dear and has lived long enough to see he was right. He lectured his young children on the importance of education. His son, Robert, is a Stanford professor, one of America’s top theoretical mathematicians. He believes in family . . . Every year Mr. Finn, who has survived two wives, takes a California winter vacation. Last year, as usual, he put down a deposit for the next. Finn attributed his longevity to the right foods, exercise, curiosity, and having a grandfather who lived to the age of 112. He could not know if his parents had the same genes for longevity since they were exterminated in World War II.6

After the lecture at 2:00 pm, Eli Finn, who is 100 years old, “hurried downstairs . . . By 2:10, he was back on I-95. By 2:13, he was in the passing lane.” When “bad news” struck the Jewish family, it often resulted in disbelief or denial as in the story of Yacov Riegler. Four days after Eli Finn’s story was   4 Angela D. Danzi, “Jewish and Italian American Women and Childbirth, 1920–1940,” presented at the Annual Meeting of the American Sociological Association, August 5–9, 1994.   5 Michael Winerip, “Our Towns: A Man of his Age, and Still Driving in the Fast Lane,” New York Times (November 9, 1990), B1.   6 Ibid.

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published, the Times carried a story about 8-year-old Yacov Riegler of the Borough Park section of Brooklyn, who was murdered by his 33-year-old mother, Shulamis.7 Yacov was brought to a Maimonides Medical Center in a coma on Yom Kippur, September 29, and died on October 14, without regaining consciousness. Yacov was a victim of “child-abuse syndrome” and according to spokeswoman for the New York City Medical Examiner’s office, Ellen Borakowe, “suffered from a leg fractured just before hospitalization” and “old and recent fractures in various stages of healing.” The principal cause of death was head injury, according to the deputy medical examiner who performed the autopsy. The story sent shock waves through the Orthodox Jewish community. While corporal punishment and violence are abhorred in the community, child abuse is nevertheless known to exist. Assemblyman Dov Hilkind, who represented Borough Park, acknowledged: I don’t want to whitewash anything. It’s taken us a little longer to realize certain social ills in our community . . . It’s a very tight knit community [with] many problems . . . they attempt to resolve them internally. We don’t like to talk about child abuse in an Orthodox Jewish community. You never hear about problems like that, but they are here.8

It was explained that religious law, known as Lashon Hara, prevents neighbors and friends from talking ill of anyone, except to a rabbi or someone of authority in the community. In addition, going to secular authorities is not advised. Problems are resolved within the community. In July 2011, the Orthodox community of Borough Park in New York City was shattered by spasms of grief for 9-year-old Leiby Kletzky, who disappeared while walking home from summer camp to meet with his parents. Members of ethnic groups of all persuasions joined in a search for Leiby, whose dismembered remains were found 36 hours later in the apartment of Levi Aron, a fellow Jew who was charged with the murder of the child. While the shocked horror of the community reverberated worldwide, it also fomented intense feelings of   7 Robert D. McFadden, “Murder Case in Community of Families,” New York Times (November 13, 1990), B1, B9.   8 McFadden, “Murder Case in Community of Families.”

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shame that a co-religionist had committed a crime all too reminiscent of what this Chasidic sect knew of the Holocaust.9 STRESS, MENTAL DISEASE, AND SOCIAL SUPPORT The interplay between stress and social support has been given much attention recently. As early as 1974, epidemiologist John Cassel suggested that the effect of social support in human society could be inferred from studies of lower animal life.10 In an animal study by John J. Conger and colleagues, rats that had been conditioned to avoid electric shocks were given a series of random and unanticipated shocks.11 The rats that lived in isolation from other rats had higher rates of peptic ulcers than did the rats that received the same noxious stimuli in the presence of littermates. Similarly, when humans are faced with seemingly insoluble tasks, they become far more greatly stressed in the presence of strangers than in the presence of friends.12 The medical literature is replete with studies that acknowledge the protective influence of supportive social relationships on health.13 However, support is far more likely to come from normal families than from chaotic families. Individuals who grew up in chaotic families and were subject to varying degrees of psychosocial stress have been shown to be subject   9 Liz Robbins,” After Coming Together for a Frantic Search, a Community is Left Reeling,” New York Times ( July 14, 2011), A22. 10 John Cassel, “An Epidemiological Perspective of Psychosocial Factors in Disease Etiology,” American Journal of Public Health 64 (1974): 1040–1043. 11 John J. Conger, William L. Sawrey, and Eugene S. Turrell, “The Role of Social Experience in the Production of Gastric Ulcers in Hooded Rats Placed in a Conflict Situation,” Journal of Abnormal Psychology 57 (1958): 214–220. 12 Morton D. Bogdanoff, Kurt W. Back, Robert F. Klein, et al., “The Physiologic Response to Conformity Pressure in Man,” Annals of Internal Medicine 57 (1962): 389–397. 13 Carol S. Aneshensel and Ralph R. Frerichs, “Stress, Support, and Depression: A Longitudinal Causal Model,” Journal of Community Psychology 10 (1982): 363–376; M. K. Lee, E. Lee, J. Ro, et al., “Social Support and Depression in Patients with Breast Cancer during 1 Year from Diagnosis Compared with the General Population,” Journal of Clinical Oncology 26 (2008): 9612; H. S. Lett, J. A. Blumenthal, M. A. Babyak, et al., “Social Support and Coronary Heart Disease: Epidemiologic Evidence and Implications for Treatment,” Psychosomatic Medicine 67 (2005): 869–878; N. Frasure-Smith, F. Lespée, G. Gravel, et al., “Social Support, Depression, and Mortality During the First Year after Myocardial Infarction,” Circulation 101 (2000): 1919–1924; Y. Koizumi, S. Awata, S. Kuriyama, et al., “Association Between Social Support and Depression Status in the Elderly: Results of a 1-Year Community-Based Prospective Cohort Study in Japan,” Psychiatry and Clinical Neurosciences 59 (2005): 563–569.

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to higher incidences of a variety of diseases. In their sample of 6,574 children, Scott M. Montgomery and colleagues found that more children who had experienced family conflict had slow growth and were of short stature compared with children who came from more stable homes (31 and 20 percent, respectively).14 A follow-up study of Harvard men (who 35 years earlier had participated in the Harvard Mastery of Stress Study) found an association between diseases diagnosed in mid-life (coronary artery disease, hypertension, duodenal ulcer, and alcoholism) and the lack of a warm maternal relationship during childhood.15 Another study found a relationship between poor quality parental care and an increased risk of coronary heart disease in women.16 Adverse childhood experiences have been linked with adult psychiatric disorders, overeating, smoking, drug use, promiscuity, chronic headache or back pain, primary pulmonary fibrosis, osteoporosis, and heart disease.17 In the Adverse Childhood Experiences study, adult diseases and disorders, such as depression, ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease, were found to be strongly associated with adverse childhood experiences.18 Perceptions of parental love or lack of love and caring

14 Scott M. Montgomery, Mel J. Bartley, and Richard G. Wilkinson, “Family Conflict and Slow Growth,” Archives of Disease in Childhood 77 (1997): 326–330. 15 L. G. Russek and G. E. Schwartz, “Feeling of Parental Caring Predict Health Status in Midlife: A 35-Year Follow-Up of the Harvard Mastery of Stress Study,” Journal of Behavioral Medicine 20 (1997): 1–13. 16 N. D. Almeida, E. B. Loucks, L. Kubzansky, et al., “Quality of Parental Emotional Care and Calculated Risk for Coronary Heart Disease,” Psychosomatic Medicine 72 (2010): 148–155. 17 R. C. Kessler, C. G. Davis, and K. S. Kendler, “Childhood Adversity and Adult Psychiatric Disorder in the US National Comorbidity Survey,” Psychological Medicine 27 (1997): 1101– 1119; M. Dong, W. H. Giles, Vincent. J. Felitti, et al., “Insights into Causal Pathways for Ischemic Heart Disease: Adverse Childhood Experiences Study,” Circulation 110 (2004): 1761–1766; Vincent J. Felitti, “Adverse Childhood Experiences and Adult Health,” Academic Pediatrics 9 (2009): 131–132. 18 Dong et al., “Insights into Causal Pathways for Ischemic Heart Disease”; Felitti, “Adverse Childhood Experiences and Adult Health”; Vincent J. Felitti and Robert F. Anda, “Adult Medical Disease, Psychiatric Disorders and Sexual Behavior: Implications for Healthcare,” in The Hidden Epidemic: The Impact of Early Life Trauma on Health and Disease, ed. R. Lanius, E. Vermetten (Cambridge: Cambridge University Press, 2009), 77–87; Vincent J. Felitti, R. F. Anda, D. Nordenberg, et al., “The Relationship of Adult Health Status to Childhood Abuse and Household Dysfunction,” American Journal of Preventive Medicine 14 (1998): 245–258; Centers for Disease Control and Prevention, “Adverse Childhood Experiences Study,” accessed August 7, 2011, http://www.cdc.gov/nccdphp/ace.

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thus clearly have serious negative consequences on biological and psychological levels later in life. In Jewish families, each member relied on the next for strength. Parents lived for and through their children. Good health increased along with the number of contacts a person had as well as the degree of assistance they had access to, whether it was monetary or in the form of advice and knowledge. As previously noted, the relationship between having good social support and health has been widely studied. Having strong social networks, for example, has been shown to encourage women to seek prenatal care.19 Several studies have shown that having a strong family life or good social ties prevents illnesses, such as angina pectoris and neuroses, and reduces mortality.20 A strong family unit can also assist the individual in interpreting the surrounding culture, resisting change, and helping members adapt to change. Some families are well disposed to perform these functions, others are not: In the meeting of new problems and crises, some families are weakened and others grow in solidity and emotional strength. Some families grow and learn from experience; others seem unable to do so because they are too inflexible and tend to disintegrate.21

Thus, the health of the family determines the strength of coping responses to minor or chronic illness, physical or mental handicaps, childhood diseases, and death in childhood. Theresa Marteau and colleagues delineated the importance of a strong family structure in helping diabetic children maintain control 19 Margaret S. Boone, Capital Crime: Black Infant Mortality in America (Newbury Park: Sage Publications, 1989); R. Jay Turner, Carl F. Grindstaff, Norman Phillips, “Social Support Outcome in Teenage Pregnancy,” Journal of Health and Social Behavior 31 (1990): 43–57; Barbara A. Israel, “Social Networks and Social Support: Implications for Natural Helper and Community Level Interventions,” Health Education Quarterly 12 (1985): 65–80. 20 S. K. Henderson, D. G. Byrne, P. Duncan-Jones, et al., “Social Bounds in the Epidemiology of Neurosis: A Preliminary Communication,” British Journal of Psychiatry 132 (1978): 463–466; D. G. Blazer, “Social Support and Mortality in an Elderly Community Population,” American Journal of Epidemiology 115 (1982): 684–694; J. S. House, C. Robbins, and H. L. Metzner, “The Association of Social Relationships and Activities with Mortality: A Prospective Evidence from the Tecumseh Community Health Study,” American Journal of Epidemiology 116 (1982): 123–140. 21 Nathan W. Ackerman, “Psychological Dynamics of the Family Organism,” Public Health Reports 71 (1956): 1019.

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over their disease.22 Children who resided with both biological parents or with at least one parent had much greater control over their diabetes, for example, than those living with stepparents or adoptive parents, independent of social class, family income, and employment status. The relationship between disease and family dynamics has been further clarified in studies involving disorders, such as bulimia and anorexia and other diseases.23 Dysfunctional families are significantly more susceptible to infection. Chaotic and rigid families tend to experience a higher incidence of diseases, such as influenza. Among children with cystic fibrosis, Brian L. Lewis and Kon-Taik Kaw found that adjustment problems were more a matter of family dynamics than the presence of a chronic childhood illness.24 Family structure and function also have a direct impact on fetal birth weight. Christian Ramsey and colleagues attributed family functioning to seven percent of the variance in an infant’s birth weight.25 Women residing in families where the extremes of cohesion might exist, such as enmeshment and disengagement, or women living where the extremes of adaptability exist, such as rigidity and chaos, were more likely than other women to deliver children of low birth weight. Empirical studies have repeatedly shown a positive receptivity to health care by American Jews. A survey by Srole and colleagues of Jewish attitudes regarding seeking professional care confirmed that many would deal with mental health problems head-on. They found that Jews were far more likely to seek care for a child with “serious behavioral difficulties” compared with

22 Theresa M. Marteau, Sidney Bloch, and J. David Baum, “Family Life and Diabetic Control,” Journal of Child Psychology and Psychiatry 28 (1987): 832–833. 23 J. E. Mitchell, D. Hatsukami, E. D. Eckert, and R. L. Pyle, “Characteristics of 275 Patients with Bulimia,” American Journal of Psychiatry 142 (1985): 482–485; D. K. Norman and D. B. Herzog, “Persistent Social Maladjustment in Bulimia: A 1-year Follow-Up,” American Journal of Psychiatry 141 (1984): 444–446; Jan S. Kent and James R. Clopton, “Bulimia: A Comparison of Psychological Adjustment and Familial Characteristics in a Nonclinical Sample,” Journal of Clinical Psychology 44 (1988): 964–971. 24 Brian L. Lewis and Kon-Taik Khaw, “Family Functioning as a Mediating Variable Affecting Psychosocial Adjustment of Children with Cystic Fibrosis,” Journal of Pediatrics 101 (1982): 636–640. 25 Christian H. Ramsey, Troy D. Abell, and Lisa C. Baker, “The Relationship between Family Functioning, Life Events, Family Structure, and the Outcome of Pregnancy,” Journal of Family Practice 22 (1986): 521–527.

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Catholics or Protestants (49, 24, and 21 percent, respectively).26 Furthermore, Jews were more likely than Catholics to be familiar with child guidance resources, and both Jews and Protestants had greater knowledge of available community resources for help with marital problems.27 The Jews appeared to have higher rates of psychoneuroses than others, based on treatment prevalence data; however, this might have been a function of their acceptance of the validity of treatment. Nonetheless, their religious doctrine, as we have seen, encouraged acceptance of mental health treatment, unlike the opposition to it shown in the Catholic community at the time. David Spiegel and Terry Wissler found that family environment was also a strong predictor of re-hospitalization among the psychiatrically ill.28 Higher ratings of family expressiveness predicted fewer days of re-hospitalization. Higher family cohesion scores predicted better family-rated patient adjustment. There were fewer days of re-hospitalization in the year after discharge regardless of the diagnosis for which the patient was originally hospitalized, but particularly for patients with schizophrenia. CHRONIC DISEASE The relationship between family and social support and the adjustment of patients to chronic diseases has been frequently examined in the literature.29 Families that are cohesive or devoid of conflict and allow for the expression of emotions are more effective than nonsupportive families in helping cancer 26 Leo Srole, Thomas S. Langner, Marvin K. Michael, et al., Mental Health in the Metropolis: The Midtown Manhattan Study (New York: McGraw-Hill, 1962), 316–317. 27 Margaret B. Bailey, “Community Orientations Toward Social Casework and Other Professional Resources” (PhD diss., New York School of Social Work, 1958), 86. 28 David Spiegel and Terry Wissler, “Family Environment as a Predictor of Psychiatric Rehospitalization,” American Journal of Psychiatry 143 (1986): 56–60. 29 E. H. Olsen, “The Impact of Serious Illness on the Family System,” Postgraduate Medicine 169 (1970): 169–174; J. G. Bruhn, “Effects of Chronic Illness on the Family,” Journal of Family Practice 4 (1977): 1057–1060; T. J. Litman, “The Family as a Basic Unit in Health and Medical Care: A Social Behavioral Overview,” Social Science & Medicine 8 (1974): 495–519; M. R. DiMatteo and R. Hayes, “Social Support and Serious Illness,” in Social Networks and Social Support in Community Mental Health, ed. B. H. Gottlieb (Thousand Oaks: Sage Publications, 1981), 117–148; A. Rozanski, J. A. Blumenthal, K. W. Davidson, P. G. Saab, and L. Kubzansky, “The Epidemiology, Pathophysiology, and Management of Psychosocial Risk Factors in Cardiac Practice: The Emerging Field of Behavioral Cardiology,” Journal of the American College of Cardiology 45 (2005): 637–651; C. Schaefer, J. C. Coyne, and R. S. Lazarus, “The Health-Related Functions of Social Support,” Journal of Behavioral Medicine 4 (1981): 381–406.

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patients adjust to their illness.30 Lois C. Friedman and colleagues associated psychosocial adjustment of women with breast cancer with very high levels of family cohesion.31 They suggested that, “while extreme degrees of family closeness may be dysfunctional for families under other circumstances, women with breast cancer have a need for family closeness that goes beyond the norm for medically healthy persons.” Marteau and colleagues examined the influence of parents versus physicians on diabetic control in their children and found that the influence of family on children is even stronger than the influence of physicians, particularly in families that lack conflict. When the goals of parents and doctors for the shortterm treatment of diabetes were reviewed, treatment outcomes were closer to parents’ goals than to doctors’ goals.32 The deleterious effects of chronic disease, such as alcoholism or drug abuse, in families are no secret. Excesses of alcohol can affect the hormonal (endocrine) system, resulting in cardiovascular abnormalities and reproductive deficits in men and women as well as immune dysfunction and bone disease (osteoporosis).33 The effects of alcohol on the hypothalamic-pituitary-adrenal axis can result in obesity, acne, diabetes, menstrual disorders, a variety of psychological disorders, anovulation, pseudo-Cushing’s syndrome, diminished sexual function, diminished serum testosterone levels in men, and liver disease. Addiction also places huge psychological, mental, physical, monetary, and emotional strain on families. Alcohol has also been found to be a risk factor for trauma and increased mortality from associated chronic diseases.34 The incidence of alcoholism among Jews has been very low compared with that of other ethnic 30 J. R. Bloom, “Social Support, Accommodation to Stress, and Adjustment to Mastectomy,” Social Science & Medicine 16 (1982): 1329–1338; D. Spiegel, J. Bloom, and E. Gottheil, “Family Environment as a Predictor of Adjustment to Metastatic Breast Carcinoma,” Journal of Psychosocial Oncology 1 (1983): 33–44; H. Peters-Golden, “Breast Cancer: Varied Perceptions of Social Support in the Illness Experience,” Social Science & Medicine 16 (1982): 483–491. 31 Lois C. Friedman, P. E. Baer, D. V. Nelson, M. Lane, F. E. Smith, and R. J. Dworkin, “Women with Breast Cancer: Perception of Family Functioning and Adjustment to Illness,” Psychosomatic Medicine 50 (1988): 529–540; 536. 32 Marteau et al., “Family Life and Diabetic Control.” 33 Nicholas Emanuele and Mary Ann Emanuele, “The Endocrine System: Alcohol Alters Critical Hormonal Balance,” Alcohol Health and Research World 21 (1997): 53–64. 34 Norman Giesbrecht, “Is Alcohol a Risk Factor for Trauma and Chronic Disease Mortality? Narrowing the Gap Between Evidence and Action,” American Journal of Epidemiology 168 (2008): 1110–1118.

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groups, accounting in part for a lesser degree of adverse effects on their overall health (see also Chapter 6, Alcoholism Among the Jews). USE OF HOSPITALS AND DISPENSARIES Jewish immigrants were far more favorably disposed to using hospitals and dispensaries than were members of other ethnic groups. They were also more likely than other groups to accept new medical technology and to vaccinate their children.35 Data from the Chicago Central Free Dispensary of the Rush Medical College (1921) showed that Poles and Jews were more likely to use the healthcare system (33 and 32 percent of cases, respectively) than Italians, Bohemians, Lithuanians, and Greeks (17, 11, 5, and 2 percent, respectively).36 Furthermore, Jews did not appear to need motivation. Although 55 percent of Poles and 45 percent of Italians were referred to dispensaries, only 13 percent of Jews required referral.37 The Jews flocked to dispensaries, knowing they would receive care by a specialist there and could take an active part in their care and that of their children. Similarly, Jewish women were careful to avail themselves of organized maternity services that were staffed by well-qualified obstetricians and nurses. JEWISH FAMILIES—JEWISH ROOTS Much of our information regarding family life in Eastern Europe was derived from the highly romanticized portrayal by Mark Zborowski, who described the “Yiddisheh mammeh” as someone who would love you no matter what happened.38 Despite the sometimes irritating ways she showed her love, it was unshakable. And in a hazardous and unknown world, unshakable love was invaluable to the immigrants. Zborowski’s stories of mothers who pawned pearls or went hungry for their children or pled with hostile authorities to free their sons are the stuff of legends. 35 Michael Marks Davis Jr., Immigrant Health and the Community (New York: Harper and Brothers Co., 1921); Maurice Fishberg, The Jews: A Study of Race and Environment (New York: Charles Scribner’s Sons, 1911). 36 Davis, Immigrant Health and the Community. 37 Ibid. 38 Mark Zborowski, Life Is With People (San Francisco: Jossey Blass, 1965).

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Above all, the Eastern European Jewish family was obligated by the Jewish precept shalom bayis, that is, peace or harmony in the house. Everything was done to keep strife from upsetting the household. Elaborate precautions helped ensure the maintenance of family unity, including withdrawing from verbal communication, as well as by using a third person to complain to an adversary. Despite the strife from which many families emerged, shalom bayis was considered the ideal. We do not wish to over-romanticize the Jewish family, but we support that in balance there was an overriding sense of cohesiveness. The renting of rooms to non-family members, the frequent traffic in and out of the house by neighbors, and the constant extended family gatherings to celebrate the various holidays enhanced a sense of cohesiveness. If a parent was unable to provide support for or help their children, other members of the family were expected to do their part.39 A Jewish family member with resources would give before he was asked and often gave more than what was needed. Waiting to be asked was considered poor taste, since the individual was always viewed as part of the whole—the Jewish people. FAMILY LIFE IN AMERICA For Jewish immigrants, family loyalty was the principle foundation of life. Many German, English, and Italian Jews had left friends and families behind and often dreamed of returning to their old countries; however, Eastern European Jews lacked such feelings because their emigrations “were a form of exodus from a land of slavery unto a land of freedom.”40 Mass emigration to America by the Jews was not seen as something performed by the Jewish community but by the House of Israel.41 It was the close family unit that supported the Jews at the turn of the century. The immigrants became family to each other. In the absence of family, community organizations sprang up to support Jews, especially where their religious or 39 Ibid. 40 Abraham Menes, “The East Side: Matrix of the Jewish Labor Movement,” in Jewish Life in America, ed. T. Friedman and R. Gordis (New York: Horizon Press, 1955), 134. 41 Ben Zion Dinur, “American Jewish Historiography in the Light of Modern Jewish History,” in The Writing of American History, ed. M. Davis and I. Meyer (New York: American Jewish Historical Society, 1957), 201–202.

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physical needs were concerned.42 The necessity for family cohesion had spurred the mass immigration between 1885 and 1890. Jews who were already in America were strangers to the country and required the support of their families. The Jews already in America kept one hope alive: to save enough money to bring other members of their families to the country. More than 80 percent of the more than two million Eastern European immigrants who emigrated to the United States between the early 1880s and 1915 were brought over to America by relatives who had arrived there earlier.43 Many immigrant Jews had pride and took care of their homes and their appearances. Of the Jews of Philadelphia, Charles S. Bernheimer wrote: . . . when one steps into one of these homes of the Russian, Rumanian, or Hungarian Jew of better grade and should have any preconceived notions as to dirty, ill-smelling apartments in the “slums,” he will be quickly disillusioned, and will find a superior state of affairs. He will see in the family a social attractiveness, an intellectual interest, and an enthusiastic wholesomeness that may at times take him aback, and he may be compelled to admit that the family has even some points of superiority over many of his acquaintances who do not live in the slums and who pretend to be in an advanced state of mind. . . . When, therefore, we cast up the account of the immigrant Jew on the score of cleanliness, we must take into consideration these families, for they give tone, dignity, and worth to the population, and nowhere can be found an immigrant class which shows the advanced state which these show.44

THE OVERPROTECTIVE MOTHER Illness sometimes disrupted family life. The immigrants were susceptible to virulent forms of diseases to which they had not been previously exposed. Tuberculosis, which had infected some Jews in Eastern Europe, became such a familiar ailment in America that it was known as “Jewish asthma.”45 In Bride of the Sabbath, Samuel Ornitz describes one mother’s struggle to protect her children 42 Ibid. 43 Bernheimer, The Russian Jew in the United States. 44 Ibid. 45 Charlotte Baum, Paula Hyman, and Sony Michel, The Jewish Woman in America (New York: The Dial Press, 1976).

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from the disease.46 To circumvent the New York City Health Department’s rules blocking consumptives from factories, she had herself certified as suffering from “Jewish asthma” and continued working. She boiled her dishes and ceased eating with her children and picking up her baby and kissing her son. Only years after her death did her son realize that he had done nothing to warrant his mother’s sudden coldness; she was only trying to spare her children from tuberculosis. One child wrote endearingly about his mother, who was able to feed and clothe her large family with only one dollar a day. She took in destitute boarders and walked blocks to save a penny on meat and bread. His mother lost all of her teeth and her cheeks were caved in because there was no money for a dentist, but the children were kept clean and well fed: “On a dollar and a quarter we would have lived in luxury.”47 Irving Howe suggested that the behavior of the overprotective Jewish mother had its roots in real fears.48 The Jewish mother was obsessed with feeding her children (and many times overfed her children), because she was haunted by memories of a hungry childhood. She was consumed with her children’s health because infant mortality was prevalent in the old country. She was demanding and she was dominating because the “disarranged family structure endowed her with powers she had not known before.”49 Because the Jewish mother was just that—Jewish—she was haunted by a closet of skeletons that caused her to be very cautious with her children: When she worried about her little boy going down to play, it was not merely the dangers of Rivington and Cherry streets that she saw—though there were dangers on such streets; it was the streets of Kishinev and Bialystok and other towns in which the blood of Jewish children had been spilled.50

Dorothy Hall, a mental hygiene supervisor for the Infant Welfare Society of Chicago, examined differences between early parent-child relationships in Jewish and non-Jewish families. The Jewish mother would often bring well-­ nourished children to the doctors’ offices for physical examinations. Against the 46 Samuel Ornitz, Bride of the Sabbath (New York: Rinehart & Co, 1951). 47 Zalmen Yoffeh, “The Passing of the East Side,” Menorah Journal 17 (December, 1929): 268. 48 Irving Howe and Kenneth Libo, How We Lived: A Documentary History of Immigrant Jews in America (New York: Richard Marek, 1979). 49 Ibid., 46. 50 Ibid.

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protests of her physicians, she would insist her children were undernourished and did not eat well. Some mothers would follow their children from room to room with food, attempting to make them eat.51 FAMILY DEVOTION Many children assumed the burdens of their stressed-out parents. Lincoln Steffens, the American journalist who covered the Jewish quarter in the 1890s, observed how quickly children, especially the girls, took on the burdens of adults, such as writing and signing checks, cooking, washing, and watching over the younger siblings.52 A turn of the century description of Jewish family life in Boston further examined the close-knit nature of family life, where parents were devoted guardians of their children. Even in the homes of the poorest, candles are always lighted for the Friday evening service, and the family assembles for the beginning of the Sabbath. On Saturday, after returning from the synagogue, the day is spent in visiting or receiving calls. The neighbor, with the very convenient shawl thrown over her head, comes to have a chat and a glass of tea from the steaming samovar.53

Alfred Kazin portrayed the subjective nature of this belonging as he went to the synagogue for study before his own Bar Mitzvah: Whether I agreed with its beliefs or not, I belonged; whether I assented to its rights over me or not, I belonged; whatever I thought of them, no matter how far I might drift from that place, I belonged. This was understood in the very nature of things; I was a Jew. It did not matter how little I knew or understood of the faith, or that I was always reading alien books; I belonged, I had been expected, I was now to take my place in the great tradition.54

51 Franz Alexander, “Section Meeting on Culture and Personality,” American Journal of Orthopsychology 8 (1938): 587–626. 52 Lincoln Steffens, Shame of the Cities (New York: Dover Books, 2004). 53 Jesse Fremont Beale and Anne Withington, “Life’s Amenities,” in Americans in Process: A Settlement Study, ed. R. A. Woods (Boston: Houghton, Mifflin & Co., 1902), 224–253; 240. 54 Alfred Kazin, Walker in the City (New York: Harcourt Brace & World, 1951), 45.

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According to Nathan Goldberg, hostility by non-Jews may have increased the Jewish husband’s devotion to his wife and children and the Jewish child’s affection for his parents: “Deprived of many of the normal sources of psychical gratification, emotional security, and social recognition, they had a greater need to love and to be loved than other parents, children and spouses.”55 Thus, his home became his “castle,” and his family became the sole people from whom he could receive words of appreciation and encouragement. Family life was incorporated with work. The East Side streets were filled with the whirring of sewing machines. Every family member—men, women, and children—­ worked from dawn. Many people would slave together in the constricted space of a tiny room, the same room where meals were cooked and clothing washed and dried. Despite all of the horrible difficulties, “a measure of self-respect was attainable, while hearts beat and minds stirred with hopes and thoughts of a brighter future.”56 However, after marriage, a Jewish woman was less likely to work outside the home, especially in the factories, even when manufacturing demanded it.57 In 1880, only two percent of Jewish wives worked outside the home. By 1905, their numbers had dropped to one percent.58 Among the reasons to keep women from the factories was that the proximity of workers to men was thought to contribute to a loosening of standards, language, and dress, and supervision of young women was considered inadequate.59 Jewish men were reluctant to allow their wives to make clothing or do piecework at home. This was borne out in a 1908 survey of 488 home finishers; none was a Russian Jewess.60 Jacob Riis recounted tenement life in the ghetto, where although things were difficult and illness and sorrow were shared far too often, the family worked tirelessly to support each other and dignity was rarely lost: How strong is this attachment to home and kindred that makes the Jew cling to the humblest hearth and gather his children and his children’s children 55 Nathan Goldberg, “Dynamics of the Economic Structure of the Jews in the United States,” in The Writing of American Jewish History, ed. M. Davis and I. Meyer (New York: American Jewish Historical Society, 1957), 120. 56 Rischin, The Promised City, 61. 57 Joel Isaac Seidman, The Needle Trades (New York: Farrar & Rinehart, Inc., 1942). 58 Thomas Kessner, The Golden Door: Italian and Jewish Immigrant Mobility in New York City, 1880–1915 (New York: Oxford University Press, 1977). 59 Robert Archey Woods and Albert Joseph Kennedy, Young Working Girls: A Summary of Evidence from Two Thousand Social Workers (Boston: Houghton Mifflin, 1913). 60 Kessner, The Golden Door: Italian and Jewish Immigrant Mobility in New York City.

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about it, though grinding poverty leave them only a bare crust to share . . . I saw in the case of little Jette Brodsky, who strayed away from her own door, looking for her papa. They were strangers and ignorant and poor, so that weeks went by before they could make their loss known and get a hearing, and meanwhile Jette, who had been picked up and taken to Police Headquarters, had been hidden away in an asylum, given another name when nobody came to claim her, and had been quite forgotten. But in the two years that passed before she was found at last, her empty chair stood ever by her father’s, at the family board, and no Sabbath eve [passed] but heard his prayer for the restoration of their lost one. It happened once that I came in on a Friday evening at the breaking of bread, just as the four candles upon the table had been lit with the Sabbath blessing upon the home and all it sheltered. Their light fell on little else than empty plates and anxious faces; but in the patriarchal host who arose and bade the guest welcome with a dignity a king might have envied, I recognized with difficulty the humble peddler I had known only from the street and from the police office, where he hardly ventured beyond the door.61

FEEDING THE FAMILY Immigrant Jews were accustomed to eating a wide variety of foods, more so than other immigrant groups. Olives and olive oil were the common fare of Jews from Spain and Portugal, while sour and sweet stewing meat and vegetables were staples of German Jews.62 Their love for pickles, cucumbers, and herring as well as butter cakes was borne of connections with Holland. Jews from Poland favored fremsel soup cooked with goose drippings and stuffed and stewed fishes. Russian Jews brought over a taste for blintzes, kugel, and many kinds of puddings and stews (or zimes). Zimes could also contain apples, pears, figs, and prunes, introduced by Jews from Rumania, Galicia, and Lithuania. Food was important to Jews, who would spend nearly 50 percent of their annual budget for well chosen and well prepared foods. In 1905, Pope described the Jews as “good livers” who took great pains to find wholesome foods.63 61 Jacob Riis, The Children of the Poor (New York: Charles Scribner’s Sons, 1908), 43. 62 Mary L. Schapiro, “Jewish Dietary Problems,” Journal of Home Economics 11 (1919): 51. 63 Jesse Eliphalet Pope, The Clothing Industry in New York (Columbia: E.W. Stephens Publishing, 1905).

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EVOLVING ATTITUDES TOWARD FAMILY AND MARRIAGE In 1960, Judson Landis examined the cohesiveness of the Jewish family and its relationship to religion and family values.64 He obtained a sample of 2,654 college students (904 males and 1,750 females of middle or upper class background) who were taking courses in family sociology in various colleges in the United States between 1952 and 1955. Landis attempted to determine the relationship between religious and family values and family relationships among Protestants, Catholics, and Jews. Jewish students were more likely than Protestant or Catholic students or student with no religious preference to report their parents as being “happy” or “very happy.” And fewer Jewish families had undergone divorce, compared with Catholics, Protestants, and families with no religious affiliation. Landis further found that the Jewish students were closer to their parents than were Catholics, Protestants, or students with no religious faith. Parents of Jewish and Protestant children more often than parents of Catholic and non-faith children had given sex information to their children. Also, the Jewish and Protestant students reported fewer undesirable attitudes and more desirable attitudes toward sex. This set of findings suggests that the Jewish family was not only more closely knit than many non-Jewish families, but, with the exception of the Protestant family, also permitted more communication and discussion of topics, such as sex. If a family feels free to discuss sex, we may suppose that they are as free when discussing less “forbidden” subjects. It would seem that the greater the communication between family members, the more positive the interaction. The more positive the interaction between family members, the more closely knit the family. Fred Strodtbeck conducted a similar survey among 3,000 children of Southern Italian and Jewish immigrant families who had resided in New Haven since their arrival from Europe.65 He found that Jews were less likely than Italians to believe that even after marriage a young person’s first loyalty was to his parents and he should thus not move far from them. Jewish children 64 Judson T. Landis, “Religiousness, Family Relationships, and Family Values in Protestant, Catholic, and Jewish families,” Marriage and Family Living 22 (1960): 341–347. 65 Fred L. Strodtbeck, “The Family Interaction, Values, and Achievement,” in The Jew in American Society, ed. Marshall Sklare (Berkeley: Glencoe Press, 1958): 147–165.

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were more likely than Italian children to report that their parents were permissive regarding sex, masturbation, or nudity in the home. Jewish parents were also more permissive with regard to their children’s aggression towards them, more likely to value spanking, more likely to show equality of power in the husband-wife relationship, and warmer with regard to the emotional atmosphere of parent-child relations. Bessie Wessel also found that Jewish families were relatively more cohesive than were Gentile families, since they offered “an oasis of understanding.”66 She observed a tendency of the Jews to improve and strengthen the ethnic community as a means of encouraging social participation. Attitudes, however, inevitably evolve over time and with new experiences in new places. M. Freund observed changes that took place in second-generation Eastern European Jewish families in the United States. Compared with their parents, the second-generation American Jewish family was: . . . more democratic (father less likely to share high status alone); more mobile; likely to emphasize the secular rather than the religious; less likely to participate in Jewish celebration; smaller in size; less likely to provide recreational, religious, social and protective functions; less likely to have in-group solidarity; less likely to transmit Jewish culture; more likely to give all children equally high status (rather than sons only); more permissive of the mother gaining a general education and working outside the home; subordinate to the individual (rather than the individual being subordinate to the family); less likely to view the father with fear and respect; less likely to view marriage as a religious duty; more likely to have mates selected by children instead of parents; less likely to emphasize marrying someone from the same national origin or place of birth; less reluctant to marry outside of the Jewish religion [this is still discouraged, however]; more likely to practice birth control and discuss sex matters; less likely to require that young people be chaperoned, and more likely to permit premarital kissing and petting.67 66 Bessie B. Wessel, “Ethnic Family Patterns,” American Journal of Sociology 53 (1948): 439. 67 M. Freund, Tentative Analysis of Differences Between the Small-Town Jewish Family in Eastern Europe and the First and Second-Generation Jewish Family in the United States (New York: Training Bureau for Jewish Communal Services, 1950).

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Several other important differences evolved in these second-generation Jewish families, including the relatively higher status of the son compared with the father and the reliance on higher wages rather than religious and scholarly standing to determine status. This change was likely wrought in part by the pressure of American law that rendered the failure to provide for a family as punishable by law.68 In the mid-1950s, investigators were astounded to learn that the inhabitants of Roseto, a town in Eastern Pennsylvania, were remarkably healthier despite discrimination, high-cholesterol diets, smoking, drinking wine with abandon, and working in dangerous mines compared with other groups of people in towns who had greater wealth.69 This so-called “Roseto effect” was linked to strong ties among Italian families, where the elderly were never institutionalized but valued as arbitrators in everyday affairs, and where heart disease was extremely low, despite the disregard for healthy living. Intra-marriage (Italian to Italian) was common. Loneliness, stress, and abandonment were nonexistent. Residents patronized local businesses almost exclusively, and families were self-supporting. As towns succumbed to the pressure of the times and suburbanization, social ties weakened, and the Roseto effect waned. Unlike the Roseto effect, however, which wore off as the families became more Americanized and less interdependent, children of Jewish immigrants seemed to have sustained a similar effect—particularly with regard to maintaining strong family ties and caring for family—far longer than two generations. This might be attributed in part to the spirit of halakha and having an innate love of learning inculcated over many generations, as well as an almost hypochondriacal concern for health. The immigrants had left their mark. The rest would be left in the hands of the American-born Jew.

68 Ruth Landes and Mark Zborowski, “Hypotheses Concerning the Eastern European Jewish Family,” Psychiatry 13 (1950): 447–464. 69 Stewart Wolf and John G. Bruhn, The Power of Clan: The Influence of Human Relationships on Heart Disease (New Brunswick: Transaction Publishers, 1998).

HEALTH-RELATED BEHAVIORS

CHAPTER 5

Childrearing Practices and Attitudes A pair of substantial mammary glands has the advantage over the two hemispheres of the most learned processor’s brain in the art of compounding a nutritious fluid for infants. Oliver Wendell Holmes, Scholastic and Bedside Teaching1

BREASTFEEDING We have been attempting to show that Jewish families have enjoyed the full range of advantages wrought by good health as well as the deprivations brought on by disease. In this section, we recount how breastfeeding and child spacing had a direct impact on the child, the mother, the family, and the community at large. The Bible is replete with references to breastfeeding.2 The Hebrew word for milk is chalav, thought to be derived from a word meaning “attached to the heart.” The Aruch Ha Schulchan notes that the milk has a positive effect on the health of the child (Yoreh Deah, 81:334). Among the canons of early childhood care in this country and abroad were the benefits to be accrued from breastfeeding. Having   1 Oliver Wendell Holmes, Scholastic and Bedside Teaching, Medical Essays, 1842–1882 (Boston: Houghton-Mifflin, 1911), 276.   2 These include Lamentations 4:3, “Even the jackals give the breast and suckle their young”; 1 Samuel 4:16, “Then Naomi took the child and laid him in her bosom, and became his nurse”; and Isaiah 66:11, “. . . suck and be satisfied with her consoling breasts, that you may drink deeply with delight from the abundance of her glory.” And in Genesis 21:7–8, being weaned is celebrated, as the mother follows the needs of her child: “Who would have said to Abraham that Sarah would suckle children. . . . And the child grew, and was weaned; and Abraham made a great feast on the day that Isaac was weaned.”

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a strong approach to health and hygiene, ranging from normal care and attention to hypochondriacal behavior, Jewish women strongly subscribed to breastfeeding. It was rare for a Jewish infant to be brought up by artificial feeding, barring the mother’s inability to suckle, which was similarly rare.3 Compared with hand-fed infants, mortality among breastfed infants was much lower. Furthermore, the comparatively low rates of participation in the labor force by Jewish women allowed Jewish infants to be breastfed. Robert Woodbury provided evidence that Jewish women were also more likely to breastfeed their children longer than many other ethnic groups, but noted that this could not be clearly correlated with mortality levels.4 Maurice Fishberg, who reported lower rates of malnutrition, marasmus, and rickets among tenement-raised Jewish infants, attributed it to greater maternal care, breastfeeding, and maternal sobriety compared with the care provided by other immigrant mothers.5 Although Jewish immigrant infants were approximately 0.5 inches shorter than American children, they eventually thrived and became more muscular and physically stronger than their brothers and sisters in Eastern Europe. Writing at the turn of the eighteenth century, William Buchan wrote that “mother’s milk, or that of a healthy nurse, is unquestionably the best food for an infant. Neither art nor nature can afford a proper substitute for it.”6 He further noted that breastfeeding appeared to strengthen children against some childhood diseases. Throughout history, breast milk was the sole source of infant feeding until the domestication of cattle several thousand years ago. The turn to using bovine milk may have been spurred by several factors: spontaneous cessation of the lactation process, illness and death of the mother, or insufficient milk syndrome. The pro-breastfeeding attitude remained unaltered throughout the nineteenth century,7 as witnessed by the comments of Dr. Job Lewis Smith,   3 Maurice Fishberg, “Health and Sanitation of the Immigrant Jewish Population of New York,” Menorah 33 (1902): 73–82.   4 Robert M. Woodbury, Causal Factors in Infant Mortality: A Statistical Study Based on Eight American Cities (Washington: U.S. Government Printing Office, 1925).   5 Fishberg, “Health and Sanitation.”   6 William Buchan, “Domestic Medicine,” 2nd ed. (1785), accessed May 26, 2009, http:// americanrevolution.org/medicine.html; Part I, Of the General Causes of Diseases. Chapter 1, Of Children.   7 According to the World Alliance for Breastfeeding Action (WABA), “Breastfeeding is at the heart of the family because [it] is an expression of love, care, protection, and a way of nurturing”

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(“World Alliance for Breastfeeding Action (WABA),” accessed July 14, 2006, www.waba.org. my/). The World Health Organization (WHO) and the United Nation Children’s Fund (UNICEF) recognize that exclusive breastfeeding on demand is an important factor in child survival. According to WABA, WHO, and UNICEF, breastfed babies are well nourished since breastfeeding works by supply and demand, that is, demand increases supply. The WHO recommends breastfeeding for at least the first two years of life (World Health Organization, “Breastfeeding,” accessed July 14, 2009, www.who.int/topics/breastfeeding/en/ The American Academy of Pediatrics Work Group on Breastfeeding recommended breastfeeding infants for at least the first six months of life, barring serious illness, such as active, untreated tuberculosis, galactosemia, HIV, or maternal treatment with radioisotopes or chemotherapy or the use of illicit drugs (American Academy of Pediatrics, “Breastfeeding and the Use of Human Milk: Work Group on Breastfeeding,” accessed December 4, 2009, http://pediatrics. aappublications.org/cgi/content/full/pediatrics;100/6/1035 . Data from a plethora of studies from developing countries as well as the more industrialized ones suggest that breastfeeding plays a vital role in the reduction of infant and perinatal mortality. The American Academy of Pediatrics Work Group on Breastfeeding further concluded that human milk was “uniquely superior for infant feeding and is species-specific.” Among the advantages of human milk and breastfeeding gleaned from epidemiologic research in the United States, Canada, Europe, and other developed countries (predominantly among middle-class populations) were a decreased incidence and/or severity of diarrhea (P. W. Howie, J. S. Forsyth, and S. A. Ogston, “Protective Effect of Breast Feeding against Infection,” British Medical Journal 300 [1990]: 11–16; M. G. Kovar, M. K. Serdula, and J. S. Marks, “Review of the Epidemiologic Evidence for an Association Between Infant Feeding and Infant Health,” Pediatrics 74 [1984]: S615–S638; B. M. Popkin, L. Adair, and J. S. Akin, “Breast-Feeding and Diarrheal Morbidity,” Pediatrics 86 [1990]: 874–882); lower rates of respiratory tract infection (A. L. Frank, L. H. Taber, and W. P. Glezen, “Breast-Feeding and Respiratory Virus Infection,” Pediatrics 70 [1982]: 239–245; A. I. Wright, C. J. Holberg, and F. D. Martinez, “Breast Feeding and Lower Respiratory Tract Illness in the First Year of Life,” British Medical Journal 299 [1989]: 945–949; A. L. Wright, C. J. Holberg, and L. M. Taussig, “Relationship of Infant Feeding to Recurrent Wheezing at Age 6 Years,” Archives of Pediatric and Adolescent Medicine 149 [1995]: 758–763); necrotizing enterocolitis (A. Lucas and T. J. Cole, “Breast Milk and Neonatal Necrotising Enterocolitis,” Lancet 336 [1990]: 1519–1523; R. F. Covert, N. Barman, and R. S. Domanico, “Prior Enteral Nutrition with Human Milk Protects against Intestinal Perforation in Infants Who Develop Necrotizing Enterocolitis,” Pediatric Research 37 [1995]: 305A Abstract); otitis media (M. G. Kovar et al., “Review of the Epidemiologic Evidence for an Association Between Infant Feeding and Infant Health,” Pediatrics 74 [1984]: 615–638; U. M. Saarinen, “Prolonged Breast Feeding as Prophylaxis for Recurrent Otitis Media,” Acta Paediatrica Scandinavica 71 [1982]: 567–571; B. Duncan, J. Ey, and C. J. Holberg, “Exclusive Breast-Feeding for at Least 4 Months Protects against Otitis Media,” Pediatrics 91 [1993]: 867–872); bacteremia (S. L. Cochi, D. W. Fleming, A. W. Hightower, et al., “Primary Invasive Haemophilus influenzae Type B Disease: A Population Based Assessment of Risk Factors,” Journal of Pediatrics 108 [1986]: 877–896; A. K. Takala, J. Eskola, and J. Palmgren, “Risk Factors of Invasive Haemophilus influenzae Type B Disease Among Children in Finland,” Journal of Pediatrics 115 [1989]: 694–701); bacterial meningitis (Cochi et al., “Primary Invasive Haemophilus influenzae Type B Disease”; G. R. Istre, J. S. Conner, and C. V. Broome, “Risk Factors for Primary Invasive Haemophilus influenzae Disease: Increased Risk from Day Care Attendance and School-Aged Household Members,” Journal of Pediatrics 106 [1985]: 190–195); botulism (S. S. Arnon, “Breast Feeding and Toxigenic

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a founder of the American Pediatric Society, who inveighed against artificial feeding. He cautioned that artificial feeding often ended resulted in faulty nutrition and sometimes death, and touted human milk as “the only safe food for infants.”8 Woodbury and colleagues observed infant mortality rates in eight cities (see also Appendix I).9 They identified Jewish mothers by their ability to speak Yiddish, rather than by their religious practice. Of utmost significance was the comparatively low rate of respiratory diseases among Jewish infants. While Jewish infants were just as susceptible to epidemic diseases as other ethnic groups, the incidence of death from preventable diseases, such as respiratory disease, was significantly lower. Infant morbidity, especially from respiratory diseases, has a direct negative impact on health status in later life—the mortality advantage.10 Another boon: breastfeeding is free. Intestinal Infections: Missing Links in Crib Death?” Review of Infectious Diseases 6 [1984]: S193– S201); and urinary tract infection (A. Pisacane, L. Graziano, and G. Mazzarella, “Breast-Feeding and Urinary Tract Infection,” Journal of Pediatrics 120 [1992]: 87–89). Bottle-feeding with formula, on the other hand, has been associated with increased rates of respiratory and gastrointestinal infections (G. Borgnolo, F. Barbone, G. Scornavacca, et al., “A Case-Control Study of Salmonella Gastrointestinal Infection in Italian Children,” Acta Paediatrica 85 [1996]: 804–808; M. Beaudry, R. Dufour, S. Marcoux, “Relation between Infant Feeding and Infections during the First Six Months of Life,” Journal of Pediatrics 126 [1995]: 191–197; G. Aniansson, B. Alm, B. Andersson, et al., “A Prospective Cohort Study on Breastfeeding and Otitis Media in Swedish Infants,” Pediatric Infectious Disease Journal 13 [1994]: 183–188; Y. Lerman, R. Slepon, D. Cohen, “Epidemiology of Acute Diarrheal Disease in Children in a High Standard of Living Rural Settlement in Israel,” Pediatric Infectious Diseases Journal 13 [1994]: 116–122). Howie and colleagues observed that formula feeding accounted for seven percent of all infants hospitalized for respiratory infections (Howie et al., “Protective Effect of Breast Feeding Against Infection”).   8 Job Lewis Smith, A Treatise on the Diseases of Infancy and Childhood (Philadelphia: Henry C. Lea, 1869).   9 Robert Morse Woodbury, Infant Mortality and Its Causes (Baltimore: Williams & Wilkins Co., 1926). 10 Formula feeding has been associated with an increased incidence of severe rotavirus gastroenteritis compared with breastfeeding (L. C. Duffy, M. Riepenhoff-Talty, T. E. Byers, et al., “Modulation of Rotavirus Enteritis during Breastfeeding: Implications on Alterations in the Intestinal Bacterial Flora,” American Journal of the Diseases of Children 140 [1986]: 1164– 1168), and Haemophilus influenzae bacteremia and meningitis, which were 4 to 16 times higher, respectively, in formula-fed North American infants (A. K. Takala, J. Eskola, and J. Palmgren, “Risk Factors of Invasive Haemophilus influenzae Type B Disease among Children in Finland,” Journal of Pediatrics 115 [1989]: 694–701). Bottle-feeding with formula has been associated with lower cognitive scores on tests of neurological development ( J. I. Pollock, “Long-Term Associations with Infant Feeding in a Clinically Advantaged Population of Babies,” Developmental Medicine & Child Neurology 35 [1994]: 429–440; R. Morley, T. J.

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Cole, R. Powell, et al., “Mother’s Choice to Provide Breast Milk and Developmental Outcome,” Archives of Disease in Childhood 63 (1988): 1382–1385; M. Morrow-Tlucak, R. H. Haude, and C. B. Ernhart, “Breastfeeding and Cognitive Development in the First 2 Years of Life,” Social Science & Medicine 26 [1988]: 635–639) and lower IQ scores (A. Lucas, R. Morley, T. J. Cole, et al., “A Randomised Multicentre Study of Human Milk Versus Formula and Later Development in Preterm Infants,” Archives of Disease in Childhood: Fetal and Neonatal Edition 70 [1994]: F141–F146). In premature children, A. Lucas and colleagues found a direct correlation between bottle-feeding with formula and lower IQ scores. Pre-term infants in this study who were fed solely on standard formula had significantly lower developmental scores at 18 months than did children fed donor breast milk, even though the standard formula had a higher nutrient content. Bottle-feeding with formula has also been associated with an increased risk of allergies (U. M. Saarinen and M. Kajosaari, “Breastfeeding as Prophylaxis Against Atopic Disease: Prospective Follow-Up Study Until 17 Years Old,” Lancet 346 [1995]: 1065–1069), childhood lymphomas (M. K. Davies, D. A. Savitz, and B. I. Graubard, “Infant Feeding and Childhood Cancer,” Lancet 2 [1988]: 365–368), and higher rates of breast cancer in women who had been formula-fed ( J. L. Freudenheim, J. R. Marshall, S. Graham, et al., “Exposure to Breastmilk in Infancy and the Risk of Breast Cancer,” Epidemiology 5 [1994]: 324–331). Bottle-feeding has also been associated with one of the most common childhood diseases, otitis media (middle ear infection). Brown and Magnuson found that negative intratympanic pressure was frequently generated in babies who sucked either conventional non-ventilated or under-ventilated bottles, possible leading to secretory otitis (C. E. Brown and B. Magnuson, “On the Physics of the Infant Feeding Bottle and Middle Ear Sequela: Ear Disease in Infants Can Be Associated with Bottle Feeding,” International Journal of Pediatric Otorhinolaryngology 54 [2000]: 13–20). A mother who breastfeeds experiences less menstrual blood loss, since no menstruation occurs during breastfeeding, leading further to natural child spacing and family planning. A mother who does not breastfeed her child may be subject to an increased risk of pre-menopausal breast cancer, ovarian cancer, type II diabetes, hypertension, hyperlipidemia, and cardiovascular disease (A. M. Stuebe and E. B. Schwarz, “The Risks and Benefits of Infant Feeding Practices for Women and Their Children,” Journal of Perinatology 30 [2009]: 155–162). An increased duration of lactation further lowered the prevalence of these health risks (E. B. Schwarz, R. M. Ray, A. M. Stuebe, et al., “Duration of Lactation and Risk Factors for Maternal Cardiovascular Disease,” Obstetrics & Gynecology 113 [2009]: 974–982). Furthermore, breastfeeding decreases the risk of hip fractures and osteoporosis for mothers when they reach menopause (Natural Resources Defense Council, “Healthy Milk, Healthy Baby: Chemical Pollution and Mother’s Milk,” accessed December 17, 2003, http://www.nrdc.org/breastmilk/benefits.asp . The risk of several diseases in which Jews have an increased susceptibility, including diabetes, Crohn’s disease, and ulcerative colitis, is known to be enhanced by bottle-feeding (A. Rigas, M. Glassman, Y. Y. Yen, et al., “Breast-Feeding and Maternal Smoking in the Etiology of Crohn’s Disease and Ulcerative Colitis in Childhood,” Annals of Epidemiology 3 [1993]: 387–392; O. Bergstrand and G. Hellers, “Breast-Feeding During Infancy in Patients Who Later Develop Crohn’s Disease,” Scandinavian Journal of Gastroenterology 18 [1983]: 903–906). Bottle-feeding may account for between two and 26 percent of insulin-dependent diabetes mellitus, since an immunologic attack on pancreatic beta cells is believed to play an important role in its etiology. Early exposure to cow’s milk also predisposes infants to

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CHILD SPACING The relationship between child spacing, breastfeeding, and familial health has been demonstrated in many studies. Priscilla Young Colleto, writing for the Natural Child Project, observed that by prolonging the length of breastfeeding, child spacing increases naturally, thus decreasing the number of births, controlling the population, and decreasing demands on the mother, which in turn allows her to be more attentive to the children already under her care.11 The number of children in a family not only determines the physical and financial comfort of a family, but also the chances of survival of the children. Children born in small families and who were at least 24 months younger than their siblings were twice as likely to survive to the age of 5 years than were their peers non-insulin-dependent diabetes mellitus. A study of Pima Indians suggested that the increased prevalence of diabetes might have been a function of the concomitant decrease in breastfeeding (D. J. Pettitt, M. R. Forman, R. L. Hanson, et al., “Breastfeeding and Incidence of Non-Insulin-Dependent Diabetes Mellitus in Pima Indians,” Lancet 350 [1997]: 166–168). Breastfed infants who develop diabetes are also less likely to have anti-thyroid antibodies. P. Fort and colleagues found that the incidence of positive thyroid antibodies was 2.5 times higher in formula-fed diabetic children than in breastfed children; however, they were unable to document a relationship between breastfeeding and the development of insulin-dependent diabetes in children (P. Fort, Roberto Lanes, Stephen Dahlem, and F. Lifshitz, “Breast Feeding and Insulin-Dependent Diabetes Mellitus in Children,” Journal of the American College of Nutrition 5 [1986]: 439–441). Breastfed children tend to have a lower body mass index (BMI) around the age of 1 year compared with non-breastfed children (S. Scholtens, U. Gehring, B. Brunekreef, et al., “Breastfeeding, Weight Gain in Infancy, and Overweight at Seven Years of Age: The Prevention and Incidence of Asthma and Mite Allergy Birth Cohort Study,”American Journal of Epidemiology 165 [2007]: 919–926). Having a lower BMI further confers a lower risk of becoming overweight and eventually succumbing to complications associated with the metabolic syndrome.  A problem for immigrants at the turn of the century associated with bottle-feeding was “dirty milk.” Milk sold in Manhattan around 1910 was graded according to quality (E. Ewen, Immigrant Women in the Land of Dollars—Life and Culture on the Lower Each Side, 1890– 1925 [New York: Monthly Review Press, 1985]). The higher grades were available in bottles, while the cheaper grades were often not refrigerated and were sold in large open buckets. Consumers would carry the milk home in pails and glasses. Even if their own pails and glasses were clean, lack of refrigeration could not stop the milk from quickly going bad, especially on hot summer days. Many digestive tract-associated deaths in children younger than 5 years of age were traced to contaminated milk, a scourge for women who could not properly nourish their babies by the breast or whose circumstances required them to work ( J. Spargo, “Common Sense of the Milk Question,” Charities and the Commons [1908]: 595). 11 Priscilla Young Colleto, “Beyond Toddlerhood: The Breastfeeding Relationship Continues,” accessed April 26, 2009, http://www.naturalchild.com/guest/priscilla_colletto.html.

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in larger families.12 Miller investigated factors contributing to health risks among infants born within 12 months of the preceding birth in Hungary, Sweden, and the United States. His findings suggested that avoiding birth intervals of less than 24 months could decrease the risk of low birth weight and neonatal death by five to ten percent.13 The reproductive rates of Jewish women have tended to be lower than those of economically comparable Protestant women.14 The lower fertility among Jewish women has been variously attributed to high contraceptive efficiency, upward social mobility, emphasis on individual achievement, and awareness of minority status.15 Larger families have been associated with an increased incidence of malnutrition, infectious gastroenteritis, and unsatisfactory maternal care. Shorter birth intervals have been associated with an increase of domestic accidents involving infants as a result of compromised maternal 12 J. N. Hobcraft, J. W. McDonald, and S. O. Rutstein, “Demographic Determinants of Infant and Early Child Mortality,” Population Studies 39 (1985): 363–385. 13 J. E. Miller, “Birth Intervals and Perinatal Health: An Investigation of Three Hypotheses,” Family Planning Perspectives 23 (1991): 62–70. The link between high infant mortality and a short birth interval has been consistently demonstrated, particularly in developing countries (R. E. Brown, “Breast-Feeding and Family Planning: A Review of the Relationships Between Breast-Feeding and Family Planning,” American Journal of Clinical Nutrition 35 [1982]: 162–171; J. Cleland and A. Sathar, The Effect of Birth Spacing on Childhood Mortality in Pakistan, World Fertility Survey/TECH 2163 [Voorburg: International Statistical Institute, 1983]; J. Knodel and A. I. Hermalin, “Effects of Birth Rank, Maternal Age, and Sibship Size on Infant and Child Mortality: Evidence From 18th and 19th Century Reproductive Histories,” American Journal of Public Health 74 [1984]: 1098–1106; C. B. Park, “The Place of Child-Spacing as a Factor in Infant Mortality: A Recursive Model,” American Journal of Public Health 76 [1986]: 995–999; S. Thapa and R. D. Retherford, “Infant Mortality Estimates Based on the 1976 Nepal Fertility Survey,” Population Studies 36 [1975]: 61–80; J. Trussel and C. Hammerslough, “A Hazards-Model Analysis of the Covariates of Infant and Child Mortality in Sri Lanka,” Demography 20 [1983]: 1–26; D. Wolfers and S. Scrimshaw, “Child Survival and Intervals between Pregnancies in Guayaquil, Equador,” Population Studies 29 [1975]: 479–496). Randa Saadeh and D. Benbouzid attributed lower infant and maternal mortality in families with longer birth intervals in part to a greater duration and intensity of breastfeeding (Randa J. Saadeh and D. Benbouzid, “Breast-Feeding and Child-Spacing: Importance of Information Collection for Public Health Policy,” Bulletin of the World Health Organization 68 [1990]: 625–631). 14 A. J. Jaffe, “Religious Differentials in the Net Reproduction Rate,” Journal of the American Statistic Association 34 (1938): 335–342. 15 Sergio DellaPergola, “Patterns of American Jewish Fertility,” Demography 17 (1980): 261–273, 267; N. D. Ryder and C. F. Westhoff, Reproduction in the United States (Princeton: Princeton University Press, 1971); C. F. Westhoff, R. G. Potter Jr., P. C. Sagi, et al., Family Growth in Metropolitan America (Princeton: Princeton University Press, 1961).

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attention, whereas young children in small families were found to be less subject to accidents or infection.16 Alice Goldstein17 and Sergio Della Pergola18 both observed that Jewish women were less likely than Protestant or Catholic women to have a second child within 2 years of the previous birth. Jewish women were also more likely than Protestant or Catholic women to plan the children they had,19 a practice among the Jews that continued through the year 2000.20 The lower rate of births among Jews and longer birth intervals between children not only increased maternal survival and health, but also precluded division of maternal attention to many other siblings. The superior health of the small family has been attributed to several factors: (1) having an older mother who was more capable of taking care of her child, since mothers of small families tended to delay childbearing, and (2) having a greater interval between births, thus allowing a longer period of nurturing for each child.21 Increased health was particularly observed in children where family cohesiveness was

16 R. H. Gray, “Birth Intervals, Postpartum Sexual Abstinence and Health,” in Child-Spacing in Tropical Africa: Conditions and Change, ed. H. J. Pahe and R. Lesthaege (New York: Academic Press, 1981): 93–109; Leonard A. Sagan, The Health of Nations: True Causes of Sickness & Well-Being (New York: Basic Books Inc., 1987). 17 A. Goldstein, S. C. Watkins, and A. R. Spector, “Child Health-Care Practices among Italians and Jews in the United States, 1910–1940,” Health Transition Review 4 (1994): 45–61. 18 DellaPergola, “Patterns of American Jewish Fertility.” 19 R. Freedman. P. K. Whelpton, and A. A. Campbell, Family Planning, Sterility, and Population Growth (New York: McGraw-Hill, 1959); R. Freedman, P. R. Whelpton, and J. W. Smit, “Socio-Economic Factors and Religious Differentials in Fertility,” American Sociological Review 26 (1961): 608–614; C. F. Westoff, “The Changing Focus of Differential Fertility Research: The Social Mobility Hypothesis,” Milbank Memorial Fund Quarterly 31 (1953): 24–38; “National Jewish Population Survey (2000–01),” Jewish Virtual Library, accessed December 19, 2009, http://www.jewishvirtuallibrary.org/jsource/US-Israel/ujcpop.html. 20 In a small but informative survey by Angela Danzi in 1994 of Italian and Jewish octogenarian women, Jewish women, who would have had their children between 1920 and 1940, were both older at the age of marriage and younger at the end of their birthing careers than were the Italian women (Angela D. Danzi, “Jewish and Italian American Women and Childbirth, 1920–1940” [paper presented at the annual meeting of the American Sociological Association, Los Angeles, California, August 5−9, 1994]). Jewish mothers were also more highly educated: Compared with Italian mothers, more Jewish women had an eighth-grade education (27.5 versus 73.7 percent, respectively). 21 Joe D. Wray, “Population Pressure on Families: Family Size and Child Spacing,” in Rapid Population Growth: Consequences and Policy Implications (Baltimore: Johns Hopkins University Press, 1971).

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high. Finally, having fewer children permitted parents to raise their children to a higher standard.22 CIRCUMCISION The removal of the foreskin or prepuce from the un-erect penis was first commanded by God to Abraham (Genesis 17:11-14): “You shall be circumcised in the flesh of your foreskins, and it shall be a sign of the covenant between me and you. He that is eight days old among you shall be circumcised; every male throughout your generations, whether born in your house, or brought with your money from any foreigner who is not of your offspring, both he that is born in your house and he that is bought with your money, shall be circumcised. An uncircumcised male who is not circumcised in the flesh of his foreskin shall be cut off from his people.” Throughout the 1990s and into the new millennium, fewer male children are being circumcised, despite medical evidence demonstrating the benefits of this practice. It has been shown that uncircumcised men are at greater risk of infection than are circumcised men, since the presence of a prepuce results in greater microtrauma during intercourse, thus permitting infectious agents to enter the bloodstream.23 Secretions and excretions (urine), dead cells, and the growth of bacteria often accumulate in the preputial sac.24 The inner lining of the foreskin permits an entry point into the body for viruses and bacteria.25 Gerald Weiss called the preputial sac a “cesspool for infection.”26 Numerous studies have shown a protective effect of male circumcision against acquiring human immunodeficiency virus (HIV-1), citing that the inner mucosal surface of the human foreskin increases susceptibility to HIV 22 Maurice Fishberg, The Jews: A Study of Race and Environment (New York: Charles Scribner’s Sons, 1911). 23 John C. Caldwell and Pat Caldwell, “The African AIDS Epidemic,” Scientific American 274 (1996): 40–46. 24 C. J. Cold and J. R. Taylor, “The Prepuce,” British Journal of Urology International 83 (1999): 34–44; S. Parkash, S. Jeyakumar, K. Subramanyan, and S. Chaudhuri, “Human Subpreputial Collection: Its Nature and Formation,” Journal of Urology 110 (1973): 211–212. 25 Robert Szabo and Roger V. Short, “How Does Male Circumcision Protect against HIV Infection?” British Medical Journal 320 (2000): 1592–1594. 26 Gerald N. Weiss, “Prophylactic Neonatal Surgery and Infectious Diseases,” Pediatric Infectious Diseases Journal 16 (1997): 727–734.

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infection.27 A study by Aaron Tobian and colleagues further found that circumcision significantly prevented the transmission of herpes simplex virus type 2 and the prevalence of human papillomavirus infection (HPV).28 Male circumcision was also associated with a reduced risk of penile human papillomavirus infection as well as a reduced risk of cervical cancer in their female partners.29 Thus we have two practices—breastfeeding and circumcision—both prescribed by the Talmud, the backbone of Jewish life and culture. The Jewish people knew that their continued survival and development was a function of adherence to the laws outlined in the Talmud. The oral law passed from early Babylonian sages through the beginning of the Middle Ages would serve the Jews well. Those who would abandon it would have less hope of long-term survival. SOLIDARITY One of the important sources for the adaptive patterns of the Eastern European Jewish immigrants to these shores was the Bintl Brief, a collection of letters of advice published in the Jewish Daily Forward from 1906 to 1952. At the time of his death in 1947, the distinguished sociologist William Isaac Thomas was in the process of writing a book based on the Bintl Brief, a large number of letters written by American Jews. Sociologist Marvin Bressler analyzed much of this unfinished work, leading him to conclude that the key motif expressed in Jewish 27 B. A. Donovan, A. Landay, S. Moses, et al., “HIV-1 Target Cells in Foreskins of African Men with Varying Histories of Sexually Transmitted Infections,” American Journal of Clinical Pathology 125 (2006): 386–391; B. K. Patterson, A. Landay, J. N. Siegel, et al., “Susceptibility to Human Immunodeficiency Virus-1 Infection of Human Foreskin and Cervical Tissue Grown in Explant Culture,” American Journal of Pathology 161 (2002): 867–873; M. Urassa, J. Todd, J. Ties Boerma, et al., “Male Circumcision and Susceptibility to HIV Infection Among Men in Tanzania,” AIDS 11 (1997): 73–80; S. J. Reynolds, M. E. Shepherd, A. R. Risbud, et al., “Male Circumcision and Risk of HIV-1 and Other Sexually Transmitted Infections in India,” Lancet 363 (2004): 1039–1040; L. Lavreys, J. P. Rakwar, M. L. Thompson, et al., “Effect of Circumcision on Incidence of Human Immunodeficiency Virus and Other Sexually Transmitted Diseases: A Prospective Cohort Study of Trucking Company Employees in Kenya,” Journal of Infectious Diseases 180 (1999): 330–336. 28 Aaron A. R. Tobian, David Serwadda, Thomas C. Quinn, et al., “Male Circumcision for the Prevention of HSV-2 and HPV Infections and Syphilis,” New England Journal of Medicine 360 (2009): 1298–1309. 29 Xavier Castellsagué, F. Xavier Bosch, Nubia Muñoz, et al., “Male Circumcision, Penile Human Papillomavirus Infection, and Cervical Cancer in Female Partners,” New England Journal of Medicine 346 (2002): 1105–1112.

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family patterns was the preservation of a sense of familial solidarity; by this, Bressler meant the immediate family and the larger extended kinship group for whom he felt a strong awareness and a keen sense of obligation.30 In his study of the Bintl Brief, Thomas had observed that despite being dispersed and incorporated for so long in so many alien cultures, the Jews “have been able and to such a degree to maintain their peculiarities and social integrity.” Thomas was aware of the somewhat mutually exclusive nature of family and marriage brought over from Eastern Europe. The marriage relationship was primarily one of obligation. Attempts to satisfy romantic needs were construed as something unnecessary and even comic.31 The father’s only objective was to be “a good provider.” The mother’s objective was to serve as “a fine mother to [the] children.” This scheme was thought practical. The importance of the family as a unifying force transcended grievances. Outright rejection of an errant member was rare. From his notes on the Bintl Brief of November 11, 1927, Thomas was apparently so moved by the solidarity of the Jews as to observe that “these persons are like a different race of men compared with the modern, casual, and individualistic life.”32 In fact, where conflict often separates men, Thomas noted that among Jews, conflict further reinforced solidarity. If family members are separated for disciplinary purposes, it is only done with the goal of eventually coming together again. These letters provide insight into the tenacity of the immigrant Jews to sustain their families. One such letter illustrated the ravages of tuberculosis to body and family. A young widow wrote in 1906 that after many years of hard work, her husband had developed consumption. Her husband worked until he collapsed, so devoted he was to his family. She finally persuaded him to go to Colorado for his health, and while he was away, gave birth to their baby boy. Three months later, she and her seven children joined her husband, who eventually succumbed to the disease. She described her return trip to New York and having to put four of her children in an orphanage until she could afford to care for them herself. She sought further direction from the editor, who encouraged 30 M. Bressler, “Selected Family Patterns in W. I. Thomas’ Unfinished Study of the Bintl Brief,” American Sociological Review 17 (1952): 563–571; 566. 31 Ibid. 32 Ibid.

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her to return to Colorado, where it was healthier than New York, and where eventually all of her children would be reunited, noting that “her devotion to her children will help her overcome her troubles and give her consolation.”33 A 1908 letter from a distraught father speaks of the loss of physical intimacy with his young daughter for fear of infecting her with his tuberculosis. He wrote that he could not stop himself from hugging or kissing his child. The unhappy father sought advice on how to proceed. He was urged to control himself and stay away from his child, and also to seek good treatment so that he might live long enough to enjoy being with his little daughter.34 Another letter expressed one man’s devotion to his wife during illness and the desperation that almost led to their demise. He had lost his job, having taken off too many days because of his wife’s illness, and he subsequently feared having no money and being left without her. As his wife lay near death, he turned on the gas jets, hoping to end both their lives. Fortunately, they both recovered. He wrote asking the editor of the Bintl Brief if he should tell his wife how he nearly ended their lives. He was instead advised to continue keeping this episode to himself, “since it is clear he keeps [the information] from her out of love.”35 These letters illustrate time and again the devotion of the Jews to family and their tireless striving for a better life. They knew hard times and were determined to beat the odds together.

33 Isaac Metzger, A Bintel Brief: Sixty Years of Letters from the Lower East Side to the Jewish Daily Forward (New York: Ballantine Books, 1972), 42. 34 Ibid., 55. 35 Ibid.

HEALTH-RELATED BEHAVIORS

CHAPTER 6

Alcoholism among the Jews . . . between 25% and 60% of the dependency and pauperism among people of other faiths are directly or indirectly ascribed to alcoholism . . . whether alcoholism is a cause or an effect of poverty cannot be applied to the Jews either way. Maurice Fishberg, The Jews: A Study of Race and Environment1

A

mong the Jews, alcoholism has been rare. Although male and female Jews have one of the highest proportions of alcohol use (90 percent or more) for ritual purposes, historically they have had the lowest percentage of alcohol-­ related problems.2 For Jewish children, who were accustomed to participating in religious observances, alcohol was considered just another food. Alcoholism itself has been a cultural taboo among Jews throughout the centuries. The negation of bodily appetites is antithetical to Judaism; however, drink, food, and sex are not a priori sinful, only indulging in them to excess is proscribed. In Judaism, man has freedom of choice and can choose to do either good or evil; however, he is not doomed from the outset to a life of sin, but rather to one of ultimate worthiness. Although there are signs that alcoholism among Jews in the United States has increased, the overall lack of alcohol abuse among Jews might account in part for their success in business and the professions.

  1 Fishberg, The Jews: A Study of Race and Environment, 274–275.   2 Maristela G. Monteiro and Marc A. Schuckit, “Alcohol, Drug, and Mental Health Problems Among Jewish and Christian Men at a University,” American Journal of Drug and Alcohol Abuse 15 (1989): 403–412; Lydia V. Flasher and Stephen A. Maisto, “A Review of Theory and Research on Drinking Patterns among Jews,” Journal of Nervous and Mental Disease 172 (1984): 596–603.

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The well-documented rarity of alcohol abuse among Jews has given rise to numerous theories as to why the Jews remain a more sober group than others, at least in the United States. These theories range from having a strong religious commitment3 and seeking to avoid controversy4 to possessing a variant alcohol dehydrogenase allele ADH1B*2, which confers protection against alcoholism.5 The allele, found in the majority of Asians and in 25 percent of people of Jewish ancestry, causes bearers to oxidize alcohol at a faster rate than the majority of Europeans who have the ADH1B*1 variant.6 Mark Keller sought to determine when Jewish sobriety replaced heavy drinking and drunkenness.7 He noted that the Jewish inhabitants of Persia participated freely in the wine-drinking feast given by the Persian Emperor Ahasverus, but in the period following the establishment of the Second Temple (500 to 400 BC), inebriety appears to have been uncommon. Keller connected the banishment of the old heathen gods and the development of the religious culture as the law of the land with the Bible and the laws of the synagogue, and the integration of drinking in religiously oriented ceremonies with the cessation of reckless drinking among Jews. E. Morton Jellinek opined that Jews had little choice but to remain sober to avoid fear of overt aggression by the oppressive Gentiles.8 The desire to avoid censure from the outside was a powerful motivator for the Jew, who “having lived for centuries under the ceaseless ban of abuse and persecution in the European Ghettos, found it advantageous to his well-being always to be sober.”9 Although alcoholism and drinking to intoxication were rare among Jews,   3 J. K. Cochran, L. Beeghley, and E. W. Bock, “Religiosity and Alcohol Behavior: An Exploration of Reference Group Theory,” Sociol Forum 3 (1988): 257–277; W. R. Miller, “Researching the Spiritual Dimensions of Alcohol and Other Drug Problems,” Addiction 93 (1998): 979–990.   4 Max M. Glatt, “Alcoholism and Drug Dependence amongst Jews,” British Journal of Addiction 64 (1970): 297–304.   5 Susan E. Luczak, Shoshana H. Shea, Lucinda G. Carr, Ting-Kai Li, and Tamara L. Wall, “Binge Drinking in Jewish and Non-Jewish White College Students,” Alcoholism: Clinical and Experimental Research 26 (2002): 1773–1778.   6 National Institute on Alcohol Abuse and Alcoholism, “Five-Year Strategic Plan FY07-11: Alcohol Across the Lifespan,” accessed July 15, 2012, http://pubs.niaaa.nih.gov/publications/ StrategicPlan/NIAAASTRATEGICPLAN.htm.   7 Mark Keller, “The Great Jewish Drink Mystery,” British Journal of Addiction 64 (1970): 287–296.   8 E. Morton Jellinek, The Disease Concept of Alcoholism (New Haven: Hillhouse, 1960).   9 James et al., The Immigrant Jew in America, 290.

Alcoholism among the Jews

particularly among the Russian Jews, it had begun increasing among the younger generation, who adapted the lifestyle of their Gentile neighbors.10 But for festive occasions, drinking was done in the house. In biblical times, drunkenness among the Jews may not have been as uncommon as it would become among the immigrants. The Bible strictly warns against drinking by priests entering the Temple. Occasional warnings against drunkenness have been found in later Jewish writings, indicating that drinking was at least common enough to deserve the mention. In some cases, however, Jewish sacred literature actually supports drinking: “Go, eat your bread with enjoyment, and drink your wine with a merry heart” (Ecclesiastes 9:7). “There is nothing better for a man than that he should eat and drink, and find enjoyment in his toil” (Ecclesiastes 2:24). In Talmudic times, it was customary to encourage mourners to imbibe with the meal of consolation. Nonetheless, drunkenness has always been reproved and moderation commended. Despite widespread acceptance of drinking among Jews and having to bear enough stress that might provoke drunkenness, there was little problem drinking among Jews. Kant attributed the function of alcoholism to letting man “forget the burden which is inherent in life itself.”11 It is astounding, therefore, to consider that Jews did not use this ready escape in the face of their burdens and continual persecution. Kant ascribed the rarity of alcoholic excess among Jews to their being a minority seeking to avoid censure and attracting unfavorable attention. He allowed that their weak civic position required them to be reserved in behavior, demanding self-control. Fishberg observed that it was important for the Jew to outshine the non-Jew if he wanted to succeed.12 Thus, if the Jew drank, he would have to do it in moderation, since drunkenness or any aberrant behavior in a Jew would not be tolerated by the rest of society. The disdain for drunkenness is illustrated by the European children’s song from the ghetto: “Shikker is a Goy” (Drunk is a Gentile). A Gentile might drink to excess, but the Jew had better beware. 10 Ibid. 11 E. Morton Jellinek, “Immanuel Kant on Drinking,” Quarterly Journal of Studies on Alcohol 1 (1941): 777–778. 12 Fishberg, The Jews: A Study of Race and Environment.

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WELL-INTEGRATED DRINKING HABITS It has been suggested that alcoholism is low in societies where drinking customs are consistent with the rest of the culture. Knowing how much drinking is permitted on any given occasion sets clear limits. Thus, in societies with confused attitudes toward drinking, alcoholism rates are high. The Irish and Irish-Americans, who had very high rates of alcoholism in the mid-twentieth century, were looked upon as a society with poorly integrated drinking habits.13 Like the Jews, the Italians and the Chinese are also cited as having well-integrated drinking customs. For Italians and Jews alike, drinking was usually introduced at an early age, and in Jewish households, drinking was done in the context of religious rituals.14 In fact, alcoholic beverages figure heavily in nearly all aspects of religious Jewish life: circumcision, Bar Mitzvah, marriage, and funerals, where wine is sometimes used to wash the head of the corpse. CEREMONIAL ORTHODOXY The religious connection to sobriety among the Jews has been examined extensively. In the late 1950s, Charles Snyder interviewed a sample of adult Jewish college men to investigate their drinking practices and found a connection between sobriety and the Orthodox religious life: Orthodox students were drunk least often and the Reform students more often.15 Although drunkenness has become more common among successive generations of Conservative and Reform Jews in the United States, sobriety among the Orthodox remains unimpaired. The more tenuous the connection to Orthodoxy, the more frequent the signs of alcoholism among Jews.16 13 Charles R. Snyder, Alcohol and the Jews: A Cultural Study of Drinking and Sobriety; Rutgers Center of Alcohol Studies, Monograph No. 1 (New Brunswick: Rutgers Center of Alcohol Studies Publication Division, 1958). 14 R. F. Bales, “Cultural Differences in Rates of Alcoholism,” Quarterly Journal of Studies on Alcohol 6 (1946): 480–499; R. F. Bales, “The ‘Fixation Factor’ in Alcohol Addiction: An Hypothesis Derived from a Comparative Study of Irish and Jewish Social Norms” (PhD diss., Harvard University, 1944). 15 Snyder, Alcohol and the Jews. 16 Robert E. Popham, “Some Social and Cultural Aspects of Alcoholism,” Canadian Psychiatric Association Journal 4 (1959): 222–229; M. M. Glatt, “Alcoholism and Drug Addiction amongst Jews,” British Journal of Addiction 64 (1970): 297–304.

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Bales proposed that ritualized drinking through religious practices taught the Jews to drink in a controlled manner and, therefore, resulted in low rates of alcoholism.17 Donald Glad further described drinking among the Jews as “instrumental”—such as the weekly Kiddush [ritual cup of wine] for the Sabbath meal—rather than “pleasure-oriented,” as was the custom among their non-Jewish contemporaries.18 As physician to the United Hebrew Charities of New York, Glad was convinced that alcoholism was a “negligible quantity in the etiology of poverty and dependency among Jews.”19 He also noted that persons who followed religious precepts drank regularly every Friday and Saturday and at every religious festival and celebration. A. Myerson attributed the low rates of inebriety among Jews to their position in society as the chosen people:20 “To be a drunkard is to cease being a Jew. . . . It is entirely unworthy of a Jew—man or woman—to get drunk.”21 Fishberg concurred, noting, “the Jew of the Ghetto . . . abhorred drunkenness as sin only fit for a Goi (Gentile) but not for one of the chosen people.”22 Myerson and Fishberg are partially correct. Although it is true that identification with Jewish culture is associated with lower alcohol use, religious affiliation remains an important variable. More recently, Susan Luczak and colleagues (2002) examined the relationship between religion and binge drinking.23 It was hypothesized that religious Jewish-American college students and those with a stronger Jewish cultural identity and the alcohol dehydrogenase allele ADH2*2 would be less likely to binge drink than secular Jews and certainly less than non-Jewish white students; however, there was no significant association between religious service attendance and binge drinking among the Jewish students. Within the Jewish sample, religion, more so than cultural factors, was implicated in lower levels of alcohol behavior. 17 Bales, “Cultural Differences in Rates of Alcoholism.” 18 Donald D. Glad, “Attitudes and Experiences of American-Jewish and American-Irish Male Youth as Related to Differences in Adult Rates on Inability,” Quarterly Journal of Studies on Alcohol 33 (1974): 565–576. 19 Ibid. 20 A. Myerson, “The Social Psychology of Alcoholism,” Diseases of the Nervous System 1 (1940): 43–50. 21 A. Myerson, “Neuroses and Alcoholism among the Jews,” Medical Leaves 3 (1941): 104–107. 22 Fishberg, The Jews: A Study of Race and Environment, 275. 23 Luczak et al., “Binge Drinking in Jewish and Non-Jewish White College Students.”

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Glassner and Berg also attributed the Jews’ moderation in drinking to the association of alcohol abuse with being a non-Jew, use of drink in religious and family rituals, and the avoidance of social ties to heavy drinkers.24 RESPONSE TO ETHANOL In 1991, Maristela Monteiro and colleagues compared the intensity of response to ethanol in 15 male Jews, 15 non-Jews with a close alcoholic relative, and 15 non-Jews with no family history of alcoholism.25 The three groups were matched demographically. Despite having similar expectations of the effects of alcohol or on their blood alcohol concentrations after imbibing 0.75 mL/kg of ethanol, the Jewish men had more intense subjective feelings of inebriety after the alcohol challenge. It is possible that having a heightened sensitivity to relatively low doses of alcohol contributes toward decreased rates of alcoholism among Jews in addition to a higher prevalence of the ADH2*2 allele among them. Later, S. H. Shea and colleagues found that carriers of the allele drank fewer days per month than did non-carriers.26 Although the allele predicted less drinking among carriers, it has been suggested that the protective effect of the allele might not be solely responsible for the low rate of alcoholism among Jews and that environment most likely continued to play an important role.27 THE EPIDEMIOLOGY AND ECONOMICS OF EXCESSIVE ALCOHOL INTAKE Alcoholism is a progressive disease. Early symptoms may include poor concentration, sleep disorders, depression, headache, memory loss, hangovers, blackouts, 24 Barry Glassner and Bruce Berg, “How Jews Avoid Alcohol Problems,” American Sociological Review 45 (1980): 647–664; Barry Glassner and Bruce Berg, “Social Locations and Interpretations: How Jews Define Alcoholism,” Journal of Studies in Alcohol 45 (1984): 16–25. 25 Maristela G. Monteiro, Jeffery L. Klein, and Marc A. Schuckit, “High Levels of Sensitivity to Alcohol in Young Adult Jewish Men: A Pilot Study,” Journal of Studies on Alcohol and Drugs 53 (1991): 464–469. 26 S. H. Shea, T. L. Wall, L. G. Carr, and T. K. Li, “AHD2 and Alcohol-Related Phenotypes in Ashkenazic Jewish American College Students,” Behavior Genetics 31 (2001): 231–239. 27 Shea et al., “ADH2 and Alcohol-Related Phenotypes”; D. Hasin, E. Aharonovich, X. Liu, et al., “Alcohol and ADH2 in Israel: Ashkenazis, Sephardics, and Recent Russian Immigrants,” American Journal of Psychiatry 159 (2002): 1432–1434.

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upset stomach, nausea, irritability, anxiety, and dehydration. Later symptoms may include malnutrition, increased blood sugar levels, liver damage, problems with blood production and clotting, stomach ulcers, gastritis, and tremors. The consumption of alcohol is directly related to brain cell death. A loss of cerebellar Purkinje cells and shrinkage of cerebellar molecular and granular cell layers has been noted to occur in alcohol-perfused brains. The resulting cerebellar atrophy increases the probability of damage to the midbrain, which results in short-term memory loss (“wet brain”). The memory loss results from a deficit in the acetylcholine system, which causes damage to the nucleus basalis of Meynert, a condition similar to that found in persons with Alzheimer’s disease. In other words, excessive use of alcohol can induce a condition akin to Alzheimer’s disease at an early age. Continued alcohol abuse would result in a pre-vegetative state in which bladder and bowel functions would no longer be regulated. Alcohol-related deaths can be classified as those entirely attributable to alcohol, such as cirrhosis of the liver, and those in some measure attributable to alcohol, including oropharyngeal cancers—which are six times more common in drinkers than in nondrinkers—colorectal cancer, and cancers of the upper digestive tract, and injuries from road accidents. An analysis of alcohol dependence among trauma center patients found that alcoholism was substantially higher among vehicular crash victims and other trauma patients than among the equivalent general population.28 More than half of trauma patients with a positive blood alcohol content at the time of trauma were alcoholics; nearly 1 in 7 patients who were not drinking at the time were alcohol-dependent. Alcoholism certainly is directly related to poor health and poor fiscal choices. When far enough along, the alcoholic will use every means for another drink, even seeking money from others when his or her own resources are depleted. Direct costs associated with alcoholism are difficult to compute. Likewise, the costs associated with pain and suffering are difficult to quantify. In 1996, the Attorney General’s National Symposium on Alcohol Abuse and Crime

28 L. S. Greenfeld, An Analysis of the National Data on the Prevalence of Alcohol Involvement in Crime, Prepared for the Assistant Attorney General’s National Symposium on Alcohol Abuse and Crime (Washington, D.C.: U.S. Department of Justice, April 5–7, 1998), accessed December 1, 2003, http://www.ojp.usdoj.gov/bjs/pub/ascii/ac.txt.

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examined the extent of financial losses resulting from excess alcohol usage.29 The losses resulting from medical expenses, broken or stolen property, or lost wages reported by victims of violence who perceived the use of alcohol by offenders were estimated at $400 million. Overall losses to the economy related to alcohol abuse had been estimated at between $70 billion and $117 billion in the mid-1980s.30 Although estimation methods and data sources vary widely, there is no disputing that abuse of alcohol is costly to more than the alcoholic alone. There should also be no disputing that economic losses are highly underestimated. Core considerations include the treatment of alcoholism and medical consequences of alcoholism; morbidity and mortality; productivity losses, including absenteeism and tardiness, unemployment, and reduced productivity on the job; mortality, including the value of future lost earnings and the loss of life; caring for persons born with Fetal Alcohol Syndrome; property damage resulting from alcohol-related fires and automobile crashes; increased insurance premiums and auto repair services; administration of the criminal justice and social welfare systems; and imprisonment and emotional distress. Costs associated with disease may be distinguished as direct or indirect. The former refers to tangible goods and services involved in the treatment of the disease, while the latter refers to the value placed on services not performed as a consequence of the disease. Certainly investigators have provided a plethora of data on the costs associated with alcohol abuse and alcoholism. Two concepts are useful for our purposes as we seek to reflect on the role of alcoholism, or in our case its absence, and how it might have conferred a relative advantage to American Jews. The first concept is known as the “opportunity cost principle,” which refers to resources funneled away from uses toward which they might otherwise have been directed, or “when the total amount of goods and services 29 Ibid. 30 D. P. Rice, S. Kelman, L. S. Miller, and S. Dunmeyer, The Economic Costs of Alcohol and Drug Abuse and Mental Illness: 1985, Report submitted to the Office of Financing and Coverage Policy of the Alcohol, Drug Abuse, and Mental Health Administration, U.S. Department of Health and Human Services (San Francisco: Institute for Health and Aging, University of California, 1990); H. J. Harwood, D. M. Napolitano, P. L. Kristiansen, and J. J. Collins, Economic Costs to Society of Alcohol and Drug Abuse and Mental Illness: 1980, Report Submitted to the Office of Program Planning and Coordination of the Alcohol, Drug Abuse, and Mental Health Administration, U.S. Department of Health and Human Services (Research Triangle Park: Research Triangle Institute, 1984).

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available to be consumed is reduced.”31 A second, closely related concept is known as the “human capital” approach, which seeks to assess the value of loss of expected years of life and productivity individuals might have pursued over their lifespan, assuming they did not suffer from alcoholism. The cost of alcoholism, however, cannot be computed in terms of economic costs alone. Consider, then, a society not largely beset with the problems associated with alcoholism. Compared with a society burdened with alcoholism, a largely sober society would have increased social and financial resources; greater physical and mental health; more time and resources to spend caring for and supporting each other; greater ability to profit financially, achieve goals, and contribute to society to the benefit of all, but particularly to other Jews, thus strengthening the bonds among Jews and increasing their social value and overall worth. DISEASES ASSOCIATED WITH EXCESSIVE ALCOHOL INTAKE As previously mentioned, excessive alcohol use has been linked with cancer, especially cancers of the mouth, oral cavity, pharynx, and larynx,32 and has been associated with a diminution of sexual function in men and an increased incidence of reproductive problems in women.33 Brewery workers, for one, represented one group with a heightened risk for cancer.34 The relationship between modifiable health risks and morbidity and mortality among alcoholics 31 H. Harwood, “Updating Estimates of the Economic Costs of Alcohol Abuse in the United States: Estimates, Update Methods, and Data,” Report prepared by the Lewin Group for the National Institute on Alcohol Abuse and Alcoholism, 2000; based on estimates, analyses, and data reported in H. Harwood, D. Fountain, and G. Livermore, The Economic Costs of Alcohol and Drug Abuse in the United States–1992, Report prepared for the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services. NIH Publication No. 98–4327 (Rockville: National Institutes of Health, 1998). 32 R. G. Vincent and F. Marchetta, “The Relationship of the Use of Tobacco and Alcohol to Cancer of the Oral Cavity, Pharynx, and Larynx,” American Journal of Surgery 106 (1963): 501; I. Martinez, “Factors Associated with Cancer of the Esophagus, Mouth, and Pharynx in Puerto Rico,” Journal of the National Cancer Institute 42 (1969): 1069–1094; K. J. Rothman and A. Keller, “The Effect of Joint Exposure to Alcohol on the Risk of Cancer of the Mouth and Pharynx,” Journal of Chronic Diseases 25 (1972): 711–716. 33 Emanuele and Emanuele, “The Endocrine System: Alcohol Alters Critical Hormonal Balance.” 34 O. M. Jensen, “Cancer Morbidity and Causes of Death among Danish Brewery Workers,” International Journal of Cancer 23 (1979): 454.

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has been well established.35 More than 25 years ago, epidemiologists succeeded in quantifying alcohol dependency and abuse as precursors to arthritis and musculoskeletal diseases, cardiovascular diseases, dental disease, depression, diabetes mellitus, infectious diseases, respiratory diseases, unintended pregnancy and infant mortality and morbidity, and unintentional injury as well as many forms of violence.36 In 1999, American employers paid almost all of the increased 8 percent in healthcare costs.37 This translated to an average of $2,426 per individual and $6,351 for families. This finding has led to an increased interest in modifiable risks and their potential cost savings through company-underwritten preventive programs. This situation was addressed by data from a later analysis of 46,026 private sector participants in a health-screening program.38 These data suggested that, conservatively speaking, about one in four dollars of their total health expenditures was attributable to ten modifiable health risks. Respondents had spent about $80 million on health, with one in every four dollars associated with high-risk status or risk factors amenable to changes in lifestyle, behavior, and/or pharmacologic intervention. How much control does the individual have over his future morbidity and mortality? Quite a bit, according to recent studies. Data from the Alameda County Human Population Laboratory, gathered at various intervals beginning in 1965, revealed that by 1974, disability was about fifty percent lower among individuals who minimized risk factors, such as excessive consumption of alcohol, cigarette smoking, not eating breakfast, sleeping less than 7 to 8 hours a night, or being sedentary.39 Those who had engaged in an intermediate amount 35 National Institute on Alcohol Abuse and Alcoholism, “Five-Year Strategic Plan”; R. W. Amler, and D. L. Eddins, “Cross-Sectional Analysis: Precursors of Premature Death in the United States,” in Closing the Gap: The Burden of Unnecessary Illness, ed. R. W. Amler and H. G. Dull (New York: Oxford University Press, 1987), 181–187. 36 Amler and Eddins, “Cross-Sectional Analysis.” 37 Kaiser Family Foundation/Health Research and Educational Trust, “2000 Annual Employee Benefits Survey,” accessed May 19, 2009, https://www.policyarchive.org/handle/10207/14531. 38 J. Anderson, “Clinical Practice Guidelines: Review of the Recommendations for Colorectal Screening,” Geriatrics 55 (2000): 67–73; T. J. Anderson, F. E. Alexander, and P. M. Forrest, “The Natural History of Breast Carcinoma: What We Have Learned From Screening,” Cancer 88 (2000): 1758–1759. 39 L. Breslow and N. Breslow, “Health Practices and Disability: Some Evidence from Alameda County,” Preventive Medicine 22 (1993): 86–95.

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of good health practices in 1965 experienced about two-thirds the relative disability risk as others. Every year, alcohol-related causes claim 100,000 American lives.40 The risk of dying from an alcohol-related injury is related directly to the number of drinks consumed per occasion. Both men and women who imbibe three drinks (defined as 13.6 grams of pure alcohol), experience a lifetime injury mortality risk of one percent. Altering the pattern of consumption, namely fewer drinks on more occasions or more drinks on fewer occasions, yields the same effect.41 The costs are staggering—an estimated $148 billion in 1992, rising to $185 billion two years later.42 For treatment and healthcare services, the figure amounted to $18.8 billion. The value of expected lifetime earnings, discounted at six percent, amounted to $31.3 billion. The estimated cost attributed to lost potential employment and productivity was $67.7 billion. Alcohol-related motor vehicle crashes cost the nation $24.7 billion; more specifically, $11.1 billion from premature mortality and another $13.6 billion from property destruction. Crime attributed to alcohol abuse was estimated to cost the nation another $19.7 billion in that year. Another way of looking at indirect costs involves value placed on services not performed as a consequence of alcohol-related disease, known as the proportion of disability-adjusted life years (DALYs). A DALY is an aggregate measure combining the total number of years lived with a disability and the number of years lost to premature deaths. Viewed in this way, a total of 2.8 percent of DALYs are attributable worldwide to alcoholism, with 3.8 percent of alcohol-related DALYs occurring in high-income countries.43 And who defrayed the $185 billion cost of alcohol abuse? The burden of alcohol abuse is spread among many. While 45.5 percent of the cost of alcohol abuse, $66.8 billion, is borne by the abusers and their families, an additional 40 A. H. Mokdad, J. S. Marks, D. E. Stroup, et al., “Actual Causes of Death in the United States, 2000,” Journal of the American Medical Association 29 (2004): 1238–1245. 41 B. Taylor, J. Rehm, R. Room, et al., “Determination of Lifetime Injury Mortality Risk in Canada in 2002 by Drinking Amount per Occasion and Number of Occasions,” American Journal of Epidemiology 168 (2008): 1119–1125. 42 White House Office of National Drug Control Policy [ONDCP] Drug Data Summary: Drug Use Costs to Society, March 2003. 43 Jürgen Rehm, Dan Chisholm, Robin Room, and Alan D. Lopez, “Alcohol,” in Disease Control Priorities in Developing Countries, 2nd ed., ed. D. T. Jamison, J. G. Brennan, and A. R. Breman (New York: Oxford University Press, 2006), 887–906.

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38.6 percent, or $57.2 billion, is defrayed by state and federal governments, and yet another $15.1 billion, or 10.2 percent, was assumed by the health and life insurance industry. Approximately 65 percent of lost potential productivity in 1992, or $69.2 billion, fell directly on the household of the alcohol abuser. There is evidence that employers shift some of the productivity differential to the workers themselves in the form of reduced compensation. This in turn jeopardizes the welfare of family members, particularly those who are economically dependent. An example is in order. It has been estimated that, annually, a business with 10,000 employees would have 916 problem drinkers. The 916 problem drinkers would be 30 percent more likely to be absent from work, late to work, and leave early at an annual cost of $532,103.00. Alcohol abusers and their families require significantly more health care. The alcohol abusers in our example are 33 percent more likely to remain 1.25 days longer in hospitals at an annual cost of $3,924,135. At a per diem rate of $5,306.68, the excess of 112 days in the hospital for the problem drinkers incurs an additional cost of $594,348, while at a cost of $1,191.81 per emergency room visit, the 242 excess visits amount to $288,488.44 In short, when resources were funneled away from available goods and services by drugs and alcohol abuse, the relative advantage has been conferred to the American Jew, who was more likely to abstain than were other groups. Among Russian Jewish immigrants, drugs habits, such as opium and cocaine, were almost unknown.45 Similarly, the Jews were ahead of the curve in terms of human capital, an assessment of the value of loss of expected years of life and individual productivity. ALCOHOL AND CRIME Perhaps one of the greatest effects of alcohol is its impact on crime. Decreased serotonergic activity in the brain mediated by heavy alcohol consumption increases impulsivity and aggressiveness. In 1996, more than 36 percent of all convicted adult offenders (5.3 million) had been drinking at the time of the offense. Forty-one percent of traffic fatalities in 1996 were alcohol-related. 44 The George Washington University Medical Center, “Alcohol Cost Calculator,” accessed August 12, 2004, www.alcoholcostcalculator.org. 45 Bernheimer, The Russian Jew in the United States.

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Three of four victims of spousal abuse (75 percent) described alcohol abuse by the offender. Alcohol use has been implicated in 30 percent of rapes or sexual assaults, 10 percent of robberies, 21 percent of incidents of aggravated assault, and 21 percent of incidents of simple assault.46 Approximately 63 percent of public four-year universities reported arrests for liquor law violations, including the prohibited manufacture, sale, or possession of liquor, and maintaining illegal drinking places. This figure, however, did not include public drunkenness offenses and driving under the influence. CAVEAT—IT AIN’T NECESSARILY SO In modern-day America, there are Jewish alcoholics and drug abusers. To summarily dismiss these abuses among Jews is, as Abraham Twerski cautions, to adhere to a myth.47 We are loathe to minimize the impact of alcohol and drug abuse in the United States. The incidence of alcoholism among Jews, while likely lower than that among non-Jews, provides merely a “hollow consolation.” Addiction to tranquilizers, sedatives, and pain pills continues apace among older Jews, while the use of marijuana and other street drugs among young Jewish adults is rampant. RISK FACTORS AND UPWARD MOBILITY Major influences of health in adulthood are often determined early in childhood and can determine our eventual risks for mortality.48 By the time we reach adulthood, our lives have been shaped by the genetic, biologic, educational, cultural, social, and psychological cards we drew, and what we did with this hand determines the ultimate outcome. Suffice it to say that the relationship between risk factors, such as smoking and drinking and socioeconomic status, remains complex. 46 Greenfeld, An Analysis of the National Data on the Prevalence of Alcohol Involvement in Crime. 47 Abraham J. Twerski, “Jews, Alcohol, & AA: Dispelling the Myths that Jews Aren’t Alcoholics and that Alcoholics Anonymous Is Only for Christians,” accessed February 3, 2009, http:// www.myjewishlearning.com:80/daily_life/TheBody/Health_Healing/smoking_alcohol_ drugs/AA_Prn.htm. 48 Yoav Ben-Shlomo, “Rising to the Challenges and Opportunities of Life Course Epidemiology,” International Journal of Epidemiology 36 (2007): 481–483.

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Self-reported smoking status, alcohol consumption, arterial hypertension, and being overweight were used to examine upward occupational mobility (upward transition) in 20,000 volunteers working at the French National Electricity and Gas Company (the GAZEL cohort).49 Between 1985 and 1992, non-mobile, non-upwardly mobile men were at greater risk of becoming smokers or excessive alcohol drinkers and becoming hypertensive in 1993 and 1999 compared with upwardly mobile men. By 1992, C. Ribet and colleagues found that non-mobile upwardly mobile men were more likely to be smokers, excessive alcohol drinkers, and overweight compared with active men of the same class. Health behaviors ingrained early in life thus appear to play a role in the selection process toward upward occupational mobility.

49 C. Ribet, M. Zins, A. Gueguen, et al., “Occupational Mobility and Risk Factors in Working Men: Selection, Causality or Both? Results From the GAZEL Study,” Journal of Epidemiology and Community Health 57 (2003): 901–906.

HUMAN CAPITAL

CHAPTER 7

Housing and Jobs in the New World—Health Against All Odds As to the poverty, [the Jews] brought us boundless energy and industry to overcome it.The slums are offensive, but unlike those of other less energetic races, they are not hopeless unless walled in and made so on the old world plan.They do not rot in their slum, but rising, pull it up after them. Nothing stagnates where the Jews are. The Charity Organization people in London said to me two years ago, the Jews have fairly renovated Whitechapel. They did not refer to the model buildings of the Rothschilds and fellow philanthropists. They meant the resistless energy of the people, which will not rest content in poverty. It is so in New York. Their slums on the East Side are dark mainly because of the constant influx of a new population ever beginning the old struggle over.The second generation is the last found in those tenements, if indeed it is not already on its way uptown to the Avenue. Jacob A. Riis, The Jews of New York1

W

hen the Jewish immigrants came to the United States, they never dreamed that their Goldene Medina (Golden Nation), whose streets were paved with gold, would not have sufficient living space for them and their families. The housing conditions on the Lower East Side of Manhattan, as well as in Philadelphia, Boston, Chicago, Baltimore, and many other Jewish   1 Jacob A. Riis, “The Jews of New York,” in On the Lower East Side: Observations of Life in Lower Manhattan at the Turn of the Century, ed. W. Crozier, C. Chambers, P. Costello, and C. Gaffield, Stadium B; html version, ed. W. Miller and C. Massey (Lower Manhattan Project, 1993), accessed May 30, 2009 http://tenant.net/Community/LES/contents.html, 58.

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ghettos, were deplorable. The tenement houses were crowded and congested, offering little or no light or ventilation, and no hot running water, gas, or heat—conditions that bred disease and spawned fires; yet, despite these deplorable living conditions, the immigrant Jews remained in relatively good health.2 This chapter describes the terrible housing and neighborhood environment in which the immigrant Jews found themselves upon arrival, but most of all, their ability to prevail over these conditions. Students of the great migrations at the turn of the twentieth century often lamented the unhealthy conditions in which the Jews resided, while noting their comparatively lower rates of morbidity and mortality. Many surely did succumb to illness, but those who survived did so against high odds. They survived and prospered for self, for community, and for those who gave their “all” in support of the next generation. Observers of the period further credited some of the reasons for the relative resiliency of the Jews to cultural and social factors, including temperance, religious beliefs, and philanthropy. Genetic selection for resistance to infectious diseases might also have played a role in protecting the Jews from the infectious agents associated with urban living. In his book, Ethnic America: A History, Thomas Sowell noted that observing Jews and other ethnic groups in their American experience did little to explain their successes over their handicaps. To do this, he recommended examining their history. He observed that, “with Jews as well as with many other ethnic groups, neither their success nor their handicaps can be understood solely in terms of the American context. Many of the reasons for both reached far back into history.”3 The cultural traditions of a group tend in no small way to preserve health and determine the course of disease. Hygiene was a given: hands were washed every morning and before every meal and before ritual immersion. Mark Zborowski and Elizabeth Herzog described best the importance placed by the Jews on good health: “Nothing is worse than illness. Even the loss of parnosseh   2 Jacob Jay Lindenthal, “Abi Gezunt: Health and the Eastern European Jewish Immigrant,” American Jewish History 70 (1981): 420–441; Deborah Dwork, “Health Conditions of Immigrant Jews on the Lower East Side of New York: 1880–1914,” Medical History 25 (1981): 1–40; Howe and Libo, How We Lived: A Documentary History of Immigrant Jews in America.   3 Thomas P. Sowell, Ethnic America: A History (New York: Basic Books, 1981), 94.

Housing and Jobs in the New World—Health Against All Odds 109

[income] is feared less than the loss of gezunt [health]. Illness of one member upsets the whole household, arouses the anxiety of everyone from parents to distant relatives and neighbors. With sighs, advice, and money, all participants join in efforts to cure the ailment.”4 When comparing the health of one group with another, accurate assessment of the number of individuals in each group is essential. This number becomes the denominator into which the number of cases is divided. The resulting figure is then multiplied by a standard number (e.g., 10,000), thereby permitting comparisons between and among groups of similar size. Unfortunately, this cannot be done in the case of the American Jew, as the census did not include information on religious status. The best we can do is to make informed guesses. The situation in Europe, however, is different, because the number of individuals in every religious group was collected. With this in mind, we offer a summary of the health status of European Jews in some of the countries from which they emigrated. One of the principal empirical indicators of the health of a group is infant mortality. Since the decline in the birth rate among Jews began earlier than it did among non-Jews, the result was a decrease in the absolute number of deaths in infancy, a period with the highest potential of mortality. Arthur Ruppin cited several important reasons for the comparatively lower death rate in Jewish infants, including a stronger economic position and urbanization, whose populations tend “to secure better care and medical help in illness.”5 Jews, especially in Central and Western Europe, he noted, were less likely to engage in dangerous and unhygienic occupations, including mining or the chemical industry. Ruppin also noted that “the Jews are always ready to call in the doctor.” He considered them his “best clientele.” Although Jews formed 35 percent of the population in Lodz, Poland in 1928, they accounted for 59 percent of patients in the consulting rooms of municipal doctors.6 Although there is little information on the health of the Jews when they came to the United States during the major migration beginning in the early 1880s, it is likely they were healthier than other immigrants and remained so here, despite their abysmal living conditions. One major indicator of their   4 Mark Zborowski and Elizabeth Herzog, Life Is with People: The Jewish Little-Town of Eastern Europe (New York: International Universities Press, Inc., 1955).   5 Arthur Ruppin, The Jews in the Modern World (London: MacMillan, 1934), 88.   6 Ibid., 88–89.

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relatively healthy status lies in reports of infant and child mortality while they were in Europe. Infant and child mortality was low among Jewish births compared with non-Jewish births (132 per 1,000 births compared with 259 per 1,000, respectively).7 Between 1886 and 1890, the mortality rate of Catholic children younger than five years of age in Budapest was twice as high as it was among Jewish children.8 Similarly, and roughly during the same period, mortality among Jewish infants in Prussia ranged between one-third and one-half those of Christian infants.9 The pattern of survival favoring Jewish infants and children continued through the turn of the century.10 The Jews’ ability to survive disease was clearly superior to that of non-Jews. In reports from several Eastern European countries, including Russia, Austria-Hungary, Rumania, and Poland, Jews had lower rates of mortality from smallpox, diarrheal disease, consumption, cholera, scarlet fever, measles, whooping cough, and infectious diseases compared with Catholics and Protestants (Table 3).11 Mortality rates among Jewish infants and young children were consistently lower than those of non-Jewish foreign-born groups who were similarly   7 Gretchen A. Condran and Ellen A. Kramarow, “Child Mortality among Jewish Immigrants to the United States,” Journal of Interdisciplinary History 22 (1991): 223–254.   8 Joszef von Körösi, Einfluss der Confession, des Wohlstandes und der Beschäftigung auf die Todesursachen (Berlin, 1898).   9 Arthur Ruppin, “Die Sozialen Verhaltnisse der Juden in Preussen,” Jahrbücher für Nationalekonomie und Statistik, 3rd series 23 (1902): 380. 10 Deborah Dwork, “Health Conditions of Immigrant Jews on the Lower East Side”; M. Grunwald, ed., Mitteilungen der Gesellschaft für Jüdische Volkskunde (Hamburg: 1897); Arthur Ruppin, “Das Wachstum der Jüdischen Bevölkerung in Preussen,” Zeitschrift für Demographie und Statistik der Juden 8 (1905): 5–9. 11 Ruppin, “Das Wachstum der Jüdischen Bevölkerung in Preussen”; Fishberg, The Jews: A Study of Race and Environment; J. Mitulescu, “La Tuberculose en Roumanie,” Tuberculosis 5 (1906): 187; J. Thon, “Taufbewegung der Juden in Oesterreich,” Zeitschrift für Demographie und Statistik der Juden (1907): 6; Maurice Fishberg, “The Relative Infrequency of Tuberculosis Among Jews,” American Medicine 2 (1901): 695–698; J. Jacobs, “On the Racial Characteristics of Modern Jews,” Journal of the Anthropological Institute 15 (1886): 23–62; C. Lombroso, L’Antisemitismo e le Scienze Moderne (Torino: 1894); F. L. Hoffman, “Expectation of Life,” Jewish Encyclopedia 5 (1903): 306–308. Michael George Mulhall, Dictionary of Statistics (London: G. Routledge and Sons, 1892), cited in Maurice Fishberg, “The Comparative Pathology of the Jews,” New York Medical Journal (1901): 537–543; 576–582; M. L. Levantin, “Somatische Verhältnisse bei den Juden in Odessa,” Blätter für Demographie, Statistik und Wirschaftskunde der Juden 3 (1923): 205–206; I. Koralnik, “Zur Problematik der Jüdischen Mindersterblichkeit,” Archiv für Soziale Hygiene und Demographie 4 (1929): 185; I. Koralnik, “Die Sterblichkeit an Typhus bei den Juden in Odessa Yidn,” Blätter für Demographie und Wirtschaftskunde der Juden 2 (1923): 82–84.

Housing and Jobs in the New World—Health Against All Odds 111

TABLE 3  Relative Morbidity and Mortality Among the Jews in Eastern Europe Disease

Jews

Smallpox, diarrheal disease, consumption, and inanition (Posen)

0.9

Pulmonary tuberculosis (Russia, Austria-Hungary, Rumania) All forms of tuberculosis (Russia, Austria-Hungary, Rumania)

Catholics

Protestants Source Fishberg, 1911

13.1

17.8

3.13

2.26

38.3

49.6

24.6

Fishberg, 1911; Mitulescu, 1906; Thon, 1907

32.8

Mitulescu, 1906; Thon, 1907; Fishberg, 1901

Non-Jews/General Cholera (Budapest)

Tuberculosis (Budapest)

0.257

1.85

Fishberg, 1901; Jacobs, 1886; Lombroso, 1894

20.95 (m) 18.50 (f)

27.45 (m) 27.60 (f)

Ruppin, 1905; Lombroso, 1894; Hoffman, 1903; Mulhall, 1899

Acute infectious diseases (Odessa)

26.8

47.1

Infectious diseases (Odessa)

10.5

39.8-51.8

Typhus (Odessa)

37.4

54.1

Koralnik, 1923

13.2 (m) 6.2 (c)

Koralnik, 1923

Mortality associated with typhus

9.4 (m) 0.8 (c)

Levantin, 1923 Koralnik, 1929

m= male; f = female; c = children.

disadvantaged. Jewish infant mortality was also more favorable than that among native white Americans whose average income was higher.12 This outcome was attributed to “personal and family hygiene practices in Jewish culture.” When the Jews reached the shores of America, they came with high standards with 12 O. W. Anderson, “Infant Mortality and Social and Cultural Factors: Historical Trends and Current Patterns,” in Patients, Physicians and Illness, ed. E. G. Jacob (New York: The Free Press of Glencoe, 1958), 10–24.

112 Abi Gezunt

regard to cleanliness, eating good food, and maintaining a similar environment to that of their homes in Europe.13 They would, however, find difficulty in maintaining a high standard of living at first and many of the trappings associated with domestic comfort were not immediately available to them. Most of the new arrivals to New York were densely packed into a one and one-half square mile area on the Lower East Side, bounded by the East River, Third Avenue, the Bowery, Catherine Street, and 14th Street. In the year 1893, the Tenth Ward consisted of 74,401 people residing within 1,196 tenements over forty-six blocks. Jacob Riis wrote, “Even the alley is crowded out. Through dark hallways and filthy cellars, crowded, as is every foot of the street, with dirty children, the settlements in the rear are reached.”14 The New York Times reported on January 18, 1895, that sections of the lower East Side were more densely populated than the most crowded areas of Bombay or Prague. In New York, there were more than 626 persons per acre, compared with 485 persons in Prague and 125 in Paris.15 This number continued to increase. By 1900, the Tenth Ward held the dubious distinction of being one of the most densely settled spots in Manhattan, with more than 700 persons per acre.16 In 1904, a private census undertaken by New York’s superintendent of the Educational Alliance, David Blaustein, involving approximately 32 streets south of Houston Street and east of the Bowery, turned up 64,268 families residing in 5,000 tenements.17 Its inhabitants were engaged in 84 different occupations. So dense was the population that schools could only accommodate their children for half a day. TENEMENT LIVING The tenements of New York were described as “prison-like structures,” with damp, foul-smelling courtyards,” sure to be “perfect death traps” for those seeking to flee a fire, as the stairways were too narrow and fire escapes were laden with 13 Dwork, “Health Conditions of Immigrant Jews on the Lower East Side.” 14 Jacob A. Riis, How the Other Half Lives: Studies among the Tenements of New York (New York: Charles Scribner’s Sons, 1890), 98. 15 Allon Schoener, Portal to America (New York: Holt, Rinehart & Winston, 1967), 208–212. 16 Rischin, The Promised City. 17 Miriam Blaustein, Memoirs of David Blaustein: Educator and Communal Worker (New York: McBride, Nast & Co., 1913).

Housing and Jobs in the New World—Health Against All Odds 113

junk.18 The Jewish immigrants outside New York lived in neighborhoods where conditions were not much different from those of the Jews on the Lower East Side. Whether it was Philadelphia, Boston, Baltimore, or a dozen other cities, this was slum living. In Chicago’s Jewish ghetto, the houses were one- or two-story wooden shanties, with bad drainage, no light, and filthy odors emanating from the rear alley. Day and night, children swarmed the streets, in all but the severest weather.19 William Dean Howells likened the homes of the Jews to “the dugouts or sod huts of the settlers on the great plains,” noting that while those were temporary dwellings, the tenements were meant as permanent dwellings.20 The filthy, fetid conditions of the Lower East Side of New York cannot be overemphasized. Anzia Yezierska’s Sonya Vrunsky described them in Salome of the Tenements,21 from the “haggling pushcart peddlers” to the “dirt and din of screaming hucksters, and slattern yentehs,22 “dirty babies at their breasts,”23 while the sidewalks were “crowded with broken stoves, beds, three-legged chairs . . . and dirty mattresses and bedding.”24 Thomas Sowell noted that despite the abysmal conditions, the Jews did not succumb to alcoholism, and even homicides and accidental deaths were lower there than in other slums. The Jewish children had “lower truancy rates, lower juvenile delinquency rates, and (by the 1930s) higher IQs than other children.”25 Sowell attributed the success of the Jews in the slums to their having maintained the social patterns and values of the middle class, despite their living conditions: “The Jews took those values into and out of the slums.” A LOOK INSIDE—FERTILE GROUND FOR DISEASE The number of houses without light, ventilation, hot running water, baths, or water closets was overwhelming. The 1900 Tenement House Committee of the Charity Organizations Society illustrated this problem by exhibiting a cardboard 18 Rischin, The Promised City. 19 Louis Wirth, The Ghetto (New Brunswick: Transaction Publishers, 1996). 20 William Dean Howells, Impressions and Experiences (New York: Harper’s, 1896), 144. 21 Anzia Yezierska, Salome of the Tenements (Urbana: University of Illinois Press, 1995). 22 Ibid., 3. 23 Ibid., 4. 24 Ibid., 5. 25 Sowell, Ethnic America, 94.

114 Abi Gezunt

model of an entire block in the Tenth Ward. The 80,000 square foot area boasted 39 tenement houses, six stories high, with 605 apartments. These buildings housed 2,781 people, 466 of whom were younger than age five. Only 264 apartments had water closets, and 40 had hot water.26 Diseases such as tuberculosis and diphtheria were rampant, but most cases remained unreported.27 The New York State Tenement House Commission described living conditions as “almost beyond belief.”28 Violations of the ventilation and the lighting laws contributed to the perpetual sickness of tenants. It was known that direct sunlight exercised a positive effect on health—hastening the death of the tubercle bacillus (which causes tuberculosis)—and that dampness and darkness contributed to disease.29 The harsh bitterness of winter’s cold was poignantly described by another of Anzia Yezierska’s heroines, Sophie, who cried out in despair, “Better a quick death than this slow freezing!” Having sought shelter at Beth Israel Hospital, Sophie was turned away because the beds were filled with patients ill with the flu. In the novel, she bemoaned the lack of preventive services, something her instincts told her was essential.30 Poverty compelled many to maintain boarders in their homes. The parceling of space often assumed unbelievable proportions. Riis described one such arrangement, where a tailor lived with his wife and two children. Eventually, he sublet one 8-foot-square bedroom to two other families, dividing the room with a curtain.31 The Tenth Ward, located between Division Street on the south, Norfolk Street on the east, Rivington Street on the north, and the Bowery on the west, on the Lower East Side of Manhattan, while one of the smallest, was another densely crowded ward. Violations of every law concerning tenement houses were apparent everywhere. In one seven-story tenement, there were 36 families, 58 babies, 38 children older than five years of age, and a reported case of smallpox. On Essex Street, two small rooms in a six-story tenement housed a family of 14 (mother, 26 Robert Weeks DeForest and Lawrence Veiller, The Tenement House Problem: Including the Report of the New York State Tenement House Commission of 1900 (New York: The Macmillan Co., 1903). 27 Bernheimer, The Russian Jew in the United States. 28 DeForest and Veiller, The Tenement House Problem. 29 Ibid. 30 Anzia Yezierska, Children of Loneliness: Stories of Immigrant Life in America (New York: Funk & Wagnalls Co., 1923), 80–82. 31 Riis, The Children of the Poor.

Housing and Jobs in the New World—Health Against All Odds 115

father, and 12 children), plus six boarders. Such overcrowding invariably led to the spread of diseases. The Tenth Ward was notoriously disease-ridden and had the dubious distinction of being called the suicide ward. The immigrants brought diseases with them from across the sea. Unfortunately, their first instinct was to hide the sick for fear that the authorities would carry them off to the hospital to be slaughtered. This protective instinct and the involvement of Jews in the Tenth Ward in textile manufacturing added further to the spread of disease. Garments were sometimes sewn in tenements, where considerable amounts of material were often left in filthy apartments and hallways and where diseased tenants impregnated clothing with bacteria and viruses.32 Infected clothing was then sold to unsuspecting buyers. Jacob Riis documented how children in the most contagious stage of smallpox would crawl among the half-finished clothing for warmth, or how persons feverish with typhus or consumption would be found among the coats to be sent back that week, “each one with the wearer’s death-­ warrant, unseen and unsuspected, basted in the lining.”33 It is important to bear in mind, not only with regard to consumption, but also all other bacterial disease, that the mere presence of the microscopic organism in the body does not cause disease. Only where conditions are favorable to the growth of the bacillus can it become a harmful invader. Although Mycobacterium tuberculosis is the essential cause of the disease, there are various other contributing causes that influence the production of tuberculosis. Unless these causes are at work, weakening and exhausting the vital functions, the tubercle bacillus, when present, meeting with a sterile soil and the natural resistance of the body, though otherwise a most destructive and insatiable consumer, soon dies of inanition, or at any rate remains harmless. In 1894, the New York State Tenement House Commission recommended improvements to the dwellings to forestall the spread of tuberculosis by improving the sanitary conditions with more sunlight, more air, better ventilation, and minimizing overcrowding; by providing the same improvements for the workplace; and by removing the sources of infection and renovating apartments previously occupied by consumptives to prevent the continued spread of disease.34 The new legislation required landlords to improve the sanitary conditions, provide an 32 Jacob A, Riis, The Battle with the Slum (New York: Macmillan Company, 1902). 33 Riis, The Children of the Poor, 88. 34 DeForest and Veiller, The Tenement House Problem.

116 Abi Gezunt

ample and suitable number of toilets (that is, a separate toilet for each set of apartments), supply each set of apartments with a separate water supply and a bath, provide separate storage for coal, sufficient means for washing clothes, and sanitary pantry accommodations for the keeping of food. Despite the life-saving potential of these requirements, the laws were not passed for several years. Consequently, tuberculosis and its various forms ran wild; however, no study ever concluded that the Jews had a higher incidence of tuberculosis than did other groups of immigrants. In fact, they experienced remarkably lower rates of the disease. Despite the deplorable conditions in which the Jews were made to live, the New York State Tenement House Committee of 1894 reported that the overall Jewish death rate was 25 percent lower than the rate of others living in the city, including the rich.35 The Jews were thus the “healthiest and longest lived class of the population New York City.”36 Jacob Riis observed that “the laws Moses wrote in the desert operate today in New York’s tenements as a check upon the mortality with which all the regulations of the Board of Health do not compare.”37 In 1901, Robert Hunter, unable to account for the difference in death rates between Chicago’s Jews and non-Jews (non-Jews had a 46 percent higher mortality rate), who shared similarly poor sanitary conditions, deemed the sanitary conditions of both wards the culprit.38 The only thing one could attribute to the difference in death rate in the two wards was the difference in nationality. In the Ninth Ward of Chicago, window screens were a rarity and flies carried disease from house to house. Pavements were broken, rooms were cold and smoky in the winter and unbearably hot in the summer, and dead rats rotted beneath the flooring. The Jews who lived there were indeed discontent, but remained because of “strong business or social ties.” In April of 1901 the State of New York passed what is now known as the Tenement House Laws. Seth Low, the first mayor after these laws were passed, took it upon himself to ensure that the laws were enforced. The State eventually established the Tenement House Department so it could respond to the pressing problems. The new buildings had light in every room, and the windows no longer opened in close proximity of other windows. The filth-ridden airshafts 35 Riis, The Children of the Poor. 36 Bernheimer, The Russian Jew in the United States, 286. 37 Riis, “The Jews of New York,” 59. 38 Robert Hunter, Tenement Conditions in Chicago: Report by the Investigating Committee of the City Homes Association (Chicago: City Homes Association, 1901).

