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“We're potentially worsening health inequalities”: Evaluating how delivery of the 2022 London polio booster campaign was tailored to Orthodox Jewish families to reduce transmission vulnerability
Author(s): Kasstan, Ben; Mounier-Jack, Sandra; Zuriaga-Alvaro, Ana; Weil, Leonora G.; Chantler, Tracey
Date: 2023
Topics: Health, Health Education, Main Topic: Other, Haredi / Strictly Orthodox Jews
Abstract: A polio booster campaign targeting all children aged 1–9 was implemented across London between August–December 2022 as part of a national enhanced poliovirus incident response. Orthodox Jewish (OJ) children were particularly vulnerable to transmission due to disparities in childhood vaccination coverage and the transnational spread of poliovirus affecting linked populations in New York and Israel. This study aimed to evaluate how the polio booster campaign was tailored to increase uptake and enable access for OJ families in northeast and north central London boroughs, and the impact of the campaign on local-level vaccine inequities. Semi-structured in-depth interviews (n = 36) were conducted with participants involved in the implementation and delivery of the polio booster campaign, and OJ mothers. Site visits (n = 5) were conducted at vaccine clinics, and rapid interviews (n = 26) were held to explore parental perceptions of the poliovirus incident and childhood immunisations. Enablers to vaccination during the campaign included the production of targeted printed communications and offering flexible clinic times in primary care settings or complementary delivery pathways embedded in family-friendly spaces. Barriers included digital booking systems. Mothers reported being aware of the poliovirus incident, but the majority of those interviewed did not feel their children were at risk of contracting polio. Healthcare provider participants raised concerns that the vaccine response had limited impact on reducing disparities in vaccine uptake. While OJ families were recognised as a priority for public health engagement during the poliovirus incident response, this evaluation identified limitations in reducing transmission vulnerability during the booster campaign. Lessons for future campaign delivery include effectively conveying transmission risk and the urgency to vaccinate. Priorities for mitigating vaccine inequities include public engagement to develop messaging strategies and strengthening the capacity of primary care and complementary delivery pathways to serve families with higher-than-average numbers of children.
Transmission dynamics of SARS-CoV-2 in a strictly-Orthodox Jewish community in the UK
Author(s): Waites, William; Pearson, Carl A. B.; Gaskell, Katherine M.; House, Thomas; Pellis, Lorenzo; Johnson, Marina; Gould, Victoria; Hunt, Adam; Stone, Neil RH; Kasstan, Ben; Chantler, Tracey; Lal, Sham; Roberts, Chrissy H.; Goldblatt, David; CMMID COVID-19 Working Group; Marks, Michael; Eggo, Rosalind M.
Date: 2022
Topics: Coronavirus/Covid, Demography, Main Topic: Other, Health, Haredi / Strictly Orthodox Jews
Abstract: Some social settings such as households and workplaces, have been identified as high risk for SARS-CoV-2 transmission. Identifying and quantifying the importance of these settings is critical for designing interventions. A tightly-knit religious community in the UK experienced a very large COVID-19 epidemic in 2020, reaching 64.3% seroprevalence within 10 months, and we surveyed this community both for serological status and individual-level attendance at particular settings. Using these data, and a network model of people and places represented as a stochastic graph rewriting system, we estimated the relative contribution of transmission in households, schools and religious institutions to the epidemic, and the relative risk of infection in each of these settings. All congregate settings were important for transmission, with some such as primary schools and places of worship having a higher share of transmission than others. We found that the model needed a higher general-community transmission rate for women (3.3-fold), and lower susceptibility to infection in children to recreate the observed serological data. The precise share of transmission in each place was related to assumptions about the internal structure of those places. Identification of key settings of transmission can allow public health interventions to be targeted at these locations.
SARS-CoV-2 seroprevalence in a strictly-Orthodox Jewish community in the UK: A retrospective cohort study
Author(s): Gaskell, Katherine M.; Johnson, Marina; Gould, Victoria; Hunt, Adam; Stone, Neil RH; Waites, William; Kasstan, Ben; Chantler, Tracey; Lal, Sham; Roberts, Chrissy H.; Goldblatt, David; Eggo, Rosalind M.; Marks, Michael
Date: 2021
Topics: Coronavirus/Covid, Health, Demography, Main Topic: Other, Haredi / Strictly Orthodox Jews
Abstract: Background
Ethnic and religious minorities have been disproportionately affected by SARS-CoV-2 worldwide. The UK strictly-Orthodox Jewish community has been severely affected by the pandemic. This group shares characteristics with other ethnic minorities including larger family sizes, higher rates of household crowding and relative socioeconomic deprivation. We studied a UK strictly-Orthodox Jewish population to understand transmission of COVID-19 within this community.

Methods
We performed a household-focused cross-sectional SARS-CoV-2 serosurvey between late-October and early December 2020 prior to the third national lockdown. Randomly-selected households completed a standardised questionnaire and underwent serological testing with a multiplex assay for SARS-CoV-2 IgG antibodies. We report clinical illness and testing before the serosurvey, seroprevalence stratified by age and sex. We used random-effects models to identify factors associated with infection and antibody titres.

Findings
A total of 343 households, consisting of 1,759 individuals, were recruited. Serum was available for 1,242 participants. The overall seroprevalence for SARS-CoV-2 was 64.3% (95% CI 61.6-67.0%). The lowest seroprevalence was 27.6% in children under 5 years and rose to 73.8% in secondary school children and 74% in adults. Antibody titres were higher in symptomatic individuals and declined over time since reported COVID-19 symptoms, with the decline more marked for nucleocapsid titres.

Interpretation
In this tight-knit religious minority population in the UK, we report one of the highest SARS-CoV-2 seroprevalence levels in the world to date, which was markedly higher than the reported 10% seroprevalence in London at the time of the study. In the context of this high force of infection, all age groups experienced a high burden of infection. Actions to reduce the burden of disease in this and other minority populations are urgently required.

Funding
This work was jointly funded by UKRI and NIHR [COV0335; MR/V027956/1], a donation from the LSHTM Alumni COVID-19 response fund, HDR UK, the MRC and the Wellcome Trust.
“We've all got the virus inside us now”: Disaggregating public health relations and responsibilities for health protection in pandemic London
Author(s): Kasstan, Ben; Mounier-Jack, Sandra; Gaskell, Katherine M.; Eggo, Rosalind M.; Marks, Michael; Chantler, Tracey
Date: 2022
Topics: Coronavirus/Covid, Health, Health Education, Interviews, Main Topic: Other, Jewish Organisations, Representation, Haredi / Strictly Orthodox Jews
Abstract: The COVID-19 pandemic has disproportionately impacted ethnic minorities in the global north, evidenced by higher rates of transmission, morbidity, and mortality relative to population sizes. Orthodox Jewish neighbourhoods in London had extremely high SARS-CoV-2 seroprevalence rates, reflecting patterns in Israel and the US. The aim of this paper is to examine how responsibilities over health protection are conveyed, and to what extent responsibility is sought by, and shared between, state services, and ‘community’ stakeholders or representative groups, and families in public health emergencies.

The study investigates how public health and statutory services stakeholders, Orthodox Jewish communal custodians and households sought to enact health protection in London during the first year of the pandemic (March 2020–March 2021). Twenty-eight semi-structured interviews were conducted across these cohorts. Findings demonstrate that institutional relations – both their formation and at times fragmentation – were directly shaped by issues surrounding COVID-19 control measures. Exchanges around protective interventions (whether control measures, contact tracing technologies, or vaccines) reveal diverse and diverging attributions of responsibility and authority.

