Type 2 Diabetes among Ethiopian-Israeli Adults
The benefits that once protected members of the Ethiopian community from diabetes have been lost with their integration into Israeli society
Type 2 diabetes usually develops in adulthood and is considered one of the most common chronic diseases in the world. The disease is linked to genetic factors that are partially understood, and environmental factors, which are well-described and significantly related to lifestyles, lack of physical activity and unhealthy nutrition. The risk of developing diabetes is higher among certain ethnic groups, such as the Ethiopian community in Israel. MA student, Dalia Betolin-Sherman, conducted a study under the supervision of Dr. Shiri Shinan-Altman at Bar-Ilan University’s Weisfeld School of Social Work, examining the health behaviors of Ethiopian-Israeli adults with respect to type 2 diabetes.
For Ethiopian immigrants in Israel, immigration was an abrupt transition from a traditional way of life to a Western lifestyle. While type 2 diabetes was a rare disease in Ethiopia, during the post-immigration years in Israel, there has been a sharp increase in the risk of developing the disease among Ethiopians in comparison to the general Israeli-born population. Studies show that the most effective primary prevention of type 2 diabetes is via healthy behaviors, which includes performing physical activity and consuming healthy nutrition.
The study has sought to expand the existing body of knowledge and investigate healthy behavior (physical activity and healthy nutrition) among Ethiopian immigrants in Israel, with respect to type 2 diabetes, and the factors associated with this behavior, comparing them to the Israeli-born population. The Theory of Planned Behavior (Ajzen, 1988) which incorporates personal, social, and cognitive variables, served as the theoretical base for the study.
The study was based on a sample of 207 adults, aged 30 and older, who did not have type 2 diabetes, including 110 Ethiopian immigrants in Israel and 97 native-born Israelis. The research findings show that most of the participants did not perceive themselves to be at risk for developing type 2 diabetes. Those who perceived themselves at risk for type 2 diabetes were less likely to exercise and consume a healthy diet. In the area of physical activity, 61% of the participants reported being physically active, compared to 39% who reported that they did not exercise, with no significant differences between Ethiopian immigrants and the Israeli-born population. However, the rate of those who reported participation in physical activities, such as a sports class or gym, was significantly higher among the Israeli-born population compared to the Ethiopian immigrants. As to consuming a healthy diet, the percentage of those reporting unhealthy eating habits was higher among Ethiopians compared to the Israeli born: 33.6% compared to 21.6%.
Analysis of the data showed that being single, perceived susceptibility to type 2 diabetes (negative relationship), perceived health status, attitudes, subjective norms and intention to perform physical activity clearly predicted actual performance of exercise. Regarding healthy food consumption, it was found that marriage, higher education, perceived susceptibility to type 2 diabetes (negative), perceived control and intention to consume a healthy diet clearly predicted healthy eating intake.
The research findings emphasize that behavior patterns among Ethiopian immigrants in Israel are essentially similar to those of the Israeli-born population. According to the literature, it is a common phenomenon that populations which immigrant to Western countries, often adopt the less healthy behavior of the local population and thus lose the health benefits they came with.
On the theoretical level, this study deepens knowledge and understanding of health behavior, physical activity, and consumption of healthy nutrition, with respect to type 2 diabetes among Ethiopians in Israel. It has described factors that predict health behavior and the differences between Ethiopians and Israeli-born population in health behavior. The study findings comply with the Theory of Planned Behavior. In practical terms, the importance of the research is in emphasizing the need for intervention programs to increase regular physical activity and increase healthy eating, to promote the health of the Ethiopian community in Israel and to prevent the onset of diabetes among them. Study results show that this could be accomplished by strengthening personal, cognitive and social resources that are necessary for success in adopting healthy behaviors.