Housing and Jobs in the New World—Health Against All Odds 117

were removed, overcrowding was checked regularly, water closets were provided for each apartment, windows in every hallway opened to a courtyard, the cellar roof was fireproofed (25 percent of all fires started in the cellar), and stairs replaced ladders as fire escapes. A CULTURE OF HEALTH The importance of cleanliness, sunshine, and fresh air was impressed upon children all day. In response to the teacher’s question, “What must I do to be healthy?” students were taught to respond: “I must keep my skin clean, wear clean clothes, breathe pure air, and live in the sunlight.”39 Among the benefits of sunshine and fresh air was their ability to “destroy the evil odors” (Regimen Sanitatis, iv, 1), a reference to germs. Physical and mental benefits were associated with opening windows, which let in both air and light (Daniel, vi, 10). Maintaining cleanliness, however, was a challenge. A study conducted in 1902 showed that only 8 percent of Russian Jewish families had baths and most did not have hot water. The proliferation of the Jewish tenement population led to the building of private bathhouses, including Russian, Turkish, swimming, vapor, and medicated bathhouses, that were owned by Jews. The immigrants’ general well-being was attributed in part to their regimen of cleanliness and the rules of life as laid down by the Mosaic code. Personal cleanliness has been fundamental to the Jewish faith. Synagogues and schools, while first in importance, were quickly followed by public baths on the list of must-have places. Observing bodily cleanliness was a sacred concept to the Jews.40 He observed that the euphemism for toilet in Hebrew is Bet Kissey (house of stool) and that Kissey Kavod (stool of respect) is the name used for God’s throne, giving testimony to how ingrained is the concept of cleanliness. The Birkhat Asher Yatzar praises “the King of the Universe, who has fashioned in man many orifices and tubes.” The blessing further notes that if “but one of these be opened or stopped, it would be impossible to exist and to stand before thy presence . . . O Lord, who healest all flesh and workest wondrously.” According to the Sanhedrin (Sanhedrin 17b; Kiddushin iv), “No learned man may live in a town in which amongst other things, there are no public baths or 39 Riis, How the Other Half Lives, 113. 40 Etziony, “Medicine in the Hebrew Daily Prayer.”

118 Abi Gezunt

public conveniences” (see also Chapter 1, Halakha). The Sanhedrin makes clear when to wash and what areas of the body to wash (Shabbat 109b). Hands, for example, must be washed both before and after meals (Chulin 106a). The Netillat Yadaim (washing of hands) is recited by children and adults daily: “Blessed art Thou, O Lord, our God, King of the Universe, who has sanctified us by the commandments, and has commanded us concerning the washing of hands.” The handwashing laws were prescribed specifically to prevent deafness, polyps, and injury to the eyes (Eruvin 17b). Dental hygiene was strongly promoted to prevent tooth extraction (an abomination as described in Pessachim 113a), and the use of salt was recommended for rinsing the mouth (Berachot 40a). The Talmud further prescribed regimens and cautions for good health by discouraging overcrowding in the synagogues (four square yards per person was required) and requiring light provided by at least 12 windows in every synagogue (Orach Chayim 90, 4). Food was meant to be eaten slowly (Berachot 54b) and eating too little was better than eating too much (Sabbath 33a, Gittin 70a). Eating a nutritious breakfast was essential (Baba Kama 92b), while drinking mineral water was recommended as a palliative (Abb. D’R. Nathan 35, 5). Exercise and sleep were also considered important. Eight hours of sleep was considered the norm, and the only excuse for getting insufficient sleep was to study (Abboth iii, 4). Jews were encouraged to wait between three and four hours after eating before going to sleep (Maimonides, Hilchot De’oth, iv, 4), and sleeping in a darkened room was considered best, especially for a sick person (Sabbath ii, 5). American novelist William Dean Howells visited the Lower East Side of New York in 1896, where he observed people whom he described as “usually cheerful” and “courageous.” Despite their miserable living conditions, he described how the Jews in the Hebrew quarter “kept themselves noticeably clean in an environment where, I am afraid, their betters would scarcely have had heart to wash their faces and comb their hair.”41 He also noticed a tidiness, although “an insufficiency of dress.” Despite the abject state of affairs in the Ghetto, the disease rates of the Jews remained in many cases lower than that of non-Jews (see also Appendix II). One important explanation lies in their culture of health, taught early and often in the halakha, as previously explained. Although many Jews did not study the 41 Howells, Impressions and Experiences, 139.

Housing and Jobs in the New World—Health Against All Odds 119

Talmud, they certainly rubbed shoulders with those who did and were thus more than likely to have become familiar with the halakha, and were thus influenced by the norms of the faith. Despite their deplorable living conditions, despite an average density of more than 57 tenants to the house, the Seventh and Tenth Wards, consisting largely of Russian and Polish Jews and otherwise known as the Jewish quarter, had the lowest death rates.42 The Jews, ever in support of each other, as witnessed by their willingness to share already miniscule spaces with others, respect for life, and appreciation for what little they had, were kept alive and thriving against all odds. These factors explain in part how, being the poorest in Manhattan and living in overcrowded and unsanitary conditions, the Jews managed to remain the healthiest and longest-lived class of people in the city. Education, particularly female education (as expounded in Chapter 2), also played an important role in the health of the family. THE WORKPLACE—NO RESPITE FROM CONDITIONS AT HOME The relationship between occupational pursuits and health status is particularly germane in the case of the Eastern European Jews who immigrated to the United States, mainly because their pursuits differed greatly from that of all other groups. Liebmann Hersch observed, “It is difficult to imagine an occupational structure more extraordinary and more specialized than that of the Jewish migrants.”43 No other immigrating group provided as high a proportion of skilled laborers as did the Jews, ten times more than the Polish, Russian, and Lithuanian immigrants, and 25 times more than the Rumanian immigrants. A high percentage of Jews found their way to the clothing industry: two of every three Jewish immigrants reported working at a skilled job and two of every three skilled Jewish workers were employed as tailors.44 This outcome could be attributed in part to the rapidly growing clothing industry in the United States and the ease of Jews in learning a new trade. The Jews had initially been resistant to accepting technologically based jobs because of their sense of 42 Schoener, Portal to America. 43 Liebmann Hersch, “International Migration of the Jews,” in International Migrations, Vol. II: Interpretations, ed. W. F. Willcox (Washington, D.C.: National Bureau of Economic Research, 1931), 503. 44 Samuel Joseph, Jewish Immigration to the United States (New York: Longmans, Green & Co., 1914).

120 Abi Gezunt

independence, their desire to preserve their religious observances, and their relatively frail constitutions.45 Between 1880 and 1890, capital investments in factories had risen dramatically.46 By 1920, nearly half of all ready-to-wear clothes made in the United States were made in New York City, where between 85 and 90 percent of workers in the coat, suit, and skirt industry were Jewish.47 Much of American Jewish life is built from the hands of tailors. Tailoring has been referred to as a Jewish national industry. Jews concentrated in specific occupations and, as previously noted, were less likely than other immigrants to take dangerous jobs (Table 4).48 If housing for the Jews was abysmal, it was met in kind by conditions in the workplace. At the turn of the century in the United States, working conditions were indicted as a source of ill health for workers. In 1911, George Price wrote that the work or the nature of the industry itself was not the real danger, but the conditions in which the work was conducted. He described insufficient lighting and fire protection, overcrowding, filth, and the lack of conveniences.49 A contract system known as “sweating” was set up in the clothing industry for the expediency of entrepreneurs. One room would be set up with peddle-powered machines, obviating the expense of electricity. Inexperienced Russian immigrants who barely knew the language usually provided the labor. The effect of this setup was that many experienced tailors lost their jobs to the immigrant workers, who were often forced to work more than 20 hours a day to meet quotas while earning the same wages in 1900 as they would have earned in 1880.50 In addition to putting in more hours for less pay, workers bore the prospect of contracting diseases, many of them fatal. Tailors’ disease (tuberculosis) and scarlet fever posed significant threats to the health of the garment trade 45 Rischin, The Promised City. 46 J. Greenfield, “The Role of the Jews and Development of the Cloaking Industry in the United States,” Yivo Annual of Jewish Social Science 2 (1947): 180–204. 47 First Annual Report of the Joint Board of Sanitary Control in the Cloak and Skirt Industry of NY, October 1911. 48 Reports of the Immigration Commission: US Immigration Commission (1907–1910) (Washington: Government Printing Office, 1911). 49 G. M. Price, “A General Survey of the Sanitary Conditions of the Shops in the Cloak Industry,” First Annual Report of the Joint Board of Sanitary Control in the Cloak, Suit and Skirt Industry of Greater New York (October, 1911, the Joint Board of Sanitary Control), 42. 50 Riis, How the Other Half Lives.

Housing and Jobs in the New World—Health Against All Odds 121

TABLE 4  Occupations and Associated Risks of Jewish Immigrants in the United States, 1899-1910 Occupation

Tailors

Number (percent)

At risk for:

Pulmonary tuberculosis, bursitis (tailor’s 145,272 (36.06) ankle), tailor’s callosities, occupational cramps, phthisis

Carpenters, joiners, cabinetmakers, 40, 901 (10.33) woodworkers

Dermatitis, callosities, occupational cramps, asthma, woodcutters’ disease

Dressmakers and seamstresses

39,482 (9.98)

Occupational cramps

Shoemakers

23,519 (5.94)

Occupational cramps, glanders,a dermatitis

Clerks and accountants

17,066 (4.31)

Dermatitis

Painters and glaziers

16,967 (4.14)

Colic, wrist drop, stippling of the red cells, anaemia, insomnia, mental confusion, delirium, mania, occupation cramps, dermatitis, arsenic poisoning, conjunctivitis

Butchers

11,413 (2.88)

Anthrax, glanders, Weil’s disease, erysipeloid, butcher’s tubercle, dermatitis

Bakers

10,925 (2.76)

Dermatitis, eczema, itch, asthma

Locksmiths

9,385 (2.37)

Occupational cramps

Blacksmiths

8,517 (2.10)

Blacksmith’s deafness

Watch and clockmakers

4,444 (1.12)

Occupational cramps, dermatitis, asthenopia

Tobacco workers

4,350 (1.09)

Pneumonia, asthma, hay fever, urticaria, chronic bronchitis, chronic emphysema, fibroid lung, bronchiectasis, dermatitis

Barbers and hairdressers

4,054 (1.02)

Occupational cramps, dermatitis

Weavers and spinners

3,971 (1.00)

Pulmonary tuberculosis

Tanners and curriers

3,715 (0.93)

Toxic poisoning, irritation of the conjunctiva, nasal mucosa and pharynx, bulbar conjunctivitis, ocular lesions, rhinitis, pharyngitis, bronchitis, pneumonia, dermatitis

Furriers and fur workers

3,144 (0.79)

Pneumonia, pulmonary anthrax (see also tanners and curries) Continued

122 Abi Gezunt

TABLE 4  Occupations and Associated Risks of Jewish Immigrants in the United States, 1899-1910—Continued Occupation

Number (percent)

At risk for:

Bookbinders

3,009 (0.76)

Dermatitis

Masons

2,507 (0.63)

Silicosis, fibrosis, occupational cramps, dermatitis

Plumbers

2,455 (0.62)

Plumbism,b dermatitis, arsine poisoning

Saddlers and harness makers

2,311 (0.58)

Silicosis, fibrosis, occupational cramps, dermatitis

Milliners

2,291 (0.58)

Occupational cramps

Metal workers (other than iron, steel, and tin)

2,231 (0.56)

Plumbism, metal-fume fever, silicosis, tuberculosis, ulceration of the skin, ulceration of the gums, nasal mucosa, larynx, bronchi and conjunctivae, dermatitis

Machinists

1,907 (0.48)

Dermatitis

Jewelers

1,837 (0.46)

Asthenopia, dermatitis, arsine poisoning, conjunctivitis, emphysema, digestive disturbances

Millers

1,390 (0.35)

Mill fever

Mechanics (not specified)

1,203 (0.30)

Accidents, dermatitis

Upholsterers

1,109 (0.28)

Dermatitis

Photographers

1,013 (0.26)

Pronounced irritation of the throat and nasal passages, severe bronchial irritation, asthma

604 (0.15)

Manganese poisoning with strict localization to the extrapyramidal motor system; pneumonia

436 (0.11)

Liver poisoning, multiple neuritis, phosphorous and arsenic poisoning, conjunctivitis, perifocal, emphysema, pulmonary edema, bronchitis, laryngitis

Iron and steel workers Textile workers (not specified) Other

13,938 (3.52)

TOTAL

395,832

Symptoms of glanders included nodular lesions in the lungs and ulceration of mucous membranes. b Lead poisoning Reports of the Immigration Commission. US Immigration Commission (1907-1910), Washington, DC: Government Printing Office, 1911. a

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workers; however, as noted earlier in this chapter, the scourge was not as great among Jews as it was among non-Jews. Tuberculosis among Jews in the garment industry affected three times as many men as women. The higher rate of tuberculosis among males was attributed to the greater number of years they spent in the industry. Deaths attributed to tuberculosis accounted for 58 percent of deaths among tailors aged 15 to 24 years and 49 percent of tailors aged 25 to 44 years.51 Workers often went to work ill or returned to work too soon after hospitalization out of necessity—to get out from behind the ever-mounting bills. Massachusetts laws of 1891, 1894, and 1898 required workers to have a special permit to sew or work on clothes in the privacy of their homes. A Tenement Made label was consequently required on every piece of clothing made in a home. While these regulations served to deter consumers fearful of contracting diseases, they also served to drive many in the industry from Boston to New York. The New York laws required that a label be placed only on garments manufactured in homes that were unsanitary or unlicensed, precipitating an improvement in working conditions. In 1915, Joseph Schereschewsky undertook a comprehensive study relating occupational status and health to the immigrant Jew at the request and cooperation of the Joint Board of Sanitary Control of the Cloak, Suit and Skirt, and Dress and Waist Trades of New York City.52 More than 96 percent of the 3,000 subjects were Jewish; 88 percent of these were Jewish females, largely Russian born. The age and sex of the individuals and the nature of their jobs influenced their disease status. Ninety-eight percent of Schereschewsky’s subjects had at least one disease or defect. Although the most common affliction among garment workers was tuberculosis, the workers were sometimes affected by physical deformities related to the type of work they engaged in, for example, there was a high prevalence of spinal curvatures among garment workers and severely flat feet among pressers. The immigrant Jews passed down their legacy of working hard and doing well. Despite the horrible working conditions they often suffered, immigrant Jews 51 Bulletin of the Joint Board of Sanitary Control of the Cloak, Skirt and Coat Industry 8 (March 15, 1913) [in Yiddish]. 52 J. W. Schereschewsky, “Stress and Strain,” in Out of the Sweatshop: The Struggle for Industrial Democracy, ed. Leon Stein (New York: Quadrangle/New York Times Book Co., Inc., 1977), 186–187.

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grasped the relationship between effort and reward: “It is not how much money we make that ultimately makes us happy between nine and five. It’s whether our work fulfills us.”53 And the Jews found a way to look upon their work as fulfilling. This was achieved by honing their skills and passing this legacy on to their children, who in turn rose to higher steps on the corporate or industrial ladder—from garment worker to department store owner, small grocer to supermarket manager, and so on. In tracing the steps from the Jew’s work ethic to studying longer and harder than other students, Gladwell observed, “People don’t rise from nothing . . . But in fact they are invariably the beneficiaries of hidden advantages and extraordinary opportunities and cultural legacies that allow them to learn and work hard and make sense of the world in ways other cannot.”54 EXPLOITATION OF WORKERS The conditions in the shops affected all workers. Male and female workers alike were poorly treated by management.55 Baum and colleagues noted that the conditions for women in the shops were particularly difficult.56 Despite being cheated, the workers rarely complained, both because they were fearful of losing their jobs and because most did not understand how the amounts were figured. Clocks were slowed down during working hours and speeded up during lunch hours. The workers were sometimes charged for needles and the machine belts they used on the job as well as the cost of electrical power to run machines and irons. According to the International Ladies’ Garment Workers’ Union, owners charged workers 20 percent more than they paid for electricity, and 25 percent more than the price of needles and electric belts. Workers had to rent lockers for their hats and coats—and sometimes even had to rent their chairs. They were fined for lateness and mistakes made on 53 Malcolm Gladwell, Outliers: The Story of Success (New York: Little, Brown and Company, 2008), 652. 54 Ibid., 550. 55 Charlotte Baum, Paula Hyman, and Sonya Michel, The Jewish Woman in America (New York: The Dial Press, 1976). 56 “Girls . . . were timed when they left the room to go to the toilet. And the bosses, assuming the timidity and ignorance of the most newly arrived immigrant girls, often took advantage of them in the most obvious ways: first and foremost, they were paid lower wages than the others, not because they were less skilled, but because they were unaware what other girls were being paid for the same work. Not that they would have demanded more had they known. They were grateful, in most cases, to be earning any money at all” (Ibid., 130).

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a garment sometimes at a cost of 300 to 400 percent more than the cost of the mistake itself. Thus, workers not only contributed to overhead and basic equipment, but they also provided additional profits to the bosses in the form of overcharges.57 Even worse, many women experienced sexual abuse in the shops. Sexual payoffs for the privilege of holding a job were expected and often necessary for advancement within the shop.58 The meager earnings and harshness of the work took their toll, as exemplified in Di Grine Kuzine [The Greenhorn Cousin], a popular song from the Yiddish stage: Once a cousin came to me, Pretty as gold was she, the greenhorn. Her cheeks like red oranges, Her tiny feet begging to dance . . . Since then, many years have passed, My cousin became a wreck From many years of collecting wages, Till nothing of her was left. Underneath her pretty blue eyes, Black lines now are drawn. Her cheeks, once like red oranges. Have now turned entirely green.59

LESSONS FROM THE TRIANGLE FACTORY FIRE No discussion of job-related health conditions can be considered complete without a review of the Triangle Factory fire, which occurred in New York City on Saturday afternoon, March 25, 1911. This example of industrial greed claimed the lives of 146 immigrant workers and caused what has come to be known as post-traumatic stress syndrome, a scourge for survivors. The catastrophe occurred in the context of horrible working conditions, long hours, all forms of 57 Ibid. 58 Ibid.; E. Hasanovitz, One of Them: Chapters from a Passionate Autobiography (New York: Houghton-Mifflin, 1918). 59 Translated from the Yiddish.

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exploitation, probably the least of which were low wages imposed by unscrupulous factory owners. The Triangle Factory fire was but the tip of the iceberg. Needless to say, the conditions throughout the industry were appalling. The owners of the Asch building, Max Blanck and Isaac Harris, where the conflagration occurred, had locked the doors, claiming that workers had stolen material. When the fire broke out, the workers pressed against windows, hoping to be saved by firefighters. Unfortunately, the rescue ladders and hoses were too short to reach them. The horror of this incident was recounted in part from an article by a United Press reporter, William G. Shepherd,60 who described how rather than being burned alive, many chose to jump to the horror of witnesses below.61 Four previous fires had occurred in the same building. This tragedy, while the most grievous, was not the first fire to claim the lives of workers. “Every week,” wrote the union organizer, Rose Schneiderman, “I must learn of the untimely death of one of my sister workers. Every year, thousands of us are maimed. The life of men and women is so cheap and property is so sacred. There are so many of us for one job, it matters little if 14 of us are burned to death.”62 In a memorial service held on April 2, 1911 for those who perished in the Triangle Fire, the noted Rabbi Stephen S. Wise preached that it was the 60 William Gunn Shepherd, “Eyewitness at Triangle,” in Out of the Sweatshop, ed. Leon Stein (New York: NYL Quadrangle/The New York Times Book Co., Inc., 1977), 188–193. 61 “I saw a love affair in the midst of all the horror. A young man helped a girl to the windowsill. Then he held her out, deliberately away from the building and let her drop. He seemed cool and calculating. He held out a second girl the same way and let her drop. Then he held out a third girl, who did not resist. . . . They were as unresisting as if he were helping them onto a streetcar instead of into eternity. Undoubtedly, he saw that a terrible death awaited them in the flames, and his was only a terrible chivalry. Then came the love amid the flames. He brought another girl to the window. Those of us who were looking saw her put her arms about him and kiss him. Then he held her out into space and dropped her. But quick as a flash he was on the windowsill himself. His coat fluttered upward—the air filled his trouser legs. I could see that he wore tan shoes and hose. His hat remained on his head. Thud—dead, thud—dead, thud—together they went into eternity. I saw his face before he covered it. You could see in it that he was a real man. He had done his best” (Shepherd, “Eyewitness at Triangle,” 192). 62 Rose Schneiderman, “We Have Found You Wanting,” in Out of the Sweatshop: The Struggle for Industrial Democracy, ed. Leon Stein (New York: Quadrangle/New York Times Book Co., Inc., 1977), 196.

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“wrong kind of laws and the wrong kind of enforcement,” that resulted in these deaths.63 This monumental exploitation and callous lack of concern for the industrial worker resulted in calls for reform from every sector of American society. Members of the International Ladies’ Garment Workers Union called for an investigation into the environmental conditions of workers, which soon led to the creation of the Factory Investigating Commission. The commission conducted many hearings and made numerous recommendations to the New York state legislature, leading to factory reforms throughout the nation. Meanwhile, the defense lawyer, Max Steuer, hired by Messrs. Blanck and Harris, succeeded in getting his clients acquitted by instilling enough doubt among the jurors that his clients knew about the locked doorways. The owners of the Asch building were ultimately forced to pay $75 to each of the families of the victims. HEALTH EDUCATION FOR WORKERS In 1910, the Joint Board of Sanitary Control prompted a nearly 10-week garment workers strike owing to unsatisfactory sanitary conditions.64 A concerted action was called for on the part of employers, employees, and the state. Although manufacturers knew and cared little about improving the sanitary conditions in the shops, the Joint Board sought to create a more humane working environment in which industrial efficiency and sanitation went hand in hand.65 Their goal was to improve the health conditions of the workers and teach them better personal hygiene. A newly appointed Committee on Sanitary Standards drew up a list of changes to be made, many of which also included safety features, including 63 Stephen S. Wise, “In Letters of Fire,” in Out of the Sweatshop: The Struggle for Industrial Democracy, ed. Leon Stein (New York: Quadrangle/The New York Times Book Co., Inc., 1977), 195–196. Rabbi Wise poignantly noted, “The lesson of the hour is that while property is good, life is better, that while possessions are valuable, life is priceless. The meaning of the hour is that the life of the lowliest worker in the nation is sacred and inviolable, and, if the sacred human right be violated, we shall stand adjudged and condemned before the tribunal of God and of history” (196). 64 Price, “A General Survey of the Sanitary Conditions of the Shops in the Cloak Industry.” 65 Harriet Silverman, and G. M. Bernheim, A Health Education Program for Garment Workers: Report and Recommendations of the Educational Department of the Joint Board of Sanitary Control (April 15, 1920).

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installing fire extinguishers, fire escapes, and sprinkler systems; prohibiting locked doors during working hours; and providing adequate lighting and air space for each worker, as well as functioning toilets.66 The educational activities of the Joint Board included conducting interviews with employers and issuing sanitary certificates, publishing bulletins for employers and workers, providing newspaper and press articles, setting up evening lectures for union locals and at shop meetings, and organizing sanitation committees.67 A significant portion of the publications was printed in English, Italian, and Yiddish. Members of the Committee on Sanitary Standards were required to attend classes after work over a four-week period at the Unity Center of Public School 40 on Tuesday and Saturday afternoons. At these classes, committee members were instructed in the role of the worker in the modern factory, and the means whereby the Joint Board carried out factory inspections. Members were also taught how to instruct workers in preventive health and the use of the first aid kit, as well as the development of labor laws and human relations in industry. Among the documents published by the Joint Board was the Workers’ Health Bulletin, which was available in Yiddish. The Workers’ Health Bulletin begins with the following statement: The shop is the main home of the worker. Here he lives. Here he works. Here he spends two-thirds of his waking hours from childhood to old age. It further stated that it is the worker’s right to demand safe and sanitary shops and the manufacturer’s duty to furnish such shops. The provision of proper lighting, air, ventilation, and sanitation increased not only the happiness of the worker, but also their health. Only five years earlier, in 1915, Schereschewsky reported there being an average of four health problems for each individual from among more than 3,000 workers examined.68 More than six of every ten workers in the clothing industry had defective vision, more than one in four had rhinitis or other diseases of the nose, and more than one in nine had defective hearing. Workers were exhorted to practice preventive health, including increasing 66 Bulletin of the Joint Board of Sanitary Control in the Cloak, Suit and Skirt Industry of Greater New York 2 ( July, 1911). 67 Silverman and Bernheim, A Health Education Program for Garment Workers. 68 Joseph Williams Schereschewsky, Studies in Vocational Diseases: I. The Health of Garment Workers (Washington, D.C.: Public Health Bulletin, U.S. Public Health Service, Government Printing Office, 1915).

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muscular strength, exercising regularly, maintaining a balanced diet, properly chewing food, eating slowly, and keeping their teeth in good condition.69 Issue number 3 of the Workers’ Health Bulletin, printed in 1915, examined the symptoms and proper management of a variety of commonly encountered diseases and disorders, including wound cleansing, constipation, influenza, heart problems, and hernia. A detailed description of tuberculosis was provided including a list of risk factors, methods of prevention and avoidance, and disease management. The contents of a proper first aid kit were described, and the appropriate care of burns, splinters, eye injuries, cuts, and wounds was given. Poor conditions persisted, however, and a 1911 inspection revealed improper lighting, which was implicated in defective sight among 68 percent of male and 75 percent of female workers in the needle industry alone.70 Although water closets were to be supplied in a ratio of one to 25 workers, some shops maintained a ratio of one to 85, with woefully inadequate flushing ability. It would be a decade before “miraculous” improvements were realized— all attributed to the combined efforts of the workers, employers, government officials, and Joint Board. Much of the credit was attributed to health educational activities; the provision of sanitary certificates; publication of bulletins, journals, and leaflets; lectures on health; and conferences with employers and leaders among the workers. THE UNION HEALTH CENTER The crowning glory of the Joint Board was the Union Health Center, located at 131 East 17th Street in New York City. The cost ($100,000) of reconstruction, alterations, and equipment was defrayed by the International Ladies’ Garment Workers’ Union. The Union Health Center was owned, managed, and financed by the 35,000 members of the local unions. The entire 85,000 strong membership of the International Ladies’ Garment Workers’ Union could participate in the services provided by the Center.71 The principle upon which the Center 69 Workers’ Health Bulletin, No. 3 (New York: Joint Board of Sanitary Control in the Cloak, Suit and Skirt and the Dress and Waist Industries, 1915), 14. 70 Price, “A General Survey of the Sanitary Conditions of the Shops in the Cloak Industry.” 71 Ten Years of the Industrial Sanitary Self Control: Tenth Annual Report of the Joint Board of Sanitary Control in the Cloak, Suit and Skirt and Dress and Waist Industries (New York, 1921).

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was based is embodied in a statement by Schereschewsky from a study on vocational diseases among garment workers: “In sanitation and health as well as in economics, the salvation of the workers depends upon the working class itself.”72 The Center emphasized preventive medicine and industrial hygiene by promoting appropriate healthy attitudes both in the home and at the workplace. Periodic health examinations and dental care were provided. Those unable to defray the high fees charged for physical diagnosis at ordinary diagnostic clinics or by high-priced specialists could avail themselves of the services provided by the Diagnostic Clinic. The Life Extension Service of the Union Health Center provided special examinations, such as x-rays and blood and urine analyses. Specialty and surgical clinics arose for gastroenterologic; gynecologic; podiatric; ear, nose, and throat; and nervous disorders. Membership in the International Ladies’ Garment Workers’ Union became contingent upon passing a medical examination performed at the Center. Candidates for membership who tested positive for certain acute infectious diseases were excluded either temporarily or permanently from membership. Those testing positive for active tuberculosis were rejected, while those with fibroid phthisis or chronic tuberculosis were admitted into “nonbenefit” membership. Those with other curable diseases were referred to their family physicians, and once cured, were accepted.73 The Schereschewsky report had found that at least 50 percent of the workers suffered from serious dental problems, while an additional 35 percent experienced dental problems in somewhat milder forms.74 This was not surprising, since only 15 percent of the workers practiced good oral hygiene and were free of dental defects.75 By 1917, the United States Public Health Service, with a dominant role played by Jewish political and labor union leaders and the workers themselves, had finally made dental service available to workers. UPWARD MOBILITY The Eastern European Jewish immigrant had a unique potential for upward mobility because of his occupational and educational status and his 72 Schereschewsky, Studies in Vocational Diseases. 73 Ten Years of the Industrial Sanitary Self Control. 74 Schereschewsky, Studies in Vocational Diseases. 75 Ten Years of the Industrial Sanitary Self Control.

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industriousness. The garment industry proved an excellent venue for accumulating capital, since it offered the possibility of eventually establishing one’s own business.76 By the 1920s, the Jews were leaving manufacturing and mechanical industries and were now increasingly populating the professions, clerical services, and commerce.77 This occupational distribution was a function of the middle-class values carried by the Jews from Eastern Europe. Other immigrants bore the limited horizons of the worker and peasant classes from which they came, whereas the Jewish workers had higher aspirations and were able to improve themselves beyond the reach of their fellow workers. Consequently, the Jews and their friends and relatives enjoyed more successful prospects than did other immigrants. Their successes spurred the Jews to continue working harder than others.78 Passing on the torch to those who would be successful was expected of members of Jewish society. This spirit of ambition was augmented by the nature of the immigrants who, from 1900 on, increasingly consisted of “class-conscious wage earners,” spurred by the desire to achieve more and earn more.79 The burgeoning American economic structure facilitated greatly the rise of the Eastern European immigrant. By 1930, the ratio of gainfully employed male Jews compared with the general population in trade and in the professions was more than two to one. Nearly half of those employed were engaged in service-related fields.80 The Eastern European Jews, having been inclined toward trade and the professions, provided the basis for the economic rise of many of their co-religionists. Between 1870 and 1930, there was an impressive rise in the numbers of Eastern European Jews who were gainfully employed in occupations befitting their education and mindset. From the ninth federal census of 1870 to the fifteenth federal census in 1930, there was a 290 percent increase in the proportion of Jews gainfully employed, a 697 percent increase of Jews in trade and 76 Maldwyn Allen Jones, American Immigration (Chicago: University of Chicago Press, 1992). 77 Niles Carpenter, Immigrants and Their Children: A Study Based on Census Statistics Relative to the Foreign Born and the Native White of Foreign or Mixed Parentage, U.S. Census Monograph, Vol. VII (Washington, D.C.: U.S. Government Printing Office, Department of Commerce, Bureau of the Census, 1927). 78 Nathan Glazer, “Social Characteristics of American Jews, 1654–1954,” The American Jewish Yearbook 56 (1955): 3–41. 79 Jacob Lestchinsky, “The Position of the Jews in the Economic Life of America,” in Jews in a Gentile World, ed. I. Graeber and B. S. Henderson (New York: Macmillan Company, 1942). 80 Ibid.

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transportation, and a 776 percent increase of Jews in the professions. The proportion of dentists had increased by 806 percent, teachers by 738 percent, lawyers by 295 percent, and physicians by 146 percent. A study conducted in 1935 examined the leisure-time activities of ten percent of New York youngsters. Half of the Jewish respondents derived from lower middle class homes, yet more Jews than non-Jews had participated in athletic games, including tennis and golf, and attended concerts and lectures. The Jewish boys from the Brownsville section of Brooklyn later not only rose in the professions, but also found positions as corporate executives, managers, and salesmen. More than 30 percent owned small businesses.81 The Jews of Brownsville had arrived with greater commercial experience, were more politically astute, had more frequently availed themselves of community action and mutual aid, and had a more stable family structure than many non-Jews. Jewish-owned businesses burgeoned in Los Angeles, Chicago, San Francisco, and other major cities in the United States, including Filene’s department store, Abraham and Straus, NeimanMarcus, and Hart, Schaffner, and Marx, to name a few.82 The immigrant Jews and their first-generation descendants wasted little time in reestablishing themselves in the middle class.83 This process was referred to as deproletarianization; although the father might have been a factory worker, the next generation would not be. It was understood that one day, the son would become the cultivated man his father was not destined to have become. This continual raising of status is in keeping with the Eastern European notion of takles, or purposeful existence. Takles has been described as an orientation to ultimate outcomes, rather than immediate benefits: “Our parents’ job was to feed us,” and our responsibility was not to disgrace them, but to accomplish something.84 By the 1930s, when most immigrant children had reached their twenties and were entering the labor market during the nation’s worst economic depression, the Jews had “. . . a most amazing ability to find economic openings, . . . and 81 Gerald Sorin, The Nurturing Neighborhood: The Brownsville Boys’ Club and Jewish Community in Urban America, 1940–1990 (New York: New York University Press, 1992). 82 Ibid.; Mitchell Gelfand, “Progress and Prosperity: Jewish Social Mobility in Los Angeles in the Booming Eighties,” American Jewish History 68 (1979): 408–433. 83 Will Herberg, Protestant, Catholic, Jew: An Essay in American Religious Sociology (New York: Doubleday, 1960). 84 Sorin, The Nurturing Neighborhood.

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[to have] established a community that [as of the mid-1950s] consist[ed] largely of well-to-do professionals, merchants, and white-collar workers.”85 The high concentration of the Jews in trade proved a major asset, since it provided a wide-ranging network of assistance to find other jobs. During the depression, retail positions, which were largely held by Jews, were less likely than heavy manufacturing to be cut. By the 1940s, the economic position of American Jews compared favorably with that of Catholics and Protestants.86 The upward occupational and residential mobility experienced in large urban centers was mirrored in the smaller towns. Throughout the country, increasingly more Jews held professional positions in law, medicine, and dentistry.87 Louis Wirth employed a rabbinic source to the effect that, “The world needs both the seller of spices and the tanner, but happy be he who is a seller of spices.”88 This was borne out not only in the upward occupational mobility, but also the residential mobility of the Jews in large urban centers. The Jews were more likely than any other ethnic group, with the exception of the Irish, to achieve favorable residential status by home ownership in a desirable location.89 The transformation of the Jews was nothing short of remarkable. However desperate their straits, however great their poverty, however meager their pay and hard their work, the Jews managed to instill in the next generation the desire to rise above and leave behind their legacies of misery. In large part, this was achieved through maintaining health. As noted in Chapter 6, alcoholism was rare among Jews and work was the ethic: what you did, you did well. From the youngest to the oldest, the Jews staggered under their loads, rarely engaging in lively conversation with others. The children played few games in the streets, even their clothing was sombre.90 Yet, they seemed to

85 Glazer, “Social Characteristics of American Jews.” 86 Herberg, Protestant, Catholic, Jew. 87 Glazer, “Social Characteristics of American Jews”; William Lloyd Warner and Leo Srole, The Social System of American Ethnic Groups (New Haven: Oxford University Press, 1945); Lewis M. Terman and M. H. Oden, The Gifted Child Grows Up: Twenty-Five Years’ Follow-Up of a Superior Group (Stanford: Stanford University Press, 1947); Samuel Joseph Fauman, “Occupational Selection Among Detroit Jews,” Jewish Social Studies 14 (1952): 17–50. 88 Wirth, The Ghetto, 77. 89 Warner and Srole, The Social System of American Ethnic Groups. 90 Rischin, The Promised City.

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be of a common mind to rise above this current scourge of human suffering and achieve. Crowded conditions at work and home contributed to the contagious spread of disease. This, however, was overcome by the Jews’ concern for health and the care they took to preserve it, a motivation so great that the mortality rate from tuberculosis was lower on the East Side than in any of New York’s other districts. Mothers fought unremittingly for their children and their husbands. Where illness was perceived, they found care. Personal cleanliness was maintained as much as humanly possible (see also discussion on pages 117–118): homes were cleaned at least once a week; food was properly cooked; and meat was kosher. Despite the lack of baths in the home (only eight percent of Russian Jews had baths), the Jews availed themselves of bathhouses at least once per week.91 The mikvah, or ritual bath, had been a public institution for the Jews since Roman times and had once been under rabbinic supervision; however, in New York, the baths fell under the supervision of the city’s Department of Health.92 Finally, the charity of the Jews toward each other, the strength of their family ties, and their indomitable optimism proved to be the most powerful medicine.

91 Rischin, The Promised City. 92 Arthur A. Goren, New York Jews and the Quest for Community: The Kehillah Experiment, 1908–1922 (New York: Columbia University Press, 1970).

IMPLICATIONS

CHAPTER 8

Socioeconomic Status and Health When considering the associations between sex, race, and social roles on the one hand and health and disease on the other, accurate prediction is unlikely to rest upon deductive science and more likely to result from stitching together all that one can know about the context—institutional, cultural, political, epidemiological—in which particular populations live and work. . . . Stephen J. Kunitz, Sex, Race, and Social Role—History and the Social Determinants of Health1

T

hese chapters have been an exercise in social epidemiology, a discipline whose strength resides in trying to bring what is known about populations culturally, epidemiologically, institutionally, and politically and to its power of explanation rather than prediction. Predictive validity is based on the assumption that, “analysts understand more or less intimately the people and places with which they are concerned, and because they can extrapolate sensibly from relevant experiences and groups elsewhere.”2 A significant amount of the data involving the relationship of health and wealth suggests that health flows from wealth. At first blush, this makes sense. After all, the greater the assets people have, the greater their capacity to purchase quality health care, live healthy lifestyles, and fend off the effects of unhealthy environments. Kunitz has brought evidence suggesting that attributes of individuals (wealth and health status) are associated with health and disease and that their significance is shaped by the historical, socio-economic, cultural, and   1 Stephen J. Kunitz, “Sex, Race and Social Role—History and the Social Determinants of Health,” International Journal of Epidemiology 36 (2007): 10.   2 Ibid., 8.

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epidemiologic context. Furthermore, “the association between social stratification and health so widely observed in contemporary studies is very far from being a universal characteristic of the human experience.”3 We, however, posit a view that Jews arrived on these American shores with a rich heritage of concern over the prevention of disease and promotion of health, a predisposition that played a role in their economic and social rise. While social epidemiologists have consistently documented an inverse relationship with health, evidence suggests that a graded association with health status persists at all levels of socioeconomic status. This calls for a reconsideration of the way in which a variety of variables, including health behaviors, psychological characteristics, and social ordering, operate within the socioeconomic framework.4 Scholars who have examined the relationship between ethnic status and economic mobility have attributed this relationship variously to the country of origin, urban status, age on arrival, literacy, occupational distribution, and marital status.5 The role of health status as a commodity in promoting economic mobility has not received due attention. Economists have devoted increasing attention to health status as an economic value. In this view, health serves as an economic commodity with the power to help individuals and groups maintain and enhance their wealth; in other words, good health leads to economic strength and social development. Conversely, poor health compromises a family’s capacity to earn or accumulate assets. In addition to limiting work, poor health is usually attended by increased medical expenses. Economists have long reflected on the economic status of the Jews.6 One theory to emerge from these speculations is that Jews have a predilection for   3 Ibid., 10.   4 Nancy E. Adler, Thomas Boyce, Margaret A. Chesney, et al., “Socioeconomic Status and Health: The Challenge of the Gradient,” American Psychologist 49 (1994): 15–24.   5 Gary Rand Solon, “Intergenerational Income Mobility in the United States,” American Economic Review 82 (1992): 393–408; Jeffrey G. Reitz, The Survival of Ethnic Groups (Toronto: McGraw-Hill Ryerson, 1980); Jeffrey G. Reitz, Sherrilyn M. Sklar, Culture, Race, and the Economic Assimilation of Immigrants, accessed May 26, 2009, http://www.springerlink.com/content/l615567083k05124/.   6 Thorstein Veblen, “Intellectual Pre-Eminence of the Jews in Modern Europe,” Political Science Quarterly 34 (1919): 33–42; Zosa Szajkowski, The Economic Status of the Jews in Alsace, Metz and Lorraine (1648–1789) (New York: Editions Historiques Franco-Juives, 1954); Zosa Szajkowski, Jews and the French Revolutions of 1789, 1830, and 1848 (Hoboken: Ktav Publishing House, 1970); Armen A. Alchian and R. Kessel, “Competition, Monopoly

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investing in human capital rather than physical property because, among other reasons, the former is more transportable, while the latter is more easily confiscated.7 Gary Becker observed that during the “last 150 years Jews have invested more in human capital . . . and in recent decades have had higher incomes [than non-Jews] . . . The high achievement and low fertility of Jewish families are explained by high marginal rates of return to investments in the education, health and other human capital of their children,” an attitude shared by Barry Chiswick.8 The emphasis placed on wealth is no more important than health. We suggest that the enormous value placed by Jews on health, whether in its preventive, therapeutic, or rehabilitative phases, has exerted a positive influence on their success in the United States. It is no accident that the song bearing the words Abi gezunt ken men gliklakh zayn (If you have your health, thank your lucky stars!) became one of the immigrants’ most popular songs. The relatively healthy status of American Jews allowed them to invest in human capital, particularly in education. ECONOMIC STATUS OF AMERICAN JEWS The economic and occupational distribution of American Jews has differed significantly from that of members of other ethnic groups during most of the twentieth century, and the divergences have widened significantly since World War II. An individual’s occupation, education, income, and overall wealth have enormous consequences on both morbidity and mortality. Much of what we know about the economic status of American Jewry during the last five decades can be discerned and the Pursuit of Pecuniary Gain,” Aspects of Labor Economics (Princeton: National Bureau of Economic Research, 1962), 156–218; Salo W. Baron, Arcadius Kahan, and Nachum Gross, Economic History of the Jews (New York: Schocken Books, 1975); George J. Stigler and Gary S. Becker, “De Gustibus Non Est Disputandum,” American Economic Review 67 (1977): 76–90; Howard M. Sachar, The Course of Modern Jewish History (New York: Dell Publishing, 1977); Reuven Brenner and Nicholas M. Kiefer, “The Economics of the Diaspora: Discrimination and Occupational Structure,” Economic Development and Cultural Change 29 (1981): 517–533; Barry R. Chiswick, “The Earnings and Human Capital of American Jews,” Journal of Human Resources 18 (1983): 313–336; B. S. Wenger, New York Jews and the Great Depression: Uncertain Promise (New Haven: Yale University Press, 1996).   7 Brenner and Kiefer, “The Economics of the Diaspora.”   8 Gary S. Becker, A Treatise on the Family (Cambridge, MA: Harvard University Press, 1981), 152; Chiswick, “The Earnings and Human Capital of American Jews.”

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from an analysis of two data sets by Chiswick. The first study involved an analysis of the March 1957 Current Population Survey and included a probability sample of approximately 35,000 households of individuals 14 years of age and older. The second data set was derived from the 1970 Census of Population.9 Both studies compared Jews and non-Jews with respect to education, occupation, and income. The 1957 data reveal that among respondents 25 years of age and older, the Jews had a higher median number of years of schooling (12.3 years) compared with white and non-white Protestants (11.3 years and less than 8 years, respectively) and Roman Catholics (10.4 years).10 Compared with their non-Jewish peers, educational attainment and economic gain was much greater among the Jews, whose median income was 7.7 percent higher than others with 12 years of education and 30.1 percent higher than others with 16 or more years of education. The second data set, involving the 1970 Census of the Population, showed that male Jews (aged 25 to 64 years) had an average of two more years of education compared with non-Jews.11 Of note is the significantly higher rate of income enjoyed by the Jews for every extra year of schooling: Jewish males earned an average of $27,322, whereas non-Jewish males earned only $19,750.12 In 1999, Lehrer analyzed data from the National Survey of Families and Households.13 Once again, Jewish men had a higher average number of years of schooling (17 years), compared with 15 for mainline Protestants, 13 for fundamentalist Protestants, and 14 for Catholics. The same held true for women. Jewish women had an average of 16 years of schooling, compared with 14 years for mainline Protestant and Catholic women and 13 years for fundamentalist Protestant women. The results remained statistically significant for both genders, even after controlling for parental schooling, father’s socioeconomic status, intact status of families of origin, welfare reliance during childhood, number of siblings, mother’s participation in the labor force during preschool and school years, and region of residence at age 16. The disparities are highlighted   9 Chiswick, “The Earnings and Human Capital of American Jews”; Barry R. Chiswick, “Differences in Education and Earnings Across Racial and Ethnic Groups: Tastes, Discrimination, and Investments in Child Quality,” Journal of Quarterly Economics 103 (1988): 571–597. 10 Chiswick, “Differences in Education and Earnings Across Racial and Ethnic Groups.” 11 Wenger, New York Jews and the Great Depression. 12 Barry R. Chiswick, “The Skills and Economic Status of American Jewry: Trends Over the Last Half-Century,” Journal of Labor Economics 11 (1993): 229–242. 13 Evelyn L. Lehrer, “Religion as a Determinant of Marital Fertility,” Journal of Population Economics 9 (1996): 173–196.

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further by the proportional distributions of Jews with 16 or more years of education or more than twice that of any other group. The effect of religious status is significant among Jews of both genders throughout the education course. Once again, Jews enjoyed a significantly higher return of wages per year of schooling compared with non-Jews. Similar outcomes occurred among Canadian Jews. Anthony Richmond and Warren Kalback analyzed data from the 1971 Canadian Census of the employed adult population 15 years or older and found that the higher levels of income among Jews were explained by higher levels of urbanization and education.14 Another examination of the 1971 Canadian Census involved a one percent sample of native-born white males 25 to 64 years of age. Canadian Jewish males devoted 2.6 more years to education and earned an average of 80 percent more than others in the entire sample ($14,000 compared with $7,800). There is little question that the comparatively greater Jewish investment in education was rewarded with greater returns.15 People desire both health and wealth. Insights gained from such research can potentially narrow the chasm between the two. The former declines with age and represents an increasing financial challenge to those born after World War II, who can expect to live 30 years longer than their grandparents. The National Institutes of Health has not been blind to this challenge and is turning increasingly to the sociomedical sciences and health economics to gain a fuller understanding of health behavior. THE ECONOMIC ADVANTAGES OF GOOD HEALTH Sociologists, economists, and epidemiologists have documented a strong inverse relationship between social and economic status, morbidity and mortality, as well as self-reported health status.16 This relationship has also long 14 Anthony Richmond and Warren E. Kalback, Factors in the Adjustment of Immigrants and Their Descendents (Ottawa: Statistics Canada, 1980). 15 N. Tomes, “Religion and the Rate of Return on Human Capital: Evidence From Canada,” Canadian Journal of Economics 16 (1983): 123–138; Ronald Meng and James A. Sentance, “Religion and the Determination of Earnings: Further Results,” Canadian Journal of Economics 17 (1984): 481–488. 16 Harriet O. Duleep, “Measuring Socioeconomic Mortality Differentials over Time,” Demography 26 (1989): 345–351; S. L. Ettner, “New Evidence on the Relationship between Income and Health,” Journal of Health Economics 15 (1996): 67–85; Jonathan S. Feinstein,

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been known to epidemiologists and sociologists working in the field of mental health.17 Among the most influential studies demonstrating an inverse relationship between socioeconomic position and health status are the Whitehall Studies. The first investigation examined 10-year mortality rates from a wide variety of causes among 17,530 British civil servants, who were examined between 1967 and 1969.18 Grade of employment served as the empirical indicator of social position. Subjects in this first study were relatively homogeneous; all resided in the Greater London area, were not subject to industrial hazards, unemployment, or extremes of affluence or poverty. The age-adjusted mortality rates for those 40 to 64 years old was hierarchical. As one traverses the six grade levels in the study, mortality rates were progressively lower, with a three-fold difference between those in the highest positions (administrators) and those in the lowest positions (for example, messenger and doorkeepers) in the hierarchy, that is, those who held the lower grade positions had the highest mortality rates. Although smoking and coronary risk factors were more common in men in the lowest grades, these differences accounted for only some of the difference in mortality. Mohammad Siahpush and colleagues found that socioeconomic differences among male smokers in the Melbourne Collaborative Cohort Study were associated with substantial differences in mortality as well as large variations in smoking duration between racial/ethnic and socioeconomic groups.19 Deriving “The Relationship Between Socioeconomics Status and Health: A Review of the Literature,” Milbank Quarterly 71 (1993): 279–322; G. A. Kaplan and J. E. Keil, “Socioeconomic Factors and Cardiovascular Disease: A Review of the Literature,” Circulation 88 (1993): 1973–1998; P. McDonough, G. Duncan, W. David, et al., “Income Dynamics and Adult Mortality in the United States, 1972 through 1989,” American Journal Public Health 87 (1997): 1476–1483; J. P. Smith, “Healthy Bodies and Thick Wallets: The Dual Relation Between Health and Economic Status,” Journal of Economic Perspectives 13 (1999): 145–166. 17 Brenner and Kiefer, “The Economics of the Diaspora”; E. Silver, E. P. Mulvey, and J. W. Swanson, “Neighborhood Structural Characteristics and Mental Disorder: Faris and Dunham Revisited,” Social Science & Medicine 55 (2002): 1457–1470; A. B. Hollingshead and F. C. Redlich, “Social Class and Mental Illness: A Community Study, 1958,” American Journal of Public Health 97 (2007): 1756–1757. 18 M. G. Marmot, M. J. Shipley, and G. Rose, “Inequalities in Death—Specific Explanations of a General Pattern?” Lancet 1 (1984): 1003–1006. 19 Mohammad Siahpush, Dallas English, and John Powles, “The Contribution of Smoking to Socioeconomic Differentials in Mortality: Results from the Melbourne Collaborative Cohort Study, Australia,” Journal of Epidemiology and Community Health 60 (2006): 1077– 1079; Mohammad Siahpush, A. McNeill, D. Hammond, G. T. Fond, “Socioeconomic and

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from a lower socioeconomic group appeared to be associated with having a lower awareness of the deleterious effects of smoking. Health disparities were further worsened by the longer exposure to tobacco among already disadvantaged groups.20 Higher educational and income levels, however, have been associated with an increased awareness of the connection between smoking and heart disease, stroke, impotence, and lung cancer.21 Data from the second study (Whitehall II) involved a new cohort of 10,314 British civil servants (6,900 men and 3,414 women), aged 35 to 55, whose health profiles were examined 20 years later, where social class differences in mortality from a wide variety of diseases remained the same.22 Controlling for obesity, smoking, less leisure time physical activity, greater baseline illness, hypertension, and height accounted for no more than 40 percent of the grade difference in mortality from coronary heart disease. Economists have long suggested that health is a commodity that can be purchased. They have been busy assigning dollar values to disease and disability both in terms of the cost incurred to the afflicted and their families as well as the potential savings and earnings to those fortunate enough to have better health. Good health allows the possessor to more adequately pursue life’s goals as well as to fulfill its obligations. Poor health compromises the individual’s ability to work and pursue life goals and pleasures and earning capacity, savings, and investments are diminished along with the quality of life. Thus, an unhealthy person becomes a burden to himself and others. Country Variations in Knowledge of Health Risks of Tobacco Smoking and Toxic Constituents of Smoke: Results From the 2002 International Tobacco Control (ITC) Four Country Survey,” Tobacco Control 15 (2006): iii65–iii70. 20 Mohammad Siahpush, G. K. Singh, P. R. Jones, and L. P. Timsina, “Racial/Ethnic and Socioeconomic Variations in Duration of Smoking: Results From 2003, 2006 and 2007 Tobacco Use Supplement of the Current Population Survey,” Journal of Public Health 32 (2009): 210–218. 21 Norman Hymowitz, K. Michael Cummings, Andrew Hyland, et al., “Predictors of Smoking Cessation in a Cohort of Adult Smokers Followed for Five Years,” Tobacco Control 6 (1997): s57–s62; M. J. Jarvis and J. Wardle, “Social Patterning of Individual Health Behaviours: The Case of Cigarette Smoking,” in Social Determinants of Health, ed. M. Marmot and R. G. Wilkinson (Oxford: Oxford University Press, 1999), 224–255; S. Shohaimi, R. Luben, N. Wareham, et al., “Residential Area Deprivation Predicts Smoking Habit Independently of Individual Education Level and Occupational Social Class: A Cross Sectional Study in the Norfolk Cohort of the European Investigation Into Cancer (EPIC—Norfolk),” Journal of Epidemiology and Community Health 57 (2003): 270–276. 22 Michael G. Marmot, G. Davey Smith, S. Stansfield, et al., “Health Inequalities Among British Civil Servants: The Whitehall II Study,” Lancet 337 (1991): 1387–1393.

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Economists view health as a stock whose value is best determined by inputs over a lifespan, including diet and exercise, family educational levels, genetic endowment, and the avoidance of risky behaviors, such as smoking and excessive drinking.23 Economic resources reflect long-term feedback from health to economic status, and the positive economic status conferred by these savings can in turn be employed to purchase better health. Persons in good health can work longer and more effectively, thereby increasing their earnings. J. P. Smith and R. Kington (1997) assessed the role of health in welfare status of Americans aged 70 years and older. Not surprisingly, healthier individuals were more able to work and much less likely to receive welfare.24 HEALTH STATUS AND PORTFOLIO OWNERSHIP Taking risks in the stock market over the last century has generally resulted in huge economic gains for investors compared with investments in less volatile assets. Individuals who perceive themselves in relatively good health are more likely to invest in stocks and mutual funds, while those reporting themselves in a more compromised state of health tend to invest their monies in such instruments as checking and savings accounts, certificates of deposit, and treasury bills, among others.25 Just over one in four healthy single people own some risky assets, compared with only one in 12 of their peers with compromised health status. Among married couples in which both spouses are healthy, almost one in every two dollars is invested in safe assets and almost one in five dollars in risky assets. When both spouses are sick, nearly three in every four dollars are invested in safe assets and only one in fifteen dollars is invested in risky assets. THE COST OF DISEASE In the late 1970s, a group of attorneys sought to establish the economic value of a young nursing student who had been killed in an automobile accident. 23 Michael G. Marmot, F. North, A. Feeney, et al., “Alcohol Consumption and Sickness Absence: From the Whitehall II Study,” Addiction 88 (1993): 369–382; J. P. Smith and R. Kington, “Demographic and Economic Correlates of Health in Old Age,” Demography 34 (1997): 159–170. 24 Smith and Kington, “Demographic and Economic Correlates of Health in Old Age.” 25 H. S. Rosen and S. Wu, “Portfolio Choice and Health Status,” Journal of Financial Economics 72 (2004): 457–484.

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Lawyers for the deceased were interested in assessing the value of “human capital” or an approximation of the loss incurred to the victim and her family based on the value of future lost earnings. This death was to be assigned a dollar amount, a calculation performed daily by people in the insurance industry. This challenge might also be stated by asking how much would have been lost from a pure economic perspective had this young woman not have met with an untimely death but rather severe depression or a degree of paralysis? The economic evaluation of life has a long history as found in a 1908 report by Sedgwick involving the installation of a $7 million water purification system in the city of Pittsburgh. He wrote that “in a year or two this should effect a savings of 100 deaths a year from typhoid fever . . . . Valuing these lives at $5,000 each, as is customary, the savings effected by the purification works should be half a million dollars’ worth of human life annually, making the building of the filter a sound and profitable economic as well as humanitarian measure.”26 Similarly, the value of lives of those killed in the World Trade Towers on 9/11 was assessed by one individual, Kenneth R. Feinberg, who was appointed to apportion compensation to the families of victims. In his book, What is Life Worth?, Mr. Feinberg describes his struggles in working with an unlimited budget to award more than $7 billion to the victims and family members.27 At one point, Mr. Feinberg consulted his rabbi, who cautioned that there are no easy answers. Mr. Feinberg attempted to award the money judiciously and generously, but not profligately. In the final analysis, he determined that should another such attack occur, the government should apportion the same amount of money to everyone, regardless of his or her economic worth. HEALTH AND THE ACCUMULATION OF WEALTH We begin our discussion of the role of health in the accumulation of wealth with an analysis of data performed on Union Army recruits through 1870.28 This study is helpful because it employs data from the third quarter of the nineteenth century 26 61st Congress, 2nd Session, 1909–1910, Senate Documents 59 (Washington, D.C.: U.S. Government Printing Office, 1910), 743. 27 Kenneth R. Feinberg, What is Life Worth? (Cambridge, MA: Perseus Book Group, 2005). 28 C. Lee, “Health and Wealth Accumulation: Evidence From Nineteenth-Century America,” NBER Working Paper 10035, accessed June 20, 2007, http://www.nber/org/papers/w10035.

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just before the mass migrations. The data point to the powerful role of good health in economic mobility and the gains in store for groups arriving with a preventive health orientation. The effect of poor health on wealth accumulation is accentuated by the fact that there was little in the way of effective health and medical care and no health insurance at the time. Recruits were presumably in good health at the time of enlistment, and there was no way to predict untoward illnesses and injuries. The relative young age of the recruits and their presumed positive health status permitted analysis of the long-term effects of illness and injuries. These data permitted controlling for past economic status, which was known to correlate with economic conditions at different points in the life cycle. Data from this study reveal that almost one in three Union soldiers suffered from diarrhea, almost one in five contracted malaria, one in 14 became ill with pneumonia and bronchitis, and about one in 20 was felled by measles and typhoid fever. And who among the Union recruits was more susceptible to morbidity and mortality from disease: native recruits and those with no prior exposure to disease, which might have conferred a degree of immunity. More specifically, the healthier and more isolated former farmers and rural residents were the populations at greatest risk, not foreign immigrants, and not the closeliving urban dwellers and non-farmers. Soldiers deriving from unhealthy environments were better able to fend off the ravages of infectious diseases endemic in the army than were their fellow enlistees from healthier environments. Similarly, the Jews, who worked in the poorly lit, cramped, and unsanitary sweatshops of New York and Chicago and lived in airless and crowded tenements were less susceptible to disease than were other immigrant populations. Diarrhea, and depending on the nature of the estimations employed, other illnesses, including, malaria, rheumatism, typhoid, measles, respiratory infections, tuberculosis, and syphilis (see The Lindex), had a strong negative effect on wealth accumulation. Of particular note for our purposes is the newly found relationship between the risk posed by these diseases and cardiac, respiratory, and musculoskeletal disorders later in life.29 It has further been suggested that childhood health during the late nineteenth and early twentieth centuries played a role in the etiology of subsequent health problems in adulthood.30 29 I. T. Elo and S. H. Preston, “Effects of Early-Life Conditions on Adult Mortality: A Review,” Population Index 58 (1992): 186–212. 30 S. H. Preston, D. Ewbank, and M. Hereward, “Child Mortality Differences by Ethnicity and Race in the United States: 1900–1910,” in After Ellis Island: Newcomers and Natives in the 1910

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In the Health and Retirement Study, involving Americans aged 55 to 65 in 1996, poor childhood health was shown to increase morbidity in later life.31 Among persons aged 55 to 65 in 1996, those reporting a major chronic illness in childhood were significantly more likely to report having a variety of chronic illnesses in adulthood, including cancer, chronic lung conditions, arthritis and rheumatism, and cardiovascular conditions. Child health status was more highly related to adult health outcomes than either adult or childhood socioeconomic status. The only disease unrelated to childhood conditions was diabetes.32 Jewish immigrants were also less likely to succumb to tuberculosis. Despite the high incidence of tuberculosis and subsequent mortality (11 percent) in the United States (it was the second leading cause of death in the country), Jewish immigrants rose above the challenge.33 William H. Guilfoy, Registrar of Records in the New York City Department of Health, provided proof of the health of Jewish immigrants in America, despite their difficult living and working conditions.34 Immigrants born in Russia and Poland were less likely than other immigrants to die from typhoid fever, tuberculosis, bronchopneumonia, lobar pneumonia, and chronic Bright’s disease.35 The low mortality rate of the Jews from tuberculosis was further corroborated by Fishberg, who demonstrated a relationship between social class and tuberculosis rates.36 The rates for tuberculosis among poor immigrant Jews in the 4th, 6th, 8th, and 10th Assembly Districts, ranged from 11.9 to 13.5 per 1,000 of the population. The rate for Jews in the 31st Assembly District in Harlem, however, where Jews were of a much higher social Census, ed. S. C. Watkins (New York: New York Russell Sage Foundation, 1994). 31 D. L. Blackwell, M. D. Hayward, and E. M. Crimmins, “Does Childhood Health Affect Chronic Morbidity in Later Life?” Social Science & Medicine 52 (2001): 1269–1284. 32 Blackwell, Hayward, and Crimmins, “Does Childhood Health Affect Chronic Morbidity in Later Life?” The authors concluded that “childhood health experiences appear to have rather extraordinary long-term consequences that are not ameliorated by adult life circumstances. Second, childhood health experiences appear to be an additional exogenous factor influencing chronic health problems in later life, rather than a major biomedical pathway linking childhood socioeconomic conditions with chronic health problems,” 1280. 33 Elo and Preston, “Effects of Early-Life Conditions on Adult Mortality.” 34 William H. Guilfoy, “Congested Populations,” Journal of the American Medical Association (February 22, 1908): 612. 35 Guilfoy, “Congested Populations,” 612; William H. Guilfoy, The Influence of Nationality Upon the Mortality of a Community, With Special References to the City of New York (New York: City Department of Health, 1917). 36 Maurice Fishberg, “Health and Sanitation of the Immigrant Jewish Population of New York,” Menorah 33 (1902): 73–82.

