Aviad Tur-Sinai

• Doctor of Philosophy
• Professor (Full) at University of Haifa

Informal caregivers are people providing some type of unpaid, ongoing assistance to a person with a chronic illness or disability. Long-term care measures and policies cannot take place without taking into account the quantitatively crucial role played by informal caregivers. We use the European Health Interview Survey (EHIS), the European Quality...

Our study aimed to enhance understanding of memory decline (MD) in old age by evaluating longitudinal effects of personal and national contributing factors. We used data collected by the Survey of Health, Ageing and Retirement in Europe (SHARE) from 12 European countries and Israel. Our sample included 11,930 retirees aged 50+, interviewed at basel...

For young women, mammography has limited effectiveness and entails exposure to radiation, discomfort, and additional expense. This study identifies factors associated with women's willingness to undergo mammography despite official guidelines to the contrary. Using the Health Belief Model, we surveyed Israeli women aged 40–51 who are not at high ri...

The growing population of elderly households, and their diverse economic circumstances, underscores the need to study the patterns of financial assistance in advanced ages. The proposition presented conceptualizes intergenerational financial support as contingent and dynamic. Data are drawn from Wave I to Wave VI of SHARE-Europe. The empirical exam...

Background: The experience of musculoskeletal pain is widespread among adults and entails high costs to both individuals and society. Few studies look at disparities in pain management. Aims: To examine factors associated with the presence of musculoskeletal pain and the use of pain medication use among individuals aged 50+. Design: Cross-sect...

Background and Objectives This study explores the association between informal caregiving for older adults and environmentally sustainable behaviors across the 27 European Union countries, aiming to identify how the gendered and domestic nature of environmentalism relates to elder care. Research Design and Methods Data from 41,742 respondents aged...

Background In many countries, including those with universal health insurance, cost-sharing for healthcare is prevalent, resulting in out-of-pocket expenses for cancer patients. However, the proportion of government contribution to national healthcare expenditure varies across countries. This study aims to determine the prevalence and magnitude of...

Background Ultra-Orthodox Israeli Jews face complex decisions when their doctors’ instructions contradict their rabbis’ advice. This study examines how their belief system affects their trust and decision-making in such situations, using socio-economic club theory and Gilligan’s listening guide. Methods Excerpts from 16 focus groups with 128 ultra...

Cyberbullying is a disturbing form of behavior associated with the use of communication technologies among adolescents. Many studies have been devoted to cyberbullies and cyber victims, neglecting an important growing group: cyberbullies who are also cyber victims. Moreover, few studies refer to all cyberbullying roles and factors associated with t...

We examine relationships among ultra-Orthodox Israeli Jews, their doctors, and rabbis when medical decisions are made. Analyzing excerpts from sixteen focus groups with 128 ultra-Orthodox Jews, we determine how their belief system affects their decisions about whom to trust and follow when the doctor’s instructions contradict the rabbi’s advice. We...

The COVID-19 pandemic has changed the supply of formal and informal home care to older adults in many countries across the world. This study aims to compare the initial picture of how the supply of formal and informal home care to older adults in European countries and Israel changed during the first pandemic year (from mid-2020 to mid-2021) and to...

Conflicting demands over time allocation – between family care and paid work – can be harmful to individual’s wellbeing. Individuals who are socially sandwiched and in employment experience potential conflict between supporting older and younger family generations, and with respect to the demands from paid work. These competing time demands may hav...

Background Most people who develop chronic diseases, including cardiovascular disease (CVD), live in their homes in the community in their last year of life. Since cost-sharing is common in most countries, including those with universal health insurance, these people incur out-of-pocket expenditures (OOPE). The study aims to identify the prevalence...

Objectives The experience of being sandwiched between support obligations towards both aging parents and adult offspring is likely to become more common and more relevant. We aim at assessing the effect of demographic and social sandwiching on the psychological health and subjective well-being of individuals experiencing these transitions, and to w...

The COVID-19 pandemic triggered a financial crisis that provides a unique opportunity to examine investor behavior using an administrative dataset of individuals in Israel. The dataset includes information on withdrawals from tax-sheltered training funds, switching to less risky or riskier investment tracks, and individual socioeconomic status (SES...

Background Patient-centeredness is a core element in healthcare. However, there is a gap between the understanding of this term by healthcare professionals, and patients’ capability, self-efficacy, and willingness to take part in medical decisions. We aim to expose standpoints toward “patient centeredness” among junior medical managers (JMM), as th...

Objectives Most people who develop chronic diseases, including cardiovascular disease (CVD), live in their homes in the community in their last year of life. Since cost-sharing is common in most countries, including those with universal health insurance, these people incur out of pocket expenditure (OOPE). The study aims to identify the prevalence...

