Jerusalem, 20 August, 2025 (TPS-IL) — An Israeli study released on Tuesday found that older adults with disabilities are less likely to receive essential preventive care such as flu vaccinations, eye exams, and dental checkups, but showed that increased government healthcare investment can close those gaps.
“Our findings show a very clear link between public health spending and the use of preventive care,” said Dr. Sharona Tsadok Rosenbluth, a Lady Davis postdoctoral fellow at The Hebrew University of Jerusalem and the Faculty of Health Sciences at Ben-Gurion University of the Negev.
“This tells us that smart, targeted healthcare investment really can protect vulnerable populations and improve quality of life in old age. But we still have a long way to go—especially in addressing inequities for people living with disability,” she said.
Working together with Dr. Shmuli Bramli-Greenberg of The Hebrew University, an expert in health economic inequalities, and Dr. Boaz Hovav of Max Stern Yezreel Valley College, the team analyzed data from nearly 47,000 people over the age of 50 in 27 high- and middle-income countries. The data was collected before the COVID-19 pandemic through the large-scale European SHARE survey. The SHARE survey (Survey of Health, Ageing and Retirement in Europe) is a large, cross-national research project that collects detailed data on the lives of people aged 50 and older.
The team applied a multi-level statistical model to examine how both individual disability levels and national healthcare spending influence preventive care use.
The findings were published in the peer-reviewed Journal of Public Health.
Preventive care is considered one of the most important tools for healthy aging, helping detect problems early and prevent more serious illness. Yet the research found that disabled adults were consistently less likely to receive it. Flu vaccine rates varied dramatically across the surveyed countries, ranging from just 3 percent to 60 percent. Eye exams ranged from 17 to 77 percent, and dental care from 14 to 86 percent. Disability prevalence itself also varied, from 7 to 26 percent.
The researchers discovered that while higher healthcare investment did not eliminate inequalities in eye and dental care, it did improve overall access. In better-funded systems, both disabled and non-disabled adults had higher chances of receiving checkups, even though the gap between them remained. For flu vaccinations, however, the story was different. In countries where public healthcare spending reached 8.8 percent of GDP or more, disabled adults were actually more likely to get vaccinated than their non-disabled peers.
“This reversal in flu vaccination rates highlights the impact of strong healthcare systems,” said Dr. Bramli-Greenberg. “When governments put resources into public health, the benefits extend to everyone—but especially to groups who are at risk of being left behind.”
The authors argue that the results carry an urgent policy message: preventive health is not simply a matter of individual behavior, but of public investment.
“Our data makes clear that system-level investment is a critical tool for creating equity in health outcomes. Policymakers can act on this by ensuring preventive care is funded, accessible, and inclusive,” Hovav said.
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