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class, was only 3.6 per 1,000. The Jews from Russia and Poland, on the other hand, were more likely to die from cancer and heart disease. The Jews were thus less susceptible to the effects of infectious diseases than to chronic diseases. This outcome can be attributed in part to the preoccupation of the Jews with health, the high value they placed on prevention and cleanliness as witnessed in part by their adherence to ritual bathing (see also Chapter 1, Halakha), all despite their meager living conditions and because of their unwillingness to settle for the status quo. The most important outcome from the Jewish attention to the preservation and promotion of health, and the consequent lower percentage of upper respiratory diseases, was their greater health in later years. Respiratory diseases suffered in childhood are likely to result in or be predictors of compromised health in later years. An ounce of prevention was worth its weight in gold, epidemiologically speaking (see also Pulmonary Data, Appendix I). We will not attempt to make a case for the biological difference of the Jews to explain the low morbidity among Jewish infants and subsequent health of Jewish adults, but offer instead a behavioral explanation. Religious rituals, such as handwashing and bathing, as previously mentioned, access to physicians and frequent use of medical care, lows rates of alcoholism, and family planning all contributed to low Jewish infant mortality.37 Despite their poor living conditions and poverty, Jews maintained the upper hand by preventing illness whenever possible. There is much to be said for what has often been described as hypochondriacal behavior. THE ECONOMIC VALUE OF MODIFIABLE PREVENTIVE HEALTH BEHAVIORS The relationship between modifiable health risks38 and morbidity and mortality is well established. A plethora of studies have examined the effects of modifiable risk factors on healthcare costs.39 These and other studies have attested to 37 Usiel Oskar Schmelz, “Infant and Early Childhood Mortality Among the Jews of the Diaspora,” in Jewish Population Studies (Institute of Contemporary Jewry: The Hebrew University of Jerusalem, 1971). 38 Modifiable risk factors include stress level, tobacco use, overweightness and obesity, inactivity, high blood glucose levels, depression, high blood pressure, excessive alcohol use, high cholesterol levels, and poor nutritional habits. 39 S. P. Tsai, E. J. Bernacki, and W. B. Baun, “Injury Prevalence and Associated Costs Among Participants of an Employee Fitness Program,” Preventive Medicine 17 (1988): 475–482; R.

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the reduction in work absenteeism brought about by positive changes in health behaviors.40 Smoking represents the leading cause of avoidable morbidity and death, a leading cause of cancers of the lung, and nearly $100 billion per year in healthcare costs, including lost productivity.41 This modifiable behavior serves to exacerbate L. Bertera, “The Effects of Behavioral Risks of Absenteeism and Health-Care Costs in the Workplace,” Journal of Occupational Medicine 33 (1991): 1119–1124; L. T. Yen, D. W. Edington, and P. Witting, “Associations between Health Risk Appraisal Scores and Employee Medical Claims Costs in a Manufacturing Company,” American Journal of Health Promotion 6 (1991): 46–54; M. R. Manning, C. N. Jackson, and M. R. Fusilier, “Occupational Stress, Social Support, and the Costs of Health Care,” Academy of Management Journal 39 (1996): 738–750; R. Z. Goetzel, D. R. Anderson, R. W. Whitmer, et al., “The Relationship between Modifiable Health Risks and Health Care Expenditures: An Analysis of the Multi-Employer HERO Health Risk and Cost Database,” Journal of Occupational and Environmental Medicine 40 (1998): 843–854; D. W. Edington, L. T. Yen, and P. Witting, “The Financial Impact of Changes in Personal Health Practices,” Journal of Occupational and Environmental Medicine 39 (1997): 1037–1046; W. N. Burton and D. J. Conti, “The Real Measure of Productivity,” Business and Health 17 (1999): 34–36; W. N. Burton, D. J. Conti, C. Y. Chen, et al., “The Role of Health Risk Factors and Disease on Worker Productivity,” Journal of Occupational and Environmental Medicine 41 (1999): 863–877; N. P. Pronk, A. W. Tan, and P. O’Connor, “Obesity, Fitness, Willingness to Communicate and Health Care Costs,” Medicine and Science in Sports and Exercise 31 (1999): 1535–1543; N. P. Pronk, M. J. Goodman, P. J. O’Connor, et al., “Relationship between Modifiable Health Risks and Short-Term Health Care Charges,” Journal of the American Medical Association 282 (1999): 2235–2239; S. H. Jee, M. P. O’Donnell, I. Suh, et al., “The Relationship between Modifiable Health Risks and Future Medical Care Expenditures: The Korea Medical Insurance Corporation (KMIC) Study,” American Journal of Health Promotion 15 (2001): 244–255. 40 Tsai, Bernacki, and Baun, “Injury Prevalence and Associated Costs Among Participants of an Employee Fitness Program”; Bertera, “The Effects of Behavioral Risks of Absenteeism and Health-Care Costs in the Workplace”; Burton et al., “The Role of Health Risk Factors and Disease on Worker Productivity”; Pronk et al., “Obesity, Fitness, Willingness to Communicate and Health Care Costs”; M. Steinhardt, L. Greenhow, and J. Stewart, “The Relationship of Physical Activity and Cardiovascular Fitness to Absenteeism and Medical Care Claims Among Law Enforcement Officers,” American Journal of Health Promotion 5 (1991): 455–460; L. T. Yen, D. W. Edington, and P. Witting, “Prediction of Prospective Medical Claims and Absenteeism Costs of 1284 Hourly Workers From a Manufacturing Company,” Journal of Occupational Medicine 34 (1992): 428–435; B. H. Jacobson, S. G. Aldana, R. Z. Goetzel, et al., “The Relationship Between Perceived Stress and Self-Reported Illness-Related Absenteeism,” American Journal of Health Promotion 11 (1996): 54–61; L. A. Tucker and G. M. Friedman, “Obesity and Absenteeism: An Epidemiologic Study of 10,825 Employed Adults,” American Journal of Health Promotion 12 (1998): 202–207. 41 National Cancer Institute, “Cigarette Smoking and Cancer: Questions and Answers,” accessed June 18, 2009, http://www.cancer.gov/cancertopics/factsheet/tobacco/cancer; American Lung Association, “Quit Smoking,” accessed June 18, 2009, http://www.lungusa. org/site/c.dvLUK9O0E/b.33484/k.438A/Quit_Smoking.htm.

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or lead to many serious conditions, including chronic obstructive lung disease, diabetes, heart disease and hypertension, as well as other disorders/diseases of the gastrointestinal tract. Nicotine found in tobacco affects heart rate, blood pressure, cerebral blood flow, platelet aggregation, and fibrinogen.42 Smoking during pregnancy is associated with low birth weight, pre-term delivery, birth defects, and spontaneous abortions, while sudden infant death syndrome, respiratory distress, ear infections, and asthma have also been linked to exposure to smoke.43 Coronary artery disease is a leading cause of mortality and very costly, estimated at $140 billion per year. Data gathered from the Multiple Risk Factor Intervention Trial (commonly known as MRFIT) of 356,222 individuals revealed a dramatic rise in mortality from just over 4 per 1,000 to 16 per 1,000 among individuals with serum cholesterol levels of 300 or greater.44 The incidence and economic cost of this disease are modifiable with appropriately trained physicians and motivated patients. This was demonstrated in a pioneer population-based study conducted in Alberta, Canada and reported in 2003. Prescriptions of beta-blockers and ACE inhibitors (used in monotherapy or in combination) within 3 months after hospitalization clearly decreased mortality (risk reduction, 13.3 percent) in newly diagnosed congestive heart failure in older patients with diastolic dysfunction.45 WORK PRODUCTIVITY The estimated number of work-impairment days in the United States has been calculated at 2.5 billion among persons between the ages of 25 and 54.46 Specific 42 N. L. Benowitz and S. G. Gourlay, “Cardiovascular Toxicity of Nicotine: Implications for Nicotine Replacement Therapy,” Journal of the American College of Cardiology 29 (1997): 1422–1431. 43 Healthy People 2010, “Maternal, Infant, and Child Health: Centers for Disease Control and Prevention,” accessed July 18, 2009, http://www.healthypeople.gov/document/HTML/ Volume2/16MICH.htm. 44 J. Stamler, D. Wentworth, and J. D. Neaton, “Is the Relationship Between Serum Cholesterol and Risk of Premature Death From Coronary Heart Disease Continuous and Graded? Findings in 356,222 Primary Screened of the Multiple Risk Factor Intervention Trial (MRFIT),” Journal of the American Medical Association 256 (1986): 2823–2828. 45 D. Johnson, Y. Jin, H. Quan, et al., “Beta-Blockers and Angiotensin-Converting Enzyme Inhibitor/Receptor Blockers Prescriptions after Hospital Discharge for Heart Failure are Associated with Decreased Mortality in Alberta, Canada,” Journal of the American College of Cardiology 42 (2003): 1438–1445. 46 R. C. Kessler, P. E. Greenberg, K. D. Mickelson, et al., “The Effects of Chronic Medical Conditions on Work Loss and Work Cutback,” Journal of Occupational and Environmental Medicine 43 (2001): 218–225.

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diseases known to affect work loss and work cutback days include arthritis, asthma, high blood pressure, ulcers, cancer, and heart disease as well as the psychiatric disorders of mood, panic, and generalized anxiety. Daniel Conti and Wayne Burton examined the economic impact of depression in the workplace. Depressive disorders, defined as a “spectrum of mood disorders that range in severity from major depression and bipolar illness on the ‘highest severity’ end to adjustment disorder (brief depressive reaction) on the ‘low severity’ end,” exceeded low back pain, heart disease, other mental disorders, high blood pressure, and diabetes mellitus in the number of disability days engendered.47 In the Medical Outcomes Study, Wells and colleagues found that only current advanced coronary artery disease had an impact on physical and role performance on a scale comparable to depression.48 Recent decades have witnessed a plethora of comprehensive worksite health promotion and disease management programs designed to manage risk particularly among high-risk employees, harness telemedicine delivery technologies, and extend these interventions to family members and dependents, the poor, and retirees. Reviews of the efficacy of such programs suggest they are increasingly clinically effective as well as cost effective.49

47 Daniel J. Conti and Wayne N. Burton, “The Economic Impact of Depression in a Workplace,” Journal of Occupation Medicine 36 (1994): 983–988. 48 K. B. Wells, A. Stewart, R. D. Hays, et al., “The Functioning and Well-Being of Depressed Patients. Results From the Medical Outcomes Study,” Journal of the American Medical Association 262 (1989): 914–919. 49 K. R. Pelletier, “A Review and Analysis of the Clinical and Cost-Effectiveness Studies of Comprehensive Health Promotion and Disease Management Programs at the Worksite: 1995–1998 Update (IV),” American Journal of Health Promotions 13 (1999): 333–345.

IMPLICATIONS

CHAPTER 9

Health, Culture, and Wealth To him that is joined to all the living, there is hope. Ecclesiastes 9:4

W

e have attempted to link two well-documented factors in American Jewish history: a profound belief in the value of health among the immigrants and their descendants and their remarkable economic and social rise. In other words, the basic values of a group help shape the social and economic success of its members. While the immigrants arrived with a history of relative good health and in search of economic success, they were also armed with a cultural repertoire and the social capital that enabled them to sustain a level of health that served their socioeconomic interests. It has long been a staple of historians to attribute migration to America and elsewhere to the harsh treatment of Eastern European Jews at the hands of their respective oppressive regimes. More recently, scholars have been placing far more weight on the economic pull of Western countries.1 Convincing econometric data reveal that Russian Jews were economic migrants, not political refugees.2   1 David Cesarani, “The Myth of Origins: Ethnic Memory and the Experience of Emigration,” in Patterns of Migration, 1850–1914, ed. A. Newman and S. W. Massil (London: Jewish Historical Society of England, 1996), 247–254; John Doyle Klier, Pogroms: Anti-Jewish Violence and Modern Russian History (New York: New York University Press, 1992); Todd M. Endelman, The Jews of Britain, 1656 to 2000 (Berkeley: University of California Press, 2002).   2 Andrew Godley, Jewish Immigrant Entrepreneurship in New York and London, 1880–1914 (New York: Palgrave, 2001).

Health, Culture, and Wealth

HEALTH BEHAVIORS AND LIFESTYLE Social and behavioral sciences in the last half-century have identified many factors associated with health and mortality, such as education, occupation, place of residence, family size and cohesion, and birth interval. Behaviors, such as inappropriate diet, alcohol and drug abuse, and poor hygiene, among many others, conduce to poor health. The importance of cultural values in health maintenance, both for the individual and the group, is now well accepted.3 Cultures vary significantly in terms of their orientations toward the maintenance of health and management of disease. Not all traditional values, however, are health friendly. In some cultures, illness is thought of as a punishment for sins. Physicians in some states are required to take courses to improve their ability to deal with the cultural differences of their patients and thus take into account the effect of differing traditional values in their prescription of treatments. While the relationship between health and wealth has long been a staple in the literature, sociologists and economists have increasingly been uncovering evidence for the relationship of good health as a source of human capital, which has an economic value worthy of investment. Attention devoted to health care and disease prevention, as well as to their respective associated factors, opens the door to economic success. Good health is recognized as an economic driver with the potential for increasing productivity, efficiency, and planning not only for the current population but also for future generations.4 The impact of disease and ill health is increasingly costly, and ever more attention is devoted to attaching a dollar value to healthcare interventions. The cost of a healthcare intervention can be compared with the calculated cost of quality years of life added: a quality year can easily be valued in excess of $100,000.

  3 Hope Landrine and E. A. Klonoff, “Cultural and Health-Related Schemas: A Review and Proposal for Interdisciplinary Integration,” Health Psychology 11 (1992): 267–276.   4 David M. Mirvis, Cyril F. Chang, and Arthur G. Cosby, “Health as an Economic Engine: How Better Health Leads to Economic Development,” Business Perspectives (1/1/2002), accessed November 28, 2009, http://www.entrepreneur.com/tradejournals/article/96810448_2.html.

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RELIGION, ETHNICITY, AND HEALTH Data from a carefully designed investigation of religious behavior and health by Jeffrey Levin and Harold Vanderpool5 suggest that although studies have pointed to a relationship between religious attendance and better health, a “definitive” role for this form of behavior could not be sustained when subjected to a variety of scientific demands, including epistemological, study design and measurements of religious attendance. The doyen of health among the Jews at the turn of the twentieth century, Abraham Fishberg, demonstrated that the health of the Jews in Eastern Europe had more to do with their social and economic conditions than with their religious rituals.6 Fishberg was quick to point out a similar relationship held for Orthodox immigrants on the East Side of New York who had a proportionately higher rate of morbidity and mortality from tuberculosis than their co-religionists in Harlem, who were more prosperous, more likely to discard many of their religious practices, and would even consume non-Kosher meat. We recognize also that not all Jewish traditions were healthy. Some traditional Jewish foods are clearly cardiac unfriendly. Moreover, Jewish worries about the dangers of inadequate nutrition may in some cases have led to childhood obesity and its adverse effects on a healthy life. Nonetheless, we contend that the overall effect of Jewish traditional values led to a deeply rooted striving for health. Although many Jewish immigrants were not observant Jews, the traditional values that permeated the Jewish ghettos in Europe and in the United States established a mindset of concern for health that persists to this very day. Nevertheless, many of the traditional attitudes toward health and disease served Eastern European immigrant Jews well. By fostering health-related behaviors and lifestyles, which included strong social support and a high value placed on education plus other mediating factors, such as comparatively smaller families and stronger family ties, effective use of contraception, breastfeeding, and lower levels of alcohol and drug abuse, there was a decreased risk of disease and enhanced well-being. The rules and regulations emanating from traditional   5 Jeffrey S. Levin and Harold Y. Vanderpool, “Is Frequent Religious Attendance Really Conducive to Better Health? Toward an Epidemiology of Religion,” Social Science & Medicine 24 (1987): 589–600.   6 Fishberg, The Jews: A Study of Race and Environment.

Health, Culture, and Wealth

values nurtured a spirit of temperance and cleanliness, which proved important weapons against alcoholism and infections that destroyed so many newcomers to the United States. Compliance with medical care, altering health risk behaviors, seeking help, and adapting to stress also conduce to a stable family structure.7 Employing data from the National Health Interview Survey, David Cutler and Adriana Lleras-Muney noted that higher levels of education decreased the probability of dying within five years of the interview.8 Four additional years of education were found to lower mortality by 1.8 percentage points. Educational status was also inversely related to self-report of a past diagnosis of an acute or chronic disease, mortality from the most common acute and chronic diseases, and anxiety and depression. More specifically, the risk of heart disease is reduced by 2.2 percentage points, and the risk of diabetes is reduced by 1.3 percentage points. Respondents with four or more years of education were less likely to report being in fair or poor health by six percentage points (mean, 12 percent). Finally, the better educated were less likely to smoke or to drink excessively. More educated individuals were less likely to report being overweight and obese and less likely to use illegal drugs. These findings hold for both men and women with few exceptions. Education not only increases earnings and provides jobs with health and retirement benefits, but it also provides individuals with the ability to purchase better quality foods, live and work in healthier environments, take longer vacations, devote more time to exercise, follow instructions and discourse with healthcare practitioners, and consult with equally educated peers and other sources about health and the risks and benefits of therapeutic regimens. THE AGING AMERICAN AND THE AGING AMERICAN JEW The cardinal value of life and the lengths to which Jewish tradition instructs its adherents have been outlined. The picture that emerges is of more than casual   7 D. H. Olson and K. L. Stewart, “Family Systems and Health Behaviors,” in New Directions in Health Psychology Assessment, ed. H. E. Schroeder (New York: Hemisphere Publishing Corp., 1991), 27–94.   8 David M. Cutler and Adriana Lleras-Muney, Education and Health: Policy Brief Number 9, March 2007 (National Poverty Center, Gerald R. Ford School of Public Policy: University of Michigan, 2007), accessed June 30, 2009, www.npc.umich.edu.

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interest. American Jews seem to have taken to heart the Yiddish aphorism, “Beser a lebedicke hunt vie a toiter leib,” a very rough translation of Ecclesiastes 9:4: “To him that is joined to all the living, there is hope: for a living dog is better than a dead lion.” The culture of health harbored by both the Jewish immigrant and his co-religionists coupled with steep declines in fertility played significant roles in an aging population. This is worth noting especially because America has probably been home to the oldest of the old and may have experienced the lowest death rate in the world.9 An American infant born during the height of the mass immigration at the turn of the twentieth century was fortunate to live to the age of 50; his great-grandchild, by way of contrast, born in 2005 could expect to live to the age of 77.8.10 The American Jewish population has aged even more remarkably during the last century and continues to do so. Two population surveys, each with a comparative design performed more than 30 years apart, reflect the fruits of the health culture we have been discussing. The first is the well-respected Providence study11 based on data from 1962 to1964, and the other is the 20002001 National Jewish Population Survey.12 Compared with the total white population, the Jews of Providence had a more favorable experience in all age groups until the very oldest.13 The average life expectancy favored American Jewish men in every age category, with 43 percent remaining alive till the age of 75 compared with 39 percent of their white gender peers, after which the pattern reversed itself. Jewish females also experienced favorable survival patterns throughout most age categories and until the age of 65 compared with their white gender peers (82 versus 80 percent). Ethnic groups fortunate enough to experience enhanced longevity are capable of greater economic   9 K. G. Manton and J. W. Vaupel, “Survival After the Age of 80 in the United States, Sweden, France, England, and Japan,” New England Journal of Medicine 333 (1995): 1232–1235. 10 Hsiang-Chin Kung, Donna L. Hoyert, Jiaquan Xu, and Sherry L. Murphy, “Deaths: Final Data for 2005,” National Vital Statistics Reports 56 (Washington, D.C.: Centers for Disease Control, April 24, 2008), accessed February 24, 2016, www.cdc.gov/nchs/data/nvsr56/ nvsr56_10.pdf. 11 S. Goldstein and C. Goldscheider, Jewish Americans: Three Generations in a Jewish Community; Englewood Cliffs (Upper Saddle River: Prentice-Hall, 1968). 12 National Jewish Population Survey 2000–2001: Strength, Challenge and Diversity in the American Jewish Population. United Jewish Communities ( January 2004), Jewish Virtual Library, accessed December 19, 2009, http://www.jewishvirtuallibrary.org/jsource/US-Israel/ ujcpop.html. 13 Goldstein and Goldscheider, Jewish Americans.

Health, Culture, and Wealth

productivity, less social dependence on others, and the ability to transmit vital elements of their culture. The longevity of the Jews has been attributed to their having spread widely over the earth in the last 2,000 years, being exposed physically and mentally to diverse and often adverse conditions, climates, and circumstances.14 On average, Jewish males could expect to live 3.3 years longer than males in the total white population. The favorable life expectancy of the Jewish male persisted through age 65 and diminished with advancing years. Jewish females, on the other hand, began with a slightly lower life expectancy than the total white female population, a pattern that persisted throughout life. Proportionately more Jews survived to older ages than did other white Americans, resulting from low Jewish mortality in childhood, adolescence, and middle age. Lower death rates at young ages were attributed to the attention placed on personal care, cleanliness, and healthy environmental conditions propounded by Judaism. This was seen as a result of the higher than average socioeconomic status of the Jews, which emerged from their educational status and chosen occupations. The demographic scene has altered significantly during the last quarter of the twentieth century. Between 1990 and 2000, the median age of American Jews rose a full six years more than that of the U.S. population as whole.15 In the year 2000, 23 percent of American Jews were younger than age 19, compared with 28 percent of the U.S. population. At the other end of the age spectrum, 23 percent of American Jews were 60 years of age and older, compared with only 16 percent of the total U.S. population. The social and health implications are challenging and worth some discussion. Life extension has brought about what demographers refer to as the third and fourth ages. Whereas throughout most of history, people would work almost until death, the twentieth century has witnessed the emergence of a third age, or a period in which the working person is permitted to enjoy the benefits from earnings and derive support from social security and health insurance. The demographic changes in this country, in particular among American Jews, have created a novel “fourth age,” a stage in life requiring rethinking almost every aspect of life, from the biological to the philosophical, in large measure 14 James et al., The Immigrant Jew in America. 15 National Jewish Population Survey 2000–2001.

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because of the attendant significant declines in health and increasing disabilities among the very aged.16 Graziella Caselli and Alan Lopez (1996) describe longevity as the outcome of a series of positive choices, while avoiding risk factors that could have hastened death.17 It would appear that American Jews have avoided risks that would otherwise compromise their survival. They have instead made life choices conducive to good health and long life. American Jews must now confront the consequences, which include but are not limited to having an increasing proportion of the population experience poor health. In other words, the mean health level of American Jews will continue to decline on an ever-steeper plane. The implications of this cannot be overstated, as they point to an increasingly larger dependent population, requiring more health care as well as social and economic support. How they and members of other ethnic groups who are generating relatively aged populations find ways to manage this new social phenomenon has important heuristic value. This will require a great deal of imaginative social engineering. Families will be increasingly challenged by the number of generations coexisting at one time (children, grand­children, great-grandchildren, parents, grandparents, and great-grandparents). Six coexisting generations today are not uncommon.18 Multi­generational families can be visualized as columns bulging in the middle: very few children at the bottom, some great-grandparents at the top, and many parents and grandparents in the middle. The increasing fragmentation of the multigenerational family involving separation, divorce, and remarriage leads to even more extended and fewer direct relationships. As of 2001, fertility, especially among the Jews, was below replacement levels.19 The rising numbers of American Jews above the age of 65 who do not have grandchildren, while difficult to ascertain numerically, gives rise to a diminishing reciprocal economic and cultural relationship. The American 16 P. Laslett, A Fresh Map of Life: The Emergence of the Third Age (London: Weidenfeld and Nicolson, 1989). 17 Graziella Caselli and Alan D. Lopez, “Health and Mortality Among the Elderly: Issues for Assessment,” in Health and Mortality Among Elderly Populations (Glouchestershire: Clarendon Press, 1996): 3–20. 18 Antonio Golini and Raffaella Iaccoucci, “Demographic Trends and Relationships Between Generations,” in Demography, ed. G. Caselli, J. Vallin, and G. J. Wunsch (Amsterdam: Elsevier, 2006), 305–325. 19 National Jewish Population Survey 2000–2001.

Health, Culture, and Wealth

Jewish family is already being stretched to its limits in this regard, and the point may be reached in the not too distant future when dependency on the family in old age in any meaningful sense may simply be out of the question. Compounding the demographic changes are social, matrimonial, territorial, and professional forms of mobility serving to further distance family members from one another.20 The health implications should be apparent to our readers. Donald Louria argued several critical questions regarding our aging population: will many very old people outlive their financial resources? What will happen to healthcare costs and the quality of life of those with extraordinary longevity? What impact will depression have on old and very old people? Will people usually retire at about age seventy or, with extended life spans, will they be expected to work until age eighty or ninety? How will they cope with time spent in retirement?21 Louria observed that the only way to address these issues would be to operate “full speed ahead with the basic science, but [use] great caution with regard to human application” to delay the consequences of the aging process and extend life.22 The social consequences of aging are far too important to be left to scientists and their financial backers, the pharmaceutical industry, and now the government. AN EPIDEMIOLOGIC PARADOX Our discussion has been confined largely to the period of immigration from 1880 through the outbreak of the Second World War. Since that time, America has continued to admit many people of diverse backgrounds to its teeming shores. During the last several decades, the United States has witnessed a significant increase in the numbers of immigrants from Asia and Mexico. In 1998, one in three immigrants derived from Asia and one in five from Mexico.23 By July 1, 2009, minorities in America accounted for 49 percent of births, and ethnic birthrates have been increasing in every state. According to the USA Today Diversity Index, whose data are derived from the Census Bureau, a 20 Golini and Iaccoucci, “Demographic Trends and Relationships Between Generations.” 21 Donald B. Louria, ReThink: A Twenty-First Century Approach to Preventing Societal Catastrophies (Boston: LouWat Publishing, 2010). 22 Ibid., 76. 23 U.S. Immigration and Naturalization Service, Statistical Yearbook of the Immigration and Naturalization Service (Washington, D.C.: U.S. Government Printing Office, 1998).

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considerable amount of the diversity in this country can be attributed to the influx of young Hispanics, whose fertility far exceeds that of non-Hispanic whites.24 Minorities comprise 48 percent of children younger than age five and 20 percent of persons 65 years of age or older. Consequently, this has fueled a heated debate over immigrants and how best to address and distribute health care to the nation. Our experience in assembling materials for this volume supports Louria’s thinking: “Every problem, every issue, every thing in this world is a system of actions, opinions, events and parts that have converged to create something larger than themselves.”25 We have focused on one ethnic group whose deep concern about health goes back many centuries, a matter very much embedded in its religious tradition. In the process, we have employed the rudiments of systems thinking by assembling some of the known factors conducive to health and elaborated on how they are valued by this group, including fundamental health-related ethos, attitudes toward education, family dynamics, occupational distributions, and health-promoting behaviors as well as those deleterious to health. These relationships must be considered for every immigrant group as they manifest themselves both in this country and in their countries of origin. Comparing morbidity and mortality without paying attention to the cultural context of the respective groups markedly reduces its heuristic value. Until such time as we replace our linear thinking with a systems approach to health care, as well as to the plethora of social problems facing the nation, we will continue to expend time, effort, and treasure; cause pain and suffering; and seriously threaten future generations. The health status of each group varies greatly. Asian Americans have experienced better health, lower mortality, and longer life expectancy than all other ethnic/racial groups, including white Americans.26 Among Hispanic subpopulations, Puerto Ricans have the highest age-adjusted mortality rates.27 Like the more recent immigrants from Asia and Mexico, American Jewish immigrants a century ago were healthier than most other groups upon their 24 H. E. Nasser and P. Overberg, “Diversity Grows as Majority Dwindles: Minorities Make up Almost Half of Births,” USA Today ( June 11, 2010): 1. 25 Louria, ReThink: A Twenty-First Century Approach to Preventing Societal Catastrophies, 1. 26 Richard G. Rogers, Robert A. Hummer, and Charles B. Nam, Living and Dying in the USA: Behavioral, Health and Social Differentials of Adult Mortality (San Diego: Academic Press, 2000). 27 I. Rosenwaike, “Mortality Differentials among Persons Born in Cuba, Mexico, and Puerto Rico Residing in the United States, 1979–1981,” American Journal of Public Health 77 (1987): 603–606.

Health, Culture, and Wealth

arrival. The Eastern European Jews came to these shores with a culture of health, having placed a high value on behaviors associated with good health and having occupational skills that placed them in industries which, while far from optimal from the standpoint of health, were nevertheless not as menacing to health as those in which some of their fellow immigrants found themselves. Although the incidence of smoking was reportedly high among American Jewish immigrants, we have seen evidence that this practice has decreased, particularly among males. The point is that American Jewish immigrants arrived at these shores in a relatively healthy state and harbored values conducive to maintaining that favorable status. Unfortunately, a similar health history does not appear to hold true for some of the most recent immigrants.28 The relative health advantages initially enjoyed by Mexican immigrants have diminished over time as a result of their acculturation to the United States.29 American-born Mexican women residing in the United States for more than five years are more likely to deliver preterm and low-birthweight infants than their ethnic peers resident in this country for less than five years. American-born Mexican women are also more likely to have higher parity, more complications associated with pregnancy, fewer planned pregnancies, and are more likely to smoke. Social conditions over time appear to diminish the health of Mexican children, who were otherwise born without serious medical problems.30 One of these health complications is obesity: children born of immigrant parents in the United States are more likely to become obese than their peers born outside the United States.31 We hope that some of the information found on the previous pages will foster ideas among interested parties and health planners to ensure positive 28 Anjum Hajat, Jacqueline B. Lucas, and Raynard Kington, Health Outcomes among Hispanic Subgroups: United States, 1992–1995, Advance Data from Vital and Health Statistics, No. 310 (Hyattsville: National Center for Health Statistics, 2000). 29 Sylvia Guendelman and Paul B. English, “Effect of United States Residence on Birth Outcomes among Mexican Immigrants: An Exploratory Study,” American Journal of Epidemiology 142 (1995): S30–S38; R. S. Scribner, “Paradox as Paradigm: The Health Outcomes of Mexican Americans,” American Journal of Public Health 86 (1996): 303–304. 30 Sylvia Guendelman, Paul B. English, and G. Chavez, “Infants of Mexican Immigrants: Health Status of an Emerging Population,” Medical Care 33 (1995): 41–52. 31 Barry M. Popkin and J. Richard Udry, “Adolescent Obesity Increases Significantly in Second and Third Generation U.S. Immigrants: The National Longitudinal Study of Adolescent Health,” Journal of Health and Social Behavior 128 (1998): 701–706.

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health trajectories across all populations. Overwhelming evidence suggests that health disparities are attributable to factors associated with socioeconomic status, including occupation, employment, education, and living conditions.32 Other contributors to health disparities between ethnic groups include varying levels of knowledge about diseases and their associated risk factors, lifestyle and coping behaviors, and access to health care.33 Most public health problems are rooted at psychological and sociological levels. Lack of understanding the variables associated with approaches to the etiology and management of diseases denies policymakers the wherewithal to shape effective programs. In these days of severe cost containment, the ability to focus on health problems efficiently is a sine qua non. A considerable amount of research on the relationship of race/ethnicity and health confirms that health status closely correlates with the characteristics of a person’s race or ethnic group, independent of modifiable risk factors.34 Measurement indicators and improved data sources as well as increasing attention to social environmental conditions are required to disentangle the relationship between ethnicity, social environment, health, and disease. The social and behavioral sciences have taught us much about the experience of disease. Medical school curricula are increasingly turning their attention to the psychosocial and behavioral dimensions associated with disease, and practicing physicians are far more likely to pay more attention to “where the patient is coming from.” Patients are no longer viewed solely as biological entities consisting of interrelated tissues and organs that have gone awry and are in need of repair. Patient characteristics, including educational status, ethnic background, and occupation, are more likely than ever to be considered in the process of diagnosing and treating disease. We now understand more than ever how powerful a role they play in symptom recognition and the meaning attached to them. In addition, we have a much better understanding of how these issues dictate the timing and nature of seeking help and compliance with prescribed regimens, leading to the ultimate healthcare outcomes. Engel 32 Jacob Jay Lindenthal and Mareleyn Schneider, Health Concerns of Hispanics in New York City (Lewiston: Edwin Mellen Press, 1991); M. Lillie-Blanton and T. Laveist, “Race/Ethnicity, the Social Environment, and Health,” Social Science & Medicine 43 (1996): 83–91. 33 J. Flaskerud and S. Kim, “Health Problems of Asian and Latino Immigrants,” Nursing Clinics of North America 34 (1999): 359–380. 34 Lillie-Blanton and Laveist, “Race/Ethnicity, the Social Environment, and Health.”

Health, Culture, and Wealth

observed that the biomedical model is insufficient and overlooks important behavioral, cultural, and psychosocial data.35 THE FUTURE We offer the preceding chapters as case studies of the values confined to one ethnic group in one historical period as a rudimentary beginning to decrease the darkness in this area. For our part, we have painted a scenario of a period in American history regarding American Jews with a very broad brush. Recent years have witnessed important advances in socioeconomic and demographic research, made possible by large-scale surveys, refined analytical techniques, and powerful computers. Future students are encouraged to pursue the question of the relationship between health and economic status observed during the first half of the twentieth century and to undertake prospective comparative studies linking patterns of morbidity, mortality, and economic development with appropriate adjustments for the variables discussed in the text. Our efforts should be considered a first small step in this direction. Well nigh a century ago, the Tenement House Department of the City of New York published a pamphlet entitled, For You, It is Hard to Get Money. It is Harder to Spend it Right. Health is Wealth. This booklet was designed to encourage healthy behaviors by emphasizing the cost of ill health.36 It begins with a series of questions: Do you want to get sick? Do you want to lose a day’s pay? Do you want to risk losing your job? Do you want to pay doctors’ and undertakers’ bills, or do you want to keep well? Do you know that the working people of America lose $772,892,860 a year because of sickness?37

Among the suggestions for better health were fresh air and light, frequent baths, pure water, open windows, clean water closets, sinks, toilets, halls, and yards, 35 George L. Engel, “The Need for a New Medical Model: A Challenge for Biomedicine,” Science 196 (1977): 129–136. 36 The Tenement House Department of the City of New York, For You, It is Hard to Get Money. It is Harder to Spend it Right. Health is Wealth, 3rd ed. (New York: 1917). 37 The Tenement House Department of the City of New York, For You, It is Hard to Get Money. It is Harder to Spend it Right. Health is Wealth, 3.

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and the removal of garbage. Readers were encouraged to eradicate flies and mosquitoes, both vectors for disease; to keep their children away from matches to prevent household fires and to throw away lighted cigarettes or cigars; to avoid using gasoline or benzene to clean clothes near an open flame; to avoid spitting in hallways; and to avoid leaving rubbish or trash in hallways. We have come a long way in our understanding of culture, health, and wealth since these admonitions were written, and yet they remain relevant. Higher incomes allow better nutrition and access to sanitation and quality healthcare services and, therefore, improved health. But the construct for success might also be explained by the reverse: good health leads to greater wealth. David Bloom and David Canning came to this conclusion and offered the following mechanisms for the health/income correlation: (1) healthier populations are more productive, suffering fewer lost work days from illness or the need to care for other family members; (2) health enhances cognitive function and being healthy strengthens the incentive to invest in education and the development of useful skills; (3) longevity creates a greater need for people to save for their retirement; and (4) the decline in mortality among infants and children leads eventually to an increase in the proportion of the working population, declines in fertility, and dramatic increases in per capita income.38 Increasing methodologic rigor is crucial when examining health and ethnicity, including the need to specify in great detail attitudes and behaviors that impinge directly on health status.39 Some would believe that increased income results in improved health; however, that appears to be a greatly truncated version of the truth. As health is an instrument for sustaining economic growth and progress, poor health is a fundamental cause of low income. Bloom and Canning have deduced that “increased health is another form of human capital . . . long life expectancy may be the fundamental force that creates the demand for education and encourages the domestic saving that is a key determinant of economic growth . . . the evidence for viewing health as one of the

38 David E. Bloom and David Canning, “The Health and Wealth of Nations,” Science 287 (2000): 1207–1209. 39 David R. Williams, Risa Lavizzo-Mourey, and Rueben C. Warren, “The Concept of Race and Health Status in America,” Public Health Reports 109 (1994): 26–41.

Health, Culture, and Wealth

more effective arrows in the development quiver is surely growing stronger.”40 Improvements in health and income are thus “mutually reinforcing.” Central to our discussion has been the value of health, at least as experienced by one immigrant group, and a suggestion that it played an important role in promoting the economic interests of its members. Inculcating both the centrality of health and the responsibility of everyone in its pursuit transcends all of the remedies proposed by our leaders. This will require, instead, instilling the principles of disease prevention and health promotion along with the ability to read and write, the opportunity for which has been given to and viewed by many of the subjects of this discourse throughout the millennia. Every work, whether a creative work of art, a scientific experiment, or an historical review, affords a learning experience for both the author and his audience. In this work, we have focused on two major facets of American Jewish life—their strongly held views about health and their rapid economic rise— and have attempted to suggest how they might be related to one another. Most of our discussion is limited to the immigrant period, particularly the first third of the twentieth century. We suggest that the value of health and its associated variables were particularly potent in catapulting the Jews during this critical period. Although there is anecdotal evidence that Old World health practices extended into the second generation among non-Jews,41 when they and their peers incorporated those variables among their own, differences narrowed appreciably. We remind our readers respectfully once again that the relationships are only hypothetical. A more definitive hypothesis would involve precise epidemiologic data, including base rates. These rates can only be calculated when the precise number of individuals in each group to be compared is known. We would have felt more secure with better confirmatory data involving the identification of Jews, and their numbers in comparative prospectively designed studies. Most of the health data at our disposal involve small-scale investigations, some better than others, as in the case of some cancer mortality studies (see The Lindex). At our disposal, nonetheless, is a cornucopia of anecdotal and historical data supporting an exceptional concern among Jews not 40 Bloom and Canning, “The Health and Wealth of Nations,” 1209. 41 Goldstein et al., “Child Health-Care Practices among Italians and Jews in the United States, 1910–1940.”

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only for health, but also many values and behaviors associated with health. We believe that the health experiences of American Jews from immigration to the current time are intertwined and deserve to be entered into any equation that seeks to address their historical significance. We hope to have begun narrowing the gap between the two and inspired others to proceed with this line of thinking.

Appendix I

WOODBURY DATA ON NEONATAL AND INFANT MORTALITY The most reliable data involving infant mortality and ethnicity are derived from analysis of the 1910 United States Census of the Population, published by Robert Morse Woodbury (1925).1 The data are particularly instructive because for the first time the mother tongue of foreign-born respondents—as in this case, Yiddish—was gathered. Other studies relied on the probability that identifying Russia as the country of origin was sufficient to equate the respondent with Judaism. More than half of the Jews who migrated to the United States arrived at these shores by the end of the first decade of the last century; however, the Woodbury data provided the important empirical evidence of the health status of the American Jew at the mid-point of migration. With only one exception of mortality from epidemic diseases, Jewish infants were far less likely to expire from “All causes,” as well as from “Other causes,” and from each of the other classification of diseases. That one exception was the infant mortality rate for epidemic diseases (3.9 and 4.9 for Portuguese and Jewish infants, respectively) (Table 5). Infants of foreign-born mothers (Table 5) experienced significantly higher death rates from “all causes” (127.0) compared white babies born to American-born mothers (93.8). Infants born to Jewish mothers had significantly lower death rates (53.5) than any other group. There was a remarkably lower rate of respiratory diseases—a particularly significant issue—among   1 Robert Morse Woodbury, Causal Factors in Infant Mortality: A Statistical Study Based on Eight American Cities (Washington, D.C.: U.S. Government Printing Office, 1925).

12,102

9,408

1,426

1,233

1,074

776

1,266

669

2,962

Native

All foreign born

Italian

Jewish

French-Canadian

German

Polish

Portuguese

Other

1,457

225

–

384

134

199

80

184

66

148

1,195

1,135

2,330

2,555

Infant deaths

Woodbury, Causal Factors in Infant Mortality, 1925.

Colored

3

21,150

White

Not reported

22,967

Live births

Total

Color and nationality of mother

154.4

–

129.6

200.3

157.2

103.1

171.3

53.3

103.8

127.0

93.8

108.3

111.2

All causes

28.1

–

38.5

101.6

64.0

27.1

64.2

10.5

21.7

42.2

25.2

32.6

32.4

44.6

–

20.6

50.8

33.2

18.0

25.1

8.9

27.3

24.2

13.0

17.9

19.6

Gastric and Respiratory intestinal disease disease

52.5

–

35.8

20.9

38.7

30.9

44.7

22.7

33.7

33.7

36.1

35.1

36.1

Early infancy

17.2

–

8.1

14.9

3.9

11.6

6.5

4.9

7.7

7.7

5.4

6.4

7.1

Epidemic disease

Infant mortality rates from specified causes

TABLE 5  Infant mortality rates by cause of death and color and nationality of mother; live births in eight cities

12.4

–

26.7

12.0

17.4

15.5

30.7

6.5

13.3

19.2

14.1

16.4

16.1

Other causes

166 Appendix I

Appendix I 167

TABLE 6  Neonatal mortality rates, by color and nationality of mother; live births in eight cities Color and nationality of mother

Live births

Deaths T mutation of the Fanconi anemia gene Fac in the Ashkenazi Jewish population.

282.9

1793

1793

552.9

HERNIA (INTESTINAL OBSTRUCTION) [HERNIA OF UNSPECIFIED SITE, WITH OBSTRUCTION] 1928 Bureau of Je

84

JCSNY

1

22

44

Cross Sectional

Causes of death among Jews.

552.9

2155

2155

Lower

553.9

HERNIA [HERNIA OF UNSPECIFIED SITE] 1905 Bernheimer

44

BOOK2 1

328

Cross Sectional

The Russian Jew in the United States: studies of social conditions in New York, Philadelphia and Chicago with a description of rural settlements.

553.9

1330

1956 Liberson DM 300

1330 JSS

Higher 18

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

553.9 1912 Price GM 409

0705

0705 ACP

No Difference 1

205

268

Cross Sectional

Report on bakeries and bakers in New York City. In: preliminary report of the factory investigating commission, volume 1, Albany, New York. 174

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

553.9

1352

1352

Lower

1915 Schereschew

71

PHB

481

13

Prevalence 103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

553.9

0967

0967

HEROIN USE [OPIOID TYPE DEPENDENCE] 1905 Bernheimer

BOOK2 1

44

304.0

328

Cross Sectional

The Russian Jew in the United States: studies of social conditions in New York, Philadelphia and Chicago with a description of rural settlements.

304.0

1334

1972 Lavenhar MA

1334 Wolfson EA

286

Lower

PCSDS 1

33

53

Cross Sectional

Survey of drug abuse in six New Jersey high schools: II. Characteristics of drug users and nonusers.

304.0

1944

1944

1973 Levy L

No Difference 2

DF

298

2

141

171

Cross Sectional

Drug use on campus: prevalence and social characteristics of collegiate drug users on campuses of the University of Illinois.

304.0

0421

1989 Monteiro MG 350

0421 Schuckit MA

2596444

No Difference

AJDAA

15

4

403

412

Cross Sectional

Alcohol, drug, and mental health problems among Jewish and Christian men at a university.

304.0

1103

1972 Pearlman SP 392

1103 Philip AF

PCSDS 1

139

185

Cross Sectional

Religious affiliations and patterns of drug usage in an urban university population. In: Einstein S, Allen S, eds. Proceedings of the First Int Conference on Student Drug Surveys, Sept. 12-15, 1972, Newark, NJ. Farmingdale, NY: Baywood Publishing Co.

304.0

1165

1952 Wikler A

1165

Higher 26

PQ

575

270

293

Case Study

A psychodynamic study of a patient during experimental self-regulated re-addiction to morphine.

304.0

0858

0858

175

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

2001 Vex SL 1107

Blume SB 11760928

Vol/Iss

Journal

Pages

Findings: Total 20

JAD

4

71

Prevalence 89

Case Study

The JACS study I: characteristics of a population of chemically dependent Jewish men and women.

304.0

0449

***0449

HERPES SIMPLEX WITHOUT MENTION OF COMPLICATION 1902 Fischkin EA

JAMA

158

39

8

427

054.9 432

Cross Sectional

Six years in a dermatologic clinic: a report of service, with remarks on the treatment of the more common skin diseases.

054.9

1211

1211

Lower

201.9

HODGKIN'S DISEASE 1981 Gutensohn N

216

Cole P

6255329

NEJM

304

3

135

140

689

695

Cross Sectional

Childhood social environment Hodgkin's disease.

201.9

2166

1982 Gutensohn N 217

7074638

2166

Higher 66

CTR

4

Cross Sectional

Social class age at diagnosis of Hodgkin's disease: new epidemiological evidence for the "twodisease hypothesis."

201.9

2167

1971 Haenszel W 220

5144588

2167

Higher 7

IJMS

12

1437

1450

Cross Sectional

Cancer mortality among U.S. Jews.

201.9

0266

1960 MacMahon B 315

0266

No Difference 16

AUIC

1716

1724

Cross Sectional

The ethnic distribution of cancer mortality in New York City, 1955.

201.9

0574

1957 MacMahon B 316

0574

Sig Higher 10

CAN

5

1045

1054

405

417

Cross Sectional

Epidemiological evidence on the nature of Hodgkin's disease.

201.9

2168

1961 Newill VA

2168

Higher 26

JNCI

375

2

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

201.9

0682

0682

176

Higher

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

201.9

1301

1301

Higher

1971 Seidman H 493

4

ER

5173551

390

Prevalence 429

Cross Sectional

Cancer mortality in New York City for country-of-birth, religious, socioeconomic groups.

201.9

1502

1502

1970 Seidman H 494

Higher 3

ER

4919127

234

250

Cross Sectional

Cancer death rates by site sex for religious socioeconomic groups in New York City.

201.9

1672

1976 Cho SY 673

1672 Sastre M

1246982

Higher

AJCP

65

103

108

610

613

376

378

1179

1183

Case Study

Coexistence of Hodgkin's disease and Gaucher's disease.

201.9

1750

1980 Bruckstein A 674

1750 Karanas A

7369236

N/A 68

AJM Case Study

Gaucher's disease associated with Hodgkin's disease.

201.9

1748

1974 Sharer LR 675

1748

N/A

Barondess JA APATH 4418365

98

Case Study

Association of Hodgkin disease Gaucher disease.

201.9

1746

1996 Tonin P 857

***1746 Weber B

8898735

N/A 2

NM

11

Case study

Frequency of recurrent BRCA1 BRCA2 mutations in Ashkenazi Jewish breast cancer families.

201.9

2237

1998 Woodage T 870

2237 King SM

9731533

20

NG

1

62

65

Case study

The APC I1307K allele and cancer risk in a community-based study of Ashkenazi Jews.

201.9

2203

1997 Struewing JP 935

2203 Hartge P

9145676

NEJM

336

20

1401

1408

Case study

The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Jews.

201.9

2271

2271

1999 Breast Canc 1137

10433620

91

JNCI Cohort

Cancer risks in BRCA2 mutation carriers.

201.9

0933

***0933

177

5

1310

1316

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

E960-E969

HOMICIDE AND INJURY PURPOSELY INFLICTED BY OTHER PERSONS 1956 Liberson DM

18

JSS

300

Prevalence

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

E960-E969

1082

1082

Lower

333.4

HUNTINGTON'S CHOREA 1930 Malzberg B

14

MH

324

926

946

Cross Sectional

The prevalence of mental disease among Jews.

333.4

0589

0589

1931 Malzberg B

No Difference 15

MH

325

766

774

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

333.4

0580

0580

1919 New York St

Lower

NYSHC -

640

-

322

409

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

333.4

1706

1706

Higher

630

HYDATIDIFORM MOLE 1968 Yen S

597

Macmahon B AJOG

4296366

101

1

126

132

Cross Sectional

Epidemiologic features of trophoblastic disease.

630

1183

1183

Sig Higher

741.0

HYDROCEPHALUS WITH SPINA BIFIDA 1953 MacMahon B

Pugh TF

318

BJPSM

7

211

219

Cross Sectional

Anencephalus, spinal bifida, hydrocephalus: incidence related to sex, race, season of birth, incidence in siblings.

741.0

1517

1517

Sig Lower

272.0

HYPERCHOLESTEROLEMIA [PURE HYPERCHOLESTEROLEMIA] 1952 Adlersberg D

7

Schaefer LE

JLCM

39

237

Cross Sectional

The incidence of hereditary hypercholesteremia.

272.0

0074

0074

178

Higher

245

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1962 Brinn LB

Pages

Findings: Total 2

HH

76

Vol/Iss

Journal

Prevalence

261

275

408

424

Review

Jews, genetics and disease.

272.0

0781

0781

1966 McKusick VA 337

ALJMS

5978172

3

4

Review

Clinical genetics at a population level: the ethnicity of disease in the United States.

272.0

1421

1953 Schaefer LE

1421

Higher

Drachman SR AHJ

476

46

99

116

Cross Sectional

Genetic studies of hypercholesteremia: frequency in a hospital population and in families of hypercholesteremic index patients.

272.0

0073

2001 Barzilai N 1055

0073 Gabriely I

Higher

JAGS

49

1

76

79

5

1172

1188

11207846

Offspring of centenarians have a favorable lipid profile.

272.0

0071

2001 Durst R 1153

***0071 Colombo R

11309683

AJHG

68

Case Study

Recent origin and spread of a common Lithuanian mutation, G197del LDLR, causing familial hypercholesterolemia: positive selection is not always necessary to account for disease incidence among Ashkenazi Jews.

272.0

1808

***1808

251.1

HYPERINSULINISM 1995 Glaser B

751

Chiu KC

7633448

4

HMG

5

879

886

Case study

Recombinant mapping of the familial hyperinsulinism gene to an 0.8 cM region on chromosome 11p15.1 and demonstration of a founder effect in Ashkenazi Jews.

251.1

1553

1994 Glaser B 752

1553 Chiu KC

7920639

7

NG

2

185

188

Case study

Familial hyperinsulinism maps to chromosome 11p14-15.1 30 cm centrometric to the insulin gene.

251.1

1554

1996 Nestorowicz 863

1554 Wilson BA

8923011

5

HMG

11

1813

1822

Case study

Mutations in the sulfonylurea receptor gene are associated with familial hyperinsulinism in Ashkenazi Jews.

251.1

1887

1887 179

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

Prevalence

600 24

JSS

198

Pages

Findings: Total

HYPERPLASIA OF PROSTATE 1962 Gorwitz K

Vol/Iss

Journal

248

254

83

117

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957.

600

0472

0472

1956 Liberson DM

Higher 18

JSS

300

Cross Sectional

Causes of death among Jews in New York City in 1953.

600

0762

0762

No Difference

HYPERTENSION [MALIGNANT] 1956 Liberson DM

JSS

300

401.0 18

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

401.0

0752

1968 Thomas CB 1309

0752 Ross DC

No Difference

JHMJ

123

6

283

296

5704485

Precursors of hypertension and coronary disease among healthy medical students: discriminant function analysis. V. Family attitudes.

401.0

2130

***2130

HYPERTENSIVE HEART AND RENAL DISEASE, 404.9 UNSPECIFIED 1956 Liberson DM

18

JSS

300

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

404.9

0760

0760

Higher

HYPERTENSIVE HEART DISEASE 1968 Thomas CB

1309

Ross DC

JHMJ

123

402 6

283

296

5704485

Precursors of hypertension and coronary disease among healthy medical students: discriminant function analysis. V. Family attitudes.

402

2134

***2134

HYPERTENSIVE RENAL DISEASE, UNSPECIFIED 1916 Dublin LI

6

AER

128

403.9 3

523

548

Cross Sectional

Factors in American mortality: a study of death rates in the race stocks of New York State, 1910.

403.9

0564

0564

180

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

Prevalence

HYPERTROPHY OF BREAST [GYNECOMASTIA] 611.1 1963 Schottenfeld

Lilienfeld AM

485

AJPH

53

6

890

897

Cross Sectional

Some observations on the epidemiology of breast cancer among males.

611.1

0625

0625

790.6

HYPERURICEMIA 1966 McKusick VA

337

ALJMS

5978172

3

4

408

424

Review

Clinical genetics at a population level: the ethnicity of disease in the United States.

790.6

1424

1424

298.8

HYSTERICAL PSYCHOSIS [OTHER AND UNSPECIFIED REACTIVE PSYCHOSIS] 1914 de Leon D

Karpas Morris MR

74

86

576

579

705

707

Case Study

Insanity among Jews.

298.8

1240

1996 Trappler B 744

1240 Friedman S

8615419

153

AJP

5

Case study

Posttraumatic stress disorder in survivors of the Brooklyn Bridge shooting.

298.8

1545

1545

IDIOCY [PROFOUND MENTAL RETARDATION] 318.2 1929 Sachs B

ARNP

457

21

2

247

253

Review

Amaurotic family idiocy and general lipoid degeneration.

318.2

1446

1446

IDIOPATHIC PROCTOCOLITIS [ULCERATIVE COLITIS] 1960 Acheson ED

1

GUT

4

291

556 293

Cross Sectional

The distribution of ulcerative colitis regional enteritis in United States veterans with particular reference to the Jewish religion.

556

1074

1963 Acheson ED 5

1074 Nefzger MD

44

G

1

7

19

Cross Sectional

Ulcerative colitis in the United States Army in 1944, epidemiology: comparisons between patients and controls.

556

0189

0189

181

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1988 Ament ME 12

Berquist W 3050919

Vol/Iss

Journal

Pages

Findings: Total 15

PED

Prevalence

45

57

277

282

Review

Advances in ulcerative colitis.

556

0842

1972 Franklin JL 169

0842 Kirsner JB

4148337

141

IMJ

3

Review

Ulcerative colitis selected clinical, diagnostic and therapeutic aspects.

556

0185

1963 Kirsner JB

0185 Spencer JA

271

59

ANIM

2

133

144

Cross Sectional

Family occurrences of ulcerative colitis, regional enteritis, and ileocolltis.

556

0194

0194

1966 McKusick VA 337

Higher

ALJMS

5978172

3

4

408

424

Review

Clinical genetics at a population level: the ethnicity of disease in the United States.

556

1425

1966 Mendeloff AI 340

1425 Monk M

5923198

51

G

5

748

756

Cross Sectional

Some epidemiological features of ulcerative colitis and regional enteritis: a preliminary report.

556

0190

1967 Monk M

0190 Mendeloff AI

348

Higher 53

G

2

198

210

Cross Sectional

An epidemiological study of ulcerative colitis regional enteritis among adults in Baltimore: I. Hospital incidence prevalence, 1960 to 1963.

556

0191

1970 Monk M 349

0191 Mendeloff AI

5437450

Higher 22

JCD

565

578

Case Study

An epidemiological study of ulcerative colitis regional enteritis among adults in Baltimore: III. Psychological and possible stress-precipitating factors.

556

0192

1971 Sanders MG 465

0192 Schimmel EM AJG

5134880

56

526

534

413

420

Cross Sectional

Inflammatory colitis in a veterans hospital: I. Ulcerative colitis.

556

0186

1962 Sherlock P 498

0186 Bell BM

Higher 45

PG Case Study

Familial occurrence of regional enteritis and ulcerative colitis.

556

2063

2063

182

3

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1971 Singer HC 510

Pages

Findings: Total

Anderson JG G 5114635

Vol/Iss

Journal

61

4

Prevalence

423

430

25

38

Cross Sectional

Familial aspects of inflammatory bowel disease.

556

2061

1950 Sloan Jr WP

2061 Bargen JA

514

Higher 16

G

1

Cross Sectional

Life histories of patients with chronic ulcerative colitis: a review of 2,000 cases.

556

0187

1965 Thayer WR

0187 Bove JR

541

Higher

G

48

3

326

330

26

3

347

450

406

418

Case Study

Blood groups and ulcerative colitis.

556

1503

1954 Van Patter W

1503 Bargen JA

552

G

Cross Sectional

Regional enteritis.

556

0183

1960 Weiner HA

0183 Lewis CM

566

Higher

AJDD

5

5

Cross Sectional

Some notes on the epidemiology of nonspecific ulcerative colitis. An apparent increase in the incidence in Jews.

556

0188

1996 Ohmen JD 965

0188 Yang H-Y

Higher 5

HMG

10

1679

1683

8894707

Susceptibility locus for inflammatory bowel disease on chromosome 16 has a role in Crohn's disease, but not in ulcerative colitis.

556

2291

1993 Yang H 973

Mclree C 8491401

34

GUT

517

524

Cross sectional

Familial empirical risks for inflammatory bowel disease: differences between Jews non-Jews.

556

2299

2299

Higher

333.6

IDIOPATHIC TORSION DYSTONIA 1988 Bressman S

71

de Leon D

3400502

50

AN Case Study

Inheritance of idiopathic torsion dystonia among Ashkenazi Jews.

333.6

1055

1055

183

45

56

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1989 Bressman S 72

Vol/Iss

Journal

de Leon D

2817837

Pages

Findings: Total 26

ANN

5

612

Prevalence 620

Case Study

Idiopathic dystonia among Ashkenazi Jews: evidence for autosomal dominant inheritance.

333.6

1054

1988 Brin MF 75

1054 Moskowitz C

2899950

50

AN

215

222

Case Study

Dystonia clinical research center tissue resource facility: investigations on collected tissue.

333.6

1385

1385

1962 Brinn LB

2

HH

76

261

275

Review

Jews, genetics and disease.

333.6

0699

1989 Burke RE

0699 Brin MF

85

39

N

1

188

Cross Sectional

Comparison of the clinical course of the Jewish and non-Jewish, juvenile-onset, familial torsion dystonias.

333.6

1321

1976 Cooper IS 109

1321 Cullinan T

941769

14

AN

157

169

1108

1124

1

78

Cross Sectional

The natural history of dystonia.

333.6

0152

1933 Davison C

0152 Goodhart SP

121

Higher 29

ANP

Case Study

Dystonia musculorum deformans: a clinicopathologic study.

333.6

0910

0910

1970 Eldridge R 136

20

N 5529476

2

Cross Sectional

The torsion dystonias: literature review and genetic and clinical studies.

333.6

0151

0151

782202

Review

1976 Eldridge R 137

14

AN

105

114

Edward Flatau, Wladyslaw Sterling, torsion spasm in Jewish children, the early history of human genetics.

333.6

0153

1971 Eldridge R 138

0153 Edgar A

5173357

7

NS

1

Cross Sectional

Genetics, geography and intelligence in the torsion dystonias.

333.6

2500

2500

184

167

177

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1969 Eldridge R 139

Riklan M 5394403

Vol/Iss

Journal

Pages

Findings: Total

JAMA

210

4

705

Prevalence 708

Cross Sectional

The limited role of psychotherapy in torsion dystonia: experience with 44 cases.

333.6

0018

1939 Hassin GB

0018 Poncher HG

224

AJDC

57

105

115

Case Study

Dystonia musculorum deformans: clinicopathologic report of a case.

333.6

1382

1990 Kramer PL 281

1382 de Leon D

2317008

27

ANN

2

114

120

Case Study

Dystonia gene in Ashkenazi Jewish population is located on chromosome 9q32-34.

333.6

1181

1991 Kwiatkowski 282

1181 Ozlius L

1867195

AJHG

49

366

371

Case Study

Torsion dystonia genes in two populations confined to a small region on chromosome 9q32-34.

333.6

1906

1906

1967 McKusick VA 338

20

JCD

6021517

115

118

779

783

1427

1434

1626

1628

Review

The ethnic distribution of disease in the United States.

333.6

1442

1987 Menkes JH 341

1442 Wetterberg L N

3574676

37

5

Case Study

Catecholaminergic activity in idiopathic torsion dystonia.

333.6

0010

1989 Ozelius L 383

0010 Kramer PL

2576373

2

NE Case Study

Human gene for torsion dystonia located on chromosone 9q32-q34.

333.6

1908

1990 Park DH 386

1908 Kang UJ

2215959

40

N

10

Cross Sectional

Dopamine beta hydroxylase activity in cerebrospinal fluid of idiopathic torsion dystonia.

333.6

1453

1960 Ribera AB

1453 Cooper IS

427

No Difference 77

AP

55

Case Study

The natural history of dystonia musculorum deformans: a clinical study.

333.6

1316

1316 185

71

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1990 Risch NJ 432

Pages

Findings: Total

Bressman SB AJHG 2309703

Vol/Iss

Journal

46

3

533

Prevalence 538

Case Study

Segregation analysis of idiopathic torsion dystonia in Ashkenazi Jews suggests autosomal dominant inheritance.

333.6

1179

1988 Ruberg M 451

1179 Villageois A

3400494

50

AN

2

211

213

Case Study

Acetylcholinesterase and butyrylcholinesterase in cerebrospinal fluid from patients with dystonia.

333.6

0405

1991 Schuback D 487

0405 Kramer P

1677923

87

HG

3

311

316

Case Study

Dopamine beta-hydroxylase gene excluded in four subtypes of hereditary dystonia.