The paper develops a framework of public health relations to understand negotiations between statutory services and minority groups over responsiveness and accountability in health protection. Disaggregating public health relations can help social scientists to critique who and what characterises institutional relationships with minority groups, and what ideas of responsibility and responsiveness are projected by differently-positioned stakeholders in health protection.
A partnership approach to supporting the health and wellbeing of the Charedi (Orthodox Jewish) community in London
Author(s): Zuriaga, Ana; Flannigan, Liam; Wilson, Joanne; Weiss, Sarah; Rottenberg, Gitit; Klynman, Nicole; Schwartz, Ellen Corine; Billett, Julie; Katz, Jacqueline; Weil, Leonora G.
Date: 2022
Topics: Health, Health Education, Coronavirus/Covid, Evaluation, Haredi / Strictly Orthodox Jews, Main Topic: Other
Abstract: Background
There is a need for a specific programme of engagement around COVID-19 vaccination with the Charedi Orthodox Jewish community in Stamford Hill, London, UK. We co-produced a live event for women on COVID-19 safety and vaccination and wider health topics to support vaccine uptake and improve awareness of health and wellbeing issues.
Methods
For this qualitative analysis, we organised an event that was designed and delivered by a local community organisation in partnership with regional and local health partners and community groups. The event was for Charedi women aged 16 years and older, and provided information on COVID-19, childhood immunisations, oral health and dental hygiene, childhood respiratory infections, and mental health. The event included health stalls, a panel session, co-designed culturally competent physical information, and the opportunity to speak with health professionals. We evaluated the event using attendees' feedback forms, collected in person at the end of the event, and a thematic analysis of semi-structured interviews with organisers from community and statutory organisations. The evaluation was informed by a co-produced logic model and outcomes framework.
Findings
More than 100 women attended the event on March 28, 2022. Feedback suggested the focus on wider health issues was valued, and a greater number of more targeted events (eg on health for women older than 40) would be beneficial. Dental health, COVID-19 vaccination, and childhood immunisations were identified as the most important topics by participants. 16 (55%) of 29 respondents stated they would attend a similar event again, 12 (41%) stated they were unsure, and one (3%) said they would not attend again. Informal feedback from the community highlighted that the event was useful and acted as a basis for further engagement and collaboration with the community.
Interpretation
Our findings emphasised the need to work in partnership with a lead community organisation to identify and address principal health challenges within communities, to share community-specific insights, and to promote community events through community communication channels. Statutory institutions should engage with local community organisations to support and facilitate public health interventions to increase relevant vaccine uptake and to improve awareness around wider health and wellbeing issues and services.
Health, Religiosity and Hatred: A Study of the Impacts of COVID-19 on World Jewry
Author(s): Sundberg, Kelly W.; Mitchell, Lauren M.; Levinson, Dan
Date: 2023
Topics: Antisemitism, Health, Coronavirus/Covid, Main Topic: Antisemitism
Abstract: This exploratory study examines the likely causes of the alarming global rise of antisemitism during the COVID-19 pandemic. Beginning with an appraisal of today’s world Jewry, this exploratory study highlights the main social, health, and religious impacts COVID-19 has had on Jews worldwide and goes on to highlight how various Jewish communities managed and adjusted to COVID-19 public health restrictions. From this contextual backdrop, an assessment of how and why antisemitism has surged during the pandemic is presented, along with a review of what efforts are being taken to curtail this rise in hatred toward Jews. A central aim of this study is to underline the point that until meaningful, broad, and international steps are taken to curb online hate, the historic antisemitic tropes and myths suggesting Jews are the cause of disease will undoubtedly evolve and surge (especially across social media) during future pandemics and times of global crisis and unrest.
Life-threatening and terminal illness: considerations for hospitalised Orthodox Jewish patients
Author(s): Tatz, Akiva
Date: 2023
Topics: Chaplaincy, Death and Mourning, Health, Main Topic: Other, Orthodox Judaism
Abstract: For Orthodox Jewish patients, palliative care in general and withholding and withdrawing treatment in particular pose potential conflicts with some aspects of current religious practice. This article gives an introduction to the relevant cultural context and summarises the relevant principles of Jewish law to help clinicians provide appropriate care for their Jewish patients.
COVID-19 mortality among Jews in 2020: a global overview and lessons taught about the Jewish longevity advantage
Author(s): Staetsky, L. Daniel
Date: 2023
Topics: Coronavirus/Covid, Health, Demography, Death and Mourning, Main Topic: Other
Abstract: An extensive body of demographic literature has described Jews as ‘long-lifers’. From the mid-nineteenth century onwards, this pattern affected all age groups and was particularly well expressed among Jewish males but was also present among Jewish females. It held good independently of the Jews’ socio-economic position. This became known as ‘Jewish pattern of mortality’. This paper has two aims. The first aim is to show the impact of COVID-19 on Jewish mortality. This is a study of a global pandemic in the Jewish population which is, to the best of our knowledge, unique in its scope and quality. The second aim is to settle the finding of relatively high mortality from COVID-19 in certain Jewish communities (‘Jewish penalty’ in relation to COVID-19) with the notion of ‘Jewish pattern of mortality’. The author proceeds to show that the status of Jews as a low mortality group under a Western epidemiological regime, when mortality and morbidity are dominated by non-communicable diseases, does not stand in contradiction to a higher vulnerability among Jews to coronavirus. Thus, the paper further develops understanding of mortality of Jews and serves as a contribution to ethnic and religious demography and epidemiology.
‘Working Together’ Community strengths and assets in Greater Manchester
Date: 2023
Topics: Main Topic: Other, Jewish Community, Jewish Organisations, Strategic Planning, Policy, Demography, Haredi / Strictly Orthodox Jews, Care and Welfare, Health, Children, Youth, Poverty, Housing, Elderly Care, Age and Generational Issues
Abstract: At 28,075 Jewish people, Greater Manchester recorded the largest Jewish population in the UK
outside of London and adjacent Hertfordshire. At first sight, it appears to have grown by 12%
between 2011 and 2021, most likely driven largely by high birth-rates among the strictly Orthodox
community. Similarly, if the data eventually proves to be accurate, this constitutes a growth of 29%
over the twenty years between 2001 and 2021. Provisional estimates of the Haredi community
based on other data sources (such as Manchester Connections) suggest that the Haredi community
could be as large as 22,778 but, again, further analysis is needed before any firm conclusions can be
drawn. Whatever the final numbers, it is clear that Greater Manchester, which includes the largest
Eruv in the UK with a perimeter of more than 13 miles, covering parts of Prestwich, Crumpsall and
Higher Broughton, is an important and growing centre of Jewish life.

This report was commissioned by Jewish Representative Council of Greater Manchester & Regions
(GMJRC) to research and analyse community strengths and provide a mapping of Jewish
organisations in the Greater Manchester area. It was overseen by the GMJRC strategic group – a
group that was formed of Councils and organisations across the Jewish religious spectrum as a
response to the pandemic. It reviews services in seven themes: Children & Young People; Adult
Services; Older People; Health; Employment; Emergency Response; and Housing. As well as looking
at delivery, governance, leadership, and building assets, it also tries to understand where the gaps
and support needs are. As the demographics and relative sizes of the mainstream and strictly
Orthodox Jewish populations continue to change, this study represents an important examination
of both the challenges and opportunities of how the respective communities work together. As
these populations change across the UK, and beyond, the study will have significance to other cities
where these Jewish communities exist side by side.