Background In most countries, including those with national health insurance or comprehensive public insurance, some expenses for cancer treatment are borne by the ill and their families. Objectives This study aims to identify the areas of out-of-pocket (OOP) spending in the last half-year of the lives of cancer patients and examine the extent of...

Background: Patient centeredness is a core element in healthcare. However, there is a gap between the understanding of this term by health care professionals, and patients’ capability, self-efficacy and willingness to take part in medical decisions. We aimed to expose standpoints toward "patient centeredness" among junior medical managers (JMM), as...

In recent years, several studies have examined the effect of parents and friends on cyberbullying victims. Less is known about their combined effect on cyber perpetrators, especially among Jewish and Arab teens in Israel. We collected data from a representative sample of 350 Jewish and Arab adolescents (aged 15–16) and their parents. We repeated th...

Background Concern about the cost and affordability of cancer drugs is widespread and well known. Even in countries with universal healthcare systems or health insurance for all, additional patient out-of-pocket (OOP) expenses are prevalent. Studies showed that honest communication between oncologists and patients is an important component in allev...

During the first lockdown in Israel, citizens were instructed to visit community clinics only for urgent cases. However, they were not informed that emergency departments (EDs) were safe. Reports from the National Ambulance Services showed a 22% increase in at-home deaths during the lockdown. Perhaps, the reason is because some critically ill patie...

The need to ensure the economic wellbeing and quality of life of those who reach the official retirement age is a matter of concern in the world of social services and in social policy making. Since some working older adults may be forced to retire when they reach the official retirement age while others retire voluntarily, the study is based on a...

Background: Active participation of patients in managing their medical treatment is a major component of the patient empowerment process and may contribute to better clinical outcomes. Patient perceptions and preferences affect the patient-physician encounter in a variety of dimensions, such as patient autonomy, freedom of choice and trust in the...

Replacement rates have gained acceptance as a useful metric for assessing the conditions of retirees and households at point of retirement. Here we use data from the SHARE longitudinal database to investigate income dynamics within a comparative European context. Our analysis, centering on households as opposed to the individuals on whom internatio...

Unlabelled: It is frequently assumed that the inheritance of wealth undermines economic activity. If such an assumption is valid, the expected wave of bequests may have a negative impact on labour market activity of heirs, what might further weaken the financing of state pension systems. This paper provides a detailed review of the empirical findi...

Purpose: The purpose of this study is to determine which element of advance care planning (ACP) - an advance directives (AD) document or an end-of-life discussion between patient and family (DwF), if any-improves the likelihood of cancer patients' attaining their preferences regarding treatments in the last month of life and dying in the place the...

Metropolitan Haifa, Israel, has three hospitals: Rambam Health Care Campus, Bnai Zion Medical Center, and Carmel Medical Center. In 2007–2014, the length of stay at RHCC’s emergency department increased, while the number of visits decreased. We ask whether the increase in LOS is associated with the falling numbers of visits to other EDs, whether an...

The COVID-19 pandemic has created challenges in providing medical care for people with health conditions other than COVID-19. The study aims to assess the prevalence of older adults’ reportage of decline in health relative to pre-pandemic and to identify its determinants. The study is based on the Survey of Health, Ageing and Retirement in Europe (...

The upturn in life expectancy and its consequence, population aging, are challenging labor, pension, and social-security systems throughout the developed world. The focal aim of this study is to measure the extent of out-of-pocket funding of healthcare services by the older adult population. The study has three objectives: to profile the healthcare...

Research has shown that health status and self-rated health (SRH) are correlated not only with age and gender but also with socioeconomic determinants, such as income, education, and employment status, in the course of life and in late life. Much less investigated, however, are gender differences in the association between socioeconomic factors and...

Global population aging and increased longevity are making family care a nearly universal experience. Caregiving is a dynamic process that varies over time and in intensity but often takes a physical and emotional toll on carers and may inflict financial costs by attenuating their labor market participation. The study explores the implications of t...

The lengthening of the amount of time adult children depend on their parents’ support and rising longevity have pushed scholars to devote increasing attention to the phenomenon of older sandwich family generations. This brief report develops a descriptive portrait of the prevalence of being demographically and socially sandwiched in the population...

To promote long-term care policies for older adults, accurate mapping of the often invisible and insufficiently recognized role of their informal caregivers is needed. This paper measures the prevalence of informal caregivers in the European population, illustrates current difficulties in gathering unequivocal information on this topic and deals wi...

