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Author(s): Staetsky, Daniel
Date: 2020
Abstract: Since the earliest days of the coronavirus outbreak in the UK, concerns have been expressed that Jews have been disproportionately affected, with mortality levels among them abnormally high. Initial hypotheses arguing that this could largely be explained by geographical and age factors were both proven and challenged by a June 2020 paper published by the Office for National Statistics. It showed that Jews were more likely to be affected because of their above average age profile and where they tend to live (London and other urban centres), but that even after accounting for these and other socio-demographic variables, they were still found to be disproportionately vulnerable. This short paper draws on existing evidence to investigate why this might be the case. In particular, it explores whether the long-established above average health profile of Jews in the UK has shifted in such a way as to result in elevated levels of mortality from COVID-19, and whether behavioural factors – particularly in the most Orthodox parts of the community – affect the numbers in any significant way. In brief, it finds that there has been no such change in the fundamental health status of British Jews, and that regardless of any specific issues within haredi communities, the vast majority of COVID-19 related deaths among Jews have occurred in the mainstream, non-haredi sector. Its key conclusions are as follows: 1) Even though Jewish mortality from COVID-19 is high as it is for other Black, Asian and minority ethnic groups, Jews are a completely different case and should be analysed and understood as such; 2) The high mortality levels found among Jews is not caused in any significant way by any particular developments occurring in the strictly Orthodox (haredi) population; 3) Elevated mortality among Jews may in part be due to the interconnected and contact-rich social and religious lives that Jews have, but further analysis is required to confirm this.
Author(s): Kasstan, Ben
Date: 2016
Abstract: Using an integrated archival and ethnographic approach, this study investigates how the growing Haredi Jewish minority and the UK government negotiate their positions in the context of healthcare services in Manchester as one of the few sites where they directly engage. Low-level uptake of certain maternal and infant health interventions has led to claims that Haredi Jews are ‘hard to reach’ or a ‘non-compliant community.’ This thesis critically engages the above outlook by exploring how responses to healthcare services should be framed.
Rather than evading the NHS altogether, as the ‘hard to reach’ label implies, Haredi Jews in Manchester selectively negotiate healthcare services in order to avoid a cosmological conflict with the halachic custodianship of Jewish bodies. Maternal and infant care is situated as a particularly sensitive area of minority-state relations in which competing constructions of bodily protection are at play. Whilst maternal and infant care has historically formed part of the state’s strategy to govern the population, it is increasingly being seized as a point of intervention by Haredi rabbis, doulas, and parents when attempting to reproduce the Haredi social body.
Following Roberto Esposito’s (2015 [2002]) theoretical elaboration of ‘immunitas’ the present work depicts the margins as giving rise to antonymic conceptions of ‘immunity’ as a means of protecting collective life. Interventions that the state regard as protecting the health of the nation can, in turn, be viewed as a threat to the life of the Jewish social body. Immunity at the margins can be characterised by an antonymic fault of both the Haredim and the state to understand each other’s expectations of health and bodily care. The margins of the state illustrate how responses to healthcare interventions can be entangled within a struggle of integration, insulation, and assimilation for minority groups in ways that are contiguous over time.
Author(s): Rowland, Gemma
Date: 2016
Abstract: Previous research suggests that children of minority groups may be underserved by
mainstream services (Elster, Jarosik, VanGeest & Fleming, 2003). There has been
an identified need for research that focuses on barriers to accessing services faced
by minority groups, such as the Orthodox Jewish community (Dogra, Singh,
Svirdzenka & Vostansis, 2012). Given that parents are often the gate-keepers to
care (Stiffman, Pescosolido & Cabassa, 2004), understanding their help-seeking
behaviour is crucial to ensure that Orthodox children and families are given the same
opportunities to access services as their majority group peers. To date there is
extremely limited research on the help-seeking behaviours of Orthodox Jewish
parents. The current study sought to consider the experiences of Orthodox Jewish
parents who have accessed Child and Adolescent Mental Health Services (CAMHS)
in order to seek help for their families.

Semi-structured interviews were completed with nine Orthodox Jewish parents with
regards to their experiences of accessing tier 2 CAMHS for their child. A thematic
analysis was conducted. Four themes were found: ‘The Orthodox community as
unique’, ‘Pathways to help’, ‘Attitudes towards mental health’ and ‘The parental
journey’.