333.6

1973

1973 Wooten GF 583

1973 Eldridge R

4682668

NEJM

288

6

284

287

Case Study

Elevated plasma dopamine-beta-hydroxylase activity in autosomal dominant torsion dystonia.

333.6

0004

1967 Zeman W 602

0004 Dyken P

6050693

70

PNN

77

121

Cross Sectional

Dystonia musculorum deformans: clinical, genetic pathoanatomical studies.

333.6

1383

1991 Kwiatkowski 615

1383 Nygaard TG

1985454

AJHG

48

1

121

128

Case Study

Identification of a highly polymorphic microsatellite VNTR within the argininosuccinate synthetase locus: exclusion of the dystonia gene on 9q32-34 as the cause of dopa-responsive dystonia in a large kindred.

333.6

1602

1994 Bressman S 649

1602 Heiman GA

8309575

44

N

283

287

Case Study

A study of idiopathic torsion dystonia in a non-Jewish family: evidence for genetic heterogeneity.

333.6

1644

1994 Bressman S 683

1644 Hunt AL

7845403

9

MD

6

626

Case Study

Exclusion of the DYT1 locus in a non-Jewish family with early-onset dystonia.

333.6

1778

186

632

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1995 Risch N 688

de Leon De 7719342

Vol/Iss

Journal

Pages

Findings: Total 9

NG

152

Prevalence 159

Case Study

Genetic analysis of idiopathic torsion dystonia in Ashkenazi Jews their recent descent from a small founder population.

333.6

1779

1992 Ozelius L 693

***1779 Kramer PL

1347197

AJHG

50

619

628

Case Study

Strong allelic association between the torsion dystonia gene (DYT1) and loci on chromosome 9q34 in Ashkenazi Jews.

333.6

1782

***1782

1986 Fahn S 699

9

CNP 7607910

S37

S48

2

103

106

10

2

143

152

20

2

107

113

Case Study

Generalized dystonia: concept and treatment.

333.6

1792

1792

1970 Mandell S 702

20

N 5529471

Case Study

The treatment of dystonia with L-dopa and haloperidol.

333.6

1798

1995 Greene P 712

***1798 Kang UJ

7753056

MD Case Study

Spread of symptoms in idiopathic torsion dystonia.

333.6

1124

1970 Barrett RE 773

***1124 Yahe MD

5529472

N Case study

Torsion dystonia and spasmodic torticollis-results of treatment with L-dopa.

333.6

1794

1994 Bressman S 795

1794 de Leon D

7979224

36

AN

5

771

777

Cross sectional

Dystonia in Ashkenazi Jews: clinical characterization of a founder mutation.

333.6

1744

1744

1970 Coleman M 802

20

N

5529473

2

114

121

303

305

Case study

Preliminary remarks on the L-dopa therapy of dystonia.

333.6

1795

1976 Kanter W 803

1795 Wooten GF

941775

14

AN Case study

Dopamine beta-hydroxylase and the torsion dystonias.

333.6

1796

1796

187

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1976 Ziegler MG 804

Lake CR

941776

Vol/Iss

Journal

Pages

Findings: Total 14

AN

Prevalence

307

318

Cross sectional

Plasma norepinephrine dopamine-beta-hydroxylase in dystonia.

333.6

1797

1997 Bressman S 807

1797 de Leon D

9191768

N

48

6

1751

1777

11

1

13

14

9

99

101

78

79

91

62

377

384

Case study

Secondary dystonia the DYTI gene.

333.6

1821

1821

1996 Zoosmann-Di

NG

809

Case study

ITD in Ashkenazi Jews--genetic drift or selection.

333.6

1823

1823

1995 Motulsky AG 886

NG

7719352

Review

Jewish diseases and origins.

333.6

2215

1998 Bressman S 987

2215 de Leon D

AN

9750905

Clinical-genetic spectrum of primary dystonia.

333.6

2312

1999 Ozelius LJ 1044

***2312 Page CE

10644435

GEN Cohort

The TOR1A (DYT1) gene family and its role in early onset torsion dystonia.

333.6

2717

1996 Fitzgerald M 1053

***2717 MacDonald D NEJM

8531968

334

3

143

149

Cross Sectional

Germ-line BRAC1 mutations in Jewish and non-Jewish women with early-onset breast cancer.

333.6

0906

0906

1970 Chase TN 1097

20

N 5529474

2

122

130

457

474

Case Control

Biochemical and pharmacologic studies of dystonia.

333.6

1802

1976 Eldridge R 1191

***1802 Gottlieb R

782203

14

AN

Cross Sectional

The primary hereditary dystonias: genetic classification of 768 families and revised estimate of gene frequency, autosomal recessive form, and selected bibliography.

333.6

1236

***1236 188

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1984 Fahn S 1197

Pages

Findings: Total 2

NC 8219232

Vol/Iss

Journal

Prevalence

541

555

715

721

Review

The varied clinical expressions of dystonia.

333.6

1234

1997 Almasy L 1260

***1234 Bressman S

12

MD

5

9380054

Ethnic variation in the clinical expression of idiopathic torsion dystonia.

333.6

2196

1997 Ozelius LJ 1295

***2196 Hewett J

7

GR

5

483

494

9149944

Fine localization of the torsion dystonia gene (DYT1) on human chromosome 9q34: YAC map and linkage disequilibrium.

333.6

2179

***2179

318.0

IMBECILITY [MODERATE MENTAL RETARDATION] 1914 de Leon D

Karpas Morris MR

74

86

576

579

70

143

154

Case Study

Insanity among Jews.

318.0

1207

1913 Swift HM

1207 AJI

537

Cross Sectional

Insanity and race.

318.0

1080

1080

684

IMPETIGO

1902 Fischkin EA

158

JAMA

39

8

427

432

Cross Sectional

Six years in a dermatologic clinic: a report of service, with remarks on the treatment of the more common skin diseases.

684

1217

1217

Higher

001-139

INFECTIOUS AND PARASITIC DISEASES 1919 Eastman PR

133

17

JDC

195

211

Cross Sectional

The relation of parental nativity to the infant mortality of New York State.

001-139 1902 Elstein LF 143

0843

0843

Lower

PHRNJ

1

Case Study

Sanitary report as to Russian-Hebrew colonies in New Jersey.

189

371

383

Year Author1 BiblioRef

Author2 PubMed

Design

ICD

Lindex

IsText

001-139

0123

0123

1956 Liberson DM 300

Vol/Iss

Journal

Pages

Findings: Total 18

JSS

Prevalence

83

117

273

345

1

27

Cross Sectional

Causes of death among Jews in New York City in 1953.

001-139

0733

0733

1973 Lindenthal JJ 305

Lower

PHDYU 1

1

Cross Sectional

The Jews of Middletown, Connecticut.

001-139

0509

0509

1917 Guilfoy WH 655

Lower

MS18 Cross Sectional

The influence of nationality upon the mortality of a community, with special references to the city of New York.

001-139

1685

1685

1925 Woodbury R 661

Lower

BP142

142

104

124

Cross Sectional

Causal factors in infant mortality: a statistical study based on investigations in eight cities.

001-139

1741

1741

Lower

487

INFLUENZA

1928 Bureau of Je

84

JCSNY

1

22

44

83

117

Cross Sectional

Causes of death among Jews.

487

2152

2152

1956 Liberson DM 300

Lower 18

JSS

Cross Sectional

Causes of death among Jews in New York City in 1953.

487

0754

0754

1923 Spivak CD

No Difference 1

CM

523

46

49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

487

0791

0791

E800-E999

INJURY AND POISONING 1928 Bureau of Je

84

JCSNY

1

22

Cross Sectional

Causes of death among Jews.

E800-E999

2144

2144

Lower 190

44

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

1973 Lindenthal JJ

Findings: Total

PHDYU 1

305

Pages

1

Prevalence

273

345

327

332

101

112

Cross Sectional

The Jews of Middletown, Connecticut.

E800-E999

0508

0508

1994 Rosenwaike I 657

Higher 23

IJE

8082959

2

Cross Sectional

Causes of death among elderly Jews in New York City, 1979-1981.

E800-E999

1729

1729

1953 Rosenberg L

15

JSS

1333

Cross Sectional

Births, Deaths and Morbidity Among Jews in Montreal in 1950

E800-E999

1814

***1814

lower

869.0

INTERNAL INJURY 2000 Farkash U

1046

Scope A

48

JTR

2

303

308

10697091

Preliminary experience with postmortem computed tomography in military penetrating trauma.

869.0

2719

INTESTINAL DISACCHARIDASE DEFICIENCIES AND DISACCHARIDE MALABSORPTION 1971 Leichter J

AJDD

289

271.3

16

12

1123

1125

16

9

845

848

Case Study

Lactose tolerance in a Jewish population.

271.3

0857

1971 Tandon R 1079

0857 Mandell H

5098211

DD

Case Control

Lactose intolerance in Jewish patients with ulcerative colitis.

271.3

2073

***2073

INTESTINAL OBSTRUCTION [ADHESIONS (INTESTINAL)] 1923 Spivak CD

1

CM

523

46

560.81 49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

560.81

0812

0812

191

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

431

INTRACEREBRAL HEMORRHAGE 1928 Bureau of Je

JCSNY

84

Prevalence

1

22

44

46

49

Cross Sectional

Causes of death among Jews.

431

2158

2158

1923 Spivak CD

Lower 1

CM

523

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

431

0790

0790

INVOLUTIONAL MELANCHOLIA [MAJOR DEPRESSIVE DISORDER, SINGLE EPISODE OR UNSPECIFIED] 1888 Bannister H

Hektoen L

32

44

AJI

296.2

455

470

86

576

579

6

98

101

194

213

663

670

Cross Sectional

Race and insanity.

296.2

1399

1914 de Leon D

1399

Higher

Karpas Morris MR

74

Case Study

Insanity among Jews.

296.2

1164

1164

296.2

1241

1241

1957 Frumkin RM

Frumkin MZ

173

JHR

Cross Sectional

Religion, occupation, and major mental disorders: a research note.

296.2

0390

1928 Goldberg JA

0390 Malzberg B

190

Lower 2

PQ

Cross Sectional

Mental disease among Jews.

296.2

0321

1909 Kirby GH

0321

Lower 1

SHB

270

4

Cross Sectional

A study in race psychopathology.

296.2

0339

0339

Higher

296.2

1270

1270

No Difference

192

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1973 Malzberg B 322

Pages

Findings: Total 49

APS

4746013

Vol/Iss

Journal

479

Prevalence 518

Cross Sectional

Mental disease among Jews in New York State, 1960-1961: a study of ethnic variation in incidence.

296.2

0350

0350

1930 Malzberg B

Higher 14

MH

324

926

946

Cross Sectional

The prevalence of mental disease among Jews.

296.2

0311

0311

1931 Malzberg B

No Difference 15

MH

325

766

774

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

296.2

0378

0378

1962 Malzberg B

No Difference 46

MH

328

4

510

522

Cross Sectional

The distribution of mental disease according to religious affiliation in New York State, 1949-1951.

296.2

1149

1992 Yeung PP 598

1149 Greenwald S

1492249

Higher

SPPE

27

6

292

297

Cross Sectional

Jewish Americans mental health: results of the NIMH Epidemiologic Catchment Area Study.

296.2

1484

1484

1919 New York St

Sig Higher

NYSHC -

640

-

322

409

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

296.2

1714

1714

No Difference

410-414

ISCHEMIC HEART DISEASE 1966 Goldstein S

13

EQ

195

1

48

61

Cross Sectional

Jewish mortality and survival patterns: Providence, Rhode Island, 1962-1964.

410-414

0457

0457

Higher

239.2

KAPOSI'S SARCOMA 1938 Becker SW

39

Thatcher HW JID

1

1

379

398

Case Study

Multiple idiopathic hemorrhagic sarcoma of Kaposi: historical review, nomenclature; and theories relative to the nature of the disease, with experimental studies of two cases.

239.2

0936

0936 193

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1973 Brownstein M 81

Shapiro L

4682537

Vol/Iss

Journal

Pages

Findings: Total 107

AD

Prevalence

137

138

759

765

299

303

408

424

Cross Sectional

Kaposi's sarcoma in community practice.

239.2

0053

1979 Harwood AR 222

0053 Osoba D

159624

Higher 67

AJM

Cross Sectional

Kaposi's sarcoma in recipients of renal transplants.

239.2

1493

1979 Laor Y 284

1493

Higher

Schwartz RA JSO 574912

12

Cross Sectional

Epidemiologic aspects of American Kaposi's sarcoma.

239.2

0054

0054

1966 McKusick VA 337

Higher

ALJMS

5978172

3

4

Review

Clinical genetics at a population level: the ethnicity of disease in the United States.

239.2

1427

1985 Ross RK 443

1427 Casagrande J JNCI

3865008

75

6

1011

1015

Cross Sectional

Kaposi's sarcoma in Los Angeles, California.

239.2

2108

2108

Sig Higher

555.1

LARGE INTESTINE 1998 Duerr RH

958

Barmada MM AJHG

9634527

63

95

100

Case study

Linkage and association between inflammatory bowel disease and a locus on chromosome 12.

555.1

2283

1998 Cho JH

2283 Nicolae DL

961

PNAS

95

7502

7507

Case study

Identification of novel susceptibility loci for inflammatory bowel disease on chromosomes 1p, 3q, 4q: evidence for epistasis between 1p IBD1.

555.1

2286

1991 Podolsky DK 962

1881418

2286 NEJM Review

Inflammatory bowel disease.

555.1

2287

194

325

13

928

928

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1996 Ohmen JD 965

Yang H-Y

Vol/Iss

Journal

Pages

Findings: Total 5

HMG

10

1679

Prevalence 1683

8894707

Susceptibility locus for inflammatory bowel disease on chromosome 16 has a role in Crohn's disease, but not in ulcerative colitis.

555.1

2290

1997 Akolkar PN 969

Gulwani-Alkol AJG

9399762

92

12

2241

2244

Case study

Differences in risk of Crohn's disease in offspring of mothers and fathers with inflammatory bowel disease.

555.1

2294

1993 Yang H 971

2294 Rotter JI

Sig. Higher 92

JCI

1080

1084

8349790

Ulcerative colitis: a genetically heterogeneous disorder defined by genetic (HLA class II) subclinical (antineutrophil cytoplasmic antibodies) markers.

555.1

2296

1995 Yang H 972

2296 Vora DK

7615193

109

G

440

448

Case control

Intercellular adhesion molecule 1 gene associations with immunologic subsets of inflammatory bowel disease.

555.1

2297

1993 Yang H 973

2297 Mclree C

8491401

34

GUT

517

524

Cross sectional

Familial empirical risks for inflammatory bowel disease: differences between Jews non-Jews.

555.1

2298

2298

Higher

LATE EFFECTS OF UNSPECIFIED ACCIDENT 1966 Goldstein S

13

EQ

195

1

48

E929.9 61

Cross Sectional

Jewish mortality and survival patterns: Providence, Rhode Island, 1962-1964.

E929.9

0455

0455

1956 Liberson DM

No Difference 18

JSS

300

83

117

885

889

Cross Sectional

Causes of death among Jews in New York City in 1953.

E929.9

0725

1989 Rosenwaike I 440

0725

Lower

Hempstead K SSM

2799431

29

7

Cross Sectional

Differential mortality by ethnicity: foreign-born Irish, Italians and Jews in New York City, 1979-81.

E929.9

1050

1050 195

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

1917 Guilfoy WH

Findings: Total

MS18

655

Pages

1

Prevalence 27

Cross Sectional

The influence of nationality upon the mortality of a community, with special references to the city of New York.

E929.9

1684

1684

E929.9

1690

1690

No Difference

709.0

LENTIGO

1902 Fischkin EA

JAMA

158

39

8

427

432

Cross Sectional

Six years in a dermatologic clinic: a report of service, with remarks on the treatment of the more common skin diseases.

709.0

1212

1212

Lower

204-208.9

LEUKEMIA

1961 Askovitz SI

JAEMC

22

9

4

229

232

Cross Sectional

Distribution of malignant neoplasms with reference to the patient's religion.

204-208.9

1029

1975 Greenwald P 212

1029 Korns RF

1192415

No Difference 35

CR

3507

3512

405

417

Cross Sectional

Cancer in United States Jews.

204-208.9

2048

2048

1961 Newill VA

26

JNCI

375

2

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

204-208.9

1308

1989 Rosenwaike I 440

1308

Higher

Hempstead K SSM

2799431

29

7

885

889

Cross Sectional

Differential mortality by ethnicity: foreign-born Irish, Italians and Jews in New York City, 1979-81.

204-208.9

1045

1045

1999 Breast Canc 1137

10433620

91

JNCI Cohort

Cancer risks in BRCA2 mutation carriers.

204-208.9

0940

***0940

196

5

1310

1316

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

80

Gross S

5246759

Pages

Findings: Total

Prevalence

208.0

LEUKEMIA (ACUTE) 1968 Browning D

Vol/Iss

Journal

AJDC

116

576

585

Cross Sectional

Epidemiological studies of acute childhood leukemia: a survey of Cuyahoga County, Ohio.

208.0

1189

1976 Feldman JG 154

1189 Lee SL

1069604

No Difference 38

CAN

2548

2550

Case Study

Occurrence of acute leukemia in females in a genetically isolated population.

208.0

0396

0396

1961 Newill VA

26

JNCI

375

2

405

417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

208.0

0689

0689

Higher

208.9

LEUKEMIA [UNSPECIFIED LEUKEMIA] 1976 Cuneo JM

114

AJPH 984280

66

11

1094

1095

Cross Sectional

Leukemia incidence and ethnicity in Nassau County, New York.

208.9

0307

1970 Graham Sax 206

0307 Gibson R

5263145

No Difference

AJPH

6

2

266

274

Cross Sectional

Religion and ethnicity in leukemia.

208.9

0531

1961 Haenszel W 219

0531

Sig Higher 26

JNCI

1

37

132

Cross Sectional

Cancer mortality among the foreign-born in the United States.

208.9

0270

1971 Haenszel W 220

5144588

0270

Sig Lower 7

IJMS

12

1437

1450

Cross Sectional

Cancer mortality among U.S. Jews.

208.9

0269

1956 Liberson DM 300

0269

No Difference 18

JSS

83

Cross Sectional

Causes of death among Jews in New York City in 1953.

208.9

0741

0741

Higher

197

117

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1985 Mack TM 314

Berkel J 3834340

Vol/Iss

Journal

Pages

Findings: Total

NCIM

69

Prevalence

235

245

1716

1724

408

424

Cross Sectional

Religion and cancer in Los Angeles County.

208.9

2111

2111

1960 MacMahon B

16

AUIC

315

Cross Sectional

The ethnic distribution of cancer mortality in New York City, 1955.

208.9

2025

2025

1966 McKusick VA 337

ALJMS

5978172

3

4

Review

Clinical genetics at a population level: the ethnicity of disease in the United States.

208.9

1430

1430

1971 Seidman H 493

4

ER

5173551

390

429

Cross Sectional

Cancer mortality in New York City for country-of-birth, religious, socioeconomic groups.

208.9

1404

1404

1970 Seidman H 494

3

ER

4919127

234

250

Cross Sectional

Cancer death rates by site sex for religious socioeconomic groups in New York City.

208.9

1595

1969 Rosner F 668

1595 Dosik H

5256078

Sig Higher

JAMA

209

6

935

937

115

118

278

282

1179

1183

Case Study

Gaucher cells in leukemia.

208.9

1761

1979 Krause JR 671

1761 Bures C

291121

N/A 23

SJH Case Study

Acute leukemia and Gaucher's disease.

208.9

1754

1961 Gelfand MI

1754 Griboff SI

672

N/A

JMSH

28

Case Study

Gaucher's disease acute leukemia.

208.9

1753

1996 Tonin P 857

1753 Weber B

8898735

N/A 2

NM

11

Case study

Frequency of recurrent BRCA1 BRCA2 mutations in Ashkenazi Jewish breast cancer families.

208.9

2228

2228 198

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

LEUKEMIA AND ALEUKEMIA [OTHER LEUKEMIA OF UNSPECIFIED CELL TYPE] 1965 King H

Diamond E

268

MMFQ

43

349

Prevalence

208.8 358

Cross Sectional

Cancer mortality and religious preference: a suggested method in research.

208.8

1377

1377

208

LEUKEMIA OF UNSPECIFIED CELL TYPE 1961 Newill VA

26

JNCI

375

2

405

417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

208

0757

LEUKEMIAS 2001 Risch HA

1162

0757

Higher

204.0-208 McLaughlin J AJHG

68

700

710

11179017

Prevalence and penetrance of germline BRCA1 and BRCA2 mutations in a population series of 649 women with ovarian cancer.

204.0-208

1264

***1264

481

LOBAR-PNEUMONIA [PNEUMOCOCCAL PNEUMONIA] 1908 Guilfoy WH

215

73

MR

132

135

Cross Sectional

The death rate of the city of New York as affected by the cosmopolitan character of its population.

481

0411

0411

Lower

204

LYMPHOID LEUKEMIA 1961 Newill VA

26

JNCI

375

2

405

417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

204

0686

0686

Higher

200.1

LYMPHOSARCOMA 1960 MacMahon B

315

16

AUIC

1716

Cross Sectional

The ethnic distribution of cancer mortality in New York City, 1955.

200.1

2023

2023

Sig Higher

199

1724

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1961 Newill VA

Pages

Findings: Total 26

JNCI

375

Vol/Iss

Journal

2

405

Prevalence 417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

200.1

0680

1967 Tobin MS 543

0680 Argano SAP

5232990

Higher

NYSJM

67

2132

2134

Case Study

Prolonged survival in abdominal lymphosarcoma with very late onset of auto-immune hemolytic anemia.

200.1

1185

1185

MAJOR DEPRESSIVE DISORDER, RECURRENT EPISODE 1914 de Leon D

Karpas Morris MR

74

86

296.3

576

579

941

947

Case Study

Insanity among Jews.

296.3

0049

1997 Levav I 820

0049 Kohn R

9210744

154

AJP

7

Cross sectional

Vulnerability of Jews to affective disorders.

296.3

1834

1834

higher

188

MALIGNANT NEOPLASM OF BLADDER 1998 Woodage T

870

King SM

9731533

20

NG

1

62

65

Case study

The APC I1307K allele and cancer risk in a community-based study of Ashkenazi Jews.

188

2206

1997 Struewing JP 935

2206 Hartge P

9145676

NEJM

336

20

1401

1408

Case study

The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Jews.

188

2273

2273

174.9

MALIGNANT NEOPLASM OF FEMALE BREAST, UNSPECIFIED 1961 Askovitz SI

22

JAEMC

9

4

229

Cross Sectional

Distribution of malignant neoplasms with reference to the patient's religion.

174.9

1018

1018

Higher

200

232

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1933 Bolduan CR

Weiner L

63

Vol/Iss

Journal

Pages

Findings: Total

NEJM

208

8

407

Prevalence 416

Cross Sectional

Causes of death among Jews in New York City.

174.9

0519

0519

1906 Fishberg M

No Difference -

JE

163

-

529

531

1-2

87

101

Cross Sectional

Cancer.

174.9

1197

1197

1986 Goldstein A 192

33

SB

3775445

Cross Sectional

Patterns of mortality and causes of death among Rhode Island Jews, 1979-1981.

174.9

2534

2534

1962 Gorwitz K

24

JSS

198

248

254

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957.

174.9

0492

1975 Greenwald P 212

0492 Korns RF

1192415

No Difference 35

CR

3507

3512

Cross Sectional

Cancer in United States Jews.

174.9

2050

2050

1961 Haenszel W

Sig Lower 26

JNCI

219

1

37

132

Cross Sectional

Cancer mortality among the foreign-born in the United States.

174.9

0249

1983 Helmreich S 228

0249 Shapiro S

6823951

Sig Higher 117

AJE

1

35

45

327

333

Cross Sectional

Risk factors for breast cancer.

174.9

0904

1981 Kelsey JL 263

0904 Fischer DB

6943372

Higher 67

JNCI

2

Cross Sectional

Exogenous estrogens and other factors in the epidemiology of breast cancer.

174.9

0832

1965 King H

0832 Diamond E

268

MMFQ

43

349

Cross Sectional

Cancer mortality and religious preference: a suggested method in research.

174.9

1340

1340 201

358

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1933 Bolduan CR

Weiner L

63

Vol/Iss

Journal

Pages

Findings: Total

NEJM

208

8

407

Prevalence 416

Cross Sectional

Causes of death among Jews in New York City.

174.9

0519

0519

1906 Fishberg M

No Difference -

JE

163

-

529

531

1-2

87

101

Cross Sectional

Cancer.

174.9

1197

1197

1986 Goldstein A 192

33

SB

3775445

Cross Sectional

Patterns of mortality and causes of death among Rhode Island Jews, 1979-1981.

174.9

2534

2534

1962 Gorwitz K

24

JSS

198

248

254

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957.

174.9

0492

1975 Greenwald P 212

0492 Korns RF

1192415

No Difference 35

CR

3507

3512

Cross Sectional

Cancer in United States Jews.

174.9

2050

2050

1961 Haenszel W

Sig Lower 26

JNCI

219

1

37

132

Cross Sectional

Cancer mortality among the foreign-born in the United States.

174.9

0249

1983 Helmreich S 228

0249 Shapiro S

6823951

Sig Higher 117

AJE

1

35

45

327

333

Cross Sectional

Risk factors for breast cancer.

174.9

0904

1981 Kelsey JL 263

0904 Fischer DB

6943372

Higher 67

JNCI

2

Cross Sectional

Exogenous estrogens and other factors in the epidemiology of breast cancer.

174.9

0832

1965 King H

0832 Diamond E

268

MMFQ

43

349

Cross Sectional

Cancer mortality and religious preference: a suggested method in research.

174.9

1340

1340 201

358

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1956 Liberson DM

Pages

Findings: Total 18

JSS

300

Vol/Iss

Journal

Prevalence

83

117

343

361

Cross Sectional

Causes of death among Jews in New York City in 1953.

174.9

0716

1929 Lombard HL

0716 Doering CR

308

Higher 3

JPM

5

Cross Sectional

Cancer studies in Massachusetts: 3. Cancer mortality in nativity groups.

174.9

1463

1985 Mack TM 314

1463 Berkel J

3834340

Lower

NCIM

69

235

245

1716

1724

405

417

Cross Sectional

Religion and cancer in Los Angeles County.

174.9

2128

2128

1960 MacMahon B

Higher 16

AUIC

315

Cross Sectional

The ethnic distribution of cancer mortality in New York City, 1955.

174.9

2016

2016

1961 Newill VA

Higher 26

JNCI

375

2

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

174.9

0250

0250

1966 Post RH

Higher

EQ

403

13

1

1

29

29

7

885

889

Review

Breast cancer, lactation, and genetics.

174.9

0980

1989 Rosenwaike I 440

0980 Hempstead K SSM

2799431

Cross Sectional

Differential mortality by ethnicity: foreign-born Irish, Italians and Jews in New York City, 1979-81.

174.9

1039

1969 Salber EJ 461

1039 Trichopoulos

5389456

No Difference 43

JNCI

5

1013

1024

Cross Sectional

Lactation and reproductive histories of breast cancer patients in Boston, 1965-66.

174.9

0907

1943 Vineberg HN 554

0907

Sig Higher

JMSH

10

33

Cross Sectional

The relative infrequency of cancer of the uterus in women of the Hebrew race.

174.9

0840

0840

Higher 202

39

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1934 Weir P

Little CC

569

Vol/Iss

Journal

Pages

Findings: Total 25

JH

Prevalence

277

280

327

332

Cross Sectional

The incidence of uterine cancer in Jews and gentiles.

174.9

0648

0648

1994 Rosenwaike I 657

Higher 23

IJE

8082959

2

Cross Sectional

Causes of death among elderly Jews in New York City, 1979-1981.

174.9

1737

1995 Tonin P 728

1737 Serova O

7611288

No Difference

AJHG

57

189

266

66

Review

BRCA1 mutations in Ashkenazi Jewish women.

174.9

1523

1994 Miki Y 731

1523 Swensen J

7545954

S

71

Review

A strong candidate for the breast ovarian cancer susceptibility gene BRCA1.

174.9

1527

1995 Struewing J 732

1527 Brody LC

7611277

AJHG

57

1

7

Case Study

Detection of eight BRCA1 mutations in 10 breast/ovarian cancer families, including 1 family with male breast cancer.

174.9

1529

***1529

1996 Collins FS 739

NEJM

334

3

186

188

13

1

126

128

8531977

BRCA1 lots of mutations, lots of dilemmas.

174.9

1540

1996 Neuhausen 740

1540 Gilewski T

8673092

NG

Cross sectional

Recurrent BRCA2 6174 delT mutations in Ashkenazi Jewish women affected by breast cancer.

174.9

1541

1996 Offit K 745

1541 Gilewski T

8642955

347

L

1643

1645

Case study

Germline BRCA1 185delAG mutations in Jewish women with breast cancer.

174.9

1546

1996 Egan KM 746

1546 Newcomb PA L

8642956

347

1645

Cross sectional

Jewish religion and risk of breast cancer.

174.9

1547

1547

higher 203

1647

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1995 Szabo CI 764

King M-C 8541881

Vol/Iss

Journal

Pages

Findings: Total 4

HMG

Prevalence

1811

1817

1166

1176

Review

Inherited breast and ovarian cancer.

174.9

1566

1996 Berman DB 767

1566 Wagner-Cost AJHG

8651293

58

6

Case study

Two distinct origins of a common BRCA1 mutation in breast-ovarian cancer families:a genetic study of 15 185 delAG-mutation kindreds.

174.9

1569

1995 Friedman LS 769

1569 Szabo CI

8533757

AJHG

57

6

1284

1297

Case study

Novel inherited mutations and variable expressivity of BRCA1 alleles, including the founder mutation 185delAG in Ashkenazi Jewish families.

174.9

1571

1996 Roa B 781

1571 Boyd AA

8841191

14

NG

2

185

187

Cross sectional

Ashkenazi Jewish population frequencies for common mutations in BRCA1 and BRCA2.

174.9

1584

1996 Oddoux C 784

1584 Struewing JP NG

8841192

14

2

188

190

Case study

The carrier frequency of the BRCA2 6174delT mutation among Ashkenazi Jewish individuals is approximately 1%.

174.9

1587

1996 Berman DB 787

1587 Costalas J

8758903

56

CR

15

3409

3414

Case study

A common mutation in BRCA2 that predisposes to a variety of cancers is found in both Jewish Ashkenazi and non-Jewish individuals.

174.9

1590

1997 Karp SE 808

1590 Tonin PN

9241077

80

CAN

3

435

441

Case study

Influence of BRCA1 mutations on nuclear grade and estrogen receptor status of breast carcinoma in Ashkenazi Jewish women.

174.9

1822

1993 Biesecker BB Boehnke M 812

8352830

1822 JAMA

269

15

1970

1974

Case study

Genetic counseling for families with inherited susceptibility to breast and ovarian cancer.

174.9

1826

1826

204

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1997 Chakraborty

Little MP

814

Vol/Iss

Journal

Pages

Findings: Total 147

RR

309

Prevalence 320

Case study

Cancer predisposition, radiosensitivity the risk of radiation-induced cancers. Iii. Effects of incomplete penetrance dose-dependent radiosensitivity on cancer risks in populations.

174.9

1828

1997 Fitzgerald M 815

1828 Bean JM

9054948

15

NG

3

307

309

Case study

Heterozygous ATM mutations do not contribute to early onset of breast cancer.

174.9

1829

1995 Hoskins KF 817

1829 Stopfer JE

7837392

JAMA

273

7

577

585

Case study

Assessment and counseling for women with a family history of breast cancer.

174.9

1831

1997 Shattuck-Eid 831

1831 Oliphant A

JAMA

278

15

1242

1250

9333265

BRCA1 sequence analysis in women at high risk for susceptibility: risk factor analysis implications for genetic testing.

174.9

1851

1994 Futreal PA 835

1851 Liu Q

7939630

266

S

7

120

122

2

1416

1421

Case study

BRCA1 mutations in primary breast and ovarian carcinomas.

174.9

1855

1997 Krainer M 841

1855 Silva-Arrieta

NEJM

336

9145678

Differential contributions of BRCA1 and BRCA2 to early-onset breast cancer.

174.9

1861

1996 Langston AA 842

1861 Malone KE

NEJM

334

3

137

142

8531967

BRCA1 mutations in a population-based sample of young women with breast cancer.

174.9

1862

1862

1998 Wilcox-Hann 843

LPCP

9644442

2

3

271

283

Review

Breast cancer and gene testing: risk, rationale, and responsibilities of primary care providers.

174.9

1865

1998 Richter S 844

1865 Seth A

9592184

12

IJO

6

1263

1267

Case study

One step direct detection of recurrent mutations in the breast cancer susceptibility gene, BRCA1.

174.9

1866

1866

205

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1996 Phelan C 845

Pages

Findings: Total

Lancaster JM NG 8673090

Vol/Iss

Journal

13

120

Prevalence 122

case study

Multinational analysis of the BRCA2 gene in 49 site-specific breast cancer families.

174.9

1867

1867

1997 Keoun B 846

higher 89

JNCI 8978398

1

8

9

Review

Ashkenazim not alone: other ethnic groups have breast cancer gene mutations, too.

174.9

1869

1997 Brody LC 848

Biesecker BB HPR

32

10

59

80

67

4

267

274

20

1409

1415

9341636

Breast cancer: the high-risk mutations.

174.9

1871

1998 Mann GB 850

***1871 Borgen PI

9579377

JSO

Review article

Breast cancer genes and the surgeon.

174.9

1873

1997 Couch FJ 852

1873 Deshano ML

9145677

NEJM

336

Case study

BRCA1 mutations in women attending clinics that evaluate the risk of breast cancer.

174.9

1876

1995 Shattuck-Eid 853

1876 McClure M

7837387

higher

JAMA

273

7

535

541

Case study

A collaborative survey of 80 mutations in the BRCA1 breast ovarian cancer susceptibility gene.

174.9

1877

1996 Couch FJ 855

1877 Weber BL

8

HM

8807330

Mutations and polymorphisms in the familial early-onset breast cancer (BRCA1) gene.

174.9

1879

1996 Tonin P 857

Weber B 8898735

2

NM

11

1179

1183

Case study

Frequency of recurrent BRCA1 BRCA2 mutations in Ashkenazi Jewish breast cancer families.

174.9

1881

1994 Castilla LH 858

Couch FJ

7894491

8

NG

387

Case study

Mutations in the BRCA1 gene in families with early-onset breast ovarian cancer.

174.9

1883

***1883 206

391

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1995 Struewing JP 860

Abeliovich D

7550349

Vol/Iss

Journal

Pages

Findings: Total 11

NG

198

Prevalence 200

Case study

The carrier frequency of the BRCA1 185delAG mutation is approximately 1 percent in Ashkenazi Jewish individuals.

174.9

1884

1998 Grann VR 864

1884

sig higher

Panageas KS JCO 9508180

16

3

979

985

Case study

Decision analysis of prophylactic mastectomy and oophorectomy in BRCA1-positive or BRCA2positive patients.

174.9

1888

1998 Redston M 929

1888 Nathanson KL NG

9731522

20

1

13

14

45

51

Case study

The APC I1307K allele breast cancer risk.

174.9

2253

1998 Fodor FH 934

2253 Weston A

9634504

AJHG

63

Case study

Frequency and carrier risk associated with common BRCA1 and BRCA2 mutations in Ashkenazi Jewish breast cancer patients.

174.9

2258

1997 Struewing JP 935

Hartge P

9145676

NEJM

336

20

1401

1408

Case study

The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Jews.

174.9

2259

1998 Randall TC 951

2259 Bell KA

9790802

70

GNO

432

434

Case study

Germline mutations of the BRCA1 and BRCA2 genes in a breast and ovarian cancer patient.

174.9

2276

1998 Bandera CA 955

2276 Muto MG

9764635

92

OG

4

596

600

Case study

BRCA1 gene mutations in women with papillary serous carcinoma of the peritoneum.

174.9

2280

1996 Skolnick MH

2280 Frank T

1008

45

PB

245

249

623

630

Case study

Genetic susceptibility to breast ovarian cancer.

174.9

2333

1998 Wacholder S 1013

2333 Hartge P

148

AJE

9778168

The kin-cohort study for estimating penetrance.

207

7

Year Author1 BiblioRef

Author2 PubMed

Design

ICD

Lindex

IsText

174.9

2338

***2338

1994 Wooster R 1015

Vol/Iss

Journal

Pages

Findings: Total

Neuhausen S S

265

518 2088

Prevalence 2090

8091231

Localization of a breast cancer susceptibility gene, BRCA2, to chromosome 13q12-13.

174.9

2340

1995 Wooster R 1018

Bignell G

8524414

378

NAT

789

792

1228

1230

963

970

Case study

Identification of the breast cancer susceptibility gene BRCA2.

174.9

2348

1999 Maresco DL 1047

2348 Arnold PH

10090911

AJHG

64

4

Letter to the Edito

The APC I1307K allele and BRCA-associated ovarian cancer risk.

174.9

2720

1999 Hartge P 1050

Struewing JP AJHG 10090881

64

4

Case study

The prevalence of common BRCA1 and BRCA2 mutations among Ashkenazi Jews.

174.9

2723

1996 Fitzgerald M 1053

MacDonald D NEJM

8531968

334

3

143

149

Cross Sectional

Germ-line BRAC1 mutations in Jewish and non-Jewish women with early-onset breast cancer.

174.9

1552

2000 Chappuis PO 1056

1552 Kapusta L

11118465

18

JCO

24

4045

4052

Retrospective Co

Germline BRCA1/2 mutations and the p27(Kip1) protein levels independently predict outcome after breast cancer.

174.9

0076

2000 Phillips KA 1063

***0076 Warner E

10852372

57

CG

5

376

383

Cohort

Perceptions of Ashkenazi Jewish breast cancer patients on genetic testing for mutations in BRCA1 and BRCA2.

174.9

0172

2001 Press NA 1065

***0172 Yasui Y

AJMG

99

2

99

110

11241466

Women’s interest in genetic testing for breast cancer susceptibility may be based on unrealistic expectations.

174.9

0175

***0175

208

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

2000 Armstrong K 1073

Calzone K

11097234

Vol/Iss

Journal

Pages

Findings: Total

CEBP

9

Prevalence

1251

1254

148

151

Cohort

Factors associated with decisions about clinical BRCA1/2 testing.

174.9

0362

2000 Tobias D 1087

***0362 Eng C

78

GNO

2

10926794

Founder BRCA1 and 2 mutations among a consecutive series of Ashkenazi Jewish ovarian cancer patients.

174.9

0340

1999 Lu KH 1095

***0340 Cramer DW

93

OG

1

34

37

9916952

A population-based study of BRCA1 and BRCA2 mutations in the Jewish women with epithelial ovarian cancer.

174.9

0361

1999 Warner E 1096

***0361 Foulkes W

10413426

91

JNCI

14

1241

1247

Case Control

Prevalence and penetrance of BRCA1 and BRCA2 gene mutations in unselected Ashkenazi Jewish women with breast cancer.

174.9

2580

1997 Scully R 1102

***2580 Chen J

88

CE

2

265

275

123

138

9008167

Association of BRCA1 with Rad51 in mitotic and meiotic cells.

174.9

0037

2001 Chatterjee N 1103

***0037 Shih J

11507721

21

GE

2

Retrospective Co

Association and aggregation analysis using kin-cohort designs with applications to genotype and family history data from the Washington Ashkenazi study.

174.9

0406

1999 Friedman LC 1104

***0406 Webb JA

11336456

1

GIM

3

74

79

Case Study

Psychological impact of receiving negative BRCA1 mutation test results in Ashkenazim.

174.9

0427

2000 Plon SE 1106

***0427 Peterson LE

2

GIM

6

307

311

11339650

Mammography behavior after receiving a negative BRCA1 mutation test result in the Ashkenazim: a community-based study.

174.9

0433

***0433

209

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

2001 Satagopan J 1130

Offit K

11352856

Vol/Iss

Journal

Pages

Findings: Total

CEBP

10

467

Prevalence 473

Case Control

The lifetime risks of breast cancer in Ashkenazi Jewish carriers of BRCA1 and BRCA2 mutations.

174.9

0888

2002 Liede A 1132

***0888 Karlan BY

11896106

20

JCO

6

1570

1577

Cohort

Cancer incidence in a population of Jewish women at risk of ovarian cancer.

174.9

1921

2002 Frank TS 1133

***1921 Deffenbaugh

11896095

6

JCO

1480

1490

Cohort

Clinical characteristics of individuals with germline mutations in BRCA1 and BRCA2: analysis of 10,000 individuals.

174.9

0996

2001 Lawrence W 1134

***0996 Peshkin BN

11352857

CEBP

10

475

481

Cohort

Cost of genetic counseling and testing for BRCA1 and BRCA2 breast cancer susceptibility mutations.

174.9

0900

2002 Shih HA 1135

***0900 Couch FJ

11844822

20

JCO

4

994

999

Cohort

BRCA1 and BRCA2 mutation frequency in women evaluated in a breast cancer risk evaluation clinical trial.

174.9

0884

1998 Neyhausen S 1136

***0884 Godwin AK

9585613

AJHG

62

1381

1388

Cohort

Haplotype and phenotype analysis of nine recurrent BRCA2 mutations in 111 families: results of an international study.

174.9

2066

2000 BRCA1 Exon 1138

***2066 Screening Gr AJHG

10827109

67

207

212

Cohort

The exon 13 duplication in the BRCA1 gene is a founder mutation present in geographically diverse population.

174.9

0896

2002 Lee SC 1141

***0896 Bernhardt BA CAN

11920551

94

6

1876

1885

Retrospective

Utilization of BRCA1/2 genetic testing in the clinical setting: report from a single institution.

174.9

1000

***1000

210

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1997 Biesecker BB Brody LC 1160

Vol/Iss

Journal

Pages

Findings: Total

JAMW

52

1

22

Prevalence 27

9033168

Genetic susceptibility testing for breast and ovarian cancer: a progress report.

174.9

1956

1998 Diez O 1161

***1956 Domenech M HG

9921907

103

6

707

708

Cohort

Identification of the 185delAG BRCA1 mutation in a Spanish gypsy population.

174.9

1959

2001 Risch HA 1162

***1959 McLaughlin J AJHG

68

700

710

11179017

Prevalence and penetrance of germline BRCA1 and BRCA2 mutations in a population series of 649 women with ovarian cancer.

174.9

0649

1996 Durocher F 1163

***0649 Tonin P

8933332

33

JMG

10

814

819

Interview

Families with cases of cancer of the breast, ovary, and multiple other sites.

174.9

2325

2000 Moslehi R

2325 Chu W

1166

ASHG

66

1259

1272

Cohort

BRCA1 and BRCA2 mutation analysis of 208 Ashkenazi women with ovarian cancer.

174.9

2024

1997 Foulkes WD 1174

***2024 Wong N

9815648

3

CCR

2465

2469

Case Study

Germ-line BRCA 1 mutation is an adverse prognostic factor in Ashkenazi Jewish women with breast cancer.

174.9

1863

2002 Hartge P 1200

***1863 Chatterjee N

11964925

13

EPI

3

255

261

Case Study

Breast cancer risk in Ashkenazi BRCA1/2 mutation carriers: effects of reproduction history.

174.9

1075

1996 Rosenblatt D

***1075 Foulkes W

1215

NEJM

27

287

291

431

434

Case Control

Genetic screening for breast cancer.

174.9

1014

2002 Levine D 1220

***1014 Federici M

12051869

85

GNO Cohort

Cell proliferation and apoptosis in BRCA- associated hereditary ovarian cancer.

174.9

1274

***1274

211

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1997 Abelovich D 1221

Kaduri L

9042909

Vol/Iss

Journal

AJHG

Pages

Findings: Total 60

505

Prevalence 514

Cohort

The founder mutations 185delAG and 5382insC in BRCA1 and 6174delT in BRCA2 appear in 60% of ovarian cancer and 30% of early-onset breast cancer patients among Ashkenazi women.

174.9

1276

2002 Quenneville 1253

***1276 Phillips KA

CAN

95

10

2068

2075

12412159

HER-2/neu status and tumor morphology of invasive breast carcinomas in Ashkenazi women with known BRCA1 mutation status in the Ontario Familial Breast Cancer Registry.

174.9

2310

1997 Burke W 1271

***2310 Daly M

JAMA

277

12

997

1003

9091675

Recommendations for follow-up care of individuals with an inherited predisposition to cancer. II. BRCA1 and BRCA2. Cancer Genetics Studies Consortium.

174.9

2198

1997 Ganguly A 1278

***2198 Leahy K

GT

1

2

85

90

10464631

Genetic testing for breast cancer susceptibility: frequency of BRCA1 and BRCA2 mutations.

174.9

2197

2002 Lehmann LS 1326

***2197 Weeks JC

GIM

4

5

346

352

12394347

A population-based study of Ashkenazi Jewish women's attitudes toward genetic discrimination and BRCA1/2 testing.

174.9

2097

***2097

MALIGNANT NEOPLASM OF KIDNEY AND OTHER UNSPECIFIED URINARY ORGANS [KINDEY, RENAL PELVIS] 1956 Liberson DM

300

JSS

18

189-189.1

83

117

1716

1724

Cross Sectional

Causes of death among Jews in New York City in 1953.

189-189.1

0739

1960 MacMahon B 315

0739 AUIC

Higher 16

Cross Sectional

The ethnic distribution of cancer mortality in New York City, 1955.

189-189.1 1961 Newill VA 375

2020

2020 JNCI

Sig Higher 26

2

405

417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58. 212

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

189-189.1

1305

1305

Higher

1971 Seidman H 493

4

ER

5173551

390

Prevalence 429

Cross Sectional

Cancer mortality in New York City for country-of-birth, religious, socioeconomic groups.

189-189.1

1467

1467

1970 Seidman H 494

Higher 3

ER

4919127

234

250

Cross Sectional

Cancer death rates by site sex for religious socioeconomic groups in New York City.

189-189.1

1650

1650

MALIGNANT NEOPLASM OF LYMPHATIC AND HEMATOPOIETIC TISSUE 1962 Gorwitz K

24

JSS

198

200-208

248

254

3507

3512

405

417

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957.

200-208

0486

1975 Greenwald P 212

0486 Korns RF

1192415

Higher 35

CR

Cross Sectional

Cancer in United States Jews.

200-208

2045

2045

1961 Newill VA

26

JNCI

375

2

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

200-208

1306

1306

Higher

190-199

MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED NATURE 1965 King H

Diamond E

268

MMFQ

43

349

358

Cross Sectional

Cancer mortality and religious preference: a suggested method in research.

190-199

1370

1370

MALIGNANT NEOPLASM OF RESPIRATORY AND INTRATHORACIC ORGANS 1933 Bolduan CR

63

Weiner L

NEJM

208

8

Cross Sectional

Causes of death among Jews in New York City.

160-165

1123

1123

Higher 213

407

160-165 416

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1965 King H

Diamond E

268

Vol/Iss

Journal

Pages

Findings: Total

MMFQ

43

349

Prevalence 358

Cross Sectional

Cancer mortality and religious preference: a suggested method in research.

160-165

1338

1338

1961 Newill VA

26

JNCI

375

2

405

417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

160-165

0248

0248

Lower

MALIGNANT NEOPLASM OF THE DIGESTIVE ORGANS AND PERITONEUM 1906 Fishberg M

-

JE

163

-

150-159

529

531

87

101

Cross Sectional

Cancer.

150-159

1198

1198

1986 Goldstein A 192

Higher 33

SB

3775445

1-2

Cross Sectional

Patterns of mortality and causes of death among Rhode Island Jews, 1979-1981.

150-159

2532

2532

1961 Newill VA

26

JNCI

375

2

405

417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

150-159

0239

0239

Higher

179-189

MALIGNANT NEOPLASMS OF GENITOURINARY ORGANS 1986 Goldstein A

192

33

SB

3775445

1-2

87

101

Cross Sectional

Patterns of mortality and causes of death among Rhode Island Jews, 1979-1981.

179-189

2531

2531

1962 Gorwitz K

24

JSS

198

248

254

349

358

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957.

179-189 1965 King H 268

0481

0481 Diamond E

Lower

MMFQ

43

Cross Sectional

Cancer mortality and religious preference: a suggested method in research.

214

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

179-189

1341

1341

Lower

1961 Newill VA

26

JNCI

375

2

405

Prevalence 417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

179-189

1302

1302

Lower

162

MALIGNANT NEOPLASMS OF TRACHEA, BRONCHUS, AND LUNG 1965 King H

Diamond E

268

MMFQ

43

349

358

Cross Sectional

Cancer mortality and religious preference: a suggested method in research.

162

1313

2001 Risch HA 1162

1313 McLaughlin J AJHG

68

700

710

11179017

Prevalence and penetrance of germline BRCA1 and BRCA2 mutations in a population series of 649 women with ovarian cancer.

162

0863

***0863

MANIC DEPRESSION (DEPRESSED) [BIPOLAR AFFECTIVE DISORDER, DEPRESSED] 1913 Swift HM

70

AJI

537

143

296.5 154

Cross Sectional

Insanity and race.

296.5

1065

1065

MANIC-DEPRESSIVE PSYCHOSIS, OTHER AND UNSPECIFIED 1939 Fleming R

Tillotson K

1213

NEJM

221

19

741

296.8 745

Case Control

Further studies on the personality and sociological factors in the prognosis and treatment of chronic alcoholism.

296.8

0979

***0979

296.80

MANIC-DEPRESSIVE PSYCHOSIS, UNSPECIFIED 1914 de Leon D

Karpas Morris MR

74

86

Case Study

Insanity among Jews.

296.80

1187

1187 215

576

579

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1957 Frumkin RM

Frumkin MZ

173

Vol/Iss

Journal

Pages

Findings: Total 6

JHR

Prevalence

98

101

194

213

663

670

479

518

Cross Sectional

Religion, occupation, and major mental disorders: a research note.

296.80

0391

1928 Goldberg JA

0391 Malzberg B

190

Lower 2

PQ

Cross Sectional

Mental disease among Jews.

296.80

0320

0320

1909 Kirby GH

Higher 1

SHB

270

4

Cross Sectional

A study in race psychopathology.

296.80

0343

0343

1973 Malzberg B 322

Higher 49

APS

4746013

Cross Sectional

Mental disease among Jews in New York State, 1960-1961: a study of ethnic variation in incidence.

296.80

0351

0351

1930 Malzberg B

Higher 14

MH

324

926

946

Cross Sectional

The prevalence of mental disease among Jews.

296.80

0303

0303

1931 Malzberg B

No Difference 15

MH

325

766

774

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

296.80

0373

0373

1936 Malzberg B

Lower 20

MH

327

280

291

Cross Sectional

New data relative to incidence of mental disease among Jews.

296.80

0387

0387

1880 Spitzka EC

No Difference

JNMD

7

613

630

292

297

522 Contributions to nervous mental pathology.

296.80

1133

1992 Yeung PP 598

1133 Greenwald S

1492249

Lower

SPPE

27

6

Cross Sectional

Jewish Americans mental health: results of the NIMH Epidemiologic Catchment Area Study.

296.80

0728

0728

Higher 216

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1919 New York St

Vol/Iss

Journal

Findings: Total

NYSHC -

640

Pages

-

322

Prevalence 409

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

296.80

1654

1654

Higher

296.80

1713

1713

Higher

261

MARASMUS

1917 Guilfoy WH

MS18

655

1

27

Cross Sectional

The influence of nationality upon the mortality of a community, with special references to the city of New York.

261

1693

1693

Lower

305.2

MARIJUANA ABUSE [CANNABIS ABUSE] 1971 Anker JL

14

Milman DH

5101083

JACHA

19

178

186

Cross Sectional

Drug usage and related patterns of behavior in university students: I. General survey and marijuana use.

305.2

0127

1974 Biggs DA

0127 Orcutt JB

51

Higher

JCSP

15

22

30

1

16

86

92

Cross Sectional

Correlates of marijuana and alcohol use among college students.

305.2

0111

1972 Gergen MK

0111 Gergen KJ

181

Higher 2

JASP

1

Cross Sectional

Correlates of marijuana use among college students.

305.2

0126

1974 Grossman J 213

0126 Goldstein R

4153159

Higher 48

PQ

Cross Sectional

Undergraduate marijuana and drug use as related to openness to experience.

305.2

0124

1968 Hinckley RG 233

0124

Sig Higher

Messenheime JACHA

5730810

17

35

42

141

171

Cross Sectional

Nonmedical drug use and the college student.

305.2

0128

1973 Levy L

0128

Higher 2

DF

298

2

Cross Sectional

Drug use on campus: prevalence and social characteristics of collegiate drug users on campuses of the University of Illinois.

305.2

0422

0422

217

Higher

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1973 Milman DH 345

Su W-H

4685687

Vol/Iss

Journal

Pages

Findings: Total

JACHA

21

181

Prevalence 187

Cross Sectional

Patterns of drug usage among university students: V. Heavy use of marijuana and alcohol by undergraduates.

305.2

0432

1989 Monteiro MG 350

0432 Schuckit MA

2596444

Higher

AJDAA

15

4

403

412

Cross Sectional

Alcohol, drug, and mental health problems among Jewish and Christian men at a university.

305.2

1098

1972 Pearlman SP

1098 Philip AF

392

PCSDS 1

139

185

Cross Sectional

Religious affiliations and patterns of drug usage in an urban university population. In: Einstein S, Allen S, eds. Proceedings of the First Int Conference on Student Drug Surveys, Sept. 12-15, 1972, Newark, NJ. Farmingdale, NY: Baywood Publishing Co.

305.2

1144

1974 Strimbu JL 533

1144 Sims Jr OS

4154923

Higher 9

IJA

4

569

583

121

136

Cross Sectional

A university system drug profile.

305.2

0436

0436

1977 Weinstein R 568

Higher 12

IJA

863556

1

Cross Sectional

Interpersonal expectations for marijuana behavior.

305.2

0122

1986 Amoateng A 678

0122 Bahr SJ

Sig Higher

SOCP

29

1

53

76

1

114

Cross Sectional

Religion, family and adolescent drug use.

305.2

1769

1971 Johnson BD 707

Higher SDUDD Cross Sectional

Social determinants of the use of "dangerous drugs" by college students. Unpublished doctoral dissertation, Columbia University.

305.2

1131

1980 Daum M

1131

Higher

Lavenhar MA SRR

1201

Cross Sectional

Religiosity and drug use: a study of Jewish and gentile college students.

305.2

0577

***0577

218

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1107

Blume SB

11760928

Pages

Findings: Total

Prevalence

304.3

MARIJUANA DEPENDENCE 2001 Vex SL

Vol/Iss

Journal

20

JAD

4

71

89

Case Study

The JACS study I: characteristics of a population of chemically dependent Jewish men and women.

304.3

0453

***0453

MEASLES [MEASLES WITHOUT MENTION OF COMPLICATION] 1908 Guilfoy WH

73

MR

215

132

055.9 135

Cross Sectional

The death rate of the city of New York as affected by the cosmopolitan character of its population.

055.9

0415

0415

1900 Department

Higher 3

VS

642

117

133

440

449

Cross Sectional

Twelfth census of the United States.

055.9

1660

1987 Schulman S 1204

1660

Lower

Werzberger A MMWR

3110572

36

27

Case Control

Multistate outbreak of shigella sonnei gastroenteritis – United States.

055.9

0719

***0719

172.9

MELANOMA [MELANOMA OF SKIN, SITE UNSPECIFIED] 1961 Askovitz SI

JAEMC

22

9

4

229

232

Cross Sectional

Distribution of malignant neoplasms with reference to the patient's religion.

172.9

1035

1975 Greenwald P 212

1035 Korns RF

1192415

No Difference 35

CR

3507

3512

235

245

Cross Sectional

Cancer in United States Jews.

172.9

2044

1985 Mack TM 314

2044 Berkel J

3834340

NCIM

69

Cross Sectional

Religion and cancer in Los Angeles County.

172.9

2110

1960 MacMahon B 315

2110

No Difference 16

AUIC

Cross Sectional

The ethnic distribution of cancer mortality in New York City, 1955.

219

1716

1724

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

172.9

2029

2029

Sig Higher

1961 Newill VA

26

JNCI

375

2

405

Prevalence 417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

172.9

0669

1996 Tonin P 857

0669 Weber B

8898735

Higher 2

NM

11

1179

1183

Case study

Frequency of recurrent BRCA1 BRCA2 mutations in Ashkenazi Jewish breast cancer families.

172.9

2234

1998 Woodage T 870

2234 King SM

9731533

20

NG

1

62

65

Case study

The APC I1307K allele and cancer risk in a community-based study of Ashkenazi Jews.

172.9

2207

2207

1999 Breast Canc 1137

91

JNCI

10433620

5

1310

1316

1259

1272

Cohort

Cancer risks in BRCA2 mutation carriers.

172.9

0924

2000 Moslehi R

***0924 Chu W

1166

ASHG

66

Cohort

BRCA1 and BRCA2 mutation analysis of 208 Ashkenazi women with ovarian cancer.

172.9

2015

***2015

MELANOMA AND OTHER SKIN CANCER [OTHER MALIGNANT NEOPLASM OF SKIN] 1971 Seidman H

493

5173551

4

ER

390

173 429

Cross Sectional

Cancer mortality in New York City for country-of-birth, religious, socioeconomic groups.

173

1510

1970 Seidman H 494

4919127

1510 3

ER

234

250

Cross Sectional

Cancer death rates by site sex for religious socioeconomic groups in New York City.

173

1774

1774

MENINGITIS [CEREBROSPINAL] 1923 Spivak CD

CM

523

047.0 1

46

49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

047.0

0810

0810

220

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

322.9

MENINGITIS OF UNSPECIFIED CAUSE [MENINGITIS, UNSPECIFIED] 1923 Spivak CD

1

CM

523

Prevalence

46

49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

322.9

0808

1987 Schulman S 1204

0808 Werzberger A MMWR

3110572

36

27

440

449

Case Control

Multistate outbreak of shigella sonnei gastroenteritis – United States.

322.9

0666

***0666

290-319

MENTAL DISORDERS 1965 Armstrong R

27

JSS

17

1

103

111

370

391

455

470

235

253

1

end

Review

Mental illnesses among American Jews.

290-319

1110

1110

1918 Bailey P

6

MH

28

Cross Sectional

A contribution to the mental pathology of races in the United States.

290-319

0100

1888 Bannister H

0100 Hektoen L

32

Higher 44

AJI

Cross Sectional

Race and insanity.

290-319

1392

1961 Braaten LJ

1392 Darling CD

66

Higher 10

SM

Cross Sectional

Mental health services in college: some statistical analyses.

290-319

0090

0090

1973 Brenner MH

Higher 1

HUP

70

Cross Sectional

Mental Illness and the Economy. Cambridge, Massachusetts: Harvard University Press.

290-319

0087

0087

Lower

290-319

0089

0089

Lower

1914 Brill AA

Karpas MJ

73

JNMD

41

512

Cross Sectional

Insanity among Jews. Is the Jew disproportionately insane?

290-319

0101

0101

Lower 221

517

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1914 de Leon D

Karpas Morris MR

74

Vol/Iss

Journal

Pages

Findings: Total 86

Prevalence

576

579

25

27

Case Study

Insanity among Jews.

290-319

1262

1262

1914 Burr CW

JAMA

86

62

1

Cross Sectional

The foreign-born insane: a racial study of the patients admitted to the insane department of the Philadelphia General Hospital in ten years (1903-1912).

290-319

1088

1939 Cohen BM

1088 Fairbank RE

104

HB

Lower 11

1

112

129

Cross Sectional

Statistical contributions from the mental hygiene study of the eastern health district of Baltimore. III. Personality disorder in the eastern health district in 1933.

290-319

2502

1939 Cohen BM

2502 Tietze C

105

HB

Higher 11

485

512

Cross Sectional

Statistical contributions from the mental hygiene of the eastern health district of Baltimore. IV. Further studies on personality from the eastern health district in 1933.

290-319

2503

2503

1965 Freed EX

IJSP

170

Higher 11

3

110

115

Case Study

Ethnic identification of hospitalized Jewish psychiatric patients: an exploratory study.

290-319

1112

1928 Goldberg JA

1112 Malzberg B

190

PQ

2

194

213

469

471

612

618

Cross Sectional

Mental disease among Jews.

290-319

0098

0098

1902 Hyde FG

AJI

242

Higher 58

Cross Sectional

Notes on the Hebrew insane.

290-319

0103

1944 Hyde RW

0103 Chisholm RM NEJM

243

Higher 231

18

Cross Sectional

Studies in medical sociology. III. The relation of mental disorders to race and nationality.

290-319

0092

1956 Liberson DM 300

0092 JSS

18

Cross Sectional

Causes of death among Jews in New York City in 1953. 222

83

117

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

290-319

0706

0706

Lower

1973 Lindenthal JJ

PHDYU 1

305

1

Prevalence

273

345

479

518

Cross Sectional

The Jews of Middletown, Connecticut.

290-319

0501

0501

1973 Malzberg B 322

Higher 49

APS

4746013

Cross Sectional

Mental disease among Jews in New York State, 1960-1961: a study of ethnic variation in incidence.

290-319

0088

0088

1955 Malzberg B

Lower 28

PQ

323

398

409

Cross Sectional

A statistical study of patients in the New York civil state hospitals, March 31, 1952.