The experience of pain is a widespread phenomenon among adults, especially older adults, and entails high costs to both individuals and society. The objective of the current research is to determine if the ability to pay and supplementary insurance are factors associated with pain medication among individuals over 50. Data came from Survey of Healt...

Key messages • Liver disease is now the second leading cause of years of working life lost in Europe, after only ischaemic heart disease • The clinical focus in patients with liver disease is oriented towards cirrhosis and its complications, whereas early and reversible disease stages are frequently disregarded and overlooked • The dissociation be...

Efforts to control the spread of the novel Coronavirus (COVID-19) pandemic include drastic measures such as isolation, social distancing, and lockdown. These restrictions are accompanied by serious adverse consequences such as forgoing of healthcare. The study aimed to assess the prevalence and correlates of forgone care for a variety of healthcare...

Objectives The COVID-19 pandemic has provided a rich environment for ageist attitudes towards both older and younger people. However, publications on ageism during the outbreak have been mostly non-empirical and have concentrated on ageist beliefs directed towards older people. To overcome these limitations, we examined empirically the prevalence a...

Honest communication between oncologists and patients is important in alleviating the financial burden of cancer care. This study explored patient–relative–oncologist communication regarding the affordability of out-of-pocket (OOP) medication and the extent to which this communication addresses itself to the families’ financial burden. A cross-sect...

The risk of developing a major non-communicable disease is critically affected by lifestyle choices. This study examined the consequences of factors that might predict a change in the self-rated health of older adults and aimed to assess their monetary costs. In particular, two predisposing risk factor moderators were studied: high blood pressure a...

The COVID-19 pandemic has been dramatically affecting the life of older adults with care needs and their family caregivers. This study illustrates how the initial outbreak of the pandemic changed the supply of formal and informal care to older adults in European countries and Israel and assesses the resilience of these countries in providing suppor...

Trust is an essential element in patient-physician relationships, yet trust is perceived differently among providers and customers exist. During January-February 2020 we examined the standpoints of medical managers and administrative directors from the private and public health hospitals on patient-physician trust, using a structured questionnaire....

The present study aimed to assess dementia caregivers’ reports of the prevalence and correlates of forgone care regarding visits to a general practitioner (GP) and to a specialist during the COVID-19 lockdown in Israel, using Andersen’s Behavioral Model of Healthcare Utilization. A cross-sectional study using an online survey was conducted with 73...

Background Residential segregation can foster health inequality mechanisms by increasing stress related to neighborhood violence and disorder. Aims We studied the association between neighborhood violence and disorder and inequalities in anxiety between two groups of perinatal Israeli women (Jewish, Palestinian-Arab) living in ethno-nationally seg...

Objective Cancer imposes a substantial economic burden on society, health and social care systems, patients and their families. This study aims to examine the out‐of‐pocket spending of cancer patients in their last year of life, in six countries with health insurance system hat have a defined benefits package. Methods Data from SHARE and SHARE End...

The study uses the deterioration of security situation in Israel (the “Intifada”) to investigate the uniqueness of results obtained previously in regard to Israel’s security-guard industry, as against other economic sectors, in regard to the employment stability and its implications for future career path. The findings emphasize the negative effect...

There is a considerable body of scientific knowledge about factors associated with self-rated health (SRH), a common measure of health status. However, less is known about the factors associated with changes in SRH over time. In order to fill this gap, the aim of the current study was to examine a combination of socioeconomic, psychosocial, and hea...

Background The current composition of Israeli private funding is inconsistent with the principles of the State Health Insurance Law. According with the aging process, this study identifies and investigates the predictors of out-of-pocket (hereinafter- OOP) funding of medical care and healthcare among the 50+ population. Its three objectives are to...

Background For young women, mammography has limited effectiveness and entails exposure to radiation, discomfort and additional costs. As in other countries, the Israel Ministry of Health does not officially recommend mammograms for women under age 50 who do not belong to risk groups. The study identifies factors associated with the willingness to u...

Background The increasing prevalence of cognitive decline (CD) in old age has become a global challenge. Our study aims to enhance understanding of this phenomenon by evaluating longitudinal effects of personal and national determinants on memory decline (MD) among European retirees. Methods We used data from two interviews collected in 12 Europea...

Background Cancer imposes a substantial economic burden on society, health and social care systems, patients and their families. This study aims to examine the out-of-pocket spending of cancer patients in their last year of life, in six countries with health insurance systems that have a defined benefits package. Methods Data from SHARE and SHARE...

Objectives: Family factors may play a role in adolescents' weight-control behaviours (WCB), and economic determinants strongly affect adolescents' health in terms of unhealthy weight-control behaviours (UWCB). This study examines the nexus of socioeconomic status, perceived family wealth, and number of employed parents and Israeli adolescents' WCB...