Participants described a number of significant cultural barriers to seeking help.
Stigma was identified as occurring in relation to mental health and also in relation to
the process of help-seeking, as suggested by previous research within adult
Orthodox populations (Feinberg & Feinberg, 1985). These stigmas relate to
concerns regarding labelling and future matchmaking for the child and their siblings.
Parents experience emotional and practical strains in parenting a child with mental
health difficulties and in accessing psychological support for their children. The
implications for service level change and clinical practice are considered.
Date: 1994
Abstract: Background We wished to ascertain immunization uptake rates in the strictly orthodox Jewish community in Hackney and to survey reasons for non-uptake and attitudes to immunization and immunization services within this community.

Methods A total of 575 strictly orthodox Jewish children, aged under 2 5 years, were identified from three general practices in the community, and a random sampling of 100 of these children was carried out. The sample uptake recorded by family doctors was compared with District uptake rates. A questionnaire was administered to parents. The main outcome measures were immunization uptake rate, reasons for non-uptake, and attitudes to immunization. Results Percentage immunization uptake (95 per cent confidence intervals) was: third diphtheria 86 per cent (82–90 per cent); third pertussis 82 per cent (78–86 per cent); and MMR 79 per cent (75–85 per cent). District uptake rates for a cohort of the same age, and at the time of the study, were: third diphtheria 82 per cent; third pertussis 79 per cent; and MMR 83 per cent. Sixty-seven parents completed the questionnaire (72 per cent response) and their children's uptake was the same as for children of nonresponders. All parents thought immunization to be important.

ConclusionsFor all immunizations, uptake in the strictly orthodox Jewish community is not significantly different from that of the District. Responding parents had positive attitudes to the value and safety of immunizations but wished better access to services. Health professionals need to question their perceptions so that efforts to improve uptake amongst ethnic minority groups are based on facts and are responsive to identified needs.
Date: 2009
Abstract: This paper examines how Rabbinic and communal authorities participated in treatment decisions made by a group of strictly orthodox haredi Jews with breast cancer living in London. Semi-structured interviews were conducted with five haredi breast cancer patients. The transcripts were analysed using interpretative phenomenological analysis. Demographic and personal data were collected using structured questionnaires. All participants sought Rabbinic involvement, with four seeking rulings concerning religious rituals and treatment options. Participants' motivations were to ensure their actions accorded with Jewish law and hence God's will. By delegating treatment decisions, decision-making became easier and participants could avoid guilt and blame. They could actively participate in the process by choosing which Rabbi to approach, by providing personal information and by stating their preferences. Attitudes towards Rabbinic involvement were occasionally conflicted. This was related to the understanding that Rabbinic rulings were binding, and occasional doubts that their situation would be correctly interpreted. Three participants consulted the community's ‘culture broker’ for medical referrals and non-binding advice concerning treatment. Those who consulted the culture broker had to transcend social norms restricting unnecessary contact between men and women. Hence, some participants described talking to him as uncomfortable. Other concerns related to confidentiality.

By consulting Rabbinic authorities, haredi cancer patients participated in a socially sanctioned method of decision-making continuous with their religious values. Imposing meaning on their illness in this way may be associated with positive psychological adjustment. Rabbinic and communal figures may endorse therapeutic recommendations and make religious and cultural issues comprehensible to clinicians, and as such healthcare practitioners may benefit from this involvement.
Date: 1999
Date: 2008
Abstract: Objective To assess reasons for low uptake of immunization amongst orthodox Jewish families.
Design Qualitative interviews with 25 orthodox Jewish mothers and 10 local health care workers.
Setting The orthodox Jewish community in North East London.
Main outcome measures Identification of views on immunization in the orthodox Jewish community.
Results In a community assumed to be relatively insulated from direct media influence, word of mouth is nevertheless a potent source of rumours about vaccination dangers. The origins of these may lie in media scares that contribute to anxieties about MMR. At the same time, close community cohesion leads to a sense of relative safety in relation to tuberculosis, with consequent low rates of BCG uptake. Thus low uptake of different immunizations arises from enhanced feelings of both safety and danger. Low uptake was not found to be due to the practical difficulties associated with large families, or to perceived insensitive cultural practices of health care providers.
Conclusions The views and practices of members of this community are not homogeneous and may change over time. It is important that assumptions concerning the role of religious beliefs do not act as an obstacle for providing clear messages concerning immunization, and community norms may be challenged by explicitly using its social networks to communicate more positive messages about immunization. The study provides a useful example of how social networks may reinforce or challenge misinformation about health and risk and the complex nature of decision making about children's health.
Date: 2016
Abstract: From press release:

