The Central Bureau of Statistics (CBS)
Empowering the Periphery
The Lemonade Fund Empowering the Periphery program provides additional funds to recipients of emergency financial relief grants for Israeli citizens with breast and other cancers who live in Israel’s remote communities.
The Empowering the Periphery program arose from the urgent need to provide the extra help needed for patients most affected by the inherent social, economic and healthcare inequities in the towns, villages and communities located in Israel’s periphery.
Why is the Empowering the Periphery Program So Important?
Serious illness is expensive. Research has shown that in six months, a health crisis can force a family into bankruptcy or homelessness. Cancer treatments are long and often cause many extra expenses, (i.e., childcare or household help, transportation to and from doctor appointments and treatments, etc.) However, the primary impact is loss of income due to time off from work. Some patients get to a point where they cannot pay rent and eviction becomes a threat.
These difficulties are ten-fold in under-served populations in rural cities, towns and villages. The objective of the Lemonade Fund’s Empowering the Periphery program is to give help where it is needed most: for patients crushed by the burden of time-consuming travel, high transportation costs and who face the threat of losing their homes. Empowering the Periphery program grants will be used to help cover these costs and overcome inherent inequities in Israel’s periphery communities.
Who is eligible?
- Israeli citizens, within one year of diagnosis, with proven financial need, living in the periphery
- Grant applications are submitted via hospital and community social workers.
- A committee meets once a month to review applications, vetting and verifying applications using a transparent, detailed point system
N., is a 48 year-old breast cancer patient and immigrant from Russia living in a small village in the Galilee. She is unable to work due to severe side effects from treatment. Married with five children, she needs significant assistance for childcare for her younger children. The long trips to the closest medical center for treatments are draining the family’s income. Comorbidities and prior lymphoma left both a physical and emotional toll, and she is now suffering from severe depression.
Empowering the Periphery Program Rationale
Target Population
Israel’s periphery is defined as the Northern regions of the Galilee, upper Galilee and Golan Heights, the Negev region in Israel’s south, and Eilat. Many communities in these areas have disproportionately large numbers of economically and educationally disadvantaged residents, and are home to large minority populations, such as Druze, Israeli Arabs, Beduin, Circassian, new immigrants from Ethiopia, the Former Soviet Union and Ukrainian war refugees.
Demographic Research
The ramifications of these inequities relative to outcomes and cancer care are well-documented in the Trends and Gaps in Morbidity and Mortality from Cancer Within Towns in Israel analysis, published in February 2023 by the Taub Center. This report suggests that Israelis living in the most wealthy localities have a better chance of surviving cancer than those who live in the rest of the country, indicating substantial differences between low to middle-income vs high-income areas.
The analysis suggests that there is “health inequality” related to socioeconomic status and unequal health provision outside central Israel. This stems, in part, from the fact that wealthier populations tend to lead healthier lifestyles with better access to healthcare and better knowledge of how to navigate Israel’s public healthcare systems. A second explanation reflects geographical factors. Israel’s wealthiest locales tend to be clustered in the center of the country, where there is a range of high caliber top medical facilities. In Israel’s periphery there is a much smaller choice of health facilities to choose from, most of which are not research facilities and people need to travel much farther to reach these hospitals and clinics for proper treatment of serious illnesses, like breast cancer. If there are fewer medical professionals and it is difficult for patients to schedule and reach appointments in the periphery, it follows that the rate of earlier detection declines, leaving patients sicker and with lower chances of successfully fighting disease.
Lemonade Fund Experience
This research confirms the Lemonade Fund’s historical application data. Approximately 90% of the applicants for emergency grants in 2022 and 2023 (to date) submitted by social workers for patients in the periphery suffer from late stage disease and cite they are struggling under difficulties related to transport (time and cost) Many report numerous underlying conditions and comorbidities that make their disease even more difficult to treat and manage.
A. 49 year-old Bedouin woman, the second wife of a man 20 years her senior and the mother of several children, turned to the Lemonade Fund for financial assistance for childcare and household expenses, and critical travel expenses to Soroka Hospital in Be’er Sheva, a great distance from her Bedouin settlement, for treatments. She suffers great pain from Stage IV breast cancer and is unable to care for herself or her family, causing severe depression.
“The socioeconomic situation is generally lower in the periphery. The catchment area of Soroka Hospital covers one of the largest geographical areas in the country. That means many patients have to travel by bus for close to three hours round trip for treatments, some of which are given daily for a month. There are no nearby accommodation options or cost-effective transportation for those distances. Also fewer residents in the periphery carry private health insurance making it difficult, if not impossible, to pay for medicines outside the health basket.”
Oncology Institute Social Worker
Soroka University Medical Center, Beer Sheva