Background: Youth whose parents are unemployed have poorer health and well-being, including more injuries that result in hospitalization. The current study examined the possibility of an association of parents' employment status with youth injury and the interaction of this status with other socio-economic factors and ethnicity. Methods: We dist...

In this article we examine the association between national welfare regime and the propensity of middle–aged and older individuals with adult children of their own to provide social support to aged parents. Using data from mature adults (50+) in 26 European countries, we examine whether older and younger generations compete for the time resources o...

Self-employment allows individuals to extend their working lives instead of accepting forced retirement. This study examines transitions to self-employment after age 50 but before retirement age. The study is based on data from Survey of Health, Ageing and Retirement in Europe (SHARE), in which 16,412 people from 18 countries contributed 24,583 obs...

The Israel Ministry of Health enacted regulations that aim to reduce private expenditure on healthcare services and mitigate social inequality. According to the modified rules, which went into effect in the second half of 2016, patients who undergo surgery in a private hospital and are covered by their healthcare provider’s supplemental insurance (...

Background: In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past....

Background In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past. T...

Background Economic determinants such as socioeconomic inequalities and parents’ employment have a profound impact on the health of adolescents in terms of unhealthy weight-control behaviours (UWCB). In addition, various family factors may play a role in adolescents’ weight-control behaviours (WCB). This study examines the association among socioec...

Background The latest statistics on household size in the EU show that in 2017 around one third of households in the EU comprised single adults without children. The study documents a direct relationship between individuals’ health and patterns of healthcare expenditure by isolating single-person households and creating a new reference group in whi...

Background It is a common custom to visit patients in hospital. Visitors often bring along outside food products, including some that may not be recommended for the patient. Even so, neither the Ministry of Health nor the hospitals have explicit guidelines in place as to what people can and cannot bring their inpatient friends or kin. The study dea...

Owners’ valuations of dwelling prices are central in the construction of price indices and households’ economic behavior. We analyze the variation of the self-reported valuation bias over the distribution of dwelling sale prices, using a dataset of observations from a Household Expenditure Survey merged with the national sample of housing sale tran...

Objective: Our article aims to investigate changes in the rate of informal care provision, which occurred in Israel and Italy in the last decade. In addition, we analyze typology and magnitude of the main factors contributing to explain the probability of providing informal care. Method: We used data from the Survey of Health, Ageing and Retirement...

Background: Persons with disabilities face many obstacles in their attempts at social integration, particularly in the labor market. Objective: The study investigates patterns of transition among different employment situations by persons with disabilities relative to persons without disabilities. It also studies employment transitions among ind...

Many aspects of interrelations among urban units in a metropolis and their economic effects on the central city have been explored in research so far. Questioned in this context are the extent of dominance that one may attribute to the metropolis for goingson in surrounding towns and the effect of municipal boundaries on these cities’ economic deve...

extract to Casanova G. Tur-Sinai A. & Giovanni Lamura (2019) Innovating Long-Term Care Provision in Mediterranean Welfare States: A Comparison Between Italy and Israel, Journal of Aging and social policy, published on line 31/03/2019 https://www.tandfonline.com/doi/full/10.1080/08959420.2019.1589888 Introduction: The recent international debate on...

Joint pain is a common experience among adults aged 65 and over. Although pain management is multifaceted, medication is essential in it. The paper examines the use of medication among older adults with joint pain in Israel and asks whether socioeconomic factors are associated with this usage. The data, harvested, from the Survey of Health, Aging a...

Background The study documents a direct relationship between individuals’ health and patterns of healthcare expenditure by isolating single-person households and creating a new reference group in which household healthcare expenditure is based on one person’s expenditure patterns in accordance with his or her own state of health. Method The study...

The paper explores differences in human capital between the Israel-born and immigrants within the Jorgenson and Fraumeni model. Using a unique ‘imputed education’ method, the study answers whether the immigrants’ level of education, in fact, reflects their human capital. The results show that immigrants during their first years do not work in an oc...

One characteristic of the population aging process is the emergence of the “sandwich generation,” one that has both living parents and children. The study breaks new ground by focusing on the question of this generation’s social and economic responsibilities. It asks whether there is evidence of the granting of material and nonmaterial support by t...

Social innovations in long-term care (LTC) may be useful in more effective responses to the challenges of population aging for Western societies. One of the most investigated aspects in this regard is the role of family/informal care and strategies to improve its integration into the formal care system, yielding a more holistic care approach that m...

