Variation in Covid Testing, Infections and Hospitalization by Town and Population Sector

By the end of September 2021, about 14% of Israel’s population – 1.2 million people – had been infected by Covid-19, of whom 7,800 had died.

This study looks at three major metrics of the Covid epidemic in Israel – the testing, infection, and hospitalization rates – across 205 yishuvim (towns/cities), home to about 8 million people, 88% of Israel’s population in mid-2020. A multivariate analysis is conducted using the main characteristics of the yishuvim like their socioeconomic status (as classified by the Central Bureau of Statistics), population density, and the percent of residents ages 65 and older.

Findings of the study of the Covid-19 epidemic in Israel

The 205 yishuvim are classified by their dominant residential population into one of seven groups: Jewish non-Haredi; Haredi; Arab; Bedouin; Druze; mixed Jewish and Arab; or mixed Haredi and non-Haredi.

Main findings

• The highest testing rates are in Jewish non-Haredi yishuvim.
• The lowest testing rates—less than half the national average—are in Bedouin yishuvim.
• The highest infection rates are in Haredi yishuvim—31% of the population has had a confirmed infection in Haredi yishuvim.
• A high correlation is found between infection rates and the share of the yishuv population that is Haredi, even in non-Haredi Jewish yishuvim.
• The highest rates of hospitalization are found in Arab yishuvim, due mostly to the higher prevalence of preexisting health conditions – particularly heart disease and diabetes, which are known to increase the risk of serious illness from Covid.
• Higher than expected hospitalization rates in the Bedouin yishuvim (relative to the share of confirmed infections) reflect the high prevalence of preexisting health conditions alongside low testing rates – the latter hide the true infection rate.

Multivariate impact: poverty, population density, and the share of the over 65 population

• Yishuvim from the lowest socioeconomic cluster have both the lowest testing rates and the highest rates of confirmed infections.
• The share of the resident population ages 65 and older had an influence on the testing, infection, and hospitalization rates. In yishuvim with a high share of residents ages 65 and older, low rates of infection and hospitalization are found – this indicates the success of efforts to lower infection rates among this population group. Low rates of testing and hospitalization are also found in yishuvim with a low share of elderly adults – that is with more young people, who, for the most part, even if infected are asymptomatic and do not get tested or need hospitalization.
• Population density within the yishuv does not have a significant influence on rates of testing, infection or hospitalization.

In order to continue the current fight against Covid or to deal with a future epidemic, it is important to consider differences between population sectors. Some of the differences we document here are the results of unequal access to health resources and others are the result of both behavioral differences and insufficient enforcement of restrictions intended to limit the spread of the virus. Both problems need to be addressed.