The Institute of Jewish Policy Research (JPR) used a variety of data sources to identify organisations
delivering in each theme and built maps of that data which can be seen throughout this report.
Mobilise Public Ltd use several methods to gather data from these organisations in each theme.
The main approach was qualitative, using stakeholder interviews and focus group discussions with a
purposely selected sample of these organisations, and the evidence collected was supplemented
with a short survey which was issued to a larger number of organisations. The research was
coproduced with a subset of the strategic group through a series of facilitated sessions and was
designed to build a good understanding of delivery in each theme as well as an understanding of
challenges and opportunities in readiness for the strategic group to develop a more integrated
strategy for the Greater Manchester Jewish community
Do They Feel the Same Way? Health-Related Quality of Life and Satisfaction With Life in Jewish Immigrants From the Former Soviet Union in Germany and Israel
Author(s): Nesterko, Yuriy; Ulitsa, Natalie; Friedrich, Michael; Glaesmer, Heide
Date: 2018
Topics: Main Topic: Other, Health, Mental Health, Immigration, Russian-Speaking Jews
Abstract: There is consensus that experiences gained during immigration have an impact on health status. However, studies comparing health-related outcomes in homogeneous groups of immigrants living in different host countries are rare. In a sample of Jewish immigrants from the Former Soviet Union (FSU) in two different host countries, Germany and Israel, possible predictors of health-related quality of life (HRQoL) and satisfaction with life (SWL) were examined. In total, 359 Jewish immigrants from the FSU living in Germany (n = 180) and Israel (n = 179) completed the questionnaire measuring immigration-related and sociodemographic characteristics. HRQoL was assessed via Short Form Health Survey Version 2 (SF-12v2), and SWL via Satisfaction With Life Scale (SWLS). Hierarchical linear regression models were applied for analyzing immigration-related and sociodemographic predictors of HRQoL and SWL. Participants living in Israel scored higher on HRQoL, and no differences were found concerning SWL ratings. However, no direct influences of the host country were detected by predicting HRQoL and SWL scores. In both subgroups, immigration-related factors such as perceived discrimination or level of integration were found as significant predictors. In the face of different immigration waves in the host countries, Germany and Israel, the results display similarities rather than differences between the groups concerning the sociodemographic and immigration-related predictors on HRQoL and SWL. The findings using cross-cultural analysis level underscore the need of much more detailed future research on this issue.
Orthodox Fraternities and Contingent Equalities: Muslims and Jews between Public (Health) Policy Discourse and Experience
Author(s): Kasstan, Ben
Editor(s): Gidley, Ben; Everett, Samuel Sami
Date: 2022
Topics: Main Topic: Other, Jewish - Muslim Relations, Orthodox Judaism, Minorities, Politics, Policy, Health
Abstract: This paper critiques representations of observant Muslims and Jews in Britain as constituting an ‘Orthodox fraternity’ when it comes to equality discourse by drawing on policy activism around autopsy, COVID-19 protocols, and sexuality education. The Equality Act (2010) aims to protect people with ‘protected characteristics’ from discrimination, which include (but are not limited to) religion and sexual orientation. I suggest that religious minorities are presented in policy discourse as mobilizing the Equality Act to collaboratively defend their rights to protection of difference. Similarly, anthropological and sociological attention to organised interfaith activism reifies representations of collaborations between religious minorities but obscures situated valuations of equality. I instead examine the contingent value of equality by highlighting opposition to LGBT inclusion. The trope of ‘Orthodox fraternities’ emerges as a useful tool to critique the construction of collaborations between minorities in the context of ‘multiculturalism,’ while masking everyday experiences of prejudice and xenophobia.
Pious Mobilities: Jewish Pilgrimage to Uman During the Pandemic
Author(s): Feldman, Rachel Z.
Date: 2022
Topics: Main Topic: Other, Health, Coronavirus/Covid, Haredi / Strictly Orthodox Jews, Hassidim, Pilgrimage, Zionism
Abstract: This article examines the Breslover Hasidim who attempted their annual pilgrimage to Uman during the COVID-19 pandemic. Following the Ukrainian border closure in August 2020, which was supported by the State of Israel, thousands of Breslovers were stranded in airports, land borders, and even imprisoned in the weeks leading up to the Jewish New Year. This research contributes to an emerging scholarly literature on religion and COVID-19, challenging the religion and science "conflict thesis," as interviews revealed that the choice of Breslovers to ignore public health directives stemmed less from a disbelief in science than from a conflict between state and religious authority. Pious mobilities emerge, I argue, when secular logics fail to contain and properly modify religious actors. The choice to travel to Uman was made according to a Breslover moral universe as informants turned to the spiritual tools and teachings of Rebbe Nachman to guide their decisions, especially his notion of ratzon [willpower], engaging in a form of pious mobility that attempted to transcend nation-state borders. Pious mobilities not only challenged public health initiatives in 2020, but as I demonstrate in the ethnography, Breslovers' insistence on reaching Uman simultaneously threatened the cooptation of Breslov Hasidim within a Zionist narrative, reigniting a debate over the relocation of Rebbe Nachman's remains to Israel. By ethnographically examining moments of conflict between religious groups and state officials managing the pandemic, we might better inform future public health policies and the messaging aimed at religious populations including ultra-Orthodox Jews.
Фартук, философия, фитнес: о женском образовании в хасидской общине
Translated Title: Family, Philosophy, Fitness: On Female Education in a Chassidic Community
Author(s): Зеленина, Галина Светлояровна
Editor(s): Белова, Ольга
Date: 2018
Topics: Main Topic: Education, Jewish Education, Education: Adult Education, Baal Teshuvah, Health, Health Education, Jewish Women, Chabad-Lubavitch
Abstract: Статья посвящена баалот-тшува («вернувшимся» в иудаизм женщинам) в московской общине хасидского движения Хабад Любавич. Их взгляды на свою жизнь, свою роль в семье и общине и отношение руководства любавического движения к женскому вопросу рассматриваются сквозь призму одной конкретной темы – практики регулярного образования для взрослых. Наряду с традиционными уроками Торы и религиозных практик, за которые ответственны женщины (диетарные законы, чистота семейной жизни), Хабад поощряет лекции по здоровому питанию и семейной психологии или занятия фитнесом, с тем чтобы позволить членам общины чувствовать себя современными людьми, сохраняя при этом традиционные ценности и патриархальную иерархию.
Transmission and Trust: The Impact of Covid-19 on British Jewish and British Muslim Communities
Author(s): Hargreaves, Julian; Rushworth, Philip
Date: 2022
Topics: Coronavirus/Covid, Health, Comparisons with other communities, Main Topic: Other
Abstract: The Woolf Institute has collected nationally-representative survey data to study the impact of COVID-19 on British Jewish and British Muslim communities.

Our survey asked questions concerning testing, symptoms, self-isolation and vaccination. Is the willingness to self-isolate and receive a vaccine higher or lower in Jewish and Muslim communities, and how do they compare to the general population?

We asked questions about levels of trust in various sources of public health information: from family, friends and local religious leaders, to news and social media, to the NHS and local authorities. Are faith communities less likely to ignore official public health messaging and more likely to follow guidance from a local rabbi or imam?

We heard media stories about ruling-breaking during the pandemic within both Jewish and Muslim communities. To what extent does statistical evidence support or challenge these accounts? Our survey included questions concerning adherence to Covid-19 rules and restrictions.
A collaborative genetic carrier screening model for the British Ashkenazi Jewish community
Author(s): Ziff, Monica; Harris, Juliette
Date: 2022
Topics: Main Topic: Other, Jewish Community, Health, Health Education, Genetics, Ashkenazi Jews
Abstract: We present a unique model of a British genetic carrier screening programme for individuals with Ashkenazi Jewish ancestry that exemplifies a partnership between a publicly funded healthcare service (the NHS) and a charity, Jnetics. This model provides affordable access to carrier screening for severe autosomal recessive diseases increased in this community. Prior to the development of this programme, the British healthcare system only provided Tay Sachs’ screening for this community, leaving them at higher risk of having a child with a serious autosomal recessive disease. The Jnetics screening programme is promoted through community and social media campaigns, involves educational outreach, a pre-test genetic counselling service by a dedicated NHS-based genetic counsellor, saliva-based DNA testing, comprehensive reporting and, where required, post-test genetic counselling. The charity raises funds to subsidise the screening. In 6 years, the model has been successfully implemented in hospital and community settings and in schools and universities, aiming to reach those pre-conception. In response to the COVID-19 pandemic, the programme adapted by offering genetic screening virtually and has subsequently expanded in its outreach. Furthermore, the screening panel is currently being expanded to include other conditions increased in the Ashkenazi and also the Sephardi and Mizrahi Jewish communities. An example of innovation and accessibility, providing free screening to all students and disadvantaged individuals, the programme aims to provide a model that can potentially be adopted by other genetically at-risk communities.
Do 'minority' groups have special needs? Speech therapy and the Chasidic Jewish community in north London
Author(s): Law, James; Wallfish, Tsila
Date: 1991
Topics: Children, Haredi / Strictly Orthodox Jews, Main Topic: Other, Parenthood, Health, Language
Abstract: The paper addresses the issue of whether a paediatric speech therapy service can offer an adequately sensitive service to a specific community, notably the Chasidic Jewish community of north London. Fifteen parents of Jewish children were compared with 20 parents of non-Jewish children attending the same speech therapy clinic. A questionnaire was administered to both groups. The results indicate that the groups differed in the extent to which they required therapy in their own language, the Jewish group being less concerned than the non-Jewish group. The groups did not differ in the extent to which they would object to therapists on the grounds of sex or religion. When a test of significance was used, a number of differences were identified in relation to specific responses. The results are discussed in terms of the need for a culturally sensitized service.
Clusters of COVID-19 associated with Purim celebration in the Jewish community in Marseille, France, March 2020
Author(s): Aherfi, Sarah; Gautret, Philippe; Chaudet, Hervé; Raoult, Didier; La Scola, Bernard
Date: 2020
Topics: Main Topic: Other, Coronavirus/Covid, Health, Family and Household, Festivals and Holidays, Jewish Community
Abstract: Objectives

We investigated possible COVID-19 epidemic clusters and their common sources of exposure that led to a sudden increase in the incidence of COVID-19 in the Jewish community of Marseille between March 15 and March 20, 2020.

