“People treat ‘health comes first’ as a cliché. It isn’t,” said Yasmin Nahum, chief executive of the Israel Public Health Association. “Health is what lets the rest of a life happen. Without it, very little else can.”
The association develops treatment, rehabilitation, education, and prevention programs across the country. “We want to reach people wherever they sit on that spectrum - at the bottom or already relatively well - and move them toward something better,” Nahum said.
The Israel Public Health Association (IPHA) has been working for 54 years and currently has 50 branches across Israel, running health-promotion programs in schools, local authorities, and assisted-living residences.
Nahum explains that the organization places a particular focus on vulnerable populations - people living with addiction, mental illness, disability, and post-traumatic stress disorder (PTSD), including disabled IDF veterans, soldiers and veterans with PTSD, and survivors of terrorist attacks. Members of these groups, she said, often need more than medical treatment and require social, emotional, and occupational rehabilitation, which the association also provides.
“We reach many Israeli households, often the most precarious populations,” she said: “homeless people, people caught in prostitution, people with addictions, people living on the margins.”
Nahum describes the association as the public-health equivalent of a start-up: it builds a service, tests it in the field, and hopes a ministry or a health fund will acquire it. “We look for the gaps the existing system does not fill and build programs to test their effectiveness,” she said. “In this field, the equivalent of an ‘exit’ is when the Health Ministry or a health fund (kupat holim) recognizes the merits of a given program, adopts it, and turns it