Palestinian uprising, ‘intifada’, aggravated the recession of 2001–2004 in Israel which dampened demand for labor in all industries except security services. We use this exogenous shock to study whether a cohort of young men who were attached to temporary jobs as security guards for unusually long periods of time during the intifada landed on an in...

The world is aging, and the percentages of older people are on a dramatic ascent. This dramatic demographic aging of human society is not gender neutral; it is mostly about older women. One of the key policy approaches to address the aging revolution is known as "active aging," crystalized by the WHO in 2002 by three pillars: participation, health,...

Purpose The purpose of this paper is to extract the optimal time allocation of weekly hours among work, sleep, sports, and internet use for 16 different demographic groups. Design/methodology/approach The agent wishes to minimize the gap between his or her actual and optimal allocation for each activity. His or her actual allocation of time for ea...

We used data collected in two waves of interviews (2009-T1 and 2013-T2) from the Survey of Health, Aging and Retirement in Europe (SHARE). We included 679 participants out of the Israeli sample (N=1645), who retired from work (early/on time/late), and completed T1 and T2-interviews. The memory score was calculated as the mean of 10 words recalled i...

This study explored various dimensions of generational relationships between older parents and their adult children using the latest waves of SHARE (Survey of Health, Ageing and Retirement in Europe). Intergenerational solidarity model served as the main conceptual framework. Analyses yielded four family relationship types present in all countries,...

Health is measured by subjective or self- perceived health as well as by objective parameters as the number of chronic illnesses or physical limitations. There is a well-established relationship between socioeconomic status and health indicating that individuals with lower income are likely to be less healthy than those with high income. Factors su...

We examine the effect of the first-degree students’ employment on the prolongation of their studies. When employing a popular instrumental variable, the regional unemployment rate, we find a negative impact of students’ employment on duration of studies. Then, adding a predetermined IV – the individual’s employment prior to the beginning of academi...

Overeducation has been researched extensively for nearly three decades, but some major issues in regard to it are still topics of ongoing debate. By using a panel data, that combines a survey of two cohorts of Israeli first-degree holders and data from administrative sources on jobs and wages, we examine the contribution of job turnover, cognitive...

This paper focused on estimating the participation rate of care giving to elders. We used a theoretical model frame that is in common use for analyzing activity in the labor market and adjusted it for analyzing the care giving rate in elders. Using data of the rate of start taking care and the rate of end taking care in elders from the Survey of He...

In recent years the world has been experiencing immigration in large scales. The globalization process and policies of open borders encouraged international migration. In this perspective Israel's experience seems to be valuable and insightful. This paper aims to explore the differences between the Human Capital of the Israeli- born and immigrants...

RÉSUMÉ Cette étude a exploré différentes dimensions des relations générationnelles entre les parents âgés et leurs enfants adultes, utilisant la deuxième vague de SHARE (Enquête sur la santé, le vieillissement et la retraite en Europe), et a comparée cela aux analyses de Dykstra et Fokkema (2011) de la première vague. Puis on a effectué un autre co...

In order to characterize the socioeconomic profile of various geographic units, it is common practice to use aggregated indices. However, the process of calculating such indices requires a wide variety of variables from various data sources available concurrently. Using a number of administrative databases for 2001 and 2003, this study examines the...

Drawing upon data from the fourth wave (2010) of the Survey of Health Ageing and Retirement in Europe (SHARE), the current analysis used a cross-nationally harmonized, name-generating personal social network inventory to examine the network correlates of early exit from the work force. The sample included all respondents younger than the official r...

The study examines the labor-force behavior of Israelis at older ages, focusing on the determinants of the transitions between states of labor-force participation between 2005 and 2010. The study uses panel data from the first two waves of the SHARE-Israel longitudinal survey. A multinomial logit model is used to examine the impact of sociodemograp...

Almost 5 percent of older Europeans forwent a visit to the doctor in the previous year due to its cost. More than 6 percent did without such visits because of lengthy waiting time. Forgone health care is related to one's- sociodemographic background, social networks, health and financial situation. Forgone health care is related, first and foremost...

Terror may have dire implications for the public’s behavior. According to Kirschenbaum (J Homel Secur Emerg Manag 3(1/3):1–33, 2006), in order to minimize the expected impact of a terror incident the public has to adopt a “survival strategy”. According to the underlying research hypothesis of the study, the longer the terror incidents continue, the...

Owners' valuations of dwelling prices are central in construction of price indices, empirical research of housing markets and households' economic behavior. Previous studies show that, on average, owners tend to overestimate the value of their dwellings by 5% relative to market valuation. We analyze the variation of the bias over the distribution o...