Study Finds Medical Aide Access Skewed Towards Wealthier Israeli Communities
Translated & summarized from Calcalist by baba
A new study by the Taub Center reveals that access to medical aides for students with food allergies in Israel is significantly skewed towards wealthier communities. The number of aides has nearly doubled in four years, costing over 500 million shekels, while disparities in eligibility persist. Researchers attribute this to unequal access to allergy specialists and the financial ability of affluent parents to secure necessary diagnoses. The study recommends re-evaluating the aide policy, suggesting that school nurses could offer more comprehensive and equitable health support.
The story in 6 lines · by baba
- Medical aide access for allergic students in Israel heavily favors affluent communities, a new study found.
- The number of medical aides has nearly doubled in four years, costing over 500 million shekels.
- Socioeconomic disparities show a nine-fold difference in EpiPen need declarations between highest and lowest clusters.
- Researchers link the disparity to unequal access to allergy specialists and private healthcare affordability.
- The study suggests school nurses could provide more cost-effective and comprehensive health support.
- International allergy groups question the effectiveness of blanket bans on allergenic foods in schools.
The number of medical aides assigned to students with food allergies in Israeli schools has nearly doubled in four years, rising from 4,655 in the 2020-2021 school year to 8,676 in 2024-2025. The cost of these aides has surpassed 500 million shekels, exceeding the estimated cost of placing a permanent nurse in every elementary and middle school, which ranges from 462 to 488 million shekels. A new study by the Taub Center for Social Policy Studies in Israel reveals significant disparities in accessing these aides between affluent and disadvantaged communities, suggesting that aides are reinforcing existing budget advantages for stronger localities.
The research, conducted by education researcher Dr. Sarit Silverman and Professor Nadav Davidovitch, analyzed Ministry of Education policies on food allergies and their implementation using parental health declarations from 2021-2025. Israel's policy, unique globally, includes a blanket ban on allergenic foods in schools and provides personal aides for high-risk children. This contrasts with other nations that may implement peanut-free zones. The study attributes the rise in allergy diagnoses and the need for aides partly to the elimination of school nurse positions and the practice of students eating in classrooms, increasing allergen exposure.
Eligibility for a medical aide is contingent on a parent's declaration of sensitivity and a doctor's letter confirming the need for an epinephrine auto-injector (EpiPen). The study found that while the rate of declared sensitivities more than doubled from 1.22% in 2021-2022 to 2.52% in 2024-2025, the rate of EpiPen carriers rose from 0.37% in 2022-2023 to 0.53% in 2024-2025. Notably, the highest EpiPen carrier rate was in first and second grades (0.64% in 2024-2025), which researchers link to the incentive of receiving an aide.
However, the study highlights a stark difference in EpiPen needs based on socioeconomic status. In 2024-2025, only 0.12% of students in the lowest socioeconomic clusters (1-2) declared a need for an EpiPen, compared to 1.1%, nine times higher, in the highest clusters (9-10). "The policy incentive created by eligibility for a medical aide functions almost exclusively in high-cluster communities, with negligible impact in the lowest clusters," the researchers concluded. They attribute this gap to limited access to allergists and the ability of wealthier parents to afford private healthcare.
Researchers noted that while the aide policy appears universal, it disproportionately benefits higher socioeconomic strata by increasing educational resource advantages. As the number of aides grows, so does the budgetary preference for established communities. The cost of aides is projected to increase rapidly, exceeding 523 million shekels in 2024-2025, while placing a nurse in every school would be cheaper and provide broader health support. The current aide model also prioritizes younger students, despite adolescents experiencing the majority of severe allergic reactions.
Prof. Davidovitch stated that the aide model lacks a strong research basis for its effectiveness and that school nurses previously addressed diverse health needs. He welcomed a pilot program to reintroduce school nurses. Dr. Silverman added that while eligibility is uniform on paper, accessing the required specialist diagnosis is unequal, leading to varied support based on parental means. International allergy organizations also recommend against blanket bans on allergenic foods due to unproven efficacy and the creation of false security.