290-319

0096

0096

1930 Malzberg B

Lower 14

MH

324

926

946

104

109

Cross Sectional

The prevalence of mental disease among Jews.

290-319

0097

0097

1963 Rinder ID

Lower 9

IJSP

431

Review

Mental health of American Jewish urbanites: a review of literature predictions.

290-319

1116

1954 Roberts BH

1116 Myers JK

434

110

AJP

759

764

187

211

Cross Sectional

Religion, national origin, immigration and mental illness.

290-319

0091

0091

1989 Sanua VD 473

Higher

IJPRS 2698867

26

4

Review

Studies in mental illness other psychiatric deviances among contemporary Jewry: a review of the literature.

290-319

1981

1936 Slawson J

1981 Moss M

513

JSSQ

1

343

350

613

630

Cross Sectional

Mental illness among Jews.

290-319

0093

1880 Spitzka EC

0093

Higher

JNMD

522 Contributions to nervous mental pathology.

223

7

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

290-319

1799

1799

Lower

1913 Swift HM

70

AJI

537

Prevalence

143

154

29

39

364

369

292

297

Cross Sectional

Insanity and race.

290-319

1056

1942 Tietze C

1056 Lemkau P

542

Higher 48

AJS

1

Cross Sectional

Personality disorder and spatial mobility.

290-319

1480

1480

1952 Wortis J

Higher

JNMA

584

44

5

Cross Sectional

Psychiatric problems of minorities.

290-319

1053

1992 Yeung PP 598

1053 Greenwald S

1492249

Lower

SPPE

27

6

Cross Sectional

Jewish Americans mental health: results of the NIMH Epidemiologic Catchment Area Study.

290-319

1483

1483

1929 Commonwea

No Difference

ARCMD -

650

124

Cross Sectional

Annual Report of the Commissioner of Mental Diseases for the Year Ending November 30, 1929.

290-319

1642

1642

8005779

Case Study

1994 Chiu TL 654

Lower 40

IJSP

1

61

74

The unique challenges faced by psychiatrists and other mental health professionals working in a multicultural setting.

290-319

1675

1958 Hollingshead 724

1675 Redlich FC

SCMI Case Study

Social class and mental illness: a community study (1958), New York: John Wiley and Sons, Inc.

290-319

1106

1926 Department

1106

Higher

DOC

1021 Patients in hospitals for mental disease, 1923.

290-319

1639

1906 North SND

1639 DOC

1

1242 Insane and Feeble-Minded in Hospitals and Institutions, 1904.

224

41

Year Author1 BiblioRef

Author2 PubMed

Design

ICD

Lindex

IsText

290-319

1765

***1765 Moss M

513

Pages

Findings: Total

Prevalence

317-319

MENTAL RETARDATION 1936 Slawson J

Vol/Iss

Journal

JSSQ

1

343

350

Cross Sectional

Mental illness among Jews.

317-319

0295

0295

No Difference

206

MONOCYTIC LEUKEMIA 1961 Newill VA

26

JNCI

375

2

405

417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

206

0688

0688

No Difference

MOTOR VEHICLE ACCIDENTS 1962 Gorwitz K

JSS

198

E810-E825 24

248

254

83

117

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957.

E810-E825

0487

1956 Liberson DM 300

0487

Lower 18

JSS

Cross Sectional

Causes of death among Jews in New York City in 1953.

E810-E825

0774

0774

Lower

203.0

MULTIPLE MYELOMA 1960 MacMahon B

315

16

AUIC

1716

1724

405

417

Cross Sectional

The ethnic distribution of cancer mortality in New York City, 1955.

203.0

1083

1961 Newill VA

1083

Higher 26

JNCI

375

2

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

203.0

0684

1971 Seidman H 493

5173551

0684

Higher 4

ER

390

429

Cross Sectional

Cancer mortality in New York City for country-of-birth, religious, socioeconomic groups.

203.0

1745

1745

225

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1970 Seidman H 494

Pages

Findings: Total 3

ER

4919127

Vol/Iss

Journal

234

Prevalence 250

Cross Sectional

Cancer death rates by site sex for religious socioeconomic groups in New York City.

203.0

1700

1997 Struewing JP 935

1700 Hartge P

9145676

NEJM

336

20

1401

1408

Case study

The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Jews.

203.0

2267

2267

1999 Breast Canc 1137

91

JNCI

10433620

5

1310

1316

Cohort

Cancer risks in BRCA2 mutation carriers.

203.0

0937

***0937

340

MULTIPLE SCLEROSIS 1956 Liberson DM

18

JSS

300

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

340

0747

0747

No Difference

306.0

MUSCULOSKELETAL (PSYCHOGENETIC PARALYSIS) 1880 Spitzka EC

JNMD

7

613

630

522 Contributions to nervous mental pathology.

306.0

1119

1119

Lower

205

MYELOID LEUKEMIA 1961 Newill VA

26

JNCI

375

2

405

417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

205

0687

MYOPATHY

1996 Sivakumar K

970

0687

Higher

359.9 Vasconcelos

8628478

46

N

5

1337

1342

Case study

Late-onset myopathy with vacuoles, abnormal mitochondria, absence of the common exon 5/intron 5 junction point mutation.

359.9

2295

2295

226

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Findings: Total

NARCOTIC USE [UNSPECIFIED DRUG DEPENDENCE] 1973 Arafat I

Yorburg B

15

Pages

9

JSR

Prevalence

304.9 1

21

29

Cross Sectional

Drug use and the sexual behavior of college women.

304.9

0400

1974 Strimbu JL 533

0400 Sims Jr OS

4154923

No Difference 9

IJA

4

569

583

Cross Sectional

A university system drug profile.

304.9

0439

0439

Higher

NEOPLASM OF UNSPECIFIED NATURE OF DIGESTIVE SYSTEM 1964 Quan SH

Bader G

1149

36

DCR

197

239.0 206

Cohort

Cardinoid tumors of the rectum.

239.0

0985

NEOPLASMS 1950 Hand EA

221

***0985

140-239 JMSMS 49

333

334

218

220

46

49

Review

Cancer in the Jewish race.

140-239

1186

1186

4189012

Review

1970 Kessler II 264

L

A genetic relationship between diabetes and cancer.

140-239

0538

1923 Spivak CD

0538 1

CM

523

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

140-239

1096

1096

239.8

NEOPLASMS OF UNSPECFIED NATURE (OTHER SPECIFIED SITES) 1960 MacMahon B

315

16

AUIC

1716

Cross Sectional

The ethnic distribution of cancer mortality in New York City, 1955.

239.8

1084

1084

Lower 227

1724

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

NEOPLASMS OF UNSPECIFIED NATURE (SITE UNSPECIFIED) 1933 Bolduan CR

Weiner L

63

NEJM

208

8

Prevalence

239.9

407

416

22

44

1155

1159

Cross Sectional

Causes of death among Jews in New York City.

239.9

0043

0043

1928 Bureau of Je

JCSNY

84

Higher 1

Cross Sectional

Causes of death among Jews.

239.9

2143

2143

1928 Deporte JV

NYSJM

124

Higher 28

19

Cross Sectional

Causes of death among Jews in New York State (exclusive of New York City), 1925.

239.9

0328

0328

1916 Dublin LI

AER

128

Lower 6

3

523

548

Cross Sectional

Factors in American mortality: a study of death rates in the race stocks of New York State, 1910.

239.9

0561

1920 Dublin LI

0561 Baker GW

129

QPASA 10

13

44

529

531

87

101

Cross Sectional

The mortality of race stocks in Pennsylvania and New York, 1910.

239.9

0693

1906 Fishberg M 163

0693 JE

-

-

Cross Sectional

Cancer.

239.9

1201

1986 Goldstein A 192

3775445

1201 SB

Lower 33

1-2

Cross Sectional

Patterns of mortality and causes of death among Rhode Island Jews, 1979-1981.

239.9

2526

1966 Goldstein S 195

2526 EQ

13

1

48

61

Cross Sectional

Jewish mortality and survival patterns: Providence, Rhode Island, 1962-1964.

239.9 1962 Gorwitz K 198

0458

0458 JSS

Higher 24

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957. 228

248

254

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

239.9

0464

0464

Lower

1975 Greenwald P 212

Korns RF

1192415

CR

35

Prevalence

3507

3512

132

135

Cross Sectional

Cancer in United States Jews.

239.9

2047

2047

1908 Guilfoy WH

MR

215

73

Cross Sectional

The death rate of the city of New York as affected by the cosmopolitan character of its population.

239.9

0412

0412

1961 Haenszel W

JNCI

219

Lower 26

1

37

132

Cross Sectional

Cancer mortality among the foreign-born in the United States.

239.9

0050

0050

1971 Haenszel W 220

IJMS

5144588

Sig Higher 7

12

1437

1450

349

358

Cross Sectional

Cancer mortality among U.S. Jews.

239.9

0052

1965 King H

0052 Diamond E

268

MMFQ

Higher 43

Cross Sectional

Cancer mortality and religious preference: a suggested method in research.

239.9

0047

0047

1956 Liberson DM

JSS

300

18

83

117

273

345

343

361

Cross Sectional

Causes of death among Jews in New York City in 1953.

239.9

0702

0702

1973 Lindenthal JJ

Higher

PHDYU 1

305

1

Cross Sectional

The Jews of Middletown, Connecticut.

239.9

0055

1929 Lombard HL 308

0055 Doering CR

JPM

Higher 3

5

Cross Sectional

Cancer studies in Massachusetts: 3. Cancer mortality in nativity groups.

239.9

1464

1464

239.9

1468

1468

1960 MacMahon B 315

AUIC

16

Cross Sectional

The ethnic distribution of cancer mortality in New York City, 1955. 229

1716

1724

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

239.9

1085

1085

Higher

1934 Maller JB

JSSQ

321

10

Prevalence

271

276

405

417

Cross Sectional

A study of Jewish neighborhoods in New York City.

239.9

1237

1237

1961 Newill VA

Lower 26

JNCI

375

2

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

239.9

0213

1989 Rosenwaike I 440

0213

Higher

Hempstead K SSM

2799431

29

7

885

889

Cross Sectional

Differential mortality by ethnicity: foreign-born Irish, Italians and Jews in New York City, 1979-81.

239.9

1037

1971 Seidman H 493

5173551

1037 4

ER

390

429

Cross Sectional

Cancer mortality in New York City for country-of-birth, religious, socioeconomic groups.

239.9

1379

1970 Seidman H 494

4919127

1379 3

ER

234

250

Cross Sectional

Cancer death rates by site sex for religious socioeconomic groups in New York City.

239.9

1514

1917 Guilfoy WH 655

1514 MS18

1

27

Cross Sectional

The influence of nationality upon the mortality of a community, with special references to the city of New York.

239.9

1679

1994 Rosenwaike I 657

8082959

1679 23

IJE

2

Cross Sectional

Causes of death among elderly Jews in New York City, 1979-1981.

239.9

1726

1912 Davis WH

1726 PDCB

679

Cross Sectional

The relation of the foreign population to Boston mortality rates.

239.9

1772

Lower

230

327

332

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

583.9

NEPHRITIS [WITH UNSPECIFIED PATHOLOGICAL LESION IN KIDNEY] 1928 Bureau of Je

JCSNY

84

Prevalence

1

22

44

1155

1159

Cross Sectional

Causes of death among Jews.

583.9

2148

2148

1928 Deporte JV

Lower

NYSJM

124

28

19

Cross Sectional

Causes of death among Jews in New York State (exclusive of New York City), 1925.

583.9

0331

1920 Dublin LI

0331 Baker GW

129

Lower

QPASA 10

13

44

87

101

Cross Sectional

The mortality of race stocks in Pennsylvania and New York, 1910.

583.9

0696

1986 Goldstein A 192

3775445

0696 33

SB

1-2

Cross Sectional

Patterns of mortality and causes of death among Rhode Island Jews, 1979-1981.

583.9

2530

1962 Gorwitz K

2530

No Difference 24

JSS

198

248

254

132

135

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957.

583.9

0473

1908 Guilfoy WH 215

0473

Lower 73

MR

Cross Sectional

The death rate of the city of New York as affected by the cosmopolitan character of its population.

583.9

0417

1956 Liberson DM 300

0417

Lower 18

JSS

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

583.9

0707

0707

No Difference

583.9

0724

0724

No Difference

1912 Price GM

1

ACP

409

205

268

Cross Sectional

Report on bakeries and bakers in New York City. In: preliminary report of the factory investigating commission, volume 1, Albany, New York.

583.9

1367

1367

No Difference 231

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1923 Spivak CD

Pages

Findings: Total 1

CM

523

Vol/Iss

Journal

46

Prevalence 49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

583.9

0787

0787

1900 Department

3

VS

643

128

Cross Sectional

Twelfth census of the United States.

583.9

1668

1668

Lower

583

NEPHRITIS AND NEPHROPATHY NOT SPECIFIED AS ACUTE OR CHRONIC 2001 Parvari R

1054

Shnaider A

AJMG

99

3

204

209

11241491

Clinical and genetic characterization of an autosomal dominant nephropathy.

583

0159

1953 Rosenberg L 1333

***0159 15

JSS

101

112

Cross Sectional

Births, Deaths and Morbidity Among Jews in Montreal in 1950

583

1809

***1809

lower

NEPHRITIS, NEPHROTIC SYNDROME, AND NEPHROSIS 1973 Lindenthal JJ

305

PHDYU 1

1

273

580-589 345

Cross Sectional

The Jews of Middletown, Connecticut.

580-589

0502

0502

Higher

799.2

NERVOUSNESS 1915 Schereschew

481

71

PHB

13

103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

799.2

0964

1942 Harms E

0964 3

DNS

1218

Review

The nervous Jew. A study in social psychiatry.

799.2

1094

***1094

232

3

47

57

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

NEURASTHENIA 1905 Bernheimer

44

Vol/Iss

Journal

Pages

Findings: Total

Prevalence

300.5 BOOK2 1

328

Cross Sectional

The Russian Jew in the United States: studies of social conditions in New York, Philadelphia and Chicago with a description of rural settlements.

300.5

1331

1331

1915 Schereschew

Higher 71

PHB

481

13

103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

300.5

0977

0977

1911 Schwab SI

ALLR

488

1

27

33

70

143

154

Case Study

Neurasthenia among garment workers.

300.5

0978

0978

1913 Swift HM

AJI

537

Cross Sectional

Insanity and race.

300.5

1068

1068

No Difference

NEUROSES AND PERSONALITY DISORDERS 1942 Harms E

3

DNS

1218

3

47

300-301.9 57

Review

The nervous Jew. A study in social psychiatry.

300-301.9

1222

***1222

094.9

NEUROSYPHILIS [NEUROSYPHILIS, UNSPECIFIED] 1928 Goldberg JA

Malzberg B

190

2

PQ

194

213

Cross Sectional

Mental disease among Jews.

094.9

0315

0315

Lower

094.89

NEUROSYPHILIS [OTHER SPECIFIED NEUROSYPHILIS (OTHER)] 1930 Malzberg B

324

14

MH

926

Cross Sectional

The prevalence of mental disease among Jews.

094.89

0305

0305

Lower 233

946

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1931 Malzberg B

Pages

Findings: Total 15

MH

325

Vol/Iss

Journal

766

Prevalence 774

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

094.89

0579

0579

1919 New York St

Lower

NYSHC -

640

-

322

409

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

094.89

1705

1705

Lower

300

NEUROTIC DISORDERS 1918 Bailey P

6

MH

28

370

391

514

517

98

101

194

213

612

618

Cross Sectional

A contribution to the mental pathology of races in the United States.

300

0080

0080

300

0289

0289

1956 Eichler RM

Lirtzman S

135

JNMD

124

Cross Sectional

Religious background of patients in a mental hygiene setting.

300

1977

1957 Frumkin RM

1977 Frumkin MZ

173

Higher 6

JHR

Cross Sectional

Religion, occupation, and major mental disorders: a research note.

300

0394

1928 Goldberg JA

0394 Malzberg B

190

Lower 2

PQ

Cross Sectional

Mental disease among Jews.

300

0324

1944 Hyde RW

0324

Higher

Chisholm RM NEJM

243

231

18

Cross Sectional

Studies in medical sociology. III. The relation of mental disorders to race and nationality.

300

0364

1909 Kirby GH

0364 1

SHB

270

4

Cross Sectional

A study in race psychopathology.

300

0345

0345

Higher

234

663

670

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1973 Malzberg B 322

Pages

Findings: Total 49

APS

4746013

Vol/Iss

Journal

479

Prevalence 518

Cross Sectional

Mental disease among Jews in New York State, 1960-1961: a study of ethnic variation in incidence.

300

0353

0353

1930 Malzberg B

Lower 14

MH

324

926

946

Cross Sectional

The prevalence of mental disease among Jews.

300

0306

0306

1931 Malzberg B

No Difference 15

MH

325

766

774

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

300

0376

0376

1962 Malzberg B

Lower 46

MH

328

4

510

522

Cross Sectional

The distribution of mental disease according to religious affiliation in New York State, 1949-1951.

300

1152

1152

1920 Myerson A

Lower

MH

363

4

65

72

3

104

107

110

759

764

343

350

322

409

Review

The "nervousness" of the Jew.

300

0099

0099

1941 Myerson A

ML

364

Review

Neuroses alcoholism among the Jews.

300

1114

1954 Roberts BH

1114 Myers JK

434

AJP

Cross Sectional

Religion, national origin, immigration and mental illness.

300

1248

1936 Slawson J

1248 Moss M

513

Higher

JSSQ

1

Cross Sectional

Mental illness among Jews.

300

0297

0297

Higher

300

0299

0299

Lower

1919 New York St 640

NYSHC -

-

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

235

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

300

1718

1718

Higher

1914 Harris WJ

DOC

1210

Prevalence

25

34

741

745

Cross Sectional

Insane and feeble-minded in institutions in 1910.

300

0834

1939 Fleming R

***0834 Tillotson K

1213

NEJM

221

19

Case Control

Further studies on the personality and sociological factors in the prognosis and treatment of chronic alcoholism.

300

0949

***0949

NEUROTIC DISORDERS, PERSONALITY DISORDERS, AND OTHER NONPSYCHOTIC DISORDERS 1942 Schilder P

15

JSP

482

300-316

3

21

29

39

Case Study

The sociological implications of neuroses.

300-316

1052

1942 Tietze C

1052 Lemkau P

542

48

AJS

1

Cross Sectional

Personality disorder and spatial mobility.

300-316

1158

1158

Higher

265.2

NICOTINIC ACID 1982 Moore MR

1080

Conrad ME

6121484

AJOH

12

13

18

Cohort

Studies of nicotinamide adenine dinucleotide methemoglobin reductase activity in a Jewish population.

265.2

0276

***0276

250.0

NON-INSULIN-DEPENDANT DIABETES MELLITUS 1953 Rosenberg L

1333

15

JSS

Cross Sectional

Births, Deaths and Morbidity Among Jews in Montreal in 1950

250.0

2082

***2082

236

101

112

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

?

not sure about ICD (or icd not enterered yet) 1998 Medintz I

953

Kingston C

9728757

111

IJLM

Prevalence

275

273

Cross Sectional

DIS80 allele frequencies in Hasidic and non-Hasidic New York City populations.

?

2278

1959 Saldanha PH

2278 Becak W

1146

129

S

334 150

151

Case Control

Taste thresholds for phenylthiourea among Ashkenazi Jews.

?

1009

***1009

1914 Harris WJ

DOC

128

1183 Department of commerce, bureau of the census, twelfth census of the United States.

?

1964

1956 Epstein F

***1964 Carol R

1212

AJCN

4

1

1

9

Cross Sectional

Estimation of caloric intake from dietary histories among population groups.

?

0946

***0946

1965 Palatnik M

207

N

1338

1203

1204

Cohort

Distribution of Dia Factor in Argentine Jews.

?

2174

***2174

OBSESSIVE-COMPULSIVE DISORDER 1992 Yeung PP

598

Greenwald S

1492249

SPPE

27

300.3 6

292

297

Cross Sectional

Jewish Americans mental health: results of the NIMH Epidemiologic Catchment Area Study.

300.3

1498

1498

No Difference

365.1

OPEN-ANGLE GLAUCOMA 1957 Kornzweig A

753

Feldstein M

44

AJO

29

37

Case study

The eye in old age: IV. Ocular survey of over one thousand aged persons with special reference to normal disturbed visual function.

365.1

1556

1556

237

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

OPIOID TYPE DEPENDENCE EPISODIC USE 1980 Daum M

Prevalence

304.02

Lavenhar MA SRR

1201

Cross Sectional

Religiosity and drug use: a study of Jewish and gentile college students.

304.02

0611

***0611

ORGANIC HEART DISEASE [HEART DISEASE, UNSPECIFIED] 1891 Billings JS

152

NAR

52

429.9

70

84

22

44

523

548

Cross Sectional

Vital statistics of the Jews.

429.9

0800

0800

1928 Bureau of Je

Higher

JCSNY

84

1

Cross Sectional

Causes of death among Jews.

429.9

2141

2141

1916 Dublin LI

Higher 6

AER

128

3

Cross Sectional

Factors in American mortality: a study of death rates in the race stocks of New York State, 1910.

429.9

0562

1920 Dublin LI

0562 Baker GW

129

Lower

QPASA 10

13

44

87

101

Cross Sectional

The mortality of race stocks in Pennsylvania and New York, 1910.

429.9

0694

0694

1986 Goldstein A 192

Lower 33

SB

3775445

1-2

Cross Sectional

Patterns of mortality and causes of death among Rhode Island Jews, 1979-1981.

429.9

2524

2524

1912 Price GM

Higher 1

ACP

409

205

268

Cross Sectional

Report on bakeries and bakers in New York City. In: preliminary report of the factory investigating commission, volume 1, Albany, New York.

429.9

1369

1989 Rosenwaike I 440

1369

Higher

Hempstead K SSM

2799431

29

7

885

889

Cross Sectional

Differential mortality by ethnicity: foreign-born Irish, Italians and Jews in New York City, 1979-81.

429.9

1036

1036

Higher 238

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1912 Davis WH

Vol/Iss

Journal

Pages

Findings: Total

Prevalence

PDCB

679

Cross Sectional

The relation of the foreign population to Boston mortality rates.

429.9

1773

1995 Shatenstein 758

Lower Kark JD

8550270

24

IJE

4

730

739

Cross sectional

Mortality in two Jewish populations--Montreal and Israel: environmental determinants of

429.9

1562

1562

1953 Rosenberg L

15

JSS

1333

101

112

Cross Sectional

Births, Deaths and Morbidity Among Jews in Montreal in 1950

429.9

1780

***1780

OSTEOPOROSIS UNSPECIFIED 2000 Thearle M

1084

Horlick M

10852438

JCEM

733.00 85

6

2122

2126

Case Study

Osteoporosis: an unusual presentation of childhood Crohn’s disease.

733.00

0286

***0286

OTHER AND UNSPECIFIED ANGINA PECTORIS 413.9 1923 Spivak CD

1

CM

523

46

49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

413.9

0820

0820

OTHER AND UNSPECIFIED ATELECTASIS ORIGINATING IN THE PERINATAL PERIOD 1956 Liberson DM

18

JSS

300

83

770.5 117

Cross Sectional

Causes of death among Jews in New York City in 1953.

770.5

0768

0768

Lower

OTHER AND UNSPECIFIED DISORDERS OF METABOLISM [CYSTIC FIBROSIS] 1978 Wagener D

685

Cavalli-Sforza AJHG

677123

30

262

Case Study

Ethnic variation of genetic disease: roles of drift for recessive lethal genes.

277.0

1846

***1846

239

277.0 270

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1995 Gilbert F 798

Schoelkopf J 7495602

Vol/Iss

Journal

Pages

Findings: Total

AJPM

11

4

251

Prevalence 255

Cross sectional

Ethnic intermarriage, its consequences for cystic fibrosis carrier screening.

277.0

1790

1998 Kronn D 988

1790 Jansen V

158

AIM

777

781

9554684

Carrier screening for cystic fibrosis, Gaucher disease, Tay-Sachs disease in the Ashkenazi Jewish population: the first 1000 cases at New York University Medical Center, New York, NY.

277.0

2315

1996 Loader S 999

***2315 Caldwell P

AJHG

59

234

247

8659530

Cystic fibrosis carrier population screening in the primary care setting.

277.0

2324

1997 Eng CM 1016

2324 Schechter C

9333269

JAMA

278

15

1268

1272

Case study

Prenatal genetic carrier testing using triple disease screening.

277.0

2343

1994 Li L

2343 Caggana M

AJHG

61

824 118

118

1017 Prenatal genetics screening in the Ashkenazi Jewish population: a pilot program of multiple option testing for five disorders.

277.0

2347

1999 Monaghan K 1066

2347 Feldman GL

10419606

19

PD

7

604

609

Retrospective Co

The risk of cystic fibrosis with prenatally detected echogenic bowel in an ethnically and racially diverse North American population.

277.0

2576

***2576

OTHER ANOMALIES OF UTERUS 1969 German J

BDO

1206

752.39 5

5

117

131

Review

Chromosome breakage syndromes.

752.39

1233

***1233

219.0

OTHER BENIGN NEOPLASM OF CERVIX 1941 Smith FR

AJOG

516

41

424

Cross Sectional

Nationality and carcinoma of the cervix.

219.0

0633

0633

Lower 240

430

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

OTHER CURRENT CONDITIONS IN THE MOTHER CLASSIFIABLE ELSEWHERE, BUT COMPLICATING PREGNANCY, CHILDBIRTH, OR THE PUERPERIUM 1928 Bureau of Je

JCSNY

84

1

22

Prevalence

648

44

Cross Sectional

Causes of death among Jews.

648

2146

2146

Lower

OTHER DISORDERS OF SOFT TISSUES [NEURALGIA, NEURITIS, AND RADICULITIS, UNSPECIFIED] 1915 Schereschew

71

PHB

481

13

729.2

103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

729.2

0973

0973

OTHER LYMPHOID LEUKEMIA 1961 Newill VA

JNCI

375

204.8 26

2

405

417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

204.8

0685

0685

No Difference

OTHER NONINFECTIOUS GASTROENTERITIS AND COLITIS 1960 Acheson ED

1

GUT

4

291

558.9 293

Cross Sectional

The distribution of ulcerative colitis regional enteritis in United States veterans with particular reference to the Jewish religion.

558.9

0193

0193

1894 Billings JS

1

USDI

53

100

102

Cross Sectional

Vital statistics of New York City and Brooklyn, covering a period of six years ending May 31, 1890.

558.9

2132

1970 Gelfand MD 178

2132 Krone CL

4194553

Lower 72

ANIM

6

903

Case Study

Inflammatory bowel disease in a family: observations related to pathogenesis.

558.9

2065

2065

241

907

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1908 Guilfoy WH

Pages

Findings: Total 73

MR

215

Vol/Iss

Journal

132

Prevalence 135

Cross Sectional

The death rate of the city of New York as affected by the cosmopolitan character of its population.

558.9

0408

1989 Roth MP 444

0408

Higher

Peterson GM G 2925048

96

4

1016

1020

Case Study

Familial empiric risk estimates of inflammatory bowel disease in Ashkenazi Jews.

558.9

1057

1989 Roth MP 445

1057 Peterson GM G

2777043

97

4

900

904

Case Study

Geographic origins of Jewish patients with inflammatory bowel disease.

558.9

1059

1971 Singer HC 510

1059

Higher

Anderson JG G 5114635

61

4

423

430

Cross Sectional

Familial aspects of inflammatory bowel disease.

558.9

2054

2054

1923 Spivak CD

Sig Higher 1

CM

523

46

49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

558.9

0794

1991 Bennett RA 646

0794 Rubin PH

2019369

100

G

66

1638

1643

Case Study

Frequency of inflammatory bowel disease in offspring of couples both presenting with inflammatory bowel disease.

558.9

1641

1641

1917 Guilfoy WH

MS18

655

1

27

Cross Sectional

The influence of nationality upon the mortality of a community, with special references to the city of New York.

558.9

1689

1996 Ohmen JD 965

1689 Yang H-Y

Lower 5

HMG

10

1679

1683

8894707

Susceptibility locus for inflammatory bowel disease on chromosome 16 has a role in Crohn's disease, but not in ulcerative colitis.

558.9

2292

242

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

2000 Trachtenberg 1045

Yang H

Vol/Iss

Journal

Pages

Findings: Total 61

HI

3

326

Prevalence 333

10689124

HLA class II haplotype associations with inflammatory bowel disease in Jewish (Ashkenazi) and non-Jewish Caucasion populations.

558.9

2718

1969 Thayer WR J 1307

Brown M

57

G

3

311

318

4897232

Escherichia Coli O:14 and colon hemagglutinating antibodies in inflammatory bowel disease.

558.9

2189

1999 Yin J 1317

***2189 Harpaz N

10445854

18

O

26

3902

3904

Cross Sectional

Low prevalence of the APC I1307K sequence in Jewish and non-Jewish patients with inflammatory bowel disease.

558.9

2185

***2185

OTHER NON-TERATOGENIC ANOMALIES 1987 Lewin SO

299

Hughes HE

3812590

AJMG

26

2

385

754.89 390

Case Study

Brief clinical report: German syndrome in sibs.

754.89

0573

0573

OTHER ORGANIC PSYCHOTIC CONDITIONS (CHRONIC) 1914 de Leon D

Karpas Morris MR

74

86

294

576

579

1773

1778

Case Study

Insanity among Jews.

294

1205

2002 Luczak SE 1328

1205 Shea SH

ACER

26

12

12500100

Binge drinking in Jewish and non-Jewish white college students.

294

2095

***2095

OTHER SPECIFIED CONDITION ORIGINATING 779.8 IN THE PERINATAL PERIOD 1917 Guilfoy WH

655

MS18

1

27

Cross Sectional

The influence of nationality upon the mortality of a community, with special references to the city of New York.

779.8

1695

1695

No Difference 243

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

111.8

OTHER SPECIFIED DERMATOMYCOSIS 1902 Fischkin EA

JAMA

158

39

8

Prevalence

427

432

Cross Sectional

Six years in a dermatologic clinic: a report of service, with remarks on the treatment of the more common skin diseases.

111.8

1218

1218

Higher

OTHER SPECIFIED DISORDERS OF NERVOUS SYSTEM 1964 Banker BQ

Robertson JT N

1157

14

981

349.89 1001

Cohort

Spongy degeneration of the central nervous system in infancy.

349.89

0989

***0989

304.6

OTHER SPECIFIED DRUG DEPENDENCE 1974 Strimbu JL

533

Sims Jr OS

4154923

9

IJA

4

569

583

Cross Sectional

A university system drug profile.

304.6

0438

0438

Higher

257.2

OTHER TESTICULAR HYPOFUNCTION, EUNUCHOIDISM 1944 Kallmann FJ

Schoenfeld W AJMD

257

48

3

203

244

Case Study

The genetic aspects of primary eunuchoidism.

257.2

0547

0547

305.9

OTHER, MIXED, OR UNSPECIFIED DRUG ABUSE 1972 Dvorak EJ

132

JACHA 5007433

20

212

215

Cross Sectional

A longitudinal study of nonmedical drug use among university students: a brief summary.

305.9

0132

1989 Monteiro MG 350

0132 Schuckit MA

2596444

Sig Higher

AJDAA

15

4

403

412

Cross Sectional

Alcohol, drug, and mental health problems among Jewish and Christian men at a university.

305.9

1104

1970 Robbins ES 433

1104 Robbins L

5441725

126

AJP Case Study

College student drug use.

244

12

1743

1751

Year Author1 BiblioRef

Author2 PubMed

Design

ICD

Lindex

IsText

305.9

0133

0133

1974 Strimbu JL 533

Sims Jr OS

4154923

Vol/Iss

Journal

Pages

Findings: Total 9

IJA

4

569

Prevalence 583

Cross Sectional

A university system drug profile.

305.9

0131

1980 Daum M

0131

Higher

Lavenhar MA SRR

1201

Cross Sectional

Religiosity and drug use: a study of Jewish and gentile college students.

305.9

0637

***0637

PAINFUL MENSTRUATION [DYSMENORRHEA] 1915 Schereschew

71

PHB

481

13

625.3 103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

625.3

0960

0960

300.01

PANIC DISORDER 1992 Yeung PP

598

Greenwald S

1492249

SPPE

27

6

292

297

Cross Sectional

Jewish Americans mental health: results of the NIMH Epidemiologic Catchment Area Study.

300.01

1494

1494

No Difference

332

PARKINSON'S DISEASE 1956 Liberson DM

18

JSS

300

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

332

0708

0708

No Difference

332.1

PARKINSON'S DISEASE [SECONDARY PARKINSONISM] 1980 Elizan TS

141

Terasaki PI

7417054

37

ARN

542

544

Case Study

HLA-B 14 antigen postencephalitic Parkinson's disease: their association in an American-Jewish ethnic group.

332.1

0150

0150

245

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1902 Fischkin EA

Pages

Findings: Total

Prevalence

132.9

PEDICULOSIS, UNSPECIFIED JAMA

158

Vol/Iss

Journal

39

8

427

432

Cross Sectional

Six years in a dermatologic clinic: a report of service, with remarks on the treatment of the more common skin diseases.

132.9

1219

1219

Lower

PEMPHIGUS [VULGANS FOLIACEUS] 1990 Ahmed AR

9

Yunis EJ

2318675

27

HI

694.4 4

298

304

Case Study

Complotypes in pemphigus vulgaris: differences between Jewish and non-Jewish patients.

694.4

1969

1969

1962 Brinn LB

HH

76

2

261

275

62

786

802

Review

Jews, genetics and disease.

694.4

0552

1950 Combes FC

0552 Canizares O

107

ADS

Cross Sectional

Pemphigus vulgaris: a clinicopathological study of one hundred cases.

694.4

0202

1957 Costello MJ

0202 Jaimovich L

111

Higher

JAMA

165

10

1249

1255

Cross Sectional

Treatment of pemphigus with corticosteroids: study of fifty-two patients.

694.4

0204

1941 Eller JJ

0204 Kest LH

142

Higher 44

ADS

337

344

321

336

Cross Sectional

Pemphigus: report of seventy-seven cases.

694.4

0200

1941 Gellis S

0200 Glass FA

179

Higher 44

ADS

3

Cross Sectional

Pemphigus: a survey of one hundred seventy patients admitted to Bellevue Hospital from 1911 to 1941.

694.4

0199

0199

1938 Grace AW

Higher

MCNA

203

Review

Clinic of Dr. Arthur W. Grace: pemphigus.

694.4

0452

0452 246

22

1345

1353

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1973 Krain LS 280

Terasaki PI 4128677

Vol/Iss

Journal

Pages

Findings: Total 108

AD

Prevalence

803

805

348

357

348

357

83

117

408

424

Cross Sectional

Increased frequency of HL-A10 in pemphigus vulgaris.

694.4

0205

1942 Lever WF

0205 Talbott JH

291

46

ADS

Cross Sectional

Pemphigus: a clinical analysis follow-up study of sixty-two patients.

694.4

0201

1942 Lever WF

0201 Talbott JH

292

Higher 46

ADS

Cross Sectional

Pemphigus: a clinical analysis follow-up study of sixty-two patients.

694.4

0570

0570

Higher

694.4

0572

0572

Higher

1956 Liberson DM

18

JSS

300

Cross Sectional

Causes of death among Jews in New York City in 1953.

694.4

0765

0765

1966 McKusick VA 337

Higher

ALJMS

5978172

3

4

Review

Clinical genetics at a population level: the ethnicity of disease in the United States.

694.4

1428

1949 Miller OB

1428 Frank LJ

344

ADS

59

484

485

72

495

505

Case Study

Familial pemphigus vulgaris.

694.4

1505

1955 Nelson CT

1505 Brodey M

373

AD Case Study

Cortisone and corticotropin treatment of pemphigus: experience with twenty-eight cases over a period of five years.

694.4

0203

1979 Park MS 387

0203 Terasaki PI

89501

1

L

441

442

134

138

Case Study

HLA-DRW4 in 91% of Jewish pemphigus vulgaris patients.

694.4

0206

1932 Schamberg J 477

0206 25

ADS Case Study

Pemphigus: recovery following long-continued colonic irrigations and arsenic by mouth.

247

Year Author1 BiblioRef

Author2 PubMed

Design

ICD

Lindex

IsText

694.4

0208

0208

1980 Simon DG 509

Krutchkoff D 7416755

Vol/Iss

Journal

Pages

Findings: Total 116

AD

1035

Prevalence 1037

Cross Sectional

Pemphigus in Hartford County, Connecticut, from 1972 to 1977.

694.4

0207

0207

1948 Granirer LW

Sig Higher

CSMJ

737

12

623

625

100

103

Case study

Three cases of pemphigus in the same family: report of one case.

694.4

1506

1996 Bhol K 766

1506 Yunis J

8759194

21

CED

2

Case study

Pemphigus vulgaris in distant relatives of two families: association with major histocompatibility complex class II genes.

694.4

1568

1991 Ahmed AR 777

***1568 Wagner R

1675792

PNAS

88

5056

5060

Case study

Major histocompatibility complex haplotypes class II genes in non-Jewish patients with pemphigus vulgaris.

694.4

1580

1580

694.4

1581

1581

1996 Carson PJ 811

Hameed A 8601655

JAAD

34

4

645

652

62

67

Cross sectional

Influence of treatment on the clinical course of pemphigus vulgaris.

694.4

1825

1997 Mobini N 1089

1825 Yunis EJ

57

HI

1

9438197

Identical MHC markers in non-Jewish Iranian and Ashkenazi Jewish patients with pemphigus vulgaris: possible common central Asian ancestral origin.

694.4

0354

2001 Brenner S 1139

***0354 Tur E

11737449

40

IJD

562

569

Case Control

Pemphis vulgaris: environmental factors, occupational, behavioral, medical, and qualitative food frequence questionnaire.

694.4

0576

1988 Korman N 1198

***0576 JAAD

3290286

Review

1231

***1231

Pemphigus.

694.4

248

18

6

1219

1238

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1976 Beutner EH 1209

Pages

Findings: Total

Chorzelski TP JCP2

993399

Vol/Iss

Journal

3

2

67

Prevalence 74

Cohort

Studies on etiologic factors in pemphigus.

694.4

0826

***0826

158.9

PERITONEUM, UNSPECIFIED 1998 Bandera CA

955

Muto MG

9764635

92

OG

4

596

600

Case study

BRCA1 gene mutations in women with papillary serous carcinoma of the peritoneum.

158.9

2281

2281

281.0

PERNICIOUS ANEMIA 1967 Rosner F

Rubenberg M NYSJM

441

1

2119

2124

Case Study

Pernicious anemia, polycythemia vera, acute myelogenous leukemia in the same patient.

281.0

0617

0617

300.20

PHOBIA, UNSPECIFIED 1992 Yeung PP

598

Greenwald S

1492249

SPPE

27

6

292

297

Cross Sectional

Jewish Americans mental health: results of the NIMH Epidemiologic Catchment Area Study.

300.20

1495

1495

Higher

480-486

PNEUMONIA 1962 Gorwitz K

24

JSS

198

248

254

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957.

480-486

0469

0469

Lower

485

PNEUMONIA [BRONCHOPNEUMONIA, ORGANISM UNSPECIFIED] 1908 Guilfoy WH

215

73

MR

132

135

Cross Sectional

The death rate of the city of New York as affected by the cosmopolitan character of its population.

485

0410

0410

Lower

486

PNEUMONIA [ORGANISM UNSPECIFIED] 1905 Bernheimer

44

BOOK2 1

328

Cross Sectional

The Russian Jew in the United States: studies of social conditions in New York, Philadelphia and Chicago with a description of rural settlements.

486

1328

1328

249

Higher

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1894 Billings JS

Pages

Findings: Total 1

USDI

53

Vol/Iss

Journal

100

Prevalence 102

Cross Sectional

Vital statistics of New York City and Brooklyn, covering a period of six years ending May 31, 1890.

486

2135

1933 Bolduan CR

2135 Weiner L

63

Higher

NEJM

208

8

407

416

22

44

523

548

Cross Sectional

Causes of death among Jews in New York City.

486

0515

0515

1928 Bureau of Je

JCSNY

84

1

Cross Sectional

Causes of death among Jews.

486

2145

2145

Lower

486

2159

2159

Lower

1916 Dublin LI

6

AER

128

3

Cross Sectional

Factors in American mortality: a study of death rates in the race stocks of New York State, 1910.

486

0563

1920 Dublin LI

0563 Baker GW

129

QPASA 10

13

44

222

234

83

117

Cross Sectional

The mortality of race stocks in Pennsylvania and New York, 1910.

486

0695

1895 Hoffman FL 234

0695 55

SP

19

Cross Sectional

The Jew as a life risk.

486

0498

1956 Liberson DM 300

0498

Lower 18

JSS

Cross Sectional

Causes of death among Jews in New York City in 1953.

486

0709

1934 Maller JB

0709

No Difference

JSSQ

321

10

271

276

46

49

Cross Sectional

A study of Jewish neighborhoods in New York City.

486

0511

1923 Spivak CD

0511

Lower 1

CM

523

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

486

0809

0809

250

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1900 Department

Pages

Findings: Total 3

VS

642

Vol/Iss

Journal

117

Prevalence 133

Cross Sectional

Twelfth census of the United States.

486

1658

1658

1912 Davis WH

Lower

PDCB

679

Cross Sectional

The relation of the foreign population to Boston mortality rates.

486

1771

Lower

PNEUMONIA AND INFLUENZA 1989 Rosenwaike I

440

Hempstead K SSM

2799431

480-487 29

7

885

889

Cross Sectional

Differential mortality by ethnicity: foreign-born Irish, Italians and Jews in New York City, 1979-81.

480-487

1048

1048

1994 Rosenwaike I 657

23

IJE

8082959

2

327

332

101

112

Cross Sectional

Causes of death among elderly Jews in New York City, 1979-1981.

480-487

1730

1730

1953 Rosenberg L

15

JSS

1333

Cross Sectional

Births, Deaths and Morbidity Among Jews in Montreal in 1950

480-487

1813

***1813

lower

E981

POISONING BY GAS 1914 de Leon D

Karpas Morris MR

74

86

576

579

Case Study

Insanity among Jews.

E981

1247

1247

POLIOMYELITIS [ACUTE POLIOMYELITIS, UNSPECIFIED] 1956 Liberson DM

18

JSS

300

83

045.9 117

Cross Sectional

Causes of death among Jews in New York City in 1953.

045.9

0714

0714

No Difference

045.9

0742

0742

No Difference

1987 Schulman S 1204

Werzberger A MMWR

3110572

36

27

440

Case Control

Multistate outbreak of shigella sonnei gastroenteritis – United States.

251

449

Year Author1 BiblioRef

Author2 PubMed

Design

ICD

Lindex

IsText

045.9

0677

***0677 Henstell HH

116

Pages

Findings: Total

Prevalence

238.4

POLYCYTHEMIA VERA 1940 Dameshek

Vol/Iss

Journal

ANIM

13

1360

1387

49

43

60

597

667

Case Study

The diagnosis of polycythemia.

238.4

2055

1958 Damon A

2055 Holub DA

117

ANIM

Cross Sectional

Host factors in polycythemia vera.

238.4

1501

1501

1912 Lucas WS

Higher 10

AIM

310

Case Study

Erythremia, or polycythemia with chronic cyanosis splenomegaly: report of two cases with a summary of 179 cases reported to date.

238.4

0614

1933 McAlpin KR

0614 Edsall KS

335

NYSJM

33

17

1039

1045

Case Study

Polycythemia vera: report of ten cases treated with phenylhydrazine.

238.4

0615

0615

1966 McKusick VA 337

ALJMS

5978172

3

4

408

424

Review

Clinical genetics at a population level: the ethnicity of disease in the United States.

238.4

1423

1423

1903 Osler W

AJMS

382

126

2

187

201

Case Study

Chronic cyanosis, with polycythaemia and enlarged spleen: a new clinical entity.

238.4

2059

1934 Reznikoff P

2059 Foot NC

425

TAAP

49

273

276

Case Study

Racial geograpthic origin of patients suffering from polycythemia vera pathological findings in blood-vessels of bone-marrow.

238.4

0612

1935 Reznikoff P 426

0612 Foot NC

AJMS

189

6

Case Study

Etiologic pathologic factors in polycythemia vera.

238.4

0613

0613

Higher 252

753

759

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1967 Rosner F

Pages

Findings: Total

Rubenberg M NYSJM

441

Vol/Iss

Journal

1

2119

Prevalence 2124

Case Study

Pernicious anemia, polycythemia vera, acute myelogenous leukemia in the same patient.

238.4

0618

1980 Ratnoff WD 1051

0618 Gress RE

56

B

2

233

236

7397379

The familial occurrence of polycythemia vera: report of a father and son, with consideration of the possible etiologic role of exposure to organic solvents, including tetrachloroethylene.

238.4

2724

1965 Modan B 1052

26

B

5

657

667

5845783

An epidemiological study of polycythemia vera.

238.4

2725

698.2

POLYMORPHIC PRURIGO 1948 Schneider E

Kesten B

484

10

JID

205

214

Case Study

Polymorphic prurigo: a psychosomatic study of three cases.

698.2

0824

0824

277.3

POLYNEUROPATHIC AMYLOIDOSIS [AMYLOIDOSIS] 1981 Pras M

406

Franklin EC

6168726

154

JEM

989

993

Case Study

A variant of prealbumin from amyloid fibrils in familial polyneuropathy of Jewish origin.

277.3

1445

1983 Pras M 407

1445 Prelli F

6300852

PNAS

80

539

542

Review

Primary structure of an amyloid prealbumin variant in familial polyneuropathy of Jewish origin.

277.3

1284

1948 Reimann H 420

1284 JAMA

136

4

239

243

Case Study

Periodic disease: a probable syndrome including periodic fever, benign paroxysmal peritonitis, cyclic neutropenia intermittent arthralgia.

277.3

0556

1949 Siegal S

0556 12

G

506

Case Study

Benign paroxysmal peritonitis-second series.

277.3

0567

0567 253

2

234

247

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1964 Siegal S

Pages

Findings: Total 36

AJM

507

Vol/Iss

Journal

Prevalence

6

893

918

3

308

312

Case Study

Familial paroxysmal polyserositis: analysis of fifty cases.

277.3

0568

1995 Jacobson DR 805

0568 Alves IL

7868124

95

HG Case study

Transthyretin Ser 6 gene frequency in individuals without amyloidosis.

277.3

1803

2001 Zinberg RE 1115

1803 Kornreich R

28

CIP

2

367

382

11499058

Prenatal genetic screening in the Ashkenazi Jewish population.

277.3

0559

***0559

765.1

PREMATURE BIRTH [OTHER PRETERM INFANTS] 1923 Spivak CD

1

CM

523

46

49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

765.1

0789

1917 Guilfoy WH 655

0789 MS18

1

27

Cross Sectional

The influence of nationality upon the mortality of a community, with special references to the city of New York.

765.1

1692

1692

Lower

287.3

PRIMARY THROMBOCYTOPENIA,UNSPECIFIED 1964 Desaussure

1169

JSCMA 60

320

322

Case Study

Thrombotic thrombocytopenic purpura. A case report.

287.3

0983

***0983

698

PRURITIS AND RELATED CONDITIONS 1902 Fischkin EA

158

JAMA

39

8

427

432

Cross Sectional

Six years in a dermatologic clinic: a report of service, with remarks on the treatment of the more common skin diseases.

698

1215

1215

Higher

254

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

PSYCHEDELIC USE (LSD) [HALLUCINOGEN DEPENDENCE] 1972 Lavenhar MA

Wolfson EA

286

PCSDS 1

33

Prevalence

304.5 53

Cross Sectional

Survey of drug abuse in six New Jersey high schools: II. Characteristics of drug users and nonusers.

304.5

1940

1940

1973 Levy L

No Difference 2

DF

298

2

141

171

Cross Sectional

Drug use on campus: prevalence and social characteristics of collegiate drug users on campuses of the University of Illinois.

304.5

0424

1969 Smart RG

0424 Jackson D

515

Higher

ARFT

1

1

Cross Sectional

A preliminary report on attitudes and behaviour of Toronto students in relation to drugs.

304.5

1132

1974 Strimbu JL 533

1132 Sims Jr OS

4154923

Higher 9

IJA

4

569

583

Cross Sectional

A university system drug profile.

304.5

0437

2001 Vex SL 1107

0437 Blume SB

11760928

No Difference 20

JAD

4

71

89

Case Study

The JACS study I: characteristics of a population of chemically dependent Jewish men and women.

304.5

0495

***0495

PSYCHOPATHIC PERSONALITY [UNSPECIFIED PERSONALITY DISORDER] 1928 Goldberg JA

Malzberg B

190

2

PQ

194

301.9 213

Cross Sectional

Mental disease among Jews.

301.9

0326

1944 Hyde RW

0326

No Difference

Chisholm RM NEJM

243

231

18

612

618

Cross Sectional

Studies in medical sociology. III. The relation of mental disorders to race and nationality.

301.9

0365

1930 Malzberg B 324

0365 14

MH

Cross Sectional

The prevalence of mental disease among Jews.

255

926

946

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

301.9

0308

0308

Lower

1931 Malzberg B

15

MH

325

766

Prevalence 774

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

301.9

0382

1936 Slawson J

0382 Moss M

513

No Difference

JSSQ

1

343

350

Cross Sectional

Mental illness among Jews.

301.9

0298

1942 Tietze C

0298 Lemkau P

542

No Difference 48

AJS

1

29

39

322

409

Cross Sectional

Personality disorder and spatial mobility.

301.9

1159

1159

1919 New York St

Higher

NYSHC -

640

-

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

301.9

1719

1719

1914 Harris WJ

Higher

DOC

1210

25

34

Cross Sectional

Insane and feeble-minded in institutions in 1910.

301.9

0871

PSYCHOSES

1953 Barrabee P

***0871

290-299 Von Mering O SOP

33

1

48

53

514

517

766

774

Case Study

Ethnic variations in mental stress in families with psychotic children.

290-299

1111

1956 Eichler RM 135

1111 Lirtzman S

JNMD

124

Cross Sectional

Religious background of patients in a mental hygiene setting.

290-299

1999

1931 Malzberg B 325

1999

Lower 15

MH

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

290-299

0582

0582

Lower 256

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1936 Malzberg B

Pages

Findings: Total 20

MH

327

Vol/Iss

Journal

Prevalence

280

291

29

39

86

95

Cross Sectional

New data relative to incidence of mental disease among Jews.

290-299

0773

1942 Tietze C

0773 Lemkau P

542

Lower 48

AJS

1

Cross Sectional

Personality disorder and spatial mobility.

290-299

1157

1976 Wylan L 585

1157 Mintz NL

992954

Higher 22

IJSP

1

Case Study

Ethnic differences in family attitudes towards psychotic manifestations, with implications for treatment programmes.

290-299

1117

1117

1919 New York St

NYSHC -

640

-

322

409

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

290-299

1721

1721

1960 Jaco EG

Lower

SEMD

725

290

299

Review

The social epidemiology of mental disorders: a psychiatric survey of Texas. New York, Russel Sage Foundation.

290-299

1090

1090

Lower

PSYCHOSIS (DRUG INDUCED) [UNSPECIFIED DRUG-INDUCED MENTAL DISORDER] 1914 de Leon D

Karpas Morris MR

74

86

576

292.9 579

Case Study

Insanity among Jews.

292.9

1261

1261

PSYCHOSIS (INFECTIVE) [UNSPECIFIED TRANSIENT ORGANIC MENTAL DISORDER] 1914 de Leon D

Karpas Morris MR

74

293.9

86

576

579

2

194

213

Case Study

Insanity among Jews.

293.9

1244

1928 Goldberg JA

1244 Malzberg B

190

PQ

Cross Sectional

Mental disease among Jews.

257

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

293.9

0312

0312

Lower

1909 Kirby GH

1

SHB

270

4

663

Prevalence 670

Cross Sectional

A study in race psychopathology.

293.9

1066

1066

Lower

294.9

PSYCHOSIS (ORGANIC) [UNSPECIFIED ORGANIC BRAIN SYNDROME, CHRONIC] 1918 Bailey P

6

MH

28

370

391

322

409

Cross Sectional

A contribution to the mental pathology of races in the United States.

294.9

0292

0292

1919 New York St

NYSHC -

640

-

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

294.9

1712

1712

Higher

PSYCHOSIS (SENILE) [SENILE DEMENTIA WITH DELUSIONAL FEATURES] 1886 Kiernan JG

JNMD

1185

13

389

290.20 392

Cross Sectional

Race and insanity.

290.20

1967

***1967

319

PSYCHOSIS WITH MENTAL DEFICIENCY [UNSPECIFIED MENTAL RETARDATION] 1918 Bailey P

6

MH

28

370

391

612

618

Cross Sectional

A contribution to the mental pathology of races in the United States.

319

0294

1944 Hyde RW

0294 Chisholm RM NEJM

243

231

18

Cross Sectional

Studies in medical sociology. III. The relation of mental disorders to race and nationality.

319

0366

1909 Kirby GH

0366 1

SHB

270

4

663

Cross Sectional

A study in race psychopathology.

319

0334

0334

No Difference 258

670

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1930 Malzberg B

Pages

Findings: Total 14

MH

324

Vol/Iss

Journal

Prevalence

926

946

766

774

Cross Sectional

The prevalence of mental disease among Jews.

319

0594

0594

1931 Malzberg B

Lower 15

MH

325

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

319

1086

1954 Roberts BH

1086 Myers JK

434

Lower 110

AJP

759

764

322

409

Cross Sectional

Religion, national origin, immigration and mental illness.

319

1373

1373

1919 New York St

Lower

NYSHC -

640

-

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

319

1720

1720

Higher

297.9

PSYCHOSIS, PARANOID [UNSPECIFIED PARANOID STATE] 1888 Bannister H

Hektoen L

32

44

AJI

455

470

98

101

194

213

Cross Sectional

Race and insanity.

297.9

1396

1957 Frumkin RM

1396 Frumkin MZ

173

Lower 6

JHR

Cross Sectional

Religion, occupation, and major mental disorders: a research note.

297.9

0393

1928 Goldberg JA

0393 Malzberg B

190

Lower 2

PQ

Cross Sectional

Mental disease among Jews.

297.9

0323

1909 Kirby GH

0323

No Difference 1

SHB

270

4

Cross Sectional

A study in race psychopathology.

297.9

0342

0342

Lower

259

663

670

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1930 Malzberg B

Pages

Findings: Total 14

MH

324

Vol/Iss

Journal

926

Prevalence 946

Cross Sectional

The prevalence of mental disease among Jews.

297.9

0592

0592

1931 Malzberg B

No Difference 15

MH

325

766

774

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

297.9

0381

0381

1919 New York St

Lower

NYSHC -

640

-

322

409

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

297.9

1716

1939 Fleming R

1716 Tillotson K

1213

No Difference

NEJM

221

19

741

745

Case Control

Further studies on the personality and sociological factors in the prognosis and treatment of chronic alcoholism.

297.9

0952

***0952

PSYCHOSIS, UNSPECIFIED [OTHER SPECIFIED 294.8 ORGANIC BRAIN SYNDROMES, CHRONIC] 1914 de Leon D

Karpas Morris MR

74

86

576

579

663

670

926

946

766

774

Case Study

Insanity among Jews.

294.8

1208

1909 Kirby GH

1208 1

SHB

270

4

Cross Sectional

A study in race psychopathology.

294.8

0336

1930 Malzberg B 324

0336

Lower 14

MH

Cross Sectional

The prevalence of mental disease among Jews.

294.8

0590

0590

Lower

294.8

0593

0593

Lower

1931 Malzberg B 325

15

MH

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

294.8

0581

0581

260

Lower

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1954 Roberts BH

Myers JK

434

Vol/Iss

Journal

Pages

Findings: Total 110

AJP

759

Prevalence 764

Cross Sectional

Religion, national origin, immigration and mental illness.

294.8

0355

0355

Lower

379.4

PUPILLARY DISTURBANCE 1937 White BV

Fulton MN

574

28

JH

177

179

Case Study

A rare pupillary defect inherited by identical twins.

379.4

0554

083.0

Q FEVER

2002 Calvert PM

1229

0554 Frutcht H

137

ANIM

7

603

612

12353948

The genetics of colorectal cancer.

083.0

1558

***1558

990

RADIATION

1959 Lilienfeld AM

74

PHR

304

1

29

35

Cross Sectional

Diagnostic and therapeutic x-radiation in an urban population.

990

1946

1946

Higher

REGIONAL ENTERITIS, UNSPECIFIED SITE, CROHN'S DISEASE, UNSPECIFIED SITE 1966 Almy TP

11

Sherlock P

5923199

51

G

555.9

5

757

763

6

369

379

2

261

275

6

257

261

Review

Genetic aspects of ulcerative colitis and regional enteritis.

555.9

0011

1969 Banks BM 30

0011 Zetzel L

5787589

AJDD

14

Case Study

Morbidity and mortality in regional enteritis: report of 168 cases.

555.9

0181

0181

1962 Brinn LB

HH

76

Review

Jews, genetics and disease.

555.9 1939 Brown PW 79

0785

0785 Scheifley CH

AJDD

Case Study

Chronic regional enteritis occurring in three siblings.

261

Year Author1 BiblioRef

Author2 PubMed

Design

ICD

Lindex

IsText

555.9

0283

0283

1963 Kirsner JB

Spencer JA

271

Vol/Iss

Journal

Pages

Findings: Total 59

ANIM

2

133

Prevalence 144

Cross Sectional

Family occurrences of ulcerative colitis, regional enteritis, and ileocolltis.

555.9

0451

1948 Kirsner JB

0451 Owens FM

272

Higher

G

10

5

883

891

3

4

408

424

Case Study

Regional enteritis in father and son.

555.9

2064

2064

1966 McKusick VA 337

ALJMS

5978172

Review

Clinical genetics at a population level: the ethnicity of disease in the United States.

555.9

1426

1966 Mendeloff AI 340

1426 Monk M

5923198

51

G

5

748

756

Cross Sectional

Some epidemiological features of ulcerative colitis and regional enteritis: a preliminary report.

555.9

1077

1967 Monk M

1077 Mendeloff AI

348

Higher 53

G

2

198

210

Cross Sectional

An epidemiological study of ulcerative colitis regional enteritis among adults in Baltimore: I. Hospital incidence prevalence, 1960 to 1963.

555.9

1071

1970 Monk M 349

1071 Mendeloff AI

5437450

Higher 22

JCD

565

578

Case Study

An epidemiological study of ulcerative colitis regional enteritis among adults in Baltimore: III. Psychological and possible stress-precipitating factors.

555.9

1072

1951 Rappaport H

1072 Burgoyne FH MS

414

109

463

488

142

150

160

165

Cross Sectional

The pathology of regional enteritis.

555.9

0184

1957 Ruble PE

0184 Meyers SG

453

Higher 15

HHB Case Study

Regional enteritis.

555.9

0182

1986 Sandler RS 468

0182 Golden AL

3745850

Epidemiology of Crohn's disease.

8

JCG Review 262

2

Year Author1 BiblioRef

Author2 PubMed

Design

ICD

Lindex

IsText

555.9

2535

2535

1962 Sherlock P

Bell BM

498

Vol/Iss

Journal

Pages

Findings: Total 45

PG

Prevalence

3

413

420

2

215

218

100

104

18

20

Case Study

Familial occurrence of regional enteritis and ulcerative colitis.

555.9

2062

1961 Steigmann F

2062 Shapiro S

527

40

G Case Study

Familial regional enteritis.

555.9

2056

1967 Van Heerden 551

2056 Sigler RM

6017371

42

MCP Case Study

Regional enteritis in children: surgical aspects.

555.9

0551

1993 Aisenberg J 633

0551 Janowitz HD

8409291

17

JCG

1

Case Study

Cluster of inflammatory bowel disease in three close college friends.

555.9

1630

1998 Brant SR 1035

1630 Fu Y

9797357

115

G

1056

1081

Cohort

American families with Crohn's disease have strong evidence for linkage to chromosome 16 but not chromosome 12.

555.9

2709

2000 Thearle M 1084

***2709 Horlick M

10852438

JCEM

85

6

2122

2126

Case Study

Osteoporosis: an unusual presentation of childhood Crohn’s disease.

555.9

2192

2000 Gulwani-Akol 1085

***2192 Akolkar PN

10833064

6

IBD

2

71

76

Case Study

HLA class II alleles associated with susceptibility and resistance to Crohn’s disease in the Jewish population.

555.9

0287

2000 Duerr RH 1150

***0287 Barmada MM AJHG

66

1857

1862

10747815

High-density genome scan in Crohn's disease shows confirmed linkage to chromosome 14q11-12.

555.9

1819

***1819

263

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

2000 Rioux JD 1152

Vol/Iss

Journal

Pages

Findings: Total

Silverberg MS AJHG

66

Prevalence 1870

1863

10777714

Genomewide search in Canadian families with inflammatory bowel disease reveals two novel susceptible loci.

555.9

1811

1987 Schulman S 1204

***1811 Werzberger A MMWR

3110572

36

27

449

440

Case Control

Multistate outbreak of shigella sonnei gastroenteritis – United States.

