The Hadassah Medical Organization's Linda Joy Pollin Cardiovascular Institute for Women, created with a 10 million-dollar grant from Psychotherapist Irene Pollin in memory of her daughter, Linda Joy, has already impacted the lives of hundreds of Arab and Israeli families.
"Our mission," explains Dr. Donna Zfat-Zwas, the Institute's Director, is "to increase awareness of cardiovascular disease as a significant cause of death and illness in women throughout Israel." Her goal is to reach both women and health care providers. "People in Israel think heart disease is a man's disease," she says. "Women don't have the awareness they need."
The Institute is reaching out particularly to Israel's Arab and ultraorthodox communities, where heart risk factors are higher. Rates of diabetes among Arab women are up to 50 percent, Dr. Zfat-Zwas reports. Diet and sedentary life style are major contributors to the problem. Hadassah's Institute is working with Arab women to promote a change in their lifestyle behaviors. To that end, the institute has initiated several community programs. One entails reaching out through the local school system to Arab children, their mothers, and their teachers. So far, the Institute has reached 3500 individuals. In September, the staff plans to reach out to seven additional schools. "There is a tremendous difference in awareness in the seven neighborhoods we have already reached," relates Dr. Zfat-Zwas. When she visited these mothers and children, she was told there are no more soft drinks in the house, no more snacks.
Within the ultraorthodox population, the Institute is reaching out through two programs—one in the local school setting; another with Rabbis and their wives. The intent is to have an impact on the entire infrastructure of the Chasidic community to bring about real change toward a healthier lifestyle. For example, knowing that the Haredi teachers have continuing education requirements, the Institute was able to arrange with a Haredi school principal to give continuing education credits to their teachers for engaging in physical activity.
The Institute also has plans to begin a new program with 1,000 "activist-minded" women in East Jerusalem. The goal is to motivate them to make health the next focus of their activism. By the same token, the Institute is focused on helping women to become their own health advocates—to be more effective partners with their physicians in promoting their own own health and in effectively utilizing the health care system.
In terms of reaching health care providers, the Institute professionals are speaking with coordinators of continuing education programs for the major health plans to urge them to raise awareness among family physicians about the risks to women regarding heart disease.
Dr. Zfat-Zwas explains: "We realize that someone from outside the community cannot walk into a community and tell other people what to do; it will not be well received and it is not appropriate." Consequently, she and her staff have worked hard to develop partnerships with community leaders. For example, since second-hand smoke is an important heart disease risk factor for many married women, particularly in the Arab community, the Institute is working with the Imams in the community mosques to get them to talk about this issue because, as Dr. Zfat-Zwas notes, "the pressure on the men has to come from outside the household, not from the inside."
Dr. Zfat-Zwas emphasizes that a most important message to impart to women is how much is in their control when it comes to heart disease prevention. Simple lifestyle interventions make a big difference, she relates. Consequently, the Institute staff encourages women to think more about appropriate diet and physical activity—rather than their weight and appearance. They also educate them as to how symptoms of a heart attack may differ in women. Whereas a man often experiences a sense that an elephant is sitting on his chest, often with pain radiating down his left arm, a woman may experience less specific symptoms—intense fatigue, discomfort in the chest, shoulder or jaw, or a shortness of breath, for example.
Dr. Zfat-Zwas also brings out that women tend to have more heart disease in the smaller vessels of the heart—disease that an angiogram does not reveal. Unlike with disease in a large vessel where a balloon or stent can be inserted to open the artery and keep it open, with small-vessel disease, the options are more limited, with medication as the primary treatment.
When it comes to raising awareness about heart disease among young women, Dr. Zfat-Zwas is quick to say: "The answer is not through fear or through a focus on the 'dark cloud' that looms over us, but rather to get women to embrace healthy lifestyles." She notes too that research at Hadassah is looking into individual genetics as a way to predict what type of diet is right for a particular individual and what type of diet will reduce a specific individual's cholesterol to an acceptable level.
Embracing Mrs. Pollin's vision to help women around the world learn how to better protect themselves against heart disease, Hadassah, the Women's Zionist Organization of America has partnered with her organization, Sister to Sister, to motivate women to live heart healthier lives. To learn more about Hadassah's comprehensive heart initiative, "Every Beat Counts: Hadassah's Heart Health Program," go towww.hadassah.org/everybeatcounts or contact firstname.lastname@example.org.