Trends in specific morbidity prevalence in male adolescents in Israel over a 50 year period and the impact of recent immigration

Background: Most Israeli males aged 16-17 undergo a thorough medical examination prior to recruitment into the army. During the last 50 years, extensive data have been gathered enabling a study of time trends in the prevalence of common diseases in this age group. Objectives: To examine the current prevalence of common diseases, compare the results with those of previous cohorts, and assess the influence of the massive immigration during the 1990s. Methods: The health examination at the recruitment centers includes a medical history, complete physical examination, and review of medical documentation provided by the family physician. If needed, additional tests and referral to specialists are ordered. The prevalence of selected diseases and severity was drawn from the computerized database of the classification board. Two cohorts, 1992-94 and 2003-04, were examined and compared with three previous cohort studies in 1957-61, 1977-76 and 1982-84. Data were stratified according to origin and country of birth. Results: The prevalence of asthma increased dramatically during the years from 10.2 per 1000 examinees in 1957-61 to 111.6 per 1000 examinees in 2003-04. The prevalence of tuberculosis declined and then increased from 0.6 per 1000 adolescents in 1982-84 to 2.4 per 1000 adolescents in 2003-04. The prevalence of type 1 diabetes mellitus increased from 0.2 cases per 1000 examinees in 1957-61 to 0.8 cases in 1977-76 and 1982-84 and 0.9 cases per 1000 examinees in 2003-04. The prevalence of severe heart defects and severe epilepsy declined in the last 20 years (1.4 and 1.7 cases per 1000 examinees in the 1982-84 cohort to 0.4 and 0.3 cases per 1000 examinees in the 2003-4 cohort respectively). The patterns of diseases prevalence were different for immigrants: tuberculosis was more common while asthma and allergic rhinitis were less prevalent. Conclusions: The prevalence of common diseases among adolescents in Israel has changed over the last 50 years. There is a different pattern for immigrants and for those born in Israel.