555.9

0665

1954 Crohn BB

***0665 Janowitz HD

1205

JAMA

156

13

1221

1225

93

12

2368

2372

Review

Reflections on regional ileitis, twenty years later.

555.9

0792

1999 Heresbach D 1280

***0792 Gulwani-Akol AJG

9860394

Anticipation in Crohn's disease may be influenced by gender and ethnicity of the transmitting parent.

555.9

2302

2001 Ogura Y 1294

***2302 Bonen DK

11385577

411

NAT

683 537

539

Case Study

A frameshift mutation in NOD2 associated with susceptibility to Crohn's disease.

555.9

2178

2002 Yang H

***2178 Taylor KD

122

G

A-295

A-295

1315 Evidence for additional mutaions in the NOD2 gene conferring risk for Crohn's Disease in Ashkenazi Jews.

555.9

2114

***2114

555.2

REGIONAL ILEOCOLITIS 1963 Kirsner JB

Spencer JA

271

59

ANIM

2

133

144

Cross Sectional

Family occurrences of ulcerative colitis, regional enteritis, and ileocolltis.

555.2

0450

0450

Higher

200.0

RETICULOSARCOMA 1960 MacMahon B

315

16

AUIC

1716

Cross Sectional

The ethnic distribution of cancer mortality in New York City, 1955.

200.0

2034

2034

Sig Higher 264

1724

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1961 Newill VA

Pages

Findings: Total 26

JNCI

375

Vol/Iss

Journal

2

405

Prevalence 417

Cross Sectional

Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953-58.

200.0

0679

0679

Higher

362.74

RETINITIS PIGMENTOSA [HEREDITARY RETINAL DYSTROPHY] 1950 Bassen FA

Kornzweig AL B

35

5

381

387

Case Study

Malformation of the erythrocytes in a case of atypical retinitis pigmentosa.

362.74

0545

1957 Kornzweig A

0545 Bassen FA

278

58

AO

183

187

Case Study

Retinitis pigmentosa, acanthrocytosis, and heredodegenerative neuromuscular disease.

362.74

0544

2002 Fields RR 1228

0544 Zhou G

12145752

AJHG

71

3

607

617

Cross Sectional

Usher syndrome type III: revised genomic structure of the USH3 gene and identification of novel mutations.

362.74

1323

***1323

729.0

RHEUMATISM [UNSPECIFIED AND FIBROSITIS] 1905 Bernheimer

44

BOOK2 1

328

Cross Sectional

The Russian Jew in the United States: studies of social conditions in New York, Philadelphia and Chicago with a description of rural settlements.

729.0

1329

1912 Price GM

1329

Higher 1

ACP

409

205

268

Cross Sectional

Report on bakeries and bakers in New York City. In: preliminary report of the factory investigating commission, volume 1, Albany, New York.

729.0

1366

1366

Lower

133.0

SCABIES

1902 Fischkin EA

158

JAMA

39

8

427

432

Cross Sectional

Six years in a dermatologic clinic: a report of service, with remarks on the treatment of the more common skin diseases.

133.0

1216

1216

Higher 265

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1912 Price GM

Pages

Findings: Total 1

ACP

409

Vol/Iss

Journal

205

Prevalence 268

Cross Sectional

Report on bakeries and bakers in New York City. In: preliminary report of the factory investigating commission, volume 1, Albany, New York.

133.0

1349

1349

No Difference

034.1

SCARLET FEVER 1908 Guilfoy WH

73

MR

215

132

135

Cross Sectional

The death rate of the city of New York as affected by the cosmopolitan character of its population.

034.1

0416

0416

1895 Hoffman FL

Higher 55

SP

234

19

222

234

46

49

Cross Sectional

The Jew as a life risk.

034.1

1265

1265

1923 Spivak CD

Lower 1

CM

523

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

034.1

1095

1095

1900 Department

3

VS

642

117

133

Cross Sectional

Twelfth census of the United States.

034.1

1661

1661

Higher

295.7

SCHIZO-AFFECTIVE TYPE 1978 Templer DI

539

43

PR

746088

1210

Cross Sectional

Schizo-affective schizophrenia in Jews and non-Jews.

295.7

0085

0085

Lower

SCHIZOPHRENIA, PARANOID [PARANOID TYPE] 1914 de Leon D

Karpas Morris MR

74

86

295.3

576

579

47

57

Case Study

Insanity among Jews.

295.3

1192

1942 Harms E

1192 3

DNS

1218

Review

The nervous Jew. A study in social psychiatry.

295.3

1249

***1249

266

3

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

Frumkin MZ

173

Pages

Findings: Total

Prevalence

295

SCHIZOPHRENIC DISORDERS 1957 Frumkin RM

Vol/Iss

Journal

6

JHR

98

101

47

73

945

948

Cross Sectional

Religion, occupation, and major mental disorders: a research note.

295

0392

1950 Gerard DL

0392 Siegel J

180

Lower 24

PQ

Cross Sectional

The family background of schizophrenia.

295

0398

1990 Lieberman J 302

0398 Yunis J

2222133

47

AGP

10

Case Study

HLA-B38, DR4, DQW3 and clozapine-induced agranulocytosis in Jewish patients with schizophrenia.

295

1452

1919 Pollock HM

1452 Nolan WJ

401

4

SHQ

498

508

Cross Sectional

Sex, age and nativity of dementia praecox first admissions to the New York State hospitals 1912 to 1918.

295

1105

1954 Roberts BH

1105 Myers JK

434

Higher 110

AJP

759

764

292

297

Cross Sectional

Religion, national origin, immigration and mental illness.

295

1246

1992 Yeung PP 598

1246 Greenwald S

1492249

Lower

SPPE

27

6

Cross Sectional

Jewish Americans mental health: results of the NIMH Epidemiologic Catchment Area Study.

295

1499

1967 Faris REL

1499 Dunham HW

Higher

BOOK

723 Mental disorders in urban areas: an ecological study of schizophrenia and other psychoses (1967), Chicago: University of Chicago Press.

295

1950

1950

No Difference

SCHIZOPHRENIC DISORDERS, SIMPLE TYPE 1914 de Leon D

Karpas Morris MR

74

86

Case Study

Insanity among Jews.

295.0

1193

1193 267

576

295.0 579

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

Pages

Findings: Total

Prevalence

737.30

SCOLIOSIS

1995 Rubery PT

727

Vol/Iss

Journal

Spielman JH

7673287

77-A 9

JBJS

1362

1369

Cohort

Scoliosis in familial dysautonomia: operative treatment.

737.30

1520

***1520

706.2

SEBACEOUS CYST 1902 Fischkin EA

JAMA

158

39

8

427

432

Cross Sectional

Six years in a dermatologic clinic: a report of service, with remarks on the treatment of the more common skin diseases.

706.2

1213

1213

Lower

304.12

SEDATIVE, HYPNOTIC OR ANXIOLYTIC DEPENDENCE, EPISODIC 1980 Daum M

Lavenhar MA SRR

1201

Cross Sectional

Religiosity and drug use: a study of Jewish and gentile college students.

304.12

0595

***0595

SENILE DEMENTIA WITH DELUSIONAL OR DEPRESSIVE FEATURES 1914 de Leon D

Karpas Morris MR

74

290.2

86

576

579

6

98

101

194

213

389

392

Case Study

Insanity among Jews.

290.2

1209

1957 Frumkin RM

1209 Frumkin MZ

173

JHR

Cross Sectional

Religion, occupation, and major mental disorders: a research note.

290.2

0389

1928 Goldberg JA

0389 Malzberg B

190

Lower 2

PQ

Cross Sectional

Mental disease among Jews.

290.2

0313

1886 Kiernan JG 267

0313

Lower

JNMD

13

Cross Sectional

Race and insanity.

290.2

1087

1087

No Difference 268

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1973 Malzberg B 322

Pages

Findings: Total 49

APS

4746013

Vol/Iss

Journal

479

Prevalence 518

Cross Sectional

Mental disease among Jews in New York State, 1960-1961: a study of ethnic variation in incidence.

290.2

0349

0349

1930 Malzberg B

Lower 14

MH

324

926

946

766

774

Cross Sectional

The prevalence of mental disease among Jews.

290.2

0309

0309

1931 Malzberg B

Lower 15

MH

325

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

290.2

0370

0370

1936 Malzberg B

Lower 20

MH

327

280

291

759

764

322

409

Cross Sectional

New data relative to incidence of mental disease among Jews.

290.2

0384

1954 Roberts BH

0384 Myers JK

434

Lower 110

AJP

Cross Sectional

Religion, national origin, immigration and mental illness.

290.2

1376

1376

1919 New York St

Lower

NYSHC -

640

-

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

290.2

1702

1702

Lower

290.0

SENILE DEMENTIA, UNCOMPLICATED 1888 Bannister H

32

Hektoen L

44

AJI

455

470

510

522

Cross Sectional

Race and insanity.

290.0

1400

1962 Malzberg B 328

1400

Lower 46

MH

4

Cross Sectional

The distribution of mental disease according to religious affiliation in New York State, 1949-1951.

290.0

1148

1148

Lower

269

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1992 Silverman J 508

Li G

1561893

Vol/Iss

Journal

Pages

Findings: Total 85

APS

3

211

Prevalence 217

Cross Sectional

A cross-cultural family history study of primary progressive dementia in relatives of nondemented elderly Chinese, Italians, Jews and Puerto Ricans.

290.0

1954

1954

1880 Spitzka EC

Sig Higher

JNMD

7

613

630

522 Contributions to nervous mental pathology.

290.0

1134

1134

1913 Swift HM

No Difference 70

AJI

537

143

154

766

773

Cross Sectional

Insanity and race.

290.0

1067

1994 Osterweil D 652

1067 Mulford P

8014354

JAGS

42

7

Case Study

Cognitive function in old and very old residents of a residential facility: relationship to age, education, and dementia.

290.0

1673

1996 Duara R 747

1673 Barker WW

8559371

46

N

6

1575

1579

Cross sectional

Alzheimer's disease: interaction of apolipoprotein E genotype, family history of dementia, gender, education, ethnicity, age of onset.

290.0

1548

1994 Tsuda T 1310

1548 Lopez R

n.d. 36

ANN

1

97

100

8024269

Are the associations between Alzheimer's disease and polymorphisms in the apolipoprotein E and the apolipoprotein CII genes due to linkage disequilibrium?

290.0

2190

***2189

SENILE PSYCHOSIS WITH CEREBRAL ARTERIOSCLEROSIS [ARTERIOSCLEROTIC DEMENTIA] 1928 Goldberg JA

Malzberg B

190

2

PQ

290.4

194

213

479

518

Cross Sectional

Mental disease among Jews.

290.4

0314

1973 Malzberg B 322

4746013

0314

Lower 49

APS

Cross Sectional

Mental disease among Jews in New York State, 1960-1961: a study of ethnic variation in incidence.

270

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

Pages

PubMed

Design

ICD

Lindex

IsText

Findings: Total

290.4

0348

0348

Lower

1930 Malzberg B

14

MH

324

Prevalence

926

946

766

774

Cross Sectional

The prevalence of mental disease among Jews.

290.4

0301

0301

1931 Malzberg B

Lower 15

MH

325

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

290.4

0371

0371

1936 Malzberg B

Lower 20

MH

327

280

291

510

522

Cross Sectional

New data relative to incidence of mental disease among Jews.

290.4

0385

0385

Lower

290.4

1243

1243

Lower

1962 Malzberg B

46

MH

328

4

Cross Sectional

The distribution of mental disease according to religious affiliation in New York State, 1949-1951.

290.4

1147

1147

1919 New York St

Lower

NYSHC -

640

-

322

409

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

290.4

1703

1703

Lower

SENILITY WITHOUT MENTION OF PSYCHOSIS 797 1923 Spivak CD

1

CM

523

46

49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

797

0796

004.8

SHIGELLA

1987 Schulman S

1204

0796 Werzberger A MMWR

3110572

36

27

440

Case Control

Multistate outbreak of shigella sonnei gastroenteritis – United States.

004.8

0678

***0678

271

449

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

Pages

Findings: Total

Prevalence

044.9

SHIGELLOSIS 1987 National Cen

369

Vol/Iss

Journal

MMWR

3110572

36

440

449

Cross Sectional

Multistate outbreak of Shigella sonnei gastroenteritis in the United States.

044.9

2540

1998 Sobel J 834

2540 Cameron DN JID

177

5

1405

1409

9593035

A prolonged outbreak of Shigella sonnei infections in traditionally observant Jewish community in North America caused by a molecularly distinct bacterial subtype.

044.9

1854

1987 Schulman S 1204

1854 Werzberger A MMWR

3110572

36

27

440

449

Case Control

Multistate outbreak of shigella sonnei gastroenteritis – United States.

044.9

0664

***0664

300.23

SOCIAL PHOBIA 1992 Yeung PP

598

Greenwald S

1492249

SPPE

27

6

292

297

Cross Sectional

Jewish Americans mental health: results of the NIMH Epidemiologic Catchment Area Study.

300.23

1497

1497

No Difference

333.83

SPASMODIC TORTICOLLIS 1970 Barrett RE

773

Yahe MD

5529472

20

N

2

107

113

Case study

Torsion dystonia and spasmodic torticollis-results of treatment with L-dopa.

333.83

1576

1996 Bressman S 786

1576 Warner TT

8871591

40

ANN

4

681

684

Case study

Exclusion of the DYT1 locus in familial tortocollis.

333.83

1589

1589

SPECIFIED PARTS OF PERITONEUM 1996 Tonin P

857

Weber B

8898735

2

NM

158.8 11

1179

1183

Case study

Frequency of recurrent BRCA1 BRCA2 mutations in Ashkenazi Jewish breast cancer families.

158.8

2248

2248

272

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

SPINA BIFIDA

1953 MacMahon B

Vol/Iss

Journal

Pages

Findings: Total

Prevalence

741.9 Pugh TF

318

BJPSM

7

211

219

Cross Sectional

Anencephalus, spinal bifida, hydrocephalus: incidence related to sex, race, season of birth, incidence in siblings.

741.9

1516

1967 Naggan L 368

1516

Sig Lower

MacMahon B NEJM 4861562

277

21

1119

1123

Cross Sectional

Ethnic differences in the prevalence of anencephaly and spina bifida in Boston, Massachusetts.

741.9

0597

0597

Lower

330.2

SPONGY DEGENERATION OF THE BRAIN [CEREBRAL DEGENERATION IN GENERALIZED LIPISIS] 1968 Kamoshita S

258

Rapin I

5748754

18

N

975

985

Case Study

Spongy degeneration of the brain: a chemical study of two cases including isolation and characterization of myelin.

330.2

1515

1967 McKusick VA 338

6021517

1515 20

JCD

115

118

Review

The ethnic distribution of disease in the United States.

330.2

1444

1444

STILLBIRTH [UNSPECIFIED CONDITION ORIGINATING IN THE PERINATAL PERIOD] 1923 Spivak CD

1

CM

523

46

779.9 49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

779.9

1097

1917 Guilfoy WH 655

1097 MS18

1

27

Cross Sectional

The influence of nationality upon the mortality of a community, with special references to the city of New York.

779.9

1694

1694

Lower

273

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

Prevalence

531-534.9 18

JSS

300

Pages

Findings: Total

STOMACH, DUODENAL, AND GASTROJEJUNAL ULCERS 1956 Liberson DM

Vol/Iss

Journal

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

531-534.9

0713

0713

1925 Woodbury R

No Difference

BP142

661

142

104

124

Cross Sectional

Causal factors in infant mortality: a statistical study based on investigations in eight cities.

531-534.9

1739

1739

SUBACUTE DELIRIUM 1919 New York St

640

Lower

293.1 NYSHC -

-

322

409

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

293.1

1711

1711

Lower

E950-E959

SUICIDE

1933 Bolduan CR

Weiner L

63

NEJM

208

8

407

416

22

44

33

60

48

61

Cross Sectional

Causes of death among Jews in New York City.

E950-E959

0095

0095

1928 Bureau of Je

Higher

JCSNY

84

1

Cross Sectional

Causes of death among Jews.

E950-E959

2147

1983 Danto BL

2147 Danto JM

119

Lower 4

CRI

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E950-E959

1983

1966 Goldstein S 195

1983

Lower 13

EQ

1

Cross Sectional

Jewish mortality and survival patterns: Providence, Rhode Island, 1962-1964.

E950-E959

0460

1962 Gorwitz K

0460

Higher 24

JSS

198

248

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957.

E950-E959

0471

0471

Lower 274

254

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1895 Hoffman FL 234

Vol/Iss

Journal

Pages

Findings: Total 55

SP

19

Prevalence

222

234

83

117

271

276

247

255

Cross Sectional

The Jew as a life risk.

E950-E959

0104

1956 Liberson DM 300

0104

Lower 18

JSS

Cross Sectional

Causes of death among Jews in New York City in 1953.

E950-E959

0701

1934 Maller JB

0701

Lower

JSSQ

321

10

Cross Sectional

A study of Jewish neighborhoods in New York City.

E950-E959

0094

1981 Maris RW

0094

Lower

JHUP

331

1

Cross Sectional

Pathways to suicide: a survey of self-destructive behaviors. Baltimore, Md: the Johns Hopkins University Press.

E950-E959

1093

1938 Pollack B

1093 12

PQ

400

1

306

330

46

49

Case Study

A study of the problem of suicide.

E950-E959

2574

1923 Spivak CD

2574 1

CM

523

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

E950-E959

0793

1921 Stearns AW 524

0793 5

MH

752

777

1

27

Case Study

Suicide in Massachusetts.

E950-E959

2575

1917 Guilfoy WH 655

2575 MS18 Cross Sectional

The influence of nationality upon the mortality of a community, with special references to the city of New York.

E950-E959

1683

1683

275

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

SUICIDE AND OTHER SELF-INFLICTED INJURY BY HANGING, STRANGULATION, AND SUFFOCATION 1983 Danto BL

Danto JM

119

4

CRI

Prevalence

E953

33

60

163

177

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E953

1996

1971 Goss MEW

1996 Reed JI

199

1

LTB

3

Cross Sectional

Suicide and religion: a study of white adults in New York City, 1963-67.

E953

2568

2568

1956 Liberson DM

Lower 18

JSS

300

83

117

247

255

Cross Sectional

Causes of death among Jews in New York City in 1953.

E953

0723

0723

1981 Maris RW

Lower

JHUP

331

1

Cross Sectional

Pathways to suicide: a survey of self-destructive behaviors. Baltimore, Md: the Johns Hopkins University Press.

E953

2561

2561

SUICIDE AND SELF INFLICTED INJURY BY SUBMERSION [DROWNING] 1983 Danto BL

Danto JM

119

4

CRI

E954

33

60

163

177

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E954

1903

1903

E954

1997

1997

1971 Goss MEW 199

Reed JI

1

LTB

3

Cross Sectional

Suicide and religion: a study of white adults in New York City, 1963-67.

E954

2573

1981 Maris RW

2573

Higher

JHUP

331

1

247

255

Cross Sectional

Pathways to suicide: a survey of self-destructive behaviors. Baltimore, Md: the Johns Hopkins University Press.

E954

1091

1091 276

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

E950-E950.9

SUICIDE AND SELF-INFLICTED INJURY 1995 Shatenstein

758

Kark JD

8550270

24

IJE

4

Prevalence

730

739

Cross sectional

Mortality in two Jewish populations--Montreal and Israel: environmental determinants of

E950-E950.9

1564

1564

SUICIDE AND SELF-INFLICTED INJURY BY OTHER AND UNSPECIFIED MEANS 1983 Danto BL

Danto JM

119

4

CRI

33

E958 60

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E958

1993

1993

Sig Lower

SUICIDE AND SELF-INFLICTED INJURY BY OTHER AND UNSPECIFIED MEANS [OTHER SPECIFIED MEANS] 1983 Danto BL

Danto JM

119

4

CRI

33

E958.8

60

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E958.8

1995

1995

1981 Maris RW

Sig Higher

JHUP

331

1

247

255

Cross Sectional

Pathways to suicide: a survey of self-destructive behaviors. Baltimore, Md: the Johns Hopkins University Press.

E958.8

1092

1092

SUICIDE AND SELF-INFLICTED POISONING BY BARBITURATES 1983 Danto BL

Danto JM

119

4

CRI

33

E950.1 60

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E950.1

1985

1985

Sig Higher

SUICIDE AND SELF-INFLICTED POISONING BY GASES AND VAPORS 1956 Liberson DM

300

18

JSS

83

Cross Sectional

Causes of death among Jews in New York City in 1953.

E951-E952

0729

0729

No Difference 277

E951-E952 117

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

SUICIDE AND SELF-INFLICTED POISONING BY GASES IN DOMESTIC USE 1983 Danto BL

Danto JM

119

4

CRI

33

Prevalence

E951 60

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E951

1984

1984

SUICIDE AND SELF-INFLICTED POISONING BY OTHER GASES AND VAPORS 1983 Danto BL

Danto JM

119

4

CRI

E952

33

60

163

177

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E952

1986

1971 Goss MEW

1986 Reed JI

199

1

LTB

3

Cross Sectional

Suicide and religion: a study of white adults in New York City, 1963-67.

E952

2569

2569

1981 Maris RW

Lower

JHUP

331

1

247

255

Cross Sectional

Pathways to suicide: a survey of self-destructive behaviors. Baltimore, Md: the Johns Hopkins University Press.

E952

2562

2562

SUICIDE BY ANALGESICS, ANTIPYRETICS, AND ANTIRHEUMATICS 1983 Danto BL

Danto JM

119

4

CRI

33

E950.0 60

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E950.0

1988

1988

E958.1

SUICIDE BY BURNS, FIRE 1983 Danto BL

Danto JM

119

4

CRI

33

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E958.1

1989

1989

Sig Lower

278

60

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

Danto JM

119

Pages

Findings: Total

Prevalence

E956

SUICIDE BY CUTTING 1983 Danto BL

Vol/Iss

Journal

4

CRI

33

60

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E956

1994

1971 Goss MEW

1994 Reed JI

199

Sig Higher 1

LTB

3

163

177

Cross Sectional

Suicide and religion: a study of white adults in New York City, 1963-67.

E956

2571

2571

1981 Maris RW

Lower

JHUP

331

1

247

255

Cross Sectional

Pathways to suicide: a survey of self-destructive behaviors. Baltimore, Md: the Johns Hopkins University Press.

E956

2564

2564

E955

SUICIDE BY FIREARMS 1983 Danto BL

Danto JM

119

4

CRI

33

60

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E955

1990

1971 Goss MEW

1990 Reed JI

199

Sig Lower 1

LTB

3

163

177

Cross Sectional

Suicide and religion: a study of white adults in New York City, 1963-67.

E955

2567

2567

1981 Maris RW

Lower

JHUP

331

1

247

255

Cross Sectional

Pathways to suicide: a survey of self-destructive behaviors. Baltimore, Md: the Johns Hopkins University Press.

E955

2560

2560

E953.0

SUICIDE BY HANGING 1983 Danto BL

Danto JM

119

4

CRI

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E953.0

1991

1991

279

33

60

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

Reed JI

199

Pages

Findings: Total

Prevalence

E957

SUICIDE BY JUMPING 1971 Goss MEW

Vol/Iss

Journal

1

LTB

3

163

177

Cross Sectional

Suicide and religion: a study of white adults in New York City, 1963-67.

E957

2572

2572

1981 Maris RW

Higher

JHUP

331

1

247

255

Cross Sectional

Pathways to suicide: a survey of self-destructive behaviors. Baltimore, Md: the Johns Hopkins University Press.

E957

2565

2565

SUICIDE BY JUMPING, FALLING 1956 Liberson DM

JSS

300

E958.0 18

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

E958.0

0732

0732

Higher

E950.2

SUICIDE BY OTHER SEDATIVES AND HYPNOTICS 1983 Danto BL

Danto JM

119

4

CRI

33

60

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E950.2

1992

1992

1956 Liberson DM

Sig Lower 18

JSS

300

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

E950.2

0777

0777

No Difference

E950

SUICIDE BY POISON 1983 Danto BL

Danto JM

119

4

CRI

33

60

163

177

Cross Sectional

Jewish and non-Jewish suicide in Oakland County, Michigan.

E950

1987

1971 Goss MEW 199

1987 Reed JI

1

LTB

3

Cross Sectional

Suicide and religion: a study of white adults in New York City, 1963-67.

E950

2570

2570

Higher

280

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1981 Maris RW

Pages

Findings: Total

JHUP

331

Vol/Iss

Journal

1

247

Prevalence 255

Cross Sectional

Pathways to suicide: a survey of self-destructive behaviors. Baltimore, Md: the Johns Hopkins University Press.

E950

2563

2563

E955.4

SUICIDE BY SHOOTING 1956 Liberson DM

18

JSS

300

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

E955.4

0782

0782

Lower

780-799

SYMPTOMS, SIGNS, AND ILL-DEFINED CONDITIONS 1956 Liberson DM

18

JSS

300

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

780-799

0771

0771

1973 Lindenthal JJ

No Difference

PHDYU 1

305

1

273

345

Cross Sectional

The Jews of Middletown, Connecticut.

780-799

0507

0507

SYPHILIS, UNSPECIFIED 1905 Bernheimer

44

Lower

097.9 BOOK2 1

328

Cross Sectional

The Russian Jew in the United States: studies of social conditions in New York, Philadelphia and Chicago with a description of rural settlements.

097.9

1335

1933 Bolduan CR 63

1335 Weiner L

Lower

NEJM

208

8

407

416

427

432

Cross Sectional

Causes of death among Jews in New York City.

097.9

0020

1902 Fischkin EA 158

0020

Lower

JAMA

39

8

Cross Sectional

Six years in a dermatologic clinic: a report of service, with remarks on the treatment of the more common skin diseases.

097.9

1220

1220

Lower

281

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1962 Gorwitz K

Pages

Findings: Total 24

JSS

198

Vol/Iss

Journal

Prevalence

248

254

469

471

83

117

46

49

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957.

097.9

0476

0476

1902 Hyde FG

Lower 58

AJI

242

Cross Sectional

Notes on the Hebrew insane.

097.9

0529

0529

1956 Liberson DM

Lower 18

JSS

300

Cross Sectional

Causes of death among Jews in New York City in 1953.

097.9

0721

0721

1923 Spivak CD

Lower 1

CM

523

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

097.9

0821

0821

1917 Guilfoy WH

MS18

655

1

27

Cross Sectional

The influence of nationality upon the mortality of a community, with special references to the city of New York.

097.9

1687

1987 Schulman S 1204

1687

Lower

Werzberger A MMWR

3110572

36

27

440

449

Case Control

Multistate outbreak of shigella sonnei gastroenteritis – United States.

097.9

0681

***0681

271.2

TAURI DISEASE 1996 Sivakumar K

763

Vasconcelos

8628478

46

N

5

1337

1342

Case study

Late-onset muscle weakness in partial phosphofructokinase deficiency: a unique myopathy with vacuoles, abnormal mitochondria, absence of a common exon 5/intron 5 junction point mutation.

271.2

1565

1565

THALASSEMIA [THALASSEMIAS] 1983 Sancar GB

463

Rausher DB

6305247

98

ANIM Case Study

Alpha-thalassemia in Ashkenazi Jews.

282.4

1252

1252 282

282.4 6

933

936

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1982 Sancar GB 464

Rausher DB

6304975

Vol/Iss

Journal

Pages

Findings: Total

TAAP

95

Prevalence

205

212

793

798

Case Study

Alpha-thalassemia in Ashkenazi Jews.

282.4

1280

1996 Mitchell JJ 789

1280 Capua A

8808593

AJHG

59

4

Case study

Twenty-year outcome analysis of genetic screening programs for Tay-Sachs and beta-thalassemia disease carriers in high schools.

282.4

1593

1998 Waye S 829

1593 Eng B

9494053

22

H

1

83

85

Case study

Novel beta-thalassemia mutation in patients of Jewish descent: [beta 30 (B12) ARG-->GLY or IVS1 (-2) (A-->G=oly or IVS-1 (A->G)].

282.4

1843

2001 Zinberg RE 1115

1843 Kornreich R

28

CIP

2

367

382

11499058

Prenatal genetic screening in the Ashkenazi Jewish population.

282.4

0569

***0569

E870-E876

THERAPEUTIC MISADVENTURES 1962 Gorwitz K

24

JSS

198

248

254

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957.

E870-E876

0491

0491

No Difference

443.1

THROMBOANGIITIS OBLITERANS [BUERGER'S DISEASE] 1962 Brinn LB

HH

76

2

261

275

136

567

580

Review

Jews, genetics and disease.

443.1

0786

0786

1908 Buerger L

AJMS

83

Case Study

Thrombo-angiitis obliterans: a study of the vascular lesions leading to presenile spontaneous gangrene.

443.1

0178

1933 Evans ET

0178 Dumas AG

153

MBVA

10

99

Cross Sectional

Thrombo-angiitis obliterans: report of fifty-two cases.

443.1

1387

1387

283

Higher

109

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1937 Goodman C

Pages

Findings: Total 35

AS

196

Vol/Iss

Journal

1126

Prevalence 1144

Review

Thrombo-angiitis obliterans and typhus. Evidence of etiologic relationship.

443.1

0176

0176

1956 Liberson DM

18

JSS

300

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

443.1

0753

0753

1966 McKusick VA 337

No Difference

ALJMS

5978172

3

4

408

424

Review

Clinical genetics at a population level: the ethnicity of disease in the United States.

443.1

1429

1429

1920 Meyer W

MR

342

97

457

459

183

465

467

1149

1160

Review

The etiology of thromboangiitis obliterans.

443.1

1935

1935

1932 Samuels SS

AJMS

462

Case Study

The incidence of thrombo-angiitis obliterans in brothers.

443.1

1511

1960 Wessler S

1511 Ming S-C

573

NEJM

262

23

Cross Sectional

A critical evaluation of thromboangiitis obliterans: the case against Buerger's disease.

443.1

0177

1938 Wilensky ND

0177 Collens WS

577

JAMA

110

21

1746

1747

976

993

961

963

Case Study

Thrombo-angiitis obliterans in sisters.

443.1

1519

1519

1925 Meleney FL

81

ANS

644

Review

A contribution to the study of thrombo-angiitis obliterans.

443.1

1469

1917 Sinkowitz SJ 832

1469 Gottlieb I

JAMA

68

Case study

Thrombo-angiitis obliterans: the conservative treatment by Bier's hyperemia suction apparatus.

443.1

1852

1852 284

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1936 Maddock W

Russell ML

Vol/Iss

Journal

AHJ

Pages

Findings: Total 12

46

Prevalence 52

1143 Thromboangiitis obliterans and tobacco. The influence of sex, race, and skin sensitivity to tobacco on cardiovascular responses to smoking.

443.1

2070

***2070

1942 Allen EV

NYAM

1176

165

189

318

322

Review

Thrombo-angiitis obliterans.

443.1

1011

***1011

1933 Harkavy J

BNYAM 9

1219

Cohort

Tobacco sensitiveness in thromboangiitis obliterans, migrating phlebitis and coronary artery disease.

443.1

1271

1937 Bernheim AR

***1271 London IM

JAMA

108

2102

2109

58

147

159

13

342

347

210

229

1223 Arteriosclerosis and thrombo-angiitis obliterans.

443.1

1282

***1282

1936 Barker NW

AIM

1224 Primary idiopathic thrombophlebitis.

443.1

1285

1938 Fatheree TJ

***1285 Hines Jr EA

1225

MCP Case Study

Fatal complications of thrombo-angiitis obliterans, 1929-1938.

443.1

1288

***1288

1915 Buerger L

JMR

149

1237 Concerning vasomotor and trophic disturbances of the upper extremities; with a particular reference to thrombo-angiitis obliterans.

443.1

1925

***1925

1909 Buerger L

IC

19

3

84

105

1238 The association of migrating thrombophlebitis with thrombo-angiitis obliterans.

443.1 1910 Buerger L

1926

***1926 Kaliski DJ

MR

78

1239 Compliment fixation tests in thrombo-angiitis obliterans. 285

665

669

Year Author1 BiblioRef

Author2 PubMed

Design

ICD

Lindex

IsText

443.1

1927

***1927

1936 Cohen SS

Vol/Iss

Journal

Barron ME

Pages

Findings: Total

NEJM

214

26

1275

Prevalence 1279

1240 Thrombo-angiitis obliterans with special reference to its abdominal manifestations.

443.1

1928

1929 Allen EV

***1928 Willius FA

3

ANIM

35

39

1241 Disease of the coronary arteries associated with thrombo-angiitis obliterans of the extremities, 1929.

443.1

1929

to be typed 12

THYROTOXICOSIS WITHOUT GOITER OR OTHER CAUSE AND WITHOUT THYROTOXIC CRISIS OR STORM 1964 Boxall EA

Lauener RW

1158

JCMA

91

204

242.90

211

Case Study

Atypical manifestations of hyperthyroidism.

242.90

0993

***0993

TIC SYNDROME (GILLES DE LA TOURETTE'S SYNDROME) 1980 Nee LE

372

Caine ED

6928747

7

ANN

1

41

307.23 49

Cross Sectional

Gilles de la Tourette syndrome: clinical and family study of 50 cases.

307.23

1253

1972 Shapiro AK 495

1253 Shapiro E

4117160

No Difference

JNMD

155

5

335

344

Case Study

Birth, developmental, and family histories demographic information in Tourette's syndrome.

307.23

1645

307.2

TICS

1985 Comings DE

108

1645 Comings BG

3859204

AJHG

37

435

450

Cross Sectional

Tourette syndrome: clinical psychological aspects of 250 cases.

307.2

1254

1977 Eldridge R 140

1254 Sweet R

264605

No Difference 27

N

115

124

Cross Sectional

Gilles de la Tourette's syndrome: clinical, genetic, psychologic and biochemical aspects in 21 selected families.

307.2

0137

0137

Higher 286

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1945 Mahler MS

Luke JA

319

Vol/Iss

Journal

Pages

Findings: Total

AJOP

15

Prevalence

631

647

304

307

Cross Sectional

Clinical and follow-up study of the tic syndrome in children.

307.2

0135

1978 Wassman E 560

0135 Eldridge R

272491

Higher 28

N Case Study

Gilles de la Tourette syndrome: clinical and genetic studies in a midwestern city.

307.2

0138

0138

TOBACCO ABUSE [TOBACCO USE DISORDER] 1973 Levy L

2

DF

298

2

141

305.1 171

Cross Sectional

Drug use on campus: prevalence and social characteristics of collegiate drug users on campuses of the University of Illinois.

305.1

0425

1974 Strimbu JL 533

0425 Sims Jr OS

4154923

Higher 9

IJA

4

569

583

Cross Sectional

A university system drug profile.

305.1

0434

1995 Adrian Manu 734

0434 Dini CM

7657398

No Difference 30

IJA

6

699

734

Cross Sectional

Substance use as a measure of social integration for women of different ethnocultural groups into mainstream culture in a pluralist society: the example of Canada.

305.1

1534

1936 Maddock W

Russell ML

12

AHJ

46

52

1143 Thromboangiitis obliterans and tobacco. The influence of sex, race, and skin sensitivity to tobacco on cardiovascular responses to smoking.

305.1

2069

***2069

130.9

TOXOPLASMOSIS [TOXOPLASMOSIS, UNSPECIFIED] 1954 Jacobs L

Cook MK

247

90

JP2

6

701

702

Case Study

Serological survey data on the prevalence of toxoplasmosis in the Jewish population of New York.

130.9

0034

0034

287

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

298.9

TRAUMATIC PSYCHOSIS [UNSPECIFIED PSYCHOSIS] 1944 Hyde RW

Chisholm RM NEJM

243

231

18

Prevalence

612

618

Cross Sectional

Studies in medical sociology. III. The relation of mental disorders to race and nationality.

298.9

0367

0367

1930 Malzberg B

14

MH

324

926

946

Cross Sectional

The prevalence of mental disease among Jews.

298.9

0587

0587

1931 Malzberg B

No Difference 15

MH

325

766

774

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

298.9

0379

1976 Wylan L 585

0379 Mintz NL

992954

Lower 22

IJSP

1

86

95

Case Study

Ethnic differences in family attitudes towards psychotic manifestations, with implications for treatment programmes.

298.9

0195

0195

124.0

TRICHINOSIS 1935 Morrison H

354

NEJM

213

11

531

532

Case Study

Trichinosis among Jews.

124.0

0033

0033

TUBERCULOSIS [PULMONARY TUBERCULOSIS (UNSPECIFIED)] 1875 Baxter JH

GPO

36

011.9 1

0

Cross Sectional

Statistics, medical anthropological of the Provost-Marshal-General's Bureau.

011.9

0017

1901 Benedict AL 41

0017 7

PMJ Case Study

Tuberculosis among Russian Jews.

011.9

0014

0014

288

93

0

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1894 Billings JS

Pages

Findings: Total 1

USDI

53

Vol/Iss

Journal

100

Prevalence 102

Cross Sectional

Vital statistics of New York City and Brooklyn, covering a period of six years ending May 31, 1890.

011.9

2138

2138

1931 Bogen E

Lower 24

ART

61

522

531

10

26

407

416

22

44

Cross Sectional

Racial susceptibility to tuberculosis.

011.9

0279

0279

1940 Bogen E

Lower

BAATP

62

24

Review

Causes of the decline in tuberculosis mortality rates.

011.9

0280

1933 Bolduan CR

0280 Weiner L

63

NEJM

208

8

Cross Sectional

Causes of death among Jews in New York City.

011.9

0006

0006

1928 Bureau of Je

JCSNY

84

1

Cross Sectional

Causes of death among Jews.

011.9

2142

2142

1906 Charity Orga

Lower

FARCT

93

1

1

Cross Sectional

The fourth annual report of the committee on the prevention of tuberculosis.

011.9

1410

1410

1928 Deporte JV

Lower

NYSJM

124

28

19

1155

1159

Cross Sectional

Causes of death among Jews in New York State (exclusive of New York City), 1925.

011.9

0330

0330

1916 Dublin LI

Higher 6

AER

128

3

523

548

Cross Sectional

Factors in American mortality: a study of death rates in the race stocks of New York State, 1910.

011.9

0560

1920 Dublin LI

0560 Baker GW

129

Lower

QPASA 10

13

Cross Sectional

The mortality of race stocks in Pennsylvania and New York, 1910.

011.9

0692

0692

Lower 289

44

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1900 Dutcher A

Pages

Findings: Total 6

PMJ

131

Vol/Iss

Journal

1030

Prevalence 1032

Case Study

Where the danger lies in tuberculosis: a study of the social and domestic relations of tuberculosis outpatients.

011.9

0015

1874 Epstein EM 149

0015 30

MSR

440

442

1077

1088

2

695

699

7

7

8

73

82

13

15

16

26

248

254

Review

Have the Jews any immunity from certain diseases?

011.9

0273

1908 Fishberg M 159

0273 74

MR

26

Cross Sectional

Tuberculosis among the Jews.

011.9

0009

1901 Fishberg M 160

0009

Lower

AM Review

The relative infrequency of tuberculosis among Jews.

011.9

0136

1901 Fishberg M 161

0136 PMJ

Historical Review

Tuberculosis and Russian Jews.

011.9

0281

1902 Fishberg M 162

0281 33

TM

2

Review

Health sanitation of the immigrant Jewish population of New York.

011.9

0397

1940 Gagnon E

0397 CJPH

175

31

Case Study

The low mortality rate from tuberculosis in the Jewish race.

011.9

0198

1924 Goldsmith S 191

0198 JSSQ

1

Cross Sectional

The Jewish tuberculosis.

011.9

0007

1962 Gorwitz K

0007

Lower 24

JSS

198

Cross Sectional

Jewish mortality in St. Louis and St. Louis County, 1955-1957.

011.9

0475

0475

Lower 290

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1908 Guilfoy WH

MR

215

Vol/Iss

Journal

Pages

Findings: Total 73

132

Prevalence 135

Cross Sectional

The death rate of the city of New York as affected by the cosmopolitan character of its population.

011.9

0413

0413

1895 Hoffman FL

SP

234

Lower 55

19

222

234

99

102

624

676

811

817

Cross Sectional

The Jew as a life risk.

011.9

0013

0013

Lower

011.9

0513

0513

Lower

1913 Holt LE

JAMA

235

61

2

Case Study

Tuberculosis acquired through ritual circumcision.

011.9

0859

0859

1907 Hutchinson

NYMJ

241

86

Review

Varieties of tuberculosis according to race and social condition.

011.9

0528

1943 Hyde RW

0528 Zacks D

244

NEJM

229

22

Cross Sectional

Socioeconomic aspects of disease: a community study of pulmonary tuberculosis in selectees.

011.9

1266

1972 Kolodny EH 276

1266 PP

Lower 1

321

341

Case Study

Sandhoff's disease: studies on the enzyme defect in homozygotes and detection of heterozygotes. In Volk BW, Aronson SM, eds. Sphingolipids, Sphingolipidoses and Allied Disorders. New York: Plenum Press.

011.9

0891

1956 Liberson DM 300

0891 JSS

18

83

117

271

276

408

424

Cross Sectional

Causes of death among Jews in New York City in 1953.

011.9

0429

1934 Maller JB

0429 JSSQ

321

Lower 10

Cross Sectional

A study of Jewish neighborhoods in New York City.

011.9

0005

1966 McKusick VA 337

5978172

0005 ALJMS

Lower 3

4

Review

Clinical genetics at a population level: the ethnicity of disease in the United States. 291

Year Author1 BiblioRef

Author2 PubMed

Design

ICD

Lindex

IsText

011.9

1432

1432

1912 Price GM

Pages

Findings: Total 1

ACP

409

Vol/Iss

Journal

205

Prevalence 268

Cross Sectional

Report on bakeries and bakers in New York City. In: preliminary report of the factory investigating commission, volume 1, Albany, New York.

011.9

1365

1365

1933 Putnam P

Higher 28

ART

411

591

616

Cross Sectional

The bionomics of families attending a tuberculosis dispensary. III. Tuberculosis morbidity and mortality among Italians and Hebrews.

011.9

0601

0601

1941 Rest A

Higher

ART

422

43

0344

0356

34

186

190

Case Study

Tuberculosis in the Jewish diabetic.

011.9

1180

1180

1917 Reuben MS

AP

423

Case Study

Tuberculosis following ritual circumcision.

011.9

0008

1988 Rubinstein I 452

0008 Baum GL

3182094

16

INF

4

253

Case Study

Serum immunolglobulin levels in Jewish patients with active pulmonary tuberculosis.

011.9

0998

1904 Sachs TB

0998 JAMA

458

43

390

395

13

103

Cross Sectional

Tuberculosis in the Jewish district of Chicago.

011.9

0012

1915 Schereschew 481

0012

Lower 71

PHB Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

011.9

0972

1923 Spivak CD

0972 1

CM

523

46

49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

011.9

0780

0780 292

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1904 Stedman T

Pages

Findings: Total

MR

525

Vol/Iss

Journal

Prevalence

66

340

340

20

45

47

67

287

288

1

460

461

Case Study

Tuberculosis among Hebrews.

011.9

0635

0635

1927 Tenenbaum

JT

540

Cross Sectional

The health status of the Jews.

011.9

0638

0638

1898 Ware MW

Lower

NYMJ

559

Case Study

A case of inoculation tuberculosis after circumcision.

011.9

0016

0016

1909 Welt-Kakels

AP

571

Case Study

A case of inoculation tuberculosis following ritual circumcision.

011.9

0866

0866

1900 Department

3

VS

641

138

Cross Sectional

Twelfth census of the United States.

011.9

1656

1656

1917 Guilfoy WH

Lower

MS18

655

1

27

Cross Sectional

The influence of nationality upon the mortality of a community, with special references to the city of New York.

011.9

1676

1676

011.9

1686

1686

1912 Davis WH

Lower

PDCB

679

Cross Sectional

The relation of the foreign population to Boston mortality rates.

011.9

1770

1987 Schulman S 1204

1770

Lower

Werzberger A MMWR

3110572

36

27

440

449

Case Control

Multistate outbreak of shigella sonnei gastroenteritis – United States.

011.9

0775

1953 Rosenberg L 1333

***0775 15

JSS

Cross Sectional

Births, Deaths and Morbidity Among Jews in Montreal in 1950

293

101

112

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

PubMed

Design

ICD

Lindex

IsText

011.9

1878

***1878

Pages

Findings: Total

TUBERCULOSIS OF OTHER MALE GENITAL ORGANS UNSPECIFIED EXAMINATION 1955 Aronson SM

Volk BW

1232

31

AJP2

4

609

Prevalence

016.5 626

Case Study

Morphologic evolution of amaurotic family idiocy: the protracted phase of the disease.

016.5

1901

***1901

TUMOR OF THE THYROID [NEOPLASM OF ENDOCRINE GLANDS AND OTHER PARTS OF NERVOUS SYSTEM] 1980 Shore RE

500

Woodard ED

7410071

38

HP

451

239.7

465

Cross Sectional

Radiation host factors in human thyroid tumors following thymus irradiation.

239.7

1286

1286

No Difference

002.0

TYPHOID FEVER 1894 Billings JS

1

USDI

53

100

102

Cross Sectional

Vital statistics of New York City and Brooklyn, covering a period of six years ending May 31, 1890.

002.0

2133

1908 Guilfoy WH 215

2133

Lower 73

MR

132

135

Cross Sectional

The death rate of the city of New York as affected by the cosmopolitan character of its population.

002.0

0407

1895 Hoffman FL 234

0407

Lower 55

SP

19

222

234

15

28

Cross Sectional

The Jew as a life risk.

002.0

0496

1899 Rudisch J

0496

Lower

MSHR

454

1

Case Study

A study of the cases of typhoid fever observed in the hospital from 1883-1898.

002.0

0002

1923 Spivak CD

0002 1

CM

523

46

49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

002.0

0799

0799 294

Year Author1 BiblioRef ICD

Author2 PubMed

Design

Lindex

IsText

1987 Schulman S 1204

Pages

Findings: Total

Werzberger A MMWR

3110572

Vol/Iss

Journal

36

27

440

Prevalence 449

Case Control

Multistate outbreak of shigella sonnei gastroenteritis – United States.

002.0

0683

***0683

1953 Rosenberg L

15

JSS

1333

101

112

Cross Sectional

Births, Deaths and Morbidity Among Jews in Montreal in 1950

002.0

2078

***2078

556.9

ULCERATIVE COLITIS 1965 Thayer WR

Bove JR

541

48

G

3

326

330

806

813

Case Study

Blood groups and ulcerative colitis.

556.9

2076

1999 Tountas NA 1029

***2076 Casini-Raggi

117

G

10500062

Functional ethnic assocation of allele 2 of the interleukin-1 receptor antagonist gene in ulcerative colitis.

556.9

2705

1971 Tandon R 1079

2705 Mandell H

5098211

16

DD

9

845

848

3

198

204

Case Control

Lactose intolerance in Jewish patients with ulcerative colitis.

556.9

0275

1980 Robison WW 1092

***0275 Bentlif PS

25

DDS

7371464

Observations on 261 consecutive patients with inflammatory bowel disease seen in the southwest United States.

556.9

0358

2000 Rioux JD 1152

***0358 Silverberg MS AJHG

66

1863

1870

10777714

Genomewide search in Canadian families with inflammatory bowel disease reveals two novel susceptible loci.

556.9

1817

***1817

295

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

491.9

UNSPECIFIED CHRONIC BRONCHITIS 1915 Schereschew

71

PHB

481

Prevalence

13

103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

491.9

0971

0971

737.9

UNSPECIFIED CURVATURE OF SPINE 1915 Schereschew

71

PHB

481

13

103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

737.9

0954

0954

737.9

0958

0958

289.9

UNSPECIFIED DISEASES OF BLOOD AND BLOOD-FORMING ORGANS 1956 Liberson DM

18

JSS

300

83

117

Cross Sectional

Causes of death among Jews in New York City in 1953.

289.9

0746

0746

1919 New York St

No Difference

NYSHC -

640

-

322

409

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

289.9

1701

1996 Levy EN 1110

1701 Shen Y

Lower

AJHG

58

523

534

8644712

Linkage disequilibrium mapping places the gene causing familial Mediterranean fever close to d16s246.

289.9

0878

***0878

UNSPECIFIED DISORDER OF AUTONOMIC NERVOUS SYSTEM 1955 Cohen P

Solomon NH

1192

46

JP

Case Study

Familial dysautonomia.

337.9

1002

***1002

296

663

337.9 670

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

629.9

UNSPECIFIED DISORDER OF FEMALE GENITAL ORGANS 1928 Bureau of Je

JCSNY

84

1

Prevalence

22

44

Cross Sectional

Causes of death among Jews.

629.9

2154

2154

Lower

569.9

UNSPECIFIED DISORDER OF INTESTINES 1891 Billings JS

152

NAR

52

70

84

Cross Sectional

Vital statistics of the Jews.

569.9

0806

0806

Higher

UNSPECIFIED DISORDER OF LIVER 1933 Bolduan CR

Weiner L

63

NEJM

208

573.9 8

407

416

Cross Sectional

Causes of death among Jews in New York City.

573.9

0197

0197

Lower

709.9

UNSPECIFIED DISORDER OF SKIN AND SUBCUTANEOUS TISSUE (DERMATOSIS) 1891 Billings JS

152

NAR

52

70

84

Cross Sectional

Vital statistics of the Jews.

709.9

0804

0804

UNSPECIFIED DISORDER OF THE TEETH AND SUPPORTING STRUCTURES 1915 Schereschew

71

PHB

481

13

525.9 103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

525.9

0956

0956

UNSPECIFIED DISTURBANCE OF CONDUCT 1942 Tietze C

Lemkau P

542

48

AJS

1

29

Cross Sectional

Personality disorder and spatial mobility.

312.9

1161

1161

No Difference 297

312.9 39

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

UNSPECIFIED EPISODIC MOOD DISORDER 1888 Bannister H

32

Hektoen L

44

AJI

Prevalence

296.9

455

470

613

630

Cross Sectional

Race and insanity.

296.9

1394

1880 Spitzka EC

1394

Lower

JNMD

7

522 Contributions to nervous mental pathology.

296.9

1154

1154

Lower

UNSPECIFIED GASTRITIS AND GASTRODUODENITIS 1912 Price GM

ACP

409

535.5 1

205

268

Cross Sectional

Report on bakeries and bakers in New York City. In: preliminary report of the factory investigating commission, volume 1, Albany, New York.

535.5

1353

1353

Higher

455.6

UNSPECIFIED HEMORRHOIDS WITHOUT MENTION OF COMPLICATION 1915 Schereschew

481

71

PHB

13

103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

455.6

0966

0966

UNSPECIFIED NONTOXIC NODULAR GOITER 1964 Lubart JM

JNMD

1194

138

255

241.9 267

Cohort

Implicit personality disorder in patients with toxic and non-toxic goiter.

241.9

1007

***1007

382.9

UNSPECIFIED OTITIS MEDIA 1915 Schereschew

481

71

PHB

13

103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

382.9

0963

0963

298

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

301.10

UNSPECIFIED PERSONALITY DISORDER [AFFECTIVE PERSONALITY DISORDER, UNSPECIFIED] 1914 de Leon D

Karpas Morris MR

74

Prevalence

86

576

579

23

320

326

Case Study

Insanity among Jews.

301.10

1203

1962 Sanua VD

1203 DNS

472

Case Study

Comparison of Jewish and Protestant paranoid and catatonic patients.

301.10

1108

1915 Schereschew 481

1108 71

PHB

13

103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

301.10

0974

0974

UNSPECIFIED SENILE PSYCHOTIC CONDITION 1909 Kirby GH

1

SHB

270

290.9 4

663

670

Cross Sectional

A study in race psychopathology.

290.9

0335

0335

Lower

038.9

UNSPECIFIED SEPTICEMIA 1923 Spivak CD

1

CM

523

46

49

Case Study

The mortality of the Jews in Denver: a study in group vital statistics (a preliminary report).

038.9

0798

0798

473.9

UNSPECIFIED SINUSITIS [CHRONIC] 1915 Schereschew

481

71

PHB

13

103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

473.9

0965

0965

299

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

UNSPECIFIED TRANSIENT ORGANIC MENTAL DISORDER [TRANSIENT ORGANIC PSYCHOTIC CONDITIONS] 1931 Malzberg B

15

MH

325

766

Prevalence

293

774

Cross Sectional

Mental disease among Jews: a second study with a note on the relative prevalence of mental defect and epilepsy.

293

0377

0377

1880 Spitzka EC

Lower

JNMD

7

613

630

322

409

522 Contributions to nervous mental pathology.

293

1137

1137

1919 New York St

Higher

NYSHC -

640

-

Cross Sectional

The Thirteenth Annual Report of the New York State Hospital Commission.

293

1707

1707

Lower

295.94

UNSPECIFIED TYPE SCHIZOPHRENIA CHRONIC STATE WITH ACUTE EXACERBATION 1964 Hobson JA

JNMD

1156

138

432

442

Case Study

Identical twins discordant for schizophrenia.

295.94

0990

***0990

UNSPESIFIED ABNORMALY OF EHORION AND 762.9 AMNION 2002 Wapner R

Evans M

1340

AJOG

186

6

1133

1136

Cohort

Procedural risks versus theology: Chorionic villus sampling for Orthodox Jews at less that 8 weeks’ gestation

762.9

2275

***2275

099.9

VENEREAL DISEASE, UNSPECIFIED 1912 Price GM

1

ACP

409

205

268

Cross Sectional

Report on bakeries and bakers in New York City. In: preliminary report of the factory investigating commission, volume 1, Albany, New York.

099.9

1363

1363

No Difference 300

Year Author1 BiblioRef ICD

Author2

Vol/Iss

Journal

PubMed

Design

Lindex

IsText

Pages

Findings: Total

E960.0

VIOLENCE (EXCLUDING SUICIDE) 1920 Dublin LI

Baker GW

129

Prevalence

QPASA 10

13

44

Cross Sectional

The mortality of race stocks in Pennsylvania and New York, 1910.

E960.0

0697

0697

VIRAL ENCEPHALITIS TRANSMITTED BY OTHER AND UNSPECIFIED ARTHROPODS 1987 Schulman S

1204

Werzberger A MMWR

3110572

36

27

440

064.0 449

Case Control

Multistate outbreak of shigella sonnei gastroenteritis – United States.

064.0

0667

***0667

VIRAL HEPATITIS A WITH HEPATIC COMA 1997 Anonymous

810

9221328

MMWR

46

26

600

070.0 603

Case study

Hepatitis A vaccination programs in communities with high rates of hepatitis A.

070.0

1844

1844

368.59

VISUAL DISTURBANCES [COLOR VISION DEFICIENCIES, OTHER] 1915 Schereschew

481

PHB

71

13

103

Case Study

Studies in occupational diseases. Part I. The health of workers with special reference to the cloak, suit, skirt, dress, waist trades in New York City, NY Public Health Bulletin No. I. Washington DC: Government Printing Office.

368.59

0975

0975

WHOOPING COUGH [WHOOPING COUGH, UNSPECIFIED ORGANISM] 1908 Guilfoy WH

215

MR

73

132

033.9 135

Cross Sectional

The death rate of the city of New York as affected by the cosmopolitan character of its population.

033.9

0414

1900 Department 642

0414 VS

Higher 3

117

133

101

112

Cross Sectional

Twelfth census of the United States.

033.9

1664

1953 Rosenberg L 1333

1664 JSS

Lower 15

Cross Sectional

Births, Deaths and Morbidity Among Jews in Montreal in 1950 301

Year Author1 BiblioRef

Author2

Vol/Iss

Journal

PubMed

Design

ICD

Lindex

IsText

033.9

2087

***2087

Pages

Findings: Total

WILSON'S DISEASE [HEPATOLENTICULAR DEGENERATION] 1960 Bearn AG

24

AHG

37

1

33

Prevalence

275.1 43

Cross Sectional

A genetical analysis of thirty families with Wilson's disease (hepatolenticular degeneration).

275.1

0035

0035

Higher

XANTHELASMA [MIXED HYPERLIPIDEMIA] 1951 Reich C

Seife M

419

30

M

272.2

1

20

662

663

4

10

159

169

Case Study

Gaucher's disease: a review, and discussion of twenty cases.

272.2

1970

1970

1954 Robinson RC

70

ADS

435

Cross Sectional

Comparative incidence of xanthelasma in Jews and gentiles.

272.2

0075

1973 Schein AJ 480

0075 Arkin AM

4689130

Higher

CORR

90

Case Study

The classic hip-joint involvement in Gaucher's disease.

272.2

1971

2001 Lee M-H 1142

1971 Hazard S

11181744

42

JLR

Case Control

Fine mapping, mutation analyses, and structural mapping of cerebrotendinous xanthomatosis in U.S. Pedigrees.

