In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

We use cookies to optimise the design of this website and make continuous improvement. By continuing your visit, you consent to the use of cookies. Learn more

Country of the Month - Israel

October 2013


Report prepared by Prof Yaakov Henkin and reviewed by Prof Avi Porath, Dr Ronit Endevelt, Dr Rakefet Bacharach, Prof Chaim Yosefy, Dr Robert Klempfner and Prof Yosef Rozenman

National CVD Prevention Coordinator for Israel:

Yaakov Henkin
MD, Associate Professor
1. Head, Preventive Cardiology Service, Department of Cardiology, Soroka University Medical Centre, Beer Sheva, Israel
2. Director, Medical Simulation Centre, Ben-Gurion University, Beer-Sheva, Israel
contact: email  |  mobile number: +972-50-2365544
Health care
  |  Risk factors  |  Main actors & prevention methods  |  Cardiac Rehab.  |  Prevention activities  |  Future 


"Israel is a small, young country whose citizens are constantly threatened by economic and security instability.  So how is it that their life expectancy is amongst the highest and their cardiovascular mortality rates amongst the lowest in Europe Read more about the Israeli Health Paradox and how the Israeli health system provides incentives for coping with cardiovascular risk factors." (Yaakov Henkin, NCPC for Israel)

Documents to download

Health care

The state is responsible for providing health services to all residents of the country through 4 non-for-profit health maintenance organisations (HMO). These HMOs are membership-based and operate under the guidance of a National Health Insurance law that determines a uniform benefits package for all citizens (National Health Basket). In addition, the HMOs provide an option to acquire a few layers of private "supplementary insurance", which includes services beyond those covered by the publicly funded system. Funding of the HMOs is provided by Israel's social security organisation according to a formula based on the number of members, age distribution, and a number of other indices.


Risk factors

According to recent surveys published by the Israeli Bureau of Statistics, the overall prevalence of obesity (BMI > 30 kg/m2) is 25%, type 2 diabetes 6%, smoking 24%, hypertension 31% and physical activity (at least 3 times/week) 20%. Obesity and diabetes rates are increasing in recent years, while smoking rates are decreasing nationwide. The prevalence of obesity, diabetes, smoking and physical inactivity is generally higher in the Arabic population.
The rate of participation in cardiac rehabilitation is around 60%.


Main actors & prevention methods

Ministry of Health: Owner of many public hospitals, supervises the HMOs, auspices the National Health Basket committee, and coordinates the National Program for Quality Indicators in Community Healthcare in Israel (QICH).  The latter is a set of parameters that provide information on the quality of community healthcare. HMOs: provide all healthcare through multi-disciplinary clinics around Israel, and compete amongst themselves on the performance in each of the QICH parameters.
Israel Heart Society (IHS) and the National Council for Prevention and Treatment of Heart Disease:  provide guidance and practice guidelines for the ministry of health and the HMOs in the area of preventive cardiology and endorsed the ESC guidelines.
Other national medical societies provide guidelines and educational activities in specific areas related to preventive cardiology (e.g. hypertension, diabetes, family medicine).


Cardiac Rehabilitation

Israel had embraced cardiac rehabilitation (CR) as early as the sixties. Currently there are 22 cardiac rehabilitation centres, most of which (14) are hospital based and house both step 1 (in-hospital) and step 2+3 CR programs. Independent or private owned CR institutes are relatively few, despite the fact that reimbursement for CR exists at a national level through the “health basket”, as previously described.


Prevention activities

  • In previous years the Israel Heart Society (IHS) had been active in community campaigns for preventing cardiovascular diseases. These activities have virtually ceased in the past 4 years.

  • The IHS offers lecturers and lecture templates in preventing cardiovascular diseases for schools and workplaces, but the activity is poorly coordinated and less than optimal. A new internet program with learning centres for educating school children in “healthy living” is currently being structured.

  • In addition to endorsing recent ESC guidelines in cardiovascular prevention and dyslipidemia, the IHS initiated and participated (in collaboration with other relevant societies) in the writing of Israeli guidelines for preventive cardiology, preventive nutrition and physical activity.

  • The Forum for Preventing Cardiovascular Diseases is a collaboration between the ministry of health, the 4 HMOs and the relevant medical societies and provides educational and medical screening projects in workplaces, schools and other public enterprises

Aims for the future

  • Re-vitalise the interest of the IHS in prevention activities

  • Provide a core-curriculum for medical schools in cardiovascular prevention

  • Enhance the use of risk calculators for more logical application of prevention strategies

  • Enhance activities relating to “neglected” risk factors (smoking, physical inactivity) and target high-risk populations (35-60 year old individuals and certain ethnic groups)

  • Promote educational activities in schools

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology