Alcoholism among the Jews in Israel: a pilot study. I. Research rationale and a look at the ethnic factor.

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Abstract
The differences in alcoholism rates between the Ashkenazi (European) and the Sephardic-Oriental (Asian, African and Southern European) Jews in Israel are examined. According to the dialectic-of-differentiation theory, which proposes that Jewish minorities have historically inverted the alcohol use of their host societies, Ashkenazi Jews would drink less than the Sephardic-Oriental Jew, who come from abstinent Muslim societies. Of 311 alcoholics from 5 rehabilitation centers studied in 1979, 22% were born in Europe or America, 23% in Israel and 55% in Africa or Asia, compared with 37, 32 and 31%, respectively, in the general Israeli population (.chi.2 = 85.65, P < 0.001). These alcoholics, combined with those from 2 centers studied in 1980, were 23% Ashkenazi and 77% Sephardic-Oriental Jews. During a 6-mo. period at 1 of the centers, 11 Ashkenazi and 29 Sephardic-Oriental Jews actually entered treatment, compared with 10 and 16, respectively, who had only brief contact with the center, indicating a nonsignificant cultural difference in the use of facilities. From 1971 to 1979 there were 9 Ashkenazi and 51 Sephardic-Oriental Jews treated at a major mental health center. Sixteen physicians in the socialized medical program, which crosses all socioeconomic levels, reported having treated 12 Ashkenazi and 45 Sephardic-Oriental Jews in the preceding 2 yr. These samples were pooled to examine subgroup differences in Sephardic-Oriental Jews: the higher alcoholism rates of Indians, Moroccans and Yemenites indicate the sociocultural influence because there is no correspondence with genetic subgroup differences and because these are the subgroups that, in fact, experienced the most severe postimmigration problems in Israel, including economic ones. Socioeconomic level and the resulting differences in the use of facilities, labeling by physicians, and self-denial of alcoholism were controlled for in this study, but the conclusion is that the higher rates of alcoholism among Sephardic-Oriental Jews result from a combination of their historical ties with Islam and their low socioeconomic level in Israel. Lack of religous observance also decreases the rate of alcoholism among all Jews in Israel.

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