272.2

0042

***0042

302

List of Diseases ICD# 001.9 001139 002.0 004.8 004.9 010018 011.9 016.5

ICD 9 DESCRIPTION CHOLERA INFECTIOUS AND PARASITIC DISEASES TYPHOID FEVER SHIGELLA SHIGELLOSIS, UNSPECIFIED TUBERCULOSIS (ALL FORMS)

TUBERCULOSIS [PULMONARY TUBERCULOSIS (UNSPECIFIED)] TUBERCULOSIS OF OTHER MALE GENITAL ORGANS UNSPECIFIED EXAMINATION 023.9 BRUCELLOSIS UNSPECIFIED 032.9 DIPHTHERIA 033.9 WHOOPING COUGH [WHOOPING COUGH, UNSPECIFIED ORGANISM] 034.1 SCARLET FEVER 036.0 CEREBROSPINAL FEVER 038.9 UNSPECIFIED SEPTICEMIA 044.9 SHIGELLOSIS 045.9 POLIOMYELITIS [ACUTE POLIOMYELITIS, UNSPECIFIED] 047.0 MENINGITIS [CEREBROSPINAL] 054.9 HERPES SIMPLEX WITHOUT MENTION OF COMPLICATION 055.9 MEASLES [MEASLES WITHOUT MENTION OF COMPLICATION] 064.0 VIRAL ENCEPHALITIS TRANSMITTED BY OTHER AND UNSPECIFIED ARTHROPODS 070.0 VIRAL HEPATITIS A WITH HEPATIC COMA 070.1 HEPATITIS 081.1 BRILL'S DISEASE [RECRUDESCENT TYPHUS] 083.0 Q FEVER 085 LEISHMANIASIS 094.0 LOCOMOTOR ATAXIA [TABES DORSALIS] 094.1 GENERAL PARESIS 094.89 NEUROSYPHILIS [OTHER SPECIFIED NEUROSYPHILIS (OTHER)] 303

List of Diseases ICD# 094.9 097.9 098.0 099.9 111.8 123.1 123.4 123.9 124.0 130.9 132.9 133.0 136.9 140 140239 141.9 141149 145.9 149.0 150.0 150.3 150.9 150159 151.0

ICD 9 DESCRIPTION NEUROSYPHILIS [NEUROSYPHILIS, UNSPECIFIED] SYPHILIS, UNSPECIFIED GONORRHEA (ACUTE) VENEREAL DISEASE, UNSPECIFIED OTHER SPECIFIED DERMATOMYCOSIS CYSTICERCOSIS BOTHRIOCEPHALUS LATUS [DIPHYLLOBOTHRIASIS, INTESTINAL] DIPHYLLOBOTHRIUM LATUM [CESTODE INFECTION, UNSPECIFIED] TRICHINOSIS TOXOPLASMOSIS [TOXOPLASMOSIS, UNSPECIFIED] PEDICULOSIS, UNSPECIFIED SCABIES INFECTIVE [UNSPECIFIED INFECTIOUS AND PARASITIC DISEASES] CANCER OF THE LIP [MALIGNANT NEOPLASM 0F LIP] NEOPLASMS CANCER OF THE TONGUE [MALIGNANT NEOPLASM OF TONGUE, UNSPECIFED] CANCER OF THE LIP, ORAL CAVITY, AND PHARYNX [MALIGNANT NEOPLASM OF LIP, ORAL CAVITY, AND PHARYNX] CANCER OF THE MOUTH AND BUCCAL CAVITY [MALIGNANT NEOPLASM OF MOUTH, UNSPECIFIED] CANCER OF THE PHARYNX [MALIGNANT NEOPLASM OF PHARYNX, UNSPECIFIED] SQUAMOUS CELL CARCINOMA OF THE ESOPHOGAS CANCER OF THE ESOPHAGUS (UPPER THIRD) CANCER OF THE ESOPHAGUS [MALIGNANT NEOPLASM OF ESOPHAGUS, UNSPECIFIED] MALIGNANT NEOPLASM OF THE DIGESTIVE ORGANS AND PERITONEUM CANCER OF THE STOMACH [MALIGNANT NEOPLASM OF STOMACH, (CARDIA)]

304

List of Diseases ICD# ICD 9 DESCRIPTION 151.1- ADENOCARCINOMA OF THE DISTAL STOMACH 151.9 151.9 CANCER OF THE STOMACH [MALIGNANT NEOPLASM OF STOMACH, UNSPECIFIED] 152.9 CANCER OF THE SMALL INTESTINE [MALIGNANT NEOPLASM OF SMALL INTESTINE, UNSPECIFIED] 153.9 CANCER OF THE LARGE INTESTINE [MALIGNANT NEOP0LASM OF THE COLON, UNSPECIFIED - LARGE INTESTINE] 153CANCER OF COLON AND RECTUM 154.1 154.0 CANCER OF THE COLON [UNSPECIFIED] 154.1 CANCER OF THE RECTUM [MALIGNANT NEOPLASM OF THE RECTUM] 155 CANCER OF THE LIVER [MALIGNANT NEOPLASM OF LIVER AND INTRAHEPATIC BILE DUCTS] 155.0 CANCER OF THE LIVER, PRIMARY [MALIGNANT NEOPLASM OF LIVER, PRIMARY] 155.2 CANCER OF THE LIVER, UNSPECIFIED [MALIGNANT NEOPLASM OF LIVER, SPECIFIED AS PRIMARY] 155GALLBLADDER, PANCREAS, PERITONEUM AND OTHER ILL-DEFINED SITES 159.8 WITHIN THE DIGESTIVE ORGANS AND PERITONIUM 156.0 CANCER OF THE GALLBLADDER [MALIGNANT NEOPLASM OF GALLBLADDER] 156.1 CANCER OF THE BILE DUCTS [MALIGNANT NEOPLASM OF EXTRAHEPATIC BILE DUCTS] 157 CANCER OF THE PANCREAS [MALIGNANT NEOPLASM OF PANCREAS] 157.0 CANCER OF THE PANCREAS [MALIGNANT NEOPLASM OF PANCREAS (HEAD OF PANCREAS)] 157.9 CANCER OF THE PANCREAS [MALIGNANT NEOPLASM OF PANCREAS, PART UNSPECIFIED] 158.8 SPECIFIED PARTS OF PERITONEUM 158.9 PERITONEUM, UNSPECIFIED 159 MALIGNANT NEOPLASM OF OTHER AND ILL-DEFINED SITES WITHIN THE DIGESTIVE ORGANS AND PERITONEUM

305

List of Diseases ICD# ICD 9 DESCRIPTION 159.0 CANCER OF THE INTESTINES [MALIGNANT NEOPLASM OF INTESTINAL TRACT, PART UNSPECIFIED] 159.8 CANCER OF THE DIGESTIVE ORGANS AND PERITONIUM [MALIGNANT NEOPLASM OF OTHER SITES OF DIGESTIVE SYSTEM AND INTRAABDOMINAL ORGANS] 159.9 CANCER OF THE DIGESTIVE ORGANS [MALIGNANT NEOPLASM OF OTHER AND ILL-DEFINED SITES WITHIN THE DIGESTIVE ORGANS AND PERITONEUM (ILL-DEFINED)] 160CANCER OF THE NOSE, LARYNX, THYMUS, HEART, MEDIASTINUM 161 160MALIGNANT NEOPLASM OF RESPIRATORY AND INTRATHORACIC ORGANS 165 161 CANCER OF THE LARYNX [MALIGNANT NEOPLASM OF LARYNX] 161.9 CANCER OF THE LARYNX [MALIGNANT NEOPLASM OF LARYNX, UNSPECIFIED] 162 MALIGNANT NEOPLASMS OF TRACHEA, BRONCHUS, AND LUNG 162.0 CANCER OF THE TRACHEA [MALIGNANT NEOPLASM OF TRACHEA] 162.2 CANCER OF THE LUNG [MALIGNANT NEOPLASM OF MAIN BRONCHUS] 162.9 CANCER OF BRONCHUS AND LUNG [PRIMARY] 164CANCER OF THE NOSE, LARYNX, THYMUS, HEART, MEDIASTINUM 168 165.8 CANCER OF OTHER PARTS OF THE RESPIRATORY SYSTEM [MALIGNANT NEOPLASM OF OTHER - MALIGNANT NEOPLASM OF RESPIRATORY AND INTRATHORACIC ORGANS WHOSE POINT OF ORIGIN CANNOT BE ASSIGNED TO CATAGORIES] 165.9 CANCER OF THE RESPIRATORY SYSTEM [MALIGNANT NEOPLASM OF ILLDEFINED SITES WITHIN THE RESPIRATORY SYSTEM] 170.9 CANCER OF THE BONE [MALIGNANT NEOPLASM OF BONE AND ARTICULAR CARTILAGE, SITE UNSPECIFIED] 171.0 CANCER OF THE HEAD FACE AND NECK 171.9 CANCER OF THE LYMPHATICS [MALIGNANT NEOPLASM OF CONNECTIVE AND OTHER SOFT TISSUE, SITE UNSPECIFIED] 172.9 MELANOMA [MELANOMA OF SKIN, SITE UNSPECIFIED]

306

List of Diseases ICD# ICD 9 DESCRIPTION 173 MELANOMA AND OTHER SKIN CANCER [OTHER MALIGNANT NEOPLASM OF SKIN] 173.2 CANCER OF THE EAR 173.9 CANCER OF THE SKIN [MALIGNANT NEOPLASM OF SKIN, SITE UNSPECIFIED] 174 BREAST CANCER [MALIGNANT NEOPLASM OF FEMALE BREAST] 174.9 MALIGNANT NEOPLASM OF FEMALE BREAST, UNSPECIFIED 175.9 CANCER OF THE BREAST (MALE) [MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED SITES OF MALE BREAST] 179.0 CANCER OF THE UTERUS [MALIGNANT NEOPLASM OF UTERUS, PART UNSPECIFIED] 179MALIGNANT NEOPLASMS OF GENITOURINARY ORGANS 189 180 CANCER OF CERVIX UTERI [MALIGNANT NEOPLASM OF CERVIX UTERI] 180.0 CANCER OF THE UTERI [PART, UNSPECIFIED] 180.9 CANCER OF THE CERVIX [MALIGNANT NEOPLASM OF CERVIX UTERI, UNSPECIFIED] 181.0 CHORIOCARCINOMA 182 CANCER OF THE UTERUS [MALIGNANT NEOPLASM OF BODY OF UTERUS] 182.0 CANCER OF THE UTERI [MALIGNANT NEOPLASM OF CORPUS UTERI, EXCEPT ISTHMUS] 182.8 CANCER OF BODY OF UTERUS [MALIGNANT NEOPLASM OF BODY OF UTERUS (OTHER SPECIFIED SITES OF BODY UTERUS)] 183.0 CANCER OF THE OVARY [MALIGNANT NEOPLASM OF OVARY] 183.0- CANCER OF THE OVARY AND OTHER FEMALE GENITAL ORGANS 184.9 183.2 FALLOPIAN TUBE 184 CANCER OF OTHER AND UNSPECIFIED FEMALE GENITAL ORGANS [MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED FEMALE GENITAL ORGANS] 184.4 CANCER OF THE VULVA [MALIGNANT NEOPLASM OF VULVA, UNSPECIFIED] 184.9 CANCER OF THE FEMALE GENITAL ORGANS [MALIGNANT NEOPLASM OF FEMALE GENITAL ORGAN, SITE UNSPECIFIED] 307

List of Diseases ICD# ICD 9 DESCRIPTION 185.0 CANCER OF THE PROSTATE [MALIGNANT NEOPLASM OF PROSTATE] 186 CANCER OF THE TESTIS [MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED TESTIS] 186.9 CANCER OF THE TESTIS [MALIGNANT NEOPLASM OF TESTIS] 186CANCER OF THE TESTIS AND OTHER MALE GENITAL ORGANS 187.9 187 CANCER OF PENIS AND OTHER MALE GENITAL ORGANS [MALIGNANT NEOPLASM OF PENIS AND OTHER MALE GENITAL ORGANS] 187.4 CANCER OF THE PENIS [MALIGNANT NEOPLASM OF PENIS] 187.8 CANCER OF THE PENIS [MALIGNANT NEOPLASM OF PENIS AND OTHER MALE GENITAL ORGANS (OTHER SPECIFIED SITES OF MALE GENITAL ORGANS)] 187.9 CANCER OF THE MALE GENITAL ORGANS [MALIGNANT NEOPLASM OF MALE GENITAL ORGAN, SITE UNSPECIFIED] 188 MALIGNANT NEOPLASM OF BLADDER 188.8 CANCER OF THE BLADDER AND URINARY ORGANS [MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF BLADDER] 188.9 CANCER OF THE BLADDER [MALIGNANT NEOPLASM OF BLADDER, PART UNSPECIFIED] 189.0 CANCER OF THE KIDNEY [MALIGNANT NEOPLASM OF KIDNEY, EXCEPT PELVIS] 189.0- CANCER OF THE KIDNEY AND RENAL PELVIS 189 189.1 CANCER OF THE KIDNEY AND RENAL PELVIS [MALIGNANT NEOPLASM OF KIDNEY] 189.3 CANCER OF THE URETHRA [MALIGNANT NEOPLASM OF URETHRA] 189.9 CANCER OF THE URINARY ORGAN, SITE UNSPECIFIED [MALIGNANT NEOPLASM OF URINARY ORGAN, SITE UNSPECIFIED] 189MALIGNANT NEOPLASM OF KIDNEY AND OTHER UNSPECIFIED URINARY 189.1 ORGANS [KINDEY, RENAL PELVIS] 190 CANCER OF THE EYE [MALIGNANT NEOPLASM OF EYE] 190.9 EYE, PART UNSPECIFIED 190MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED NATURE 199 308

List of Diseases ICD# ICD 9 DESCRIPTION 191 CANCER OF THE BRAIN [MALIGNANT NEOPLASM OF BRAIN] 191.0 CANCER OF THE BASAL GANGLIA [MALIGNANT NEOPLASM OF CEREBRUM, EXCEPT LOBES AND VENTRICLES] 191.7 BRAIN CANCER [MALIGNANT NEOPLASM OF BRAIN (BRAIN STEM)] 191.9 GLIOMA [MALIGNANT NEOPLASM OF BRAIN, UNSPECIFIED] 192.9 CANCER OF THE NERVOUS SYSTEM [MALIGNANT NEOPLASM OF NERVOUS SYSTEM, PART UNSPECIFIED] 193 CANCER OF THE THYROID [MALIGNANT NEOPLASM OF THYROID GLAND] 194.0 CANCER OF THE ADRENAL GLAND [MALIGNANT NEOPLASM OF THE ADRENAL GLAND] 194.3 MALIGNANT NEOPLASM OF PITUITARY AND GLAND CRANIOPHARYNGEAL DUCT 194.9 CANCER OF THE ENDOCRINE GLAND [MALIGNANT NEOPLASM OF ENDOCRINE GLAND, SITE UNSPECIFIED] 195 CANCER OF THE NOSE 197.0 CANCER OF THE LUNG (SECONDARY) [SECONDARY MALIGNANT NEOPLASM OF LUNG] 197.7 CANCER OF THE LIVER (SECONDARY) [MALIGNANT NEOPLASM OF LIVER, SPECIFIED AS SECONDARY] 198.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES 199.0 CANCER, UNSPECIFIED SITE [MALIGNANT NEOPLASM WITHOUT SPECIFICATION OF SITE (DISSEMINATED)] 199.1 BENIGN AND UNSPECIFIED NEOPLASMS 200.0 RETICULOSARCOMA 200.0- RETICULOSARCOMA AND LYMPHOSARCOMA 200.1 200.0- LYMPHOMAS 202. 200.1 LYMPHOSARCOMA 200MALIGNANT NEOPLASM OF LYMPHATIC AND HEMATOPOIETIC AND 201.1 LYMPHOSARCOMA 200MALIGNANT NEOPLASM OF LYMPHATIC AND HEMATOPOIETIC TISSUE 208

309

List of Diseases ICD# ICD 9 DESCRIPTION 201.9 HODGKIN'S DISEASE 202.8 CANCER OF THE LYMPHATIC AND HEMATOPOIETIC TISSUES [OTHER LYMPHOMAS, MALIGNANT] 202.9 CANCER OF THE LYMPHATIC AND HEMATOPOIETIC TISSUES [UNSPECIFIED] 203.0 MULTIPLE MYELOMA 204 LYMPHOID LEUKEMIA 204.0- LEUKEMIAS 208 204.1 CHRONIC LYMPHOID LEUKEMIA 204.8 OTHER LYMPHOID LEUKEMIA 204LEUKEMIA 208.9 205 MYELOID LEUKEMIA 205.0 ACUTE MYELOGENOUS LEUKEMIA 205.1 CHRONIC MYELOGENOUS LEUKEMIA 206 MONOCYTIC LEUKEMIA 208 LEUKEMIA OF UNSPECIFIED CELL TYPE 208.0 LEUKEMIA (ACUTE) 208.8 LEUKEMIA AND ALEUKEMIA [OTHER LEUKEMIA OF UNSPECIFIED CELL TYPE] 208.9 LEUKEMIA [UNSPECIFIED LEUKEMIA] 210BENIGN AND UNSPECIFIED NEOPLASMS 229 211.3 BENIGN NEOPLASM OF COLON 219.0 OTHER BENIGN NEOPLASM OF CERVIX UTERI 225.0 BENIGN NEOPLASM OF BRAIN 226 BENIGN NEOPLASM OF THYROID GLANDS 227.3 CHROMOPHOBE ADENOMA OF ANTERIOR PITUITARY 229.9 BENIGN NEOPLASM, SITE UNSPECIFIED 233 CARCINOMA IN SITU OF BREAST AND GENITOURINARY ORGANS 233.1 CARCINOMA IN SITU OF CERVIX UTERI

310

List of Diseases ICD# ICD 9 DESCRIPTION 238.0 CANCER OF THE BONE [NEOPLASM OF BONE AND ARTICULAR CARTILAGE] 238.4 POLYCYTHEMIA VERA 239.0 NEOPLASM OF UNSPECIFIED NATURE OF DIGESTIVE SYSTEM 239.2 KAPOSI'S SARCOMA 239.3 CANCER OF THE BREAST [NEOPLASM OF BREAST] 239.7 TUMOR OF THE THYROID [NEOPLASM OF ENDOCRINE GLANDS AND OTHER PARTS OF NERVOUS SYSTEM] 239.8 NEOPLASMS OF UNSPECFIED NATURE (OTHER SPECIFIED SITES) 239.9 NEOPLASMS OF UNSPECIFIED NATURE (SITE UNSPECIFIED) 240ENDOCRINE, NUTRITIONAL AND METABOLIC DISEASES, AND IMMUNITY 279 DISORDERS 241.9 UNSPECIFIED NONTOXIC NODULAR GOITER 242.90 THYROTOXICOSIS WITHOUT GOITER OR OTHER CAUSE AND WITHOUT THYROTOXIC CRISIS OR STORM 246.9 GOITER DUE TO ENZYME DEFECT IN SYNTHESIS OF THYROID HORMONE 250 DIABETES MELLITUS 250.0 NON-INSULIN-DEPENDANT DIABETES MELLITUS 251.1 HYPERINSULINISM 253.0 ACROMEGALY AND GIGANTISM 255.2 ADRENOCORTICAL SYNDROME [ADRENOGENITAL DISORDERS] 257.2 OTHER TESTICULAR HYPOFUNCTION, EUNUCHOIDISM 259.9 UNSPECIFIED ENDOCRINE DISORDER 261 MARASMUS 265.2 NICOTINIC ACID 270.0 CYSTINURIA 270.1 DISORDERS OF AMINO-ACID TRANSPORT AND METABOLISM [PHENYLKETONURIA] 271.0 GLYCOGENOSIS 271.2 TAURI DISEASE 271.3 INTESTINAL DISACCHARIDASE DEFICIENCIES AND DISACCHARIDE MALABSORPTION

311

List of Diseases ICD# ICD 9 DESCRIPTION 271.8 DISORDERS OF CARBOHYDRATE TRANSPORT AND METABOLISM (OTHER, SPECIFIED) 272.0 HYPERCHOLESTEROLEMIA [PURE HYPERCHOLESTEROLEMIA] 272.2 XANTHELASMA [MIXED HYPERLIPIDEMIA] 272.4 DISORDERS OF LIPID METABOLISM [OTHER AND UNSPECIFIED HYPERLIPIDEMIA] 272.5 ABETALIPOPROTEINEMIA 272.7 GAUCHER'S DISEASE, MUCOLIPIDOSIS IV, NIEMANN-PICK DISEASE [LIPIDOSES], SPHINGOMYELINOSIS 275.1 WILSON'S DISEASE [HEPATOLENTICULAR DEGENERATION] 277.0 OTHER AND UNSPECIFIED DISORDERS OF METABOLISM [CYSTIC FIBROSIS] 277.00 CYSTIC FIBROSIS WITHOUT MECONIUM ILEUS 277.1 DISORDERS OF PORPHYRIN METABOLISM 277.3 POLYNEUROPATHIC AMYLOIDOSIS [AMYLOIDOSIS] 277.4 DISORDERS OF BILIRUBIN EXCRETION 277.9 ENZYMOPATHY 281.0 PERNICIOUS ANEMIA 282.4 THALASSEMIA [THALASSEMIAS] 282.9 HEREDITARY HEMOLYTIC ANEMIA 284.0 FANCONI'S ANEMIA (CONGENITAL PANCYTOPENIA) 285.9 ANEMIA, UNSPECIFIED 286.2 CONGENITAL FACTOR XI DEFICIENCY 286.3 DETECT, COAQULATION SPECIFIED TYPE 287.3 PRIMARY THROMBOCYTOPENIA,UNSPECIFIED 288.0 AGRANULOCYTOSIS 289.5 OTHER DISEASES OF SPLEEN 289.9 UNSPECIFIED DISEASES OF BLOOD AND BLOOD-FORMING ORGANS 290.0 SENILE DEMENTIA, UNCOMPLICATED 290.1 ALZHEIMER'S DISEASE [PRESENILE DEMENTIA] 290.10 CREUTZFELDT-JAKOB, WITH DEMENTIA 290.2 SENILE DEMENTIA WITH DELUSIONAL OR DEPRESSIVE FEATURES 312

List of Diseases ICD# ICD 9 DESCRIPTION 290.20 PSYCHOSIS (SENILE) [SENILE DEMENTIA WITH DELUSIONAL FEATURES] 290.4 SENILE PSYCHOSIS WITH CEREBRAL ARTERIOSCLEROSIS [ARTERIOSCLEROTIC DEMENTIA] 290.40 PSYCHOSIS (ARTERIOSCLEROTIC) [ARTERIOSCLEROTIC DEMENTIA, UNCOMPLICATED] 290.9 UNSPECIFIED SENILE PSYCHOTIC CONDITION 290PSYCHOSES 299 290MENTAL DISORDERS 319 291 ALCOHOLIC PSYCHOSES 291.0 ALCOHOLIC PSYCHOSES 291.2 OTHER ALCOHOLIC DEMENTIA 291.9 PSYCHOSIS (ALCOHOLIC) [UNSPECIFIED ALCOHOLIC PSYCHOSIS] 292 DRUG PSYCHOSES 292.1 DRUG-INDUCED PSYCHOTIC DISORDER 292.2 PATHOLOGICAL DRUG INTOXICATION 292.9 PSYCHOSIS (DRUG INDUCED) [UNSPECIFIED DRUG-INDUCED MENTAL DISORDER] 293 UNSPECIFIED TRANSIENT ORGANIC MENTAL DISORDER [TRANSIENT ORGANIC PSYCHOTIC CONDITIONS] 293.0 ACUTE DELIRIUM 293.1 SUBACUTE DELIRIUM 293.9 PSYCHOSIS (INFECTIVE) [UNSPECIFIED TRANSIENT ORGANIC MENTAL DISORDER] 294 OTHER ORGANIC PSYCHOTIC CONDITIONS (CHRONIC) 294.1 EPILEPSY [DEMENTIA IN CONDITIONS CLASSIFIED ELSEWHERE] 294.8 PSYCHOSIS, UNSPECIFIED [OTHER SPECIFIED ORGANIC BRAIN SYNDROMES, CHRONIC] 294.9 PSYCHOSIS (ORGANIC) [UNSPECIFIED ORGANIC BRAIN SYNDROME, CHRONIC] 295 SCHIZOPHRENIC DISORDERS 295.0 SCHIZOPHRENIC DISORDERS, SIMPLE TYPE 313

List of Diseases ICD# 295.1 295.2 295.3 295.7 295.9 295.94 295299 296 296.0

ICD 9 DESCRIPTION HEBEPHRENIA CATATONIA [CATATONIC TYPE] SCHIZOPHRENIA, PARANOID [PARANOID TYPE] SCHIZO-AFFECTIVE TYPE DEMENTIA PRAECOX [UNSPECIFIED SCHIZOPHRENIA] UNSPECIFIED TYPE SCHIZOPHRENIA CHRONIC STATE WITH ACUTE EXACERBATION OTHER PSYCHOSES

AFFECTIVE PSYCHOSES AFFECTIVE DISORDERS [MANIC DISORDER, SINGLE EPISODE OR UNSPECIFIED] 296.1 MANIC DISORDER, RECURRENT EPISODE 296.2 INVOLUTIONAL MELANCHOLIA [MAJOR DEPRESSIVE DISORDER, SINGLE EPISODE OR UNSPECIFIED] 296.3 MAJOR DEPRESSIVE DISORDER, RECURRENT EPISODE 296.4 BIPOLAR AFFECTIVE DISORDERS, MANIC 296.5 MANIC DEPRESSION (DEPRESSED) [BIPOLAR AFFECTIVE DISORDER, DEPRESSED] 296.6 BIPOLAR AFFECTIVE DISORDER, MIXED 296.8 MANIC-DEPRESSIVE PSYCHOSIS, OTHER AND UNSPECIFIED 296.80 MANIC-DEPRESSIVE PSYCHOSIS, UNSPECIFIED 296.9 UNSPECIFIED EPISODIC MOOD DISORDER 296.90 MELANCHOLIA [UNSPECIFIED AFFECTIVE PSYCHOSIS] 297.0 PARANOID STATE [PARANOID STATE, SIMPLE] 297.1 PARANOIA 297.9 PSYCHOSIS, PARANOID [UNSPECIFIED PARANOID STATE] 298.0 DEPRESSIVE TYPE PSYCHOSIS 298.8 HYSTERICAL PSYCHOSIS [OTHER AND UNSPECIFIED REACTIVE PSYCHOSIS] 298.9 TRAUMATIC PSYCHOSIS [UNSPECIFIED PSYCHOSIS] 299.0 AUTISM 300 NEUROTIC DISORDERS

314

List of Diseases ICD# 300.0 300.01 300.10 300.15 300.20 300.22 300.23 300.3 300.4 300.5 300.89 300.9 300301.9 300316 301.0 301.10

ICD 9 DESCRIPTION PSYCHONEUROSES PANIC DISORDER HYSTERIA, UNSPECIFIED DISSOCIATIVE DISORDER OR REACTION, UNSPECIFIED PHOBIA, UNSPECIFIED AGORAPHOBIA, WITHOUT MENTION OF PANIC ATTACKS SOCIAL PHOBIA OBSESSIVE-COMPULSIVE DISORDER DEPRESSION (NEUROTIC) NEURASTHENIA PSYCHASTHENIA PSYCHONEUROSIS [UNSPECIFIED NEUROTIC DISORDER] NEUROSES AND PERSONALITY DISORDERS

NEUROTIC DISORDERS, PERSONALITY DISORDERS, AND OTHER NONPSYCHOTIC DISORDERS PARANOIA [PARANOID PERSONALITY DISORDER] UNSPECIFIED PERSONALITY DISORDER [AFFECTIVE PERSONALITY DISORDER, UNSPECIFIED] 301.6 DEPENDENT PERSONALITY DISORDER 301.9 PSYCHOPATHIC PERSONALITY [UNSPECIFIED PERSONALITY DISORDER] 303 ALCOHOL DEPENDENCE SYNDROME 303.0 ALCOHOL DEPENDENCE [ACUTE ALCOHOL INTOXICATION] 303.9 CHRONIC ALCOHOLISM [OTHER AND UNSPECIFIED ALCOHOL DEPENDENCE] 304 DRUG DEPENDENCE 304.0 HEROIN USE [OPIOID TYPE DEPENDENCE] 304.02 OPIOID TYPE DEPENDENCE EPISODIC USE 304.1 DEPRESSANT USE 304.12 SEDATIVE, HYPNOTIC OR ANXIOLYTIC DEPENDENCE, EPISODIC 304.2 COCAINE USE [COCAINE DEPENDENCE] 304.3 MARIJUANA DEPENDENCE 315

List of Diseases ICD# ICD 9 DESCRIPTION 304.4 AMPHETAMINE AND OTHER PSYCHOSTIMULANT DEPENDENCE 304.42 AMPHETAMINE AND OTHER PSYCHOSTIMULANT DEPENDENCE EPISODIC USE 304.5 PSYCHEDELIC USE (LSD) [HALLUCINOGEN DEPENDENCE] 304.6 OTHER SPECIFIED DRUG DEPENDENCE 304.9 NARCOTIC USE [UNSPECIFIED DRUG DEPENDENCE] 305 DRUG ABUSE [NONDEPENDENT ABUSE OF DRUGS] 305.0 ALCOHOL ABUSE 305.1 TOBACCO ABUSE [TOBACCO USE DISORDER] 305.2 MARIJUANA ABUSE [CANNABIS ABUSE] 305.3 HALLUCINOGEN USE (LSD) [HALLUCINOGEN ABUSE] 305.4 BARBITURATE AND SIMILARLY ACTING SEDATIVE OR HYPNOTIC ABUSE 305.6 COCAINE USE [COCAINE ABUSE] 305.7 AMPHETAMINE OR RELATED ACTING SYMPATHOMIMETIC ABUSE 305.9 OTHER, MIXED, OR UNSPECIFIED DRUG ABUSE 306.0 MUSCULOSKELETAL (PSYCHOGENETIC PARALYSIS) 307.2 TICS 307.23 TIC SYNDROME (GILLES DE LA TOURETTE'S SYNDROME) 308.9 UNSPECIFIED ACUTE REACTION TO STRESS 311 DEPRESSIVE DISORDER [DEPRESSIVE DISORDER, NOT ELSEWHERE CLASSIFIED] 312.9 UNSPECIFIED DISTURBANCE OF CONDUCT 317MENTAL RETARDATION 319 318.0 IMBECILITY [MODERATE MENTAL RETARDATION] 318.2 IDIOCY [PROFOUND MENTAL RETARDATION] 319 PSYCHOSIS WITH MENTAL DEFICIENCY [UNSPECIFIED MENTAL RETARDATION] 320DISEASES OF THE SPINAL CORD 349.9 320DISEASES OF THE NERVOUS SYSTEM AND SENSE ORGANS 389

316

List of Diseases ICD# 322.9 330.0 330.1 330.2 330.9 330331 330337 332 332.1 333.4 333.6 333.7 333.83 334.8 335.20 337.9 340 345.9 349.89 349.9 359.0 359.9 360379 362.5 362.50 362.74 362.76

ICD 9 DESCRIPTION MENINGITIS OF UNSPECIFIED CAUSE [MENINGITIS, UNSPECIFIED] CANAVAN'S DISEASE [LEUKODYSTROPHY] AMAUROTIC IDIOCY (TAY-SACHS DISEASE) [CEREBRAL LIPIDOSES] SPONGY DEGENERATION OF THE BRAIN [CEREBRAL DEGENERATION IN GENERALIZED LIPISIS] CEREBRAL DEGENERATIONS USUALLY MANIFEST IN CHILDHOOD [UNSPECIFIED] CEREBRAL DEGENERATIONS HEREDITARY AND DEGENERATIVE DISEASES OF THE CENTRAL NERVOUS PARKINSON'S DISEASE PARKINSON'S DISEASE [SECONDARY PARKINSONISM] HUNTINGTON'S CHOREA IDIOPATHIC TORSION DYSTONIA ATHETOID CEREBRAL PALSY SPASMODIC TORTICOLLIS ATAXIA TELANGIECTASIA AMYOTROPHIC LATERERAL SCLEROSIS [SYNDROME] UNSPECIFIED DISORDER OF AUTONOMIC NERVOUS SYSTEM MULTIPLE SCLEROSIS EPILEPSY [EPILEPSY, UNSPECIFIED] OTHER SPECIFIED DISORDERS OF NERVOUS SYSTEM UNSPECIFIED DISORDERS OF THE NERVOUS SYSTEM CONGENITAL HEREDITARY MUSCULAR DYSTROPHY MYOPATHY DISEASES OF THE EYE AND ADNEXA DEGENERATION OF MACULA AND POSTERIOR POLE MACULAR DEGENERATION (SENILE) RETINITIS PIGMENTOSA [HEREDITARY RETINAL DYSTROPHY] ELAVIMACULATUS

317

List of Diseases ICD# 365.1 365.11 365.9 366.9 368.5 368.59 369.9 372.10 379.4 382.9 389.9 390459 391.9 401 401.0 401405 402 402405.9 403.9 404 404.0 404.9 405.9 405.99 410 410.9 410414

ICD 9 DESCRIPTION OPEN-ANGLE GLAUCOMA GLAUCOMA (OPEN ANGLE) GLAUCOMA [UNSPECIFIED GLAUCOMA] CATARACT COLOR BLINDNESS [COLOR VISION DEFICIENCIES] VISUAL DISTURBANCES [COLOR VISION DEFICIENCIES, OTHER] BLINDENESS AND LOW VISION [UNSPECIFIED VISUAL LOSS] CHRONIC CONJUNCTIVITIS, UNSPECIFIED PUPILLARY DISTURBANCE UNSPECIFIED OTITIS MEDIA HEARING LOSS [UNSPECIFIED HEARING LOSS] DISEASES OF THE CIRCULATORY SYSTEM ACUTE RHEUMATIC HEART DISEASE, UNSPECIFIED ESSENTIAL HYPERTENSION HYPERTENSION [MALIGNANT] HYPERTENSIVE DISEASE HYPERTENSIVE HEART DISEASE HYPERTENSIVE HEART AND RENAL DISEASE HYPERTENSIVE RENAL DISEASE, UNSPECIFIED HYPERTENSIVE HEART AND RENAL DISEASE HYPERTENSIVE HEART AND RENAL DISEASE, MALIGNANT HYPERTENSIVE HEART AND RENAL DISEASE, UNSPECIFIED SECONDARY HYPERTENSION, UNSPECIFIED CARDIO-ARTEREO-RENAL DISEASE [SECONDARY HYPERTENSION, OTHER] ACUTE MYOCARDIAL INFARCTION ACUTE MYOCARDIAL INFARCTION [UNSPECIFIED SITE] ISCHEMIC HEART DISEASE

318

List of Diseases ICD# 410429.9 413 413.9 414.0 414.9 429.2 429.9 430438 431 434.0 436 437.0 437.8 437437.9 440.9 443.1 448.0 448.9 455.6 459.9 460 460466 460519 462 463

ICD 9 DESCRIPTION HEART DISEASE ANGINA PECTORIS OTHER AND UNSPECIFIED ANGINA PECTORIS CORONARY HEART DISEASE [CORONARY ATHEROSCLEROSIS] HEART DISEASE [CHRONIC ISCHEMIC HEART DISEASE, UNSPECIFIED] CARDIOVASCULAR DISEASE ORGANIC HEART DISEASE [HEART DISEASE, UNSPECIFIED] CEREBROVASCULAR DISEASE INTRACEREBRAL HEMORRHAGE CEREBRAL THROMBOSIS AND EMBOLISM [THROMBOSIS, CEREBRAL (ARTERIES)] CEREBROVASCULAR DISEASE (ACUTE, ILL-DEFINED) CEREBRAL ATHEROSCLEROSIS GENERAL PARESIS (PARALYSIS) [OTHER AND ILL-DEFINED CEREBROVASCULAR DISEASE, OTHER] CEREBROVASCULAR DISEASE [OTHER AND ILL-DEFINED CEREBROVASCULAR DISEASE, UNSPECIFIED] ARTERIOSCLEROSIS [GENERALIZED AND UNSPECIFIED ATHEROSCLEROSIS] THROMBOANGIITIS OBLITERANS [BUERGER'S DISEASE] CONGENITAL TELANGIECTACTIC ERYTHEMIA DISEASE OF CAPILLARIES [OTHER AND UNSPECIFIED CAPILLARY DISEASES] UNSPECIFIED HEMORRHOIDS WITHOUT MENTION OF COMPLICATION CIRCULATORY DISEASES [UNSPECIFIED CIRCULATORY SYSTEM DISORDER] ACUTE NASOPHARYNGITIS ACUTE RESPIRATORY INFECTIONS DISEASES OF THE RESPIRATORY SYSTEM ACUTE PHARYNGITIS ACUTE TONSILITIS

319

List of Diseases ICD# ICD 9 DESCRIPTION 465.9 RESPIRATORY DISEASES [ACUTE UPPER RESPIRATORY INFECTIONS OF UNSPECIFIED SITE] 472.0 CHRONIC RHINITIS 473.9 UNSPECIFIED SINUSITIS [CHRONIC] 474.0 CHRONIC TONSILITIS 480PNEUMONIA 486 480PNEUMONIA AND INFLUENZA 487 481 LOBAR-PNEUMONIA [PNEUMOCOCCAL PNEUMONIA] 485 PNEUMONIA [BRONCHOPNEUMONIA, ORGANISM UNSPECIFIED] 486 PNEUMONIA [ORGANISM UNSPECIFIED] 486.0 PNEUMONIA (ALL FORMS) [PNEUMONIA, ORGANISM UNSPECIFIED] 487 INFLUENZA 490 BRONCHITIS [BRONCHITIS NOT SPECIFIED AS ACUTE OR CHRONIC] 490CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ALLIED CONDITIONS 496 491.9 UNSPECIFIED CHRONIC BRONCHITIS 493.9 ASTHMA [ASTHMA, UNSPECIFIED] 520.5 DENTINOGENESIS IMPERFECTA 520DISEASES OF THE DIGESTIVE SYSTEM 579 523.4 GINGIVAL AND PERIODONTAL DISEASES [CHRONIC PERIODONTITIS] 525.9 UNSPECIFIED DISORDER OF THE TEETH AND SUPPORTING STRUCTURES 531.9 ULCERS OF THE STOMACH [GASTRIC ULCER, UNSPECIFIED AS ACUTE OR CHRONIC, WITHOUT MENTION OF HEMORRHAGE OR PERFORATION] 531STOMACH, DUODENAL, AND GASTROJEJUNAL ULCERS 534.9 532.9 ULCERS OF THE DUODENUM [DUODENAL ULCER UNSPECIFIED AS ACUTE OR CHRONIC, WITHOUT MENTION OF HEMORRHAGE OR PERFORATION] 535.5 UNSPECIFIED GASTRITIS AND GASTRODUODENITIS 536 DISORDERS OF FUNCTION OF STOMACH

320

List of Diseases ICD# ICD 9 DESCRIPTION 537.9 DISEASES OF THE STOMACH (EXCLUDING CANCER) [UNSPECIFIED DISORDER OF STOMACH AND DUODENUM] 541 APPENDICITIS [APPENDICITIS, UNQUALIFIED] 552.9 HERNIA (INTESTINAL OBSTRUCTION) [HERNIA OF UNSPECIFIED SITE, WITH OBSTRUCTION] 553.8 HERNIA [HERNIA OF OTHER SPECIFIED SITES] 553.9 HERNIA [HERNIA OF UNSPECIFIED SITE] 555 REGIONAL ENTERITIS OF SMALL INTESTINE 555.1 LARGE INTESTINE 555.2 REGIONAL ILEOCOLITIS 555.8 zzz-fix 555.9 REGIONAL ENTERITIS, UNSPECIFIED SITE, CROHN'S DISEASE, UNSPECIFIED SITE 556 IDIOPATHIC PROCTOCOLITIS [ULCERATIVE COLITIS] 556.9 ULCERATIVE COLITIS 557.9 VASCULAR INSUFFICIENCY OF INTESTINE, UNSPECIFIED 558.9 OTHER NONINFECTIOUS GASTROENTERITIS AND COLITIS 560.81 INTESTINAL OBSTRUCTION [ADHESIONS (INTESTINAL)] 564.0 FUNCTIONAL DIGESTIVE DISORDERS, NOT ELSEWHERE CLASSIFIED [CONSTIPATION] 564.1 IRRITABLE COLON 567.9 UNSPECIFIED PERITONITIS 569.82 ULCERATION OF INTESTINE 569.9 UNSPECIFIED DISORDER OF INTESTINES 570DISEASES OF THE LIVER 573.9 571 CHRONIC LIVER DISEASE AND CIRRHOSIS 571.2 ALCOHOLIC CIRRHOSIS OF LIVER 571.5 CIRRHOSIS OF THE LIVER WITHOUT MENTION OF ALCOHOL 571.6 CIRRHOSIS (BILIARY) [BILIARY CIRRHOSIS] 573.9 UNSPECIFIED DISORDER OF LIVER

321

List of Diseases ICD# ICD 9 DESCRIPTION 580NEPHRITIS, NEPHROTIC SYNDROME, AND NEPHROSIS 589 580DISEASES OF THE GENITOURINARY SYSTEM 629 581.9 NEPHROSIS [NEPHROTIC SYNDROME WITH UNSPECIFIED PATHOLOGICAL LESION IN KIDNEY] 582.9 CHRONIC AND UNSPECIFIED NEPHRITIS [CHRONIC GLOMERULONEPHRITIS WITH UNSPECIFIED PATHOLOGICAL LESION IN KIDNEY] 583 NEPHRITIS AND NEPHROPATHY NOT SPECIFIED AS ACUTE OR CHRONIC 583.9 NEPHRITIS [WITH UNSPECIFIED PATHOLOGICAL LESION IN KIDNEY] 600 HYPERPLASIA OF PROSTATE 610.1 FIBROCYSTIC DISEASE OF BREAST [DIFFUSE CYSTIC MASTOPATHY] 611.1 HYPERTROPHY OF BREAST [GYNECOMASTIA] 625.3 PAINFUL MENSTRUATION [DYSMENORRHEA] 629.9 UNSPECIFIED DISORDER OF FEMALE GENITAL ORGANS 630 HYDATIDIFORM MOLE 630COMPLICATIONS OF PREGNANCY, CHILDBIRTH, AND THE PUERPERIUM 676 640COMPLICATIONS MAINLY RELATED TO PREGNANCY 648 648 OTHER CURRENT CONDITIONS IN THE MOTHER CLASSIFIABLE ELSEWHERE, BUT COMPLICATING PREGNANCY, CHILDBIRTH, OR THE PUERPERIUM 680DISEASES OF THE SKIN AND SUBCUTANEOUS TISSUE 709 684 IMPETIGO 691.8 EXUDATIVE DISCOID AND LICHENOID CHRONIC DERMATOSIS (NEURODERMATITIS-DISSEMINATED) [OTHER ATOPIC DERMATITIS AND RELATED CONDITIONS] 692.9 CONTACT DERMATITIS [UNSPECIFIED CAUSE] 694.4 PEMPHIGUS [VULGANS FOLIACEUS] 698 PRURITIS AND RELATED CONDITIONS

322

List of Diseases ICD# 698.2 706.1 706.2 709 709.0 709.9 710739 720

ICD 9 DESCRIPTION POLYMORPHIC PRURIGO ACNE VULGARIS [OTHER ACNE] SEBACEOUS CYST OTHER DISORDERS OF THE SKIN AND SUBCUTANEOUS TISSUE LENTIGO UNSPECIFIED DISORDER OF SKIN AND SUBCUTANEOUS TISSUE (DERMATOSIS) DISEASES OF THE MUSCOLUSKELETAL SYSTEM AND CONNECTIVE TISSUE

ANKYLOSING SPONDYLITIS AND OTHER INFLAMMATORY SPONDYLOPATHIES 729.0 RHEUMATISM [UNSPECIFIED AND FIBROSITIS] 729.2 OTHER DISORDERS OF SOFT TISSUES [NEURALGIA, NEURITIS, AND RADICULITIS, UNSPECIFIED] 733.00 OSTEOPOROSIS UNSPECIFIED 733.9 OTHER AND UNSPECIFIED DISORDERS OF BONE AND CARTILAGE 734 FLAT FOOT 737.30 SCOLIOSIS 737.9 UNSPECIFIED CURVATURE OF SPINE 740.0 ANENCEPHALUS 740CONGENITAL ANOMALIES 759 741.0 HYDROCEPHALUS WITH SPINA BIFIDA 741.9 SPINA BIFIDA 742.8 FAMILIAL DYSAUTONOMIA, RILEY-DAY SYNDROME [OTHER SPECIFIED ANOMALIES OF NERVOUS SYSTEM] 752.39 OTHER ANOMALIES OF UTERUS 754.2 SCOLIOSIS, CONGENITAL 754.89 OTHER NON-TERATOGENIC ANOMALIES 757.39 BLOOM'S SYNDROME 759.89 ALPORT'S SYNDROME 759.9 CONGENITAL ANOMALY, UNSPECIFIED

323

List of Diseases ICD# 760779 762.9 765.1 770.5 773.2 779.8 779.9 780 780.3 780799 781.1 782.5 786.09 790.6 791.5 797 797799 799.2 799.8 830.1 869.0 876.9 922.9 950959 958.9

ICD 9 DESCRIPTION CERTAIN CONDITIONS ORIGINATING IN THE PERINATAL PERIOD UNSPESIFIED ABNORMALY OF EHORION AND AMNION PREMATURE BIRTH [OTHER PRETERM INFANTS] OTHER AND UNSPECIFIED ATELECTASIS ORIGINATING IN THE PERINATAL PERIOD ERYTHROBLASTOSIS (FETALIS) (NEONATORUM) [HEMOLYTIC DISEASE DUE TO OTHER AND UNSPECIFIED ISOIMMUNIZATION] OTHER SPECIFIED CONDITION ORIGINATING IN THE PERINATAL PERIOD STILLBIRTH [UNSPECIFIED CONDITION ORIGINATING IN THE PERINATAL PERIOD] GENERAL SYMPTOMS CONVULSIONS (INFANTILE) SYMPTOMS, SIGNS, AND ILL-DEFINED CONDITIONS DISTURBANCES OF SENSATION OF SMELL AND TASTE CHRONIC CYANOSIS [CYANOSIS] DYSPENA (PAROXYSMAL) HYPERURICEMIA GLYCOSURIA SENILITY WITHOUT MENTION OF PSYCHOSIS ILL-DEFINED AND UNKNOWN CAUSES OF MORBIDITY AND MORTALITY NERVOUSNESS OTHER ILL-DEFINED CONDITIONS OPEN DISLOCATION INTERNAL INJURY UNSPECIFIED MISADVENTURE DURING MEDICAL CARE UNSPECIFIED FIREARM MISSILE INJURY TO NERVES AND SPINAL CORD COMPARTMENT SYNDROME, UNSPECIFIED

324

List of Diseases ICD# 960.0 990 E800E929.9 E800E999 E810E819 E810E825 E870E876 E876.9 E880E888 E880E929 E880E929.9 E890.0 E890E899 E910 E910.0 E922 E928.9 E929.9 E950 E950.0 E950.1 E950.2 E950E950.9

ICD 9 DESCRIPTION POISONING BY ANTIBIOTICS [PENICILLINS] RADIATION EXTERNAL CAUSES OF INJURY INJURY AND POISONING MOTOR VEHICLE TRAFFIC ACCIDENTS MOTOR VEHICLE ACCIDENTS THERAPEUTIC MISADVENTURES THERAPEUTIC MISADVENTURES ACCIDENTS CAUSED BY FALLS ACCIDENTS ACCIDENTS ACCIDENTS CAUSED BY FIRE OR EXPLOSION ACCIDENTS CAUSED BY FIRE ACCIDENTAL DROWNING AND SUBMERSION ACCIDENTS CAUSED BY DROWNING ACCIDENTS CAUSED BY FIREARMS UNSPECIFIED ACCIDENT LATE EFFECTS OF UNSPECIFIED ACCIDENT SUICIDE BY POISON SUICIDE BY ANALGESICS, ANTIPYRETICS, AND ANTIRHEUMATICS SUICIDE AND SELF-INFLICTED POISONING BY BARBITURATES SUICIDE BY OTHER SEDATIVES AND HYPNOTICS SUICIDE AND SELF-INFLICTED INJURY

325

List of Diseases ICD# E950E959 E951 E951E952 E952 E953 E953.0 E954 E955 E955.4 E956 E957 E958 E958.0 E958.1 E958.8 E958.9 E960. E960.0 E960E969 E968.9 E980E989 E981 E982 E987

ICD 9 DESCRIPTION SUICIDE SUICIDE AND SELF-INFLICTED POISONING BY GASES IN DOMESTIC USE SUICIDE AND SELF-INFLICTED POISONING BY GASES AND VAPORS SUICIDE AND SELF-INFLICTED POISONING BY OTHER GASES AND VAPORS SUICIDE AND OTHER SELF-INFLICTED INJURY BY HANGING, STRANGULATION, AND SUFFOCATION SUICIDE BY HANGING SUICIDE AND SELF INFLICTED INJURY BY SUBMERSION [DROWNING] SUICIDE BY FIREARMS SUICIDE BY SHOOTING SUICIDE BY CUTTING SUICIDE BY JUMPING SUICIDE AND SELF-INFLICTED INJURY BY OTHER AND UNSPECIFIED MEANS SUICIDE BY JUMPING, FALLING SUICIDE BY BURNS, FIRE SUICIDE AND SELF-INFLICTED INJURY BY OTHER AND UNSPECIFIED MEANS [OTHER SPECIFIED MEANS] SUICIDE FIGHT, BRAWL, RAPE VIOLENCE (EXCLUDING SUICIDE) HOMICIDE AND INJURY PURPOSELY INFLICTED BY OTHER PERSONS ASSAULT BY UNSPECIFIED MEANS INJURY UNDETERMINED WHETHER ACCIDENTALLY OR PURPOSLY INFLICTED POISONING BY GAS POISONING BY OTHER GASES, UNDETERMINED WHETHER ACCIDENTALLY OR PURPOSLY INFLICTED FALLING FROM HIGH PLACE, UNDETERMINED WHETHER ACCIDENTALLY OR PURPOSELY INFLICTED 326

List of Diseases ICD# V50.2 CIRCUMCISION

ICD 9 DESCRIPTION

327

List of Journals with Abbreviations Journal Code 8ICT AAAPS AB ACER ACERR ACLS ACP AD ADS AER AFP AG AGP AGS AHG AHJ AHRW AIM AJC AJCN AJCP AJDAA AJDC AJDD AJE AJG AJH AJHG AJI AJM

Journal Name 8th International Congress of Tuberculosis Annals of the American Academy of Political and Social Science Analytical Biochemistry Alcoholism Clinical and Experimental Research American Council On Education Research Reports Annals of Clinical Laboratory Science Argu Company Printers. Archives of Dermatology Archives of Dermatology and Syphilology American Economic Review American Family Physician Advance in Genetics Archives of General Psychiatry Archives of General Surgery Annals of Human Genetics American Heart Journal Alcohol Health and Research World Archives of Internal Medicine American Jewish Committee The American Journal of Clinical Nutrition American Journal of Clinical Pathology American Journal of Drug and Alcohol Abuse American Journal of Diseases of Children The American Journal of Digestive Diseases American Journal of Epidemiology American Journal of Gastroenterology American Journal of Hygiene American Journal of Human Genetics American Journal of Insanity The American Journal of Medicine

328

List of Journals with Abbreviations Journal Code AJMD AJMG AJMS AJO AJODW AJOG AJOH AJOP AJP AJP2 AJPH AJPM AJPT AJR AJRRT AJS ALJMS ALLR AM AN ANIM ANN ANP ANS AO AP APAM APATH APS AR

Journal Name American Journal of Mental Deficiency American Journal of Medical Genetics The American Journal of the Medical Sciences American Journal of Ophthalmology American Journal of Obstetrics and Disease of Women and Children American Journal of Obstetrics and Gynecology American Journal of Hematology The American Journal of Orthopsychiatry The American Journal of Psychiatry The American Journal of Pathology American Journal of Public Health American Journal of Preventative Medicine American Journal of Psychotherapy American Journal of Roentgenology The American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine American Journal of Sociology Alabama Journal of Medical Sciences American Labor Legislation Review American Medicine Advances in Neurology Annals of Internal Medicine Annals of Neurology Archives of Neurology and Psychiatry Annals of Surgery Archives of Ophthalmology Archives of Pediatrics Archive of Pediatrics and Adolescent Medicine Archives of Pathology Acta Psychiatrica Scandinavica American Review 329

List of Journals with Abbreviations Journal Code ARCMD ARFT ARN ARNP ART AS ASHG ASR AUIC AUJ AZM B BAATP BBA BBRC BCM&D BCR BD BDO BHJD BJA BJAA BJC BJH BJHH BJPSM BMMB BMSJ BNYAM BNYTA

Journal Name Annual Report of the Commissioner of Mental Diseases for the Year Ending November 30, 1929 Addiction Research Foundation (Toronto) Archives of Neurology Archives of Neurology and Psychiatry American Review of Tuberculosis Archives of Surgery The American Society of Human Genetics American Sociological Review Acta Unio Internationalis Contra Cancrum Acta Urologica Japonica Arizona Medicine Blood Bulletin of the American Academy of Tuberculosis Physicians Biochimica et Biophysica Acta Biochemical and Biophysical Research Communication Blood Cells, Molecules, & Diseases Breast Cancer Research Birth Defects Birth Defects: Original Article Series Bulletin of the Hospital for Joint Diseases Orthopaedic Institute British Journal of Addiction British Journal on Alcohol and Alcoholism British Journal of Cancer British Journal of Haematology Bulletin of the Johns Hopkins Hospital British Journal of Preventive and Social Medicine Biochemical Medicine and Metabolic Biology Boston Medical and Surgical Journal Bulletin of the New York Academy of Medicine Bulletin of the New York Tuberculosis Association 330

List of Journals with Abbreviations Journal Code BOOK BOOK2 BP142 BR BR2 C CA CAN CANS CANT CASJ CB CC CCA CCC CCDR CCR CE CEBP CED CG CGC CGR CIM CIP CJ CJPH CM CMAJ CN

Journal Name BOOK New York: Young People's Missionary Movement Bureau Publication Number 142, Washington DC Biological Research Blood Reviews Circulation Currents in Alcoholism Cancer Cancer Supplement Current Anthropology Canadian Anaesthetists’ Society Journal Clinical Biochemistry Clinical Chemistry Clinica Chimica Acta Cancer Causes and Control Canada Communicable Disease Report Clinical Cancer Research Cell Cancer Epidemiology, Biomarkers & Prevention Clinical and Experimental Dermatology Clinical Genetics Cancer Genetics and Cytogenetics Current Gastroenteroly Reports Clinical and Investigative Medicine Clinics in Perinatology Contemporary Judaism Canadian Journal of Public Health Colorado Medicine Canadian Medical Association Journal Clinical Neuropathology

331

List of Journals with Abbreviations Journal Code CNP COM COP CORR CP CPAJ CPED CR CRI CSMJ CTR D DC DCR DD DDS DEVNS DF DHHS DI DNA DNS DOC DPNAS DS E ECR EI EJC EJHG

Journal Name Clinical Neuropharmacology Commentary Current Opinions in Pediatrics Clinical Orthopaedics and Related Research Clinical Pharmacy Canadian Psychiatric Association Journal Clinical Pediatrics Cancer Research Crisis Connecticut State Medical Journal Cancer Treatment Reports Diabetes Diabetes Care Diseases of the Colon and Rectum Digestive Diseases Digestive Diseases and Sciences Developmental Neuroscience Drug Forum Department of Health and Human Services Diabetologia DNA Diseases of the Nervous System Department of Commerce, Bureau of the Census Drinking Practices: A National Study of Drinking Attitudes Drug Safety Endocrinology Experimental Cell Research Epidemiology and Infection European Journal of Cancer European Journal of Human Genetics

332

List of Journals with Abbreviations Journal Code EJP EJPN EMBOJ EP EPI EPR EQ ER EX FARCT FP G GE GEN GIM GNO GO GPO GR GT GUT H HB HG HH HHB HI HM HM2 HMG

Journal Name European Journal of Pediatrics European Journal of Pediatrics Neurology The Embo Journal Epilepsia Epidemiology Epidemiological Reviews Eugenics Quarterly Environmental Research Experientia Fourth Annual Report of the Committee on the Prevention of Tuberculosis Federation Proceedings Gastroenterology Genetic Epidemiology Genomics Genetics in Medicine Gynecological Oncology Gynecology and Obstetrics Government Printing Office Genome Research Genetic Testing Gut Hemoglobin Human Biology Human Genetics Harofe Haivri Harper Hospital Bulletin Human Immunology Human Mutation Health Matrix Human Molecular Genetics 333

List of Journals with Abbreviations Journal Code HP HPR HUP IBD IC IJA IJD IJE IJLM IJML IJMS IJO IJPRS IJSP IMJ INF JAAD JACHA JACS JAD JADA JADD JADE JAEMC JAGS JAMA JAMS JAMW JANMA JARG

Journal Name Health Physics Hospital Practice Harvard University Press Inflammatory Bowel Disease International Clinics The International Journal of the Addictions International Journal of Dermatology International Journal of Epidemiology International Journal of Legal Medicine International Journal of Medicine and Law Israel Journal of Medical Sciences International Journal of Oncology Israel Journal of Psychiatry and Related Sciences International Journal of Social Psychiatry Illinois Medical Journal Infection Journal of the American Academy of Dermatology Journal of the American College Health Association Journal of the American College of Surgeons Journal of Addictive Diseases Journal of the American Dental Association Journal of Autism and Developmental Disorders Journal of Alcohol and Drug Education Journal of the Albert Einstein Medical Center Journal of the American Geriatrics Society Journal of the American Medical Association Journal of the American Medical Society Journal of the American Medical Women's Association Journal of the National Medical Association Journal of Assisted Reproduction and Genetics

334

List of Journals with Abbreviations Journal Code JASP JB JBC JBJS JCD JCE JCEM JCG JCH JCI JCMA JCO JCP JCP2 JCSMS JCSNY JCSP JDC JDC2 JDE JE JEM JFS JH JHMJ JHR JHSB JHUP JI JID

Journal Name Journal of Applied Social Psychology Journal of Biochemistry The Journal of Biological Chemistry The Journal of Bone and Joint Surgery Journal of Chronic Diseases Journal of Clinical Endocrinology The Journal of Clinical Endocrinology & Metabolism Journal of Clinical Gastroenterology Journal of Community Health Journal of Clinical Investigation Journal of the Canadian Medical Association Journal of Clinical Oncology Journal of Clinical Psychiatry Journal of Cutaneous Pathology Journal of the Connecticut State Medical Society Jewish Communal Survey of Greater New York Journal of College Student Personnel American Journal of Diseases of Children Journal of Dentistry for Children Journal of Drug Education The Jewish Encyclopedia Journal of Experimental Medicine Journal of Forensic Sciences The Journal of Heredity Johns Hopkins Medical Journal Journal of Human Relations Journal of Health and Social Behavior Johns Hopkins University Press Journal of Insanity Journal of Investigative Dermatology

335

List of Journals with Abbreviations Journal Code JIMD JISMS JKMS JLCM JLR JM JMG JMN JMR JMSH JMSMS JNCI JNCN JNMA JNMD JNNP JNS JP JP2 JP3 JPJ JPM JPO JRM JSA JSCMA JSO JSP JSR JSS

Journal Name Journal of Inherited Metabolic Disease Journal of the Iowa State Medical Society Journal of Korean Medical Science Journal of Laboratory and Clinical Medicine Journal of Lipid Research The Jews of Middletown Journal of Medical Genetics Journal of Molecular Neuroscience J.M. Research Journal of the Mount Sinai Hospital Journal of the Michigan State Medical Society Journal of the National Cancer Institute Journal of Neuropsychiatry and Clinical Neurosciences Journal of the National Medical Association The Journal of Nervous and Mental Disease Journal of Neurology, Neurosurgery, and Psychiatry Journal of Neurological Sciences The Journal of Pediatrics Journal of Parasitology Journal of Personality Journal of Psychology and Judaism Journal of Preventive Medicine Journal of Pediatrics Orthopedic Journal of Reproductive Medicine Journal of Studies on Alcohol Journal of the South Carolina Medical Association Journal of Surgical Oncology The Journal of Social Psychology The Journal of Sex Research Jewish Social Studies

336

List of Journals with Abbreviations Journal Code JSSQ JT JTR JU L LAJCB LIP LJC LPCP LTB M MBVA MCFCC MCNA MCP MCR MD ME MENY MET MGM MH MIME MJR ML MM MM2 MMFQ MMWR MN

Journal Name Jewish Social Service Quarterly The Jewish Tribune The Journal of Trauma The Journal of Urology Lancet Los Angeles Jewish Community Bulletin Lipids Le Journal Canadien des Sciences Neurologiques Lippincott's Primary Care Practice Life-threatening Behavior Medicine Medical Bulletin of the Veterans Administration Marital and Coital Factors in Cervical Cancer Medical Clinics of North America Mayo Clinic Proceedings Military Chaplain's Review Movement Disorders Methods in Enzymology Medical Examiner of New York Metabolism Molecular Genetics and Metabolism Mental Hygiene Minnesota Medicine Medical Journal and Record Medical Leaves Missouri Medicine Molecular Medicine Milbank Memorial Fund Quarterly Morbidity and Mortality Weekly Report Muscle and Nerve

337

List of Journals with Abbreviations Journal Code MR MS MS18 MSHR MSJM MSR MTLIM MWH N NAR NAT NC NCIM NE NEJM NG NM NOMSJ NR NS NYAM NYMJ NYS NYSHC NYSJM O OBGYS OG OM OP

Journal Name Medical Record Military Surgeon Monograph Series No. 18, Department of Health, The City of New York Mount Sinai Hospital Reports The Mount Sinai Journal of Medicine Medical and Surgical Reporter Medical Times and Long Island Medical Journal Medscape Women's Health Neurology The North American Review Nature Neurologic Clinics National Cancer Institute Monograph Neuron The New England Journal of Medicine Nature Genetics Nature Medicine The New Orleans Medical and Surgical Journal Neurochemical Research Nervous System Bulletin of The New York Academy of Medicine New York Medical Journal New York State Journal of Medicine Thirteenth Annual Report of the New York State Hospital Commission New York State Journal of Medicine Oncogene Obstetrical and Gynecological Survey Obstetrics and Gynecology Ohio Medicine Ontario Psychologist 338

List of Journals with Abbreviations Journal Code OSMJ OSOMO P P2 P2NJC P3NCC PAPP PB PCBR PCRMA PCSDS PD PDCB PED PEDR PG PH PHB PHDYU PHR PHRNJ PIDJ PLEE PM PMG PMJ PN PNAS PNN PP

Journal Name Ohio State Medical Journal Oral Surgery Pediatrics Pemphigus Proceedings of the 2nd National Conference of Jewish Charities Proceedings of the 3rd National Cancer Conference Proceedings of the American Psychological Association Pathologie Biologie Progress in Clinical and Biological Research PCR Methods and Application Proceedings of the First International Conference on Student Drug Surveys Prenatal Diagnosis Printing Department, City of Boston Pediatrician Pediatric Research Progress in Gastroenterology Pharmacogenetics Public Health Bulletin (Unpublished Ph.D. Dissertation, Yeshiva University) Public Health Reports Public Health Reports of New Jersey The Pediatric Infectious Disease Journal Proceedings of the Life Extension Examiners Psychosomatic Medicine Progress in Medical Genetics Philadelphia Medical Journal Pediatric Nursing Proceedings of the National Academy of Science Psychiatria Plenum Press 339

List of Journals with Abbreviations Journal Code PQ PR PT QJSA QPASA R RADRE RBHNY RCMDP RIMJ RPNP S SA SB SCHB SCMI SDUDD SEMD SGO SH SHB SHQ SJH SM SMJ SO SOCP SOP

Journal Name Psychiatric Quarterly Psychological Reports Psychology Today Quarterly Journal of Studies of Alcohol Quarterly Publications of the American Statistical Association Radiology Radiation and Research Second Annual Report of the Board of Health of the Health Department Report on the Carnegie-Mellon University Drug Use Research Project Rhode Island Medical Journal Revista de Psicologia Normeal e Patologica Science Scientific American Social Biology Schizophrenia Bulletin Social Class and Mental Illness Social Determinants of the Use of "Dangerous Drugs" by College Students The Social Epidemiology of Mental Disorders: A Psychiatric Survey of Texas Surgery Gynecology and Obstetrics Series Haematologica The State Hospital Bulletin State Hospital Quarterly Scandinavian Journal of Haematology Student Medicine Southern Medical Journal Seminars in Oncology Sociological Perspectives Social Problems 340

List of Journals with Abbreviations Journal Code SP SPPE SRR SSM STH SUR T TA TAAGS TAAP TAD TH TM TMAGS TP

The Spectator: An American Weekly Review of Insurance Social Psychiatry and Psychiatric Epidemiology Services Research Report Social Science and Medicine Seminars in Thrombosis and Hemostasis Surgery Thyroid Tissue Antigens Transactions of the American Association Genito-Urinary Surgeons Transactions of the Association of American Physicians Alcohol Digest Thrombosis and Haemostasis The Menorah: A Monthly Magazine for the Jewish Home Transactions of the Medical Association of Genitourinary Surgeons The Prostate

UO USDI VMM VS VSNYC WB WJM YJBM

Urologic Oncology United States Department of the Interior Virginia Medical Monthly Vital Statistics Vital Statistics of New York City (1890) Weekly Bulletin The Western Journal of Medicine Yale Journal of Biology and Medicine

Journal Name

341

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