COVID-19 Amongst the Ultra-Orthodox Population in Israel: An Inside Look into the Causes of the High Morbidity Rates

Contemporary Jewry https://doi.org/10.1007/s12397-021-09368-0 COVID‑19 Amongst the Ultra‑Orthodox Population in Israel: An Inside Look into the Causes of the High Morbidity Rates Sara Zalcberg1,2 · Sima Zalcberg Block1,2,3 Received: 2 December 2020 / Accepted: 15 March 2021 © The Author(s), under exclusive licence to Springer Nature B.V. 2021 Abstract The current paper focuses on the circumstances that have led to the high COVID19 infection rates amongst the ultra-Orthodox population in Israel. The current study utilizes a qualitative design and is based on in-depth interviews, email correspondence and online records of 25 ultra-Orthodox individuals who either tested positive for COVID-19 or had contact with a verified COVID-19 patient. The data were analyzed through identification of main themes and an interpretation of their meanings. The findings showed that a wide range of causes led to the high infection rate, including aspects that derive from a structural element, a religious element and a social-ideological element—all of which are directly or indirectly connected to religion. These findings demonstrate the central role of religion in health outcomes among the ultra-Orthodox community in general and during pandemics in particular, and they shed light on the central role of religion in health outcomes among closed-religious communities. The findings further reveal the importance of cooperation between the state authorities and the religious ones, and of providing culturally adapted health service solutions in the fight against COVID-19 and promoting health more generally. Study limitations are discussed and recommendations for future research are provided. Keywords Ultra-Orthodox · COVID-19 · Health behaviors · Social capital · Closedreligious communities * Sima Zalcberg Block Sara Zalcberg 1 Religion Studies, Tel Aviv University, Tel Aviv, Israel 2 Social Work, Hebrew University of Jerusalem, Jerusalem, Israel 3 Social Work, Ariel University, Ariel, Israel 13 Vol.:(0123456789) S. Zalcberg, S. Z. Block Introduction The ultra-Orthodox population is a minority group in Israeli society and the Jewish world. In Israel, the ultra-Orthodox population is composed of over one million people who constitute 12.5% of the entire population of Israel (Malach and Cahaner 2020). Ultra-Orthodox society (also known as the Haredi community) is characterized by a strict interpretation of Jewish law, conservatism and seclusion from the majority society (Friedman 1991; Heilman 2000). In Israel, the ultra-Orthodox population has one of the highest life expectancies in the world and tend to report better health compared to the general population (Chernichovsky and Sharony 2015; Muhsen et al. 2017). Chernichovsky and Sharony (2015) explained these patterns by noting the positive relationship between measurements of high social capital—which characterize the ultra-Orthodox society— and various health-promoting aspects. Components of social capital in this context include close relations with family and friends, a high degree of community involvement, and trust in religious leaders. Moreover, the researchers refer to the positive effect that religious rituals and practices, and a faith-based worldview have on the health of ultra-Orthodox individuals. These relationships between religious aspects and health are similarly seen amongst other religious communities as well (Elgar et al. 2017; Milstein et al. 2020; Shapiro 2018; Shapiro and Chen 2018). Nevertheless, the spread of COVID-19 in Israel in March 2020 led to particularly high infection rates amongst the ultra-Orthodox population, and during the period March–November 2020, 40% of the total number of verified COVID-19 cases in Israel were from the ultra-Orthodox sector—a particularly high rate relative to their proportion in the population (Malach and Cahaner 2020). More so, not only were the ultra-Orthodox being infected disproportionately, they were also dying of COVID-19 at a much higher rate (Hanau 2020). It appears that the characteristics of the ultra-Orthodox community which are viewed as health-promoting (Chernichovsky and Sharony 2015), are not effective in the case of the COVID-19 pandemic. Hence, the current research sought to examine the circumstances that led to the high COVID-19 infection rates amongst the ultra-Orthodox population, based on their own perspectives. Understanding these circumstances, as they are perceived by ultra-Orthodox individuals themselves, may shed light on aspects of ultra-Orthodox society which relate both to the promotion of health and to the spread of illness. On a more general level, the findings of this study might contribute to a better understanding of the behavioral patterns of minority groups and closed-religious communities in the context of health and illness overall, and during pandemics in particular. In addition, the findings might help to create policies and plans that would decrease infection rates amongst the ultra-Orthodox population, promote culturally adapted health solutions for the ultra-Orthodox population and other similar populations, and minimize health inequalities. To situate the current research aims within a broader context, the paper starts with a review of the link between religion and various aspects of health and 13 COVID-19 Amongst the Ultra-Orthodox Population in Israel:… illness. Then, a review of the ultra-Orthodox population in Israel is presented, with a focus on the cultural characteristics that are relevant for understanding the issue at hand, as well as aspects of health and illness that are unique to the ultra-Orthodox society. The research method is then specified and findings are reported. The paper concludes with a summary of the findings and specific conclusions derived from the findings. The Link Between Various Aspects of Religion, and Health and Illness Religion shapes individuals’ beliefs and norms, which subsequently affect health behaviors. Religion further influences the social and economic systems that generate conditions for health and illness (Milstein et al. 2020; VanderWeele 2017). Most of the recent studies have indicated a positive relationship between various aspects of religion and various aspects of health promotion and disease prevention (Krause 2016; Levin 2016; Idler and Kellehear 2017; Shapiro 2018). Many studies refer specifically to the role of social capital elements that are embedded in religion, in the promotion of health, while emphasizing the role of clergy, religious institutions, religious affiliations, inter-communal welfare, and networking, in promoting health behaviors and improving health amongst religious believers (Elgar et al. 2017; Eriksson 2011; Milstein et al. 2020; Satariano 2020; Shapiro and Chen 2018). Additional aspects of religion that are also believed to contribute to health promotion are faith, trust in God, and participation in religious practices and rituals. These factors provide (...truncated)