Center for the Study of Child Development and Department of Psychology, University of Haifa, Haifa, Israel.
PLoS One. 2013 Jul 24;8(7):e69179. doi: 10.1371/journal.pone.0069179. Print 2013.
Does surviving genocidal experiences, like the Holocaust, lead to shorter life-expectancy? Such an effect is conceivable given that most survivors not only suffered psychosocial trauma but also malnutrition, restriction in hygienic and sanitary facilities, and lack of preventive medical and health services, with potentially damaging effects for later health and life-expectancy. We explored whether genocidal survivors have a higher risk to die younger than comparisons without such background. This is the first population-based retrospective cohort study of the Holocaust, based on the entire population of immigrants from Poland to Israel (N = 55,220), 4-20 years old when the World War II started (1939), immigrating to Israel either between 1945 and 1950 (Holocaust group) or before 1939 (comparison group; not exposed to the Holocaust). Hazard of death - a long-term outcome of surviving genocidal trauma - was derived from the population-wide official data base of the National Insurance Institute of Israel. Cox regression yielded a significant hazard ratio (HR = 0.935, CI (95%) = 0.910-0.960), suggesting that the risk of death was reduced by 6.5 months for Holocaust survivors compared to non-Holocaust comparisons. The lower hazard was most substantial in males who were aged 10-15 (HR = 0.900, CI (95%) = 0.842-0.962, i.e., reduced by 10 months) or 16-20 years at the onset of the Holocaust (HR = 0.820, CI (95%) = 0.782-0.859, i.e., reduced by18 months). We found that against all odds genocidal survivors were likely to live longer. We suggest two explanations: Differential mortality during the Holocaust and "Posttraumatic Growth" associated with protective factors in Holocaust survivors or in their environment after World War II.
大屠杀等灭绝种族经历是否会导致预期寿命缩短？考虑到大多数幸存者不仅遭受心理社会创伤，还遭受营养不良、卫生和卫生设施受限以及缺乏预防性医疗和保健服务的影响，这种影响可能对以后的健康和预期寿命造成损害，这种影响是可以想象的。我们探讨了大屠杀幸存者是否比没有这种背景的人更有可能早逝。这是基于从波兰移民到以色列的所有人（N=55220）的大屠杀的第一项基于人群的回顾性队列研究，他们在第二次世界大战开始时（1939 年）年龄在 4 至 20 岁之间，于 1945 年至 1950 年之间（大屠杀组）或 1939 年之前（对照组；未遭受大屠杀）移民到以色列。从以色列国家保险协会的全人口官方数据库中得出了作为生存的种族灭绝创伤的长期结果的死亡风险。Cox 回归得出了一个显著的风险比（HR=0.935，CI（95%）=0.910-0.960），表明与非大屠杀对照组相比，大屠杀幸存者的死亡风险降低了 6.5 个月。在男性中，这种较低的风险更为显著，他们在 10-15 岁（HR=0.900，CI（95%）=0.842-0.962，即减少了 10 个月）或 16-20 岁（HR=0.820，CI（95%）=0.782-0.859，即减少了 18 个月）时，大屠杀开始时年龄较大。我们发现，尽管面临种种困难，大屠杀幸存者仍有可能长寿。我们提出了两种解释：大屠杀期间的差异死亡率和与大屠杀幸存者或二战后其环境中的保护因素相关的“创伤后成长”。