Methods

All data were generated as part of routine work at Marseille university hospitals. Biological diagnoses were made by RT-PCR testing. A telephone survey of families in which a laboratory confirmed case was diagnosed was conducted to determine possible exposure events.

Results

As of March 30, 2020, 63 patients were linked to 6 epidemic clusters. The 6 clusters were linked to religious and social activities: a ski trip, organized meals for the Purim Jewish celebration in community and family settings on March 10, a religious service and a charity gala. Notably, 40% of the patients were infected by index patients during the presymptomatic period, which was 2.5 days before symptom onset. When considering household members, all 12 patients who tested negative and who did not develop any relevant clinical symptoms compatible with COVID-19 were 1–16 years of age. The clinical attack rate (symptoms compatible with COVID-19, and biologically confirmed by PCR) in adults was 85% compared to 26% in children.

Conclusions

Family and community gatherings for the Purim Jewish celebration probably accelerated the spread of COVID-19 in the Marseille Jewish community, leading to multiple epidemic clusters. This investigation of family clusters suggested that all close contacts of patients with confirmed COVID-19 who were not infected were children.
Translating COVID-19 information into Yiddish for the UK Hasidic community
Author(s): Belk, Zoë; Kahn, Lily Okalani; Szendrői, Kriszta Eszter; Yampolskaya, Sonya
Date: 2022
Topics: Main Topic: Other, Coronavirus/Covid, Haredi / Strictly Orthodox Jews, Health Education, Health, Yiddish
Abstract: This article documents a recent project translating COVID-19 information into Yiddish for the benefit of the Hasidic Jewish communities in London’s Stamford Hill and in Manchester in the UK. The translation work developed as a response to the urgent need for Yiddish-language resources specifically designed for the Hasidic community near the beginning of the pandemic. The translations were undertaken by a team consisting of linguists and native speakers of Hasidic Yiddish and took place within the framework of a research project funded by the UK Arts and Humanities Research Council, dedicated to linguistic and sociolinguistic analysis of contemporary Hasidic Yiddish worldwide. In this article we discuss the sociolinguistic background to the translations and investigate the reasons why they were so urgently needed, before going on to address the issues encountered during the course of the translation process and the decisions taken in order to resolve them. These issues include the type of Yiddish chosen for the translations, the translation of medical terminology, gender-based linguistic differences affecting the translations, and specific cultural considerations that needed to be taken into account.
“If a rabbi did say ‘you have to vaccinate,’ we wouldn't”: Unveiling the secular logics of religious exemption and opposition to vaccination
Author(s): Kasstan, Ben
Date: 2021
Topics: Conservative / Masorti Judaism, Health, Health Education, Interviews, Haredi / Strictly Orthodox Jews, Orthodox Judaism, Main Topic: Other
Abstract: Maintaining ‘faith’ in vaccination has emerged as a public health challenge amidst outbreaks of preventable disease among religious minorities and rising claims to ‘exemption’ from vaccine mandates. Outbreaks of measles and coronavirus have been particularly acute among Orthodox Jewish neighbourhoods in North America, Europe and Israel, yet no comparative studies have been conducted to discern the shared and situated influences on vaccine decision-making.

This paper synthesises qualitative research into vaccine decision-making among Orthodox Jews in the United Kingdom and Israel during the 2014–15 and 2018-19 measles epidemics, and 2020–21 coronavirus pandemic. The methods integrate 66 semi-structured informal interviews conducted with parents, formal and informal healthcare practitioners, and religious leaders, as well as analysis of tailored non-vaccination advocacy events and literature.

The paper argues that the discourse of ‘religious’ exemption and opposition to vaccination obscures the diverse practices and philosophies that inform vaccine decisions, and how religious law and leaders form a contingent influence. Rather than viewing religion as the primary framework through which vaccine decisions are made, Orthodox Jewish parents were more concerned with safety, trust and choice in similar ways to ‘secular’ logics of non-vaccination. Yet, religious frameworks were mobilised, and at times politicised, to suit medico-legal discourse of ‘exemption’ from coercive or mandatory vaccine policies. By conceptualising tensions around protection as ‘political immunities,’ the paper offers a model to inform social science understandings of how health, law and religion intersect in contemporary vaccine opposition.
Did Jews in the UK die disproportionately from COVID-19? A new look at Jewish mortality over the first year of the pandemic
Author(s): Staetsky, L. Daniel; Horup, Brigitta; Lessof, Carli
Date: 2021
Topics: Coronavirus/Covid, Demography, Health, Main Topic: Other, Death and Mourning, Jewish Community
Abstract: The COVID-19 pandemic hit the British Jewish community hard. According to data gathered by JPR in July 2020, 25% of British Jews had already contracted the virus by that time and Jewish mortality rates in London in April 2020 – the peak of the first wave – were almost three times as high as usual. In Manchester, the picture was even worse.

Building on our previous studies on this topic, this paper looks at Jewish mortality over the first year of the pandemic, taking in both the first wave (March to May 2020) and the second wave (December 2020 to February 2021).

Whilst it confirms that excess mortality among Jews during the first wave was considerably higher than among comparative non-Jews (280% higher compared to 188%), it reveals that the second wave saw the opposite picture: 69% higher than expected levels of mortality for that period among Jews, compared to 77% among the non-Jewish comparative group. This second wave picture is exactly what one might expect to see given that Jews typically enjoy relatively good health and longevity, so it forces us to ask again: what happened during the first wave to cause such devastation across the Jewish community?

Whilst not yet definitive about their conclusions, the authors point towards the ‘religious sociability’ hypothesis – that notion that close interaction between Jews, prior to the first lockdown, caused the devastating spike in Jewish deaths early on. The paper also demonstrates that the ‘Jewish penalty’ at this time was greater among Orthodox Jews than Progressive ones which further strengthens the hypothesis, as much higher proportions of Orthodox Jews gather regularly for religious reasons than Progressive Jews (even though Progressive Jews do so more regularly than British society as a whole).

The fact that the picture of extremely high excess mortality among British Jews was not repeated during the second wave (on the contrary, excess mortality among Jews was very slightly lower than among the comparator non-Jewish population, and slightly higher among Progressive Jews than Orthodox ones), suggests that the religious sociability theory was no longer a major factor at this time. With many synagogues closed or complying closely with the social distancing policies established by government, Jews were affected by coronavirus in much the same way as others.

The findings in this paper should be taken seriously by at least two key groups. Epidemiologists and public health experts should explore the impact of religious sociability more carefully, as currently, socioeconomic factors tend to dominate analysis. And Jewish community leaders must also reflect on the findings and, in the event of a similar pandemic in the future, consider instituting protective measures much more quickly than occurred in early 2020.
Lasting effects: Experiences of COVID-19 infections and Long COVID symptoms among Jews in the UK
Date: 2021
Topics: Coronavirus/Covid, Health, Main Topic: Other, Surveys
Abstract: In this report, the authors investigate the likely prevalence of COVID-19 and Long Covid among Britain’s Jewish population. Based on data collected by JPR in July 2020 – five months into the pandemic – they found that infection was already widespread in the Jewish community with a quarter (25%) of respondents (aged 16 and above) reporting having experienced COVID-19 symptoms (although testing in the UK was not widely available at this stage.) This accords with other national data showing that BAME groups, including Jews, suffered particularly badly in the early stages of the pandemic.

The data also confirm findings that the strictly Orthodox community was most likely to have been infected (40%) at this stage. And while respondents who self-described as having ‘very strong’ religiosity or who characterised their outlook as ‘religious’ were also far more likely to report having experienced COVID-19 symptoms, it appears that synagogue or communal involvement (rather than membership) is associated with higher levels.

The report also shows that almost two out of three (64%) respondents first experienced symptoms in March 2020, which was the clear peak of infection up to July 2020 when the survey took place. Nevertheless, more than one in six (16%) said they first experienced symptoms in February 2020, and these cases were mainly among more secular members of the Jewish community.