A ground-breaking survey commissioned by NHS Salford Clinical Commissioning (CCG) has revealed concerns about immunisation take-up, healthy eating, amounts of exercise and attitudes to mental health within the predominately orthodox Jewish communities in the city.
507 people took part in the year-long research project that included peer-led focus groups as well as questionnaires. Key findings reveal that less than half of the participants take more than one hour of exercise per week, with around a quarter taking less than 30 minutes. Only half meet recommended levels of physical activity, which is significantly below the England average of 61%. Fewer than half of respondents believe exercise is very important, with far fewer men than women valuing exercise.
There is particular concern related to men’s lack of exercise, with just over a third meeting the recommended levels of physical activity compared to 67% nationally. The percentage of women meeting recommending levels at 56% is comparable to the 55% of women nationally.
With regards to children’s exercise, only 40% think it is very important that their child exercises. Less than half the children do more than an hour’s exercise per week, with a third doing less than 30 mins per week. Boys tend to do slightly more exercise than girls (possibly because they play football or ride bikes), contra to what was reported as being undertaken by the adults themselves; the trend seems to be that boys are more active than girls but this switches as they become adults.
The research also suggests that the healthy eating message is not always getting through to this community; only 10% of children are getting their ‘5 a day’ with 40% getting less than 3 fruit or veg a day. Over half the children in this community seem eat cake at least once a day, though crisps and other unhealthy snacks seem far less frequent. Alcohol consumption for adults is, however, very low compared to the rest of the population, although 12% of respondents might be classed as ‘binge-drinkers’ on the Sabbath.
Attitudes to immunisation in the orthodox Jewish community remain a concern. 13% said they would be unlikely to immunise their child in the future whilst 20% felt they were not given enough information about immunisation. For Salford as a whole, MMR immunisation take-up by 5 years olds averages over 97% which is far higher than appears in the Jewish communities.
Take up of cervical smears is also lower than the rest of the population with 67% claiming they would be likely to have a smear compared to the 80% target in Salford. It is thought that some of the lower uptake of cervical screening may be due to the low perceived risk of HPV infection and cervical cancer, the higher number of pregnancies and religious norms relating to menstruation.
Other findings of interest include the fact that almost a half of participants believe that mental health is a big stigma within the Jewish community which may prevent many people seeking the help they need.
Date: 2011
Abstract: This report has been written at the request of Jewish Women’s Aid (JWA). JWA commissioned this 
research to better understand several key factors influencing their work: general Jewish opinion 
and knowledge about domestic violence; the ways in which current and former clients come to 
JWA and how useful they find its services; and the position of JWA in the UK and in comparison to 
other Jewish domestic violence charities in Israel, the USA and Canada. 

The researchers determined that the best way of ascertaining information about these areas of 
interest was to conduct a three- stage research project. Firstly, a literature review was undertaken 
to contextualise the work JWA does in both a national and international context. This literature 
review informs chapter two of this research report, which provides an overview of domestic 
violence in the UK with references throughout to three countries of interest to Jewish Women’s Aid 
(because of the presence of Jewish-specific domestic violence charities), namely Canada, the 
United States, and Israel.
 
Secondly, the researchers conducted a domestic violence Jewish general opinion survey, which 
yielded 842 complete responses. The survey was largely taken by women and this response rate 
makes this survey, to the knowledge of the authors and JWA, the largest Jewish survey on a 
women’s issue ever conducted.

This report discusses the findings from the survey; see chapter three for details, including a discussion of the methodology employed. 

Finally, and perhaps most importantly, the researchers conducted face –to- face interviews with 
twenty current or former JWA clients, who agreed to speak to them after communication from JWA 
employees. Chapter four of this report gives voice to the personal suffering experienced by 
women; it illuminates the ‘real life stories’ behind the statistics.
 
The report concludes with recommendations that JWA will be implementing to continue combating 
domestic violence in all of its forms; these recommendations are based both on the findings arising 
from the general survey and client interviews, and from examples of best practice from domestic 
violence charities in the UK and abroad.