68 In a study by the Taub Center for Social Policy Studies published this February, researchers discovered that the key determinant of Israeli patient outcomes isn’t one’s level of income, or even his education. Rather, it’s something much simpler, and arguably more sobering: Namely, where in the country that patient lives. Conceding that wealthier people lead on average healthier lives, the study’s authors nonetheless pointed to inferior health provision outside of Israel’s center as a likely cause of the stark differences in mortality along geographic lines. For Dr. Sivan Spitzer, deputy director of the Azrieli Faculty of Medicine’s ambitious, ten-year initiative to close the alarming gaps in diabetes prevalence between Israel’s center and northern periphery, the findings merely confirm what she and the faculty have long recognized as structural health inequities in the economically disadvantaged Galilee. And yet, she believes, there’s good reason for hope: By locating the problem firmly in place, we can begin to develop effective and sustainable solutions—for both the one million Israelis expected to be diagnosed with diabetes by 2040, and for the vast majority of the 463 million diabetics around the world who live in lowincome countries. Spearheaded by a $20 million gift from The Russell Berrie Foundation and directed by Prof. Naim Shehadeh, director of the Rambam Health Care Campus’ renowned Institute of Diabetes, Endocrinology, and Metabolism and president of the Israel Diabetes Association, SPHERE (the Social and Precision-Medicine Health Equity Research Endeavor) creates goal-oriented, diabetes intervention and care ecosystems through collaborations between local health-management organizations, hospitals, and municipalities. Indeed, as the largest healthcare project in Israel’s history, SPHERE is also the first to place community agencies at the very center of amodel for treatment. “It’s natural to work with health-management organizations and health clinics when you’re trying to achieve better health outcomes,” says Spitzer. “But if you look at the most important factors influencing health, only 20 percent are related to healthcare systems, whereas 50 are connected to the particular realities of your community. We understood that if we’re going to be successful, we need tomakemunicipal agencies the key.” By advancing simultaneously across three, interrelated pathways—Prevent, Control, and Care—SPHERE aims to Putting Better Health in Reach for Israel’s Northern Periphery The Russell Berrie Galilee Diabetes SPHERE
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