Reports of ongoing health issues following a COVID-19 infection began to appear early on in the pandemic. Gradually, data emerged about Long COVID showing it to be associated with 205 symptoms affecting multiple organs. In January 2021 it was estimated that 300,000 people in the UK may have been suffering from Long COVID. Our data showed that at least 15% of respondents, who said they had experienced COVID-19 symptoms, reported Long COVID symptoms in July 2020, similar to the levels found in the UK generally.

Respondents who had pre-existing health conditions, were far more likely to report Long COVID than those without such conditions. The most commonly reported health concerns were shortness of breath, affecting half of sufferers (51%), followed by ‘severe fatigue’ affecting 43%. Long COVID sufferers were also more likely to report lower levels of happiness and higher levels of anxiety.

Long COVID may ultimately be one of the main long-term health legacies of the coronavirus pandemic. While many gaps in our understanding of this complex health issue remain at the time of publication, JPR will continue to investigate this and other key health issues confronting the Jewish community during the pandemic.
Elevated Jewish Mortality from Coronavirus in England and Wales: An Epidemiological and Demographic Detective Story
Author(s): Staetsky, L. Daniel
Date: 2021
Topics: Coronavirus/Covid, Demography, Main Topic: Demography and Migration, Health, Haredi / Strictly Orthodox Jews
Abstract: In June 2020, the Office for National Statistics (ONS) in England and Wales published the results of an investigation into mortality from COVID-19 by religious group. The analysis revealed a significant “Jewish penalty”: coronavirus mortality of Jews was shown to be relatively high compared to the British Christian majority. This paper considers these findings in the light of the literature on Jewish mortality and undertakes a re-analysis of the results alongside the additional data on Jewish deaths provided by the British Jewish communal statistics. It asks two questions: (1) To what extent is elevated British Jewish mortality from COVID-19 a result of the presence of long-standing vulnerability and ill health among Jews? (2) What role do strictly Orthodox Jews play in elevating coronavirus mortality levels among British Jews? The primary contribution of the paper is to explore, via analyses of alternative data sources, the ONS finding of elevated Jewish mortality from coronavirus, to explain why it is surprising, to test whether it is real and to eliminate certain explanations. Such process of elimination in itself will highlight other alternative explanations, but the paper falls short of decisively explaining the phenomenon of the elevated British Jewish mortality from coronavirus. It ends with an outline of future directions of research in this area.
Moving beyond COVID-19: What needs to be done to help preserve and enhance Jewish communal life?
Author(s): Boyd, Jonathan
Date: 2021
Topics: Coronavirus/Covid, Health, Finance, Main Topic: Other, Policy, Synagogues, Jewish Schools, Care and Welfare, Charity / Tzedakah
Abstract: Since the COVID-19 pandemic first began, the JPR research team has focused its efforts on trying to understand how it is affecting Jewish life in the UK and around the world, and has generated a series of reports sharing our insights as they evolve. In this research and policy briefing, we draw together the findings from much of the work that has been done, and consider their implications for the future of Jewish communal life.

The report touches on multiple themes, including the economic needs of disadvantaged households, how best to maintain the Jewish charitable sector, the importance of supporting local synagogue communities and Jewish schools, how to address the potential harmful effects of the pandemic on the community’s informal educational infrastructure, health measures that should be considered to help protect lives, intracommunal relations, and issues around the use of technology to help support and bolster Jewish life.

In addition, it considers how the pandemic has impacted data collection work, for good and for bad, and makes important recommendations about the research that needs to be undertaken to support Jewish life going forward.

As well as making specific recommendations, the paper is designed to be a trigger for discussion among community leaders, philanthropists and members, and we welcome feedback from readers.
An exploration of attitudes towards breast cancer screening in orthodox Jewish women in Antwerp – Belgium
Author(s): Bruwiere, E.; Van Roosbroeck, S.; Van Hal, G.; Muys, J.; Jacquemyn, Y
Date: 2016
Topics: Focus Groups, Jewish Women, Haredi / Strictly Orthodox Jews, Health, Health Education, Main Topic: Other
Abstract: Objective: To explore determinants of participation in breast cancer screening in orthodox Jewish women living in Antwerp, Belgium, and to uncover their opinions and attitudes towards screening, and thereby to detect ways to optimize participation. Study design: Focus group discussions were performed during the last months of 2011 and the first half of 2012 to explore motivation to participate or not in breast cancer screening. Groups consisted of five to seven women. Inclusion criteria were: being female, considering oneself as orthodox Jewish, aged between 50 and 69 years. Results: Three focus group discussions with in a total of 20 women had taken place. All participants in the focus group discussions had a screening mammography taken on a regular base. All participants agreed that the social cohesion between Jewish orthodox women and the importance that is given to healthcare within the Jewish tradition are important contributors to their participation in a breast cancer screening program. Pain, lack of information during the exam, lack of confidence in the quality of the exam, perceived problems when the examining doctor/technician is male, and fear of the results are mentioned as barriers. The participants, however, state that these were not important enough to result in non-participation. Barriers could be diminished by information sessions specifically aimed at orthodox Jewish women. Conclusion: This qualitative research demonstrates a generally positive attitude of orthodox Jewish women living in Antwerp, Belgium, towards mammographic breast cancer screening. Increased and repeated structured information sessions are likely to improve breast cancer awareness in this population.
Religion and Ethics at the End of Life. A Qualitative Empirical Study among Elderly Jewish and Muslim Women in Antwerp (Belgium)
Author(s): Baeke, Goedele
Date: 2012
Topics: Ageing and the Elderly, Main Topic: Other, Comparisons with other communities, Religious Belief, Religious Observance and Practice, Health, Death and Mourning
Understanding How Communities Respond to COVID-19: Experiences from the Orthodox Jewish Communities of Antwerp City
Author(s): Vanhamel, Jeff; Meudec, Maria; Van Landeghem, Ella; Ronse, Maya; Gryseels, Charlotte; Reyniers, Thijs; Rotsaert, Anke; Ddungu, Charles; Manirankunda, Lazare; Katsuva, Deogratias; Koen, Peeters Grietens; Nöstlinger, Christiana
Date: 2021
Topics: Coronavirus/Covid, Health, Health Education, Jewish Community, Main Topic: Other, Haredi / Strictly Orthodox Jews
Abstract: Background
The importance of community involvement in the response against disease outbreaks has been well established. However, we lack insights into local communities’ experiences in coping with the current COVID-19 pandemic. This study explored both the impact of, and response to, COVID-19 within the Orthodox Jewish communities of Antwerp (Belgium) during the first lockdown period (March 2020 – May 2020).

Methods
We conducted an explorative qualitative study using a participatory approach. First, we performed a community mapping to identify relevant stakeholders. Through the active involvement of a community advisory board and based on qualitative interviews with key-informants and community members, we elicited lived experiences, attitudes, and perceptions towards COVID-19. Interviews were conducted both face-to-face and using online web conferencing technology. Data were analyzed inductively according to the principles of thematic analysis.

Results
Government-issued outbreak control measures presented context-specific challenges to the Orthodox Jewish communities in Antwerp. They related mainly to the remote organization of religious life, and practicing physical distancing in socially and culturally strongly connected communities. Existing community resources were rapidly mobilized to adapt to the outbreak and to self-organize response initiatives within communities. The active involvement of community and religious leaders in risk communication proved to be of great importance to facilitate the coverage and uptake of pandemic control measures while protecting essential community values and traditions. Creating bottom-up and community-adapted communication strategies, including addressing language barriers and involving Rabbis in the dissemination of prevention messages, fostered a feeling of trust in government’s response measures. However, unmet information and prevention needs were also identified, such as the need for inclusive communication by public authorities and the need to mitigate the negative effects of stigmatization.

