Against All Odds: Genocidal Trauma Is Associated with Longer Life-Expectancy of the Survivors

Abstract

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.

Cancer incidence and mortality among members of the Danish resistance movement deported to German concentration camps: 65‐Year follow‐up

“…In contrast to our results, a study of young immigrants from Poland to the prestate of Israel found that those potentially exposed to the Holocaust (immigrated between 1945 and 1950) had a slightly longer life expectancy than those who immigrated before 1939. 12 Our results are supported by a study of Norwegian survivors of German concentration camps, which found minor increases in mortality and cancer-specific mortality over that of the Norwegian population. 13 Overall mortality was increased particularly in the early calendar periods, lung cancer being the main reason for the increase.…”

Exposure to Genocide and the Risk of Dementia

“…The hypothesis that selective mortality, possibly reflecting trait and/or learned resilience, left Holocaust survivors at a reduced risk of dementia was not supported (Barel et al, 2010;Sagi-Schwartz et al, 2013;Solomon & Prager, 1992). Selective mortality likely occurred as some vulnerable people exposed to the adverse conditions of the Holocaust may have remained alive, such as those who were hidden (e.g., in convents and/or by non-Jewish families).…”

“…Protracted and severe anti‐Semitic persecutions of the European genocide (Lemkin, ) known as the Holocaust (Bauer, ) generated maximum adversity among survivors (Levav, ). Observational studies have indicated that survivors are at a higher risk of cancer (Keinan‐Boker, Vin‐Raviv, Liphshitz, Linn, & Barchana, ) and schizophrenia (Levine, Levav, Goldberg, et al., ) as well as some other psychiatric disorders (Barel, van IJzendoorn, Sagi‐Schwartz, & Bakermans‐Kranenburg, ; Sharon, Levav, Brodsky, Shemesh, & Kohn, ) yet have a longer life expectancy (Sagi‐Schwartz, Bakermans‐Kranenburg, Linn, & van Ijzendoorn, ) and lower risk of suicide (Levine, Levav, Yoffe, Becher, & Pugachova, ) than comparison groups. Such diverse results of the traumatic experiences of Holocaust exposure may be explained by competing hypotheses of survivor resilience versus vulnerability, as highlighted by a systematic review and meta‐analysis (Barel et al., ), which did not cover dementia as no studies in which it was examined had been published at that time.…”

No Evidence of Persistence or Inheritance of Mitochondrial DNA Copy Number in Holocaust Survivors and Their Descendants

“…Third, Holocaust survivors may consist of highly resilient individuals who were able to survive both prolonged physical and psychological trauma. It was previously shown that Holocaust survivors have higher lifeexpectancy as compared to those who did not go through the same experience, potentially due to selection during the Holocaust (Sagi-Schwartz et al, 2013), and a genetic basis to this resilience was proposed Konečná et al, 2019). Genetic factors contributing to this resilience may contribute to recovery of elevated mtDNA copy number and maintaining telomere length (Konečná et al, 2019), though it is unclear if the same factors confer protection against PTSD and other disorders.…”