Conclusion
The experiences of Orthodox Jewish communities in Antwerp demonstrate a valuable example of a feasible community-centered approach to health emergencies. Increasing the engagement of communities in local decision-making and governance structures remains a key strategy to respond to unmet information and prevention needs.
Hardship And Needs Of Elderly Hesed Clients: An Analysis Of Clients Served By Hesed Service Centers In Russia & Ukraine
Author(s): Tighe, Elizabeth; Magidin de Kramer, Raquel; Bleckman, Dina; Begli, Nursahedov; Saxe, Leonard
Date: 2012
Topics: Ageing and the Elderly, Care and Welfare, Health, Evaluation, Main Topic: Other, Social Services, Social Work, NGOs
Abstract:

The countries of the Former Soviet Union (FSU) are the home today for a substantial number of Jews, many of whom live in poor, economically disadvantaged communities. Throughout the FSU, the American Jewish Joint Distribution Committee (JDC) has supported the development of Hesed welfare and Jewish community centers to assist in the provision of services to Jews in need and to support the renewal of Jewish life after years of suppression. The present report is designed to review the current economic, health, and social conditions of these elderly Jews in need in the FSU and to compare their circumstances, as best possible, to their counterparts who live in western countries such as the United States.

Data from a large number of sources are reviewed and analyzed, including national statistics, national and local surveys, and client-level data. The data indicate clearly that, in view of demographic composition, as well as economic and social conditions, elderly Jews in the FSU have tremendous needs for supportive services funded by philanthropy compared to their peers in the United States. The comparisons also highlight the disparities in available care among those most in need.

There is a clear need for external support for basic health and social services for elderly Jews in the FSU. Twenty years after the collapse of the Soviet Union, there is not an adequate safety net for the elderly. The situation is in flux and there are unique challenges associated with understanding service delivery in societies that are in transition. The available data on pensions and living circumstances make clear that the economic situation for elderly in the FSU who seek Hesed services is dire. Faced with increasing costs for basic needs such as utilities and food, along with health services including essential medicines, quality care and homecare, the pension amounts that Hesed clients rely on are inadequate to meet their needs.
Extremely high SARS-CoV-2 seroprevalence in a strictly-Orthodox Jewish community in the UK
Author(s): Gaskell, Katherine M.; Johnson, Marina; Gould, Victoria; Hunt, Adam; Stone, Neil RH; Waites, William; Kasstan, Ben; Chantler, Tracey; Lal, Sham; Roberts, Chrissy H.; Goldblatt, David; Eggo, Rosalind M.; Marks, Michael
Date: 2021
Topics: Coronavirus/Covid, Health, Haredi / Strictly Orthodox Jews, Main Topic: Other
Abstract: Background Ethnic and religious minorities have been disproportionately affected by SARS-CoV-2 worldwide. The UK strictly-Orthodox Jewish community has been severely affected by the pandemic. This group shares characteristics with other ethnic minorities including larger family sizes, higher rates of household crowding and relative socioeconomic deprivation. We studied a UK strictly-Orthodox Jewish population to understand how COVID-19 had spread within this community.

Methods We performed a household-focused cross-sectional SARS-CoV-2 serosurvey specific to three antigen targets. Randomly-selected households completed a standardised questionnaire and underwent serological testing with a multiplex assay for SARS-CoV-2 IgG antibodies. We report clinical illness and testing before the serosurvey, seroprevalence stratified by age and gender. We used random-effects models to identify factors associated with infection and antibody titres.

Findings A total of 343 households, consisting of 1,759 individuals, were recruited. Serum was available for 1,242 participants. The overall seroprevalence for SARS-CoV-2 was 64.3% (95% CI 61.6-67.0%). The lowest seroprevalence was 27.6% in children under 5 years and rose to 73.8% in secondary school children and 74% in adults. Antibody titres were higher in symptomatic individuals and declined over time since reported COVID-19 symptoms, with the decline more marked for nucleocapsid titres.

Interpretation In this tight-knit religious minority population in the UK, we report one of the highest SARS-CoV-2 seroprevalence levels in the world to date. In the context of this high force of infection, all age groups experienced a high burden of infection. Actions to reduce the burden of disease in this and other minority populations are urgently required.

Funding This work was jointly funded by UKRI and NIHR [COV0335; MR/V027956/1], a donation from the LSHTM Alumni COVID-19 response fund, HDR UK, the MRC and the Wellcome Trust. The funders had no role in the design, conduct or analysis of the study or the decision to publish. The authors have no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Evidence before the study In January 2020, we searched PubMed for articles on rates of SARS-CoV-2 infection amongst ethnic minority groups and amongst the Jewish population. Search teams included “COVID-19”, “SARS-CoV-2”, seroprevalence, “ethnic minority”, and “Jewish” with no language restrictions. We also searched UK government documents on SARS-CoV-2 infection amongst minority groups. By January 2020, a large number of authors had reported that ethnic minority groups experienced higher numbers of cases and increased hospitalisations due to COVID-19. A small number of articles provided evidence that strictly-Orthodox Jewish populations had experienced a high rate of SARS-CoV-2 infection but extremely limited data was available on overall population level rates of infection amongst specific ethnic minority population groups. There was also extremely limited data on rates of infection amongst young children from ethnic minority groups.

Added value of the study We report findings from a population representative, household survey of SARS-CoV-2 infection amongst a UK strictly Orthodox Jewish population. We demonstrate an extremely high seroprevalence rate of SARS-CoV-2 in this population which is more than five times the estimated seroprevalence nationally and five times the estimated seroprevalence in London. In addition the large number of children in our survey, reflective of the underlying population structure, allows us to demonstrate that in this setting there is a significant burden of disease in all age groups with secondary school aged children having an equivalent seroprevalence to adults.

Implications of the available evidence Our data provide clear evidence of the markedly disproportionate impact of SARS-CoV-2 in minority populations. In this setting infection occurs at high rates across all age groups including pre-school, primary school and secondary school-age children. Contextually appropriate measures to specifically reduce the impact of SARS-CoV-2 amongst minority populations are urgently required.
An outbreak of measles in orthodox Jewish communities in Antwerp, Belgium, 2007-2008: different reasons for accumulation of susceptibles
Author(s): Lernout, T; Kissling, E; Hutse, V; De Schrijver, K; Top, G
Date: 2009
Topics: Main Topic: Other, Haredi / Strictly Orthodox Jews, Health, Health Education
Abstract: From August 2007 to May 2008, an outbreak of at least 137 cases of measles occurred in some orthodox Jewish communities in Antwerp, Belgium. The outbreak was linked to outbreaks in the same communities in the United Kingdom and in Israel. The reasons for this outbreak were diverse: cultural factors, misinformation on vaccination by some medical doctors and the lack of a catch-up vaccination programme in private Jewish schools. The identification of smaller susceptible groups for measles transmission and vaccination of these groups represent a major challenge for the measles elimination programme.
COVID-19 mortality and Jews: A global overview of the first wave of the coronavirus pandemic, March to May 2020
Author(s): Staetsky, L. Daniel; Paltiel, Ari
Date: 2020
Topics: Coronavirus/Covid, Health, Demography, Main Topic: Other, Statistics, Surveys
Abstract: This study, the first to assess mortality among Jews around the world during the COVID-19 crisis, draws on data from a wide variety of sources to understand the extent to which Jews were affected by coronavirus in different parts of the world during the first wave of the pandemic, March to May 2020.

The first section describes the methods of quantification of COVID-19 mortality, and explains why measuring it using the excess mortality method is the most effective way to understand how Jewish communities have been affected. The second section presents data on Jewish mortality during the first wave of the COVID-19 epidemic, drawing particularly on data provided to JPR by Jewish burial societies in communities all over the world. It does so in a comparative perspective, setting the data on Jews alongside the data on non-Jews, to explore both the extent to which Jews have been affected by the COVID-19 epidemic, and how the Jewish experience with COVID-19 compares to the experience of non-Jewish populations.

The immediate impression is that there is not a single ‘Jewish pattern’ that is observable everywhere, and, with respect to the presence of excess mortality, Jewish communities, by and large, followed the populations surrounding them.

The report cautions against speculation about why Jews were disproportionately affected in some places, but rule out two candidate explanations: that Jewish populations with particularly elderly age profiles were hardest hit, or that Jews have been badly affected due to any underlying health issue common among them. They consider the possibility that Jewish lifestyle effects (e.g. above average size families, convening in large groups for Jewish rituals and holidays), may have been an important factor in certain instances, noting that these are unambiguous risk factors in the context of communicable diseases. Whilst they suggest that the spread of the virus among Jews “may have been enhanced by intense social contact,” they argue that without accurate quantification, this explanation for elevated mortality in certain places remains unproven.

The report also includes a strongly worded preface from Hebrew University Professor Sergio DellaPergola, the Chair of the JPR European Jewish Demography Unit, and the world’s leading expert in Jewish demography. In it, he stresses the importance of systematically testing representative samples of the population at the national and local levels, and, in Jewish community contexts, of routinely gathering Jewish population vital statistics. He states: “If there is one lesson for Jewish community research that emerges out of this crisis it is that the routine gathering of vital statistics – the monitoring of deaths, as well as births, marriages, divorces, conversions, immigrants and emigrants – is one of the fundamental responsibilities community bodies must take.”
Becoming-dementia as an Immanent Condition of Co-dwelling in Everyday Life
Author(s): Jong-min, Jeong
Date: 2017
Topics: Elderly Care, Ethnography, Health, Mental Health, Main Topic: Other, Volunteering, Ageing and the Elderly, Care and Welfare
Abstract: What have those living with dementia lost? If they have lost aspects of their mind and self, who are they now? Are they 'normal'? Prevailing medical, therapeutic and sociopsychoanalytic interventions and studies on dementia, largely influenced by Tom Kitwood's person-centred approach, have focused mainly on revealing and evaluating the remaining intact bodily abilities and functions beyond loss. In contrast to this predominant understanding of dementia, my decade-long involvement in a Jewish Care Home as a volunteer and researcher has raised ontological, epistemological and practical critiques, acknowledging that we are never beyond loss but always alongside it, and that we simply do not know how to dwell well with it. Although the expressive and performative words, gestures and behaviours of those with dementia are often regarded as inarticulate, repetitive and nonsensical, these are the lived worlds of dementia that those affected feel, experience and live through, whilst continuously making relations and familiarising themselves with people, things, and their surroundings. This demands a paradigm shift in the ontological, epistemological and practical horizon within the study of dementia. Critically developing Canguilhem's notion of the normal and the abnormal, Ingold's dwelling perspective and Deleuze's concept of becoming, I redefine dementia not as a fixed mode of being but as a continuous process of becoming-dementia through an attentive engagement with one's immediate surroundings. In more detail, this study explores the ways in which people challenge the taken-for-granted concepts of loss and abnormality in five different dementia contexts: ethics, repetition, time, agency and emplacement. By rejecting medical preconceptions or categorisations, this study focuses on uncovering what loss does in everyday life rather than asking what loss means or what people lose. In particular, this study emphasises bodily movement, sensory perception and affect, not because of the language deterioration during dementia trajectories but because of a new way of understanding and new reality that those affected practise in daily life. Consequently, this study illustrates the immanent potential of the anthropological view for thinking and dwelling with those living with dementia alongside their limits and implications. This study is thus an autobiographical ethnographic testimony of my past decade living, learning, volunteering, studying and most importantly co-dwelling with those living with dementia. This is a collaborative co-production created with those involved, as without the participation of those affected and the co-presence of significant others, my work could not be done. Accordingly, there is neither a beginning nor end to this study, but a moving forward and generating dementia becoming as the lives of those affected and those who care for them unfold.
Jewish Holidays in the Time of the Corona Virus Pandemic in Slovakia
Author(s): Salner, Peter
Date: 2020
Topics: Coronavirus/Covid, Jewish Community, Jewish Organisations, Festivals and Holidays, Religious Observance and Practice, Main Topic: Other, Health
Abstract: The first wave of the new coronavirus pandemic swept through Slovakia between March 1 and May 31, 2020. During this relatively short period, four important Jewish holidays took place: Purim, Pesach, Lag BaOmer, and Shavuot. When the news of the pandemic initially broke, a large part of Slovak society viewed COVID-19 as a remote, and therefore, not entirely dangerous, threat. This attitude shifted on March 6, , when the first case of the disease was confirmed in the country. On March 9, the authorities reacted by introducing the first set of public health measures, which the Jewish Religious Community immediately relayed to its members. The policy adopted by the JRC leadership was faced with a serious religious challenge. In these conditions, the observance of holidays required a degree of improvisation. Bar a few extraordinary examples, it was impossible to fulfill all of the traditionally required customs. Factors of selectiveness, streamlining, and individualization therefore had an even greater impact than usual. Involuntary isolation brought out the importance of family ties, as well as the need for solidarity.
Renew our days as of old: Will we go back to Jewish activities and events?
Date: 2020
Topics: Health, Main Topic: Other, Mental Health, Coronavirus/Covid, Surveys, Religious Observance and Practice, Jewish Community
Abstract: JPR’s COVID-19 survey looks at how Jews have been impacted by the pandemic in terms of their health, jobs, finances, relationships and Jewish lives. The findings are being shared in a series of short reports looking at key policy issues, and this one focuses on the issue of how comfortable Jews feel about attending Jewish activities and events in person.

Drawing on survey responses from July 2020, it finds that whilst Jews situate themselves across the full length of the ‘comfort scale’ (running from very comfortable to very uncomfortable), there is a clear leaning towards the uncomfortable end.

Unsurprisingly, those who are uncomfortable are likely to be in older age bands and/or suffering from health conditions that make them particularly vulnerable to the virus. Similarly, those who have had the virus and continue to suffer from secondary symptoms (i.e. ‘Long COVID’) also tend to be uncomfortable about attending events in person.

However, there are some interesting exceptions. The most elderly appear to feel more comfortable than average, and the youngest age bands (those aged 16-24) feel more uncomfortable than average. Those who have had COVID-19 and recovered feel more comfortable than those who have not. And those who have experienced job losses, or have been furloughed, are rather less comfortable than those whose working loves have remained reasonably stable.

It is also very striking to see that, denominationally, the Strictly Orthodox feel most comfortable about attending in-person events, whereas non-synagogue members feel most uncomfortable. Members of other ‘mainstream’ denominations cluster together in between. However, people’s level of religiosity is actually a slightly better predictor than denomination of how comfortable they feel about attending community activities or events in person – those with strong religiosity are most likely to feel comfortable, and those with weak religiosity most likely to feel uncomfortable.

Perhaps most interestingly, there is an important relationship between how comfortable people feel about attending community activities and events in person, and their general state of mental health. Those showing signs of psychological distress feel notably less comfortable than others.

Brief details about the methodology used in the survey are contained in the report. A more detailed methodological is being prepared and will be available shortly.
Jews and coronavirus in England and Wales: What the ONS study of COVID-19 mortality comparing different religious groups in England and Wales tells us about British Jewish mortality
Author(s): Staetsky, Daniel
Date: 2020
Topics: Demography, Haredi / Strictly Orthodox Jews, Main Topic: Other, Health, Coronavirus/Covid
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.
Coronavirus (COVID-19) related deaths by religious group, England and Wales, 2 March to 15 May 2020’: Considering the implications of the Office for National Statistics report for the Jewish community and population
Author(s): Boyd, Jonathan; Lessof, Carli; Staetsky, Daniel L.
Date: 2020
Topics: Censuses, Health, Main Topic: Other, Demography, Coronavirus/Covid
Abstract: A June 2020 report by the UK's Office for National Statistics provided the first serious academic analysis of the impact of COVID-19 on religious minorities in England and Wales. In this short paper, the JPR research team considers the findings and their implications for the Jewish population.
Are Jews Disproportionately Dying from Covid-19?
Author(s): Boyd, Jonathan
Date: 2020
Topics: Main Topic: Other, Health, Demography
Abstract: JPR Executive Director, Dr Jonathan Boyd, explores the contention that Jews are dying in disproportionate numbers from COVID-19, and why it may or may not be accurate. With very limited data at the time of writing, these are initial thoughts; we expect our thinking to mature on this topic over time.
Jews and Coronavirus
Author(s): Staetsky, Daniel L.
Date: 2020
Topics: Main Topic: Other, Health, Demography, Coronavirus/Covid
Abstract: In this short essay, JPR Senior Research Fellow and Director of our European Jewish Demography Unit, Dr Daniel Staetsky, explores why Jews may be rather less vulnerable to coronavirus than average.
Coronavirus and the Plague of Antisemitism
Date: 2020
Topics: Antisemitism, Antisemitism: Discourse, Antisemitism: Far right, Health, Main Topic: Antisemitism, Coronavirus/Covid
Abstract: The antisemitic posts, comments and memes that CST has seen since the spread of COVID-19 began to attract significant attention in this country in late January fall broadly into five different categories, ranging from bizarre
conspiracy theories to the sheer nastiness of those who like to see others suffer and even die. This briefing will explain and give examples of each of these five categories.
Immunities at the margins: Negotiating health and bodily care among Haredi Jews in the UK
Author(s): Kasstan, Ben
Date: 2016
Topics: Main Topic: Other, Haredi / Strictly Orthodox Jews, Health, Birth, Body, Ethnography, Fertility, Interviews
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.
Haredi (Material) Cultures of Health at the 'Hard to Reach' Margins of the State
Author(s): Kasstan, Ben
Editor(s): Carroll, Timothy; Jeevendrampillai, David; Parkhurst, Aaron; Shackleford, Julie
Date: 2017
Topics: Haredi / Strictly Orthodox Jews, Health, Main Topic: Other
Making Bodies Kosher: The Politics of Reproduction among Haredi Jews in England
Author(s): Kasstan, Ben
Date: 2019
Topics: Main Topic: Other, Haredi / Strictly Orthodox Jews, Health, Birth, Body, Ethnography, Fertility, Interviews
Abstract: For Haredi Jews, reproduction is entangled with issues of health, bodily governance and identity. This is an analysis of the ways in which Haredi Jews negotiate healthcare services using theoretical perspectives in political philosophy. It is the first archival and ethnographic study of Haredi Jews in the UK and sits at the intersection of medical anthropology, social history and Jewish studies. It will allow readers to understand how reproductive care issues affect this growing minority population.
How do Parents within the Orthodox Jewish Community Experience Accessing a Community Child and Adolescent Mental Health Service?
Author(s): Rowland, Gemma
Date: 2016
Topics: Main Topic: Other, Haredi / Strictly Orthodox Jews, Health, Family and Household, Parenthood, Mental Health, Interviews
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.
Lay and professional views on health visiting in an orthodox Jewish community
Author(s): Abbott, Stephen
Date: 2004
Topics: Main Topic: Other, Health, Health Education, Haredi / Strictly Orthodox Jews, Jewish - Non - Jewish Relations
Abstract: This article reports research examining the relevance of a health visiting service to an orthodox Jewish community. Data were gathered by 14semi-structured interviews with community members and health visitors. The community was seen by members of both groups as self-sufficient, with a very well-developed network of voluntary support networks. Orthodox Jewish mothers typically have large families and have a lot of child-care experience. Some health visitors seemed oblivious of the Jewish religious calendar. Cultural practice and health visitor advice relating to breast-feeding were at odds. The community’s relationship with health visitors was distant rather than close, and health visitors’ role was unclear to and unvalued by the community. The service had persistent problems of recruitment and retention. Health visiting needs to work in partnership with community organizations and representatives to develop a service that the community finds valuable.
Immunization uptake and parental perceptions in a strictly orthodox Jewish community in north-east London
Author(s): Cuninghame, C. J.; Charlton, C. P. J.; Jenkins, S. M.
Date: 1994
Topics: Main Topic: Other, Health, Haredi / Strictly Orthodox Jews, Surveys
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.
Tailoring Immunisation Programmes: Charedi community, north London: Implementation of the WHO's Tailoring Immunisation Programmes (TIP)
Date: 2018
Topics: Main Topic: Other, Haredi / Strictly Orthodox Jews, Health, Health Education
Abstract: This report details Public Health England’s (PHE’s) work to address the low immunisation uptake among the Charedi Orthodox Jewish community in north east London. It uses a range of the Tailoring Immunization Programmes (TIP) methodologies to evaluate effectiveness of vaccination programmes in this area.

As part of efforts to eliminate measles and rubella, the World Health Organization Regional Office for Europe (WHO/Europe) developed the TIP method and tools to:

identify susceptible populations
determine barriers to vaccination
implement evidence-based interventions
The approach draws on health programme planning models, including the medical humanities, the social and behavioural sciences. This report incudes the London School of Hygiene and Tropical medicine (LSHTM) research report.
The effectiveness of words: Religion and healing among the Lubavitch of Stamford Hill
Author(s): Littlewood, Roland; Dein, Simon
Date: 1995
Topics: Main Topic: Other, Chabad-Lubavitch, Haredi / Strictly Orthodox Jews, Hassidim, Health, Religious Belief, Anthropology
Abstract: Testimonials of miraculous healing offered by Lubavitch Hasidim evoke images of exile and restitution which derive from Kabbalistic texts. Mediated practically through the person of the Rebbe, these testimonials articulate both immediate affliction and ultimate meaning, physical embodiment as well as symbolic representation, each constituting the other. Both Kabbalah and medical anthropology attempt to transcend not dissimilar epistemological dualisms: those characteristic of monotheism and contemporary science. Yet the ‘lower root’ of Kabbalah affirms a material reality known through immediate sensory experience which recalls the rationale of biomedicine.
Religion and Healing Among the Lubavitch Community in Stamford Hill, North London: A Case Study of Hasidism
Author(s): Dein, Simon
Date: 2004
Topics: Main Topic: Other, Anthropology, Haredi / Strictly Orthodox Jews, Hassidim, Chabad-Lubavitch, Health, Religious Belief
Abstract: This book focuses on two main areas – first, the response of British Lubavitchers to misfortune generally and sickness, in particular and the role of their religious leader the Rebbe in this process; and second, their response to the illness and ultimate death of the Rebbe. It addresses a number of issues in contemporary social and medical anthropology: the social construction of the body, the power of words in ritual, the relation between myth and praxis, religious texts as a charter for healing and the relation between the use of biomedicine and symbolic healing. This book will be of interest to students of social anthropology, medical anthropology, medical sociology, millennialism, religious studies and students of contemporary Judaism.
Involvement of Rabbinic and communal authorities in decision-making by haredi Jews in the UK with breast cancer: An interpretative phenomenological analysis
Author(s): Coleman-Brueckheimer, Kate; Spitzer, Joseph; Koffman, Jonathan
Date: 2009
Topics: Main Topic: Other, Health, Haredi / Strictly Orthodox Jews, Jewish Women, Rabbis, Interviews
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.
Why is this happening to me? Illness beliefs held by haredi Jewish breast cancer patients: an exploratory study
Author(s): Coleman, Kate; Koffman, Jonathan; Daniels, Charles
Date: 2007
Topics: Main Topic: Other, Health, Haredi / Strictly Orthodox Jews, Jewish Women, Religious Belief, Interviews
Abstract: Cultural factors influence how cancer patients interpret their illness. This paper explores the meanings haredi (strictly orthodox) Jewish breast cancer patients give to their illness. In‐depth interviews were conducted with five haredi breast cancer patients. The full transcripts were subjected to interpretive phenomenological analysis. Participants' interpretations of their cancer were strongly influenced by their religious beliefs. Two interwoven themes emerged: the cancer came from God as part of a meaningful plan; the disease was a test. The implications these beliefs may have for healthcare behaviour in this group are discussed.
Demographic characteristics and primary health care utilization patterns of strictly orthodox Jewish and non-Jewish patients
Author(s): Purdy, Sarah; Jones, Kevin P.; Sherratt, Margaret; Fallon, Paul V.
Date: 1999
Topics: Haredi / Strictly Orthodox Jews, Health, Demography, Main Topic: Demography and Migration
Abstract: Background. The importance of providing health care services that are acceptable to different cultural groups is widely acknowledged. Strictly orthodox Jewish communities have particular health care needs that reflect their religious teaching and beliefs.

Objective. To describe the demographic characteristics and health care usage patterns of the strictly orthodox Jewish population of Gateshead.

Methods. Registration and claims data were used in combination with encounter data from computerized and manual practice records. Jewish patients were identified and comparisons made between Jewish and non-Jewish populations registered at the same practices.

Results. The orthodox Jewish population was predominantly young (69% aged under 20). The birth rate in orthodox Jewish women aged 20–44 was much higher (294 per 1000) than non-Jewish women. Rates of uptake of cervical screening and childhood immunizations were significantly lower in the orthodox Jewish population. Uptake of breast screening and attendance at diabetic clinics did not differ significantly. The average number of consultations and home visits per annum was higher in Jewish than in non-Jewish patients.

Conclusions. The demographic and health care utilization patterns of orthodox Jewish and non-Jewish patients in Gateshead are different. There are implications for the provision of primary care services, particularly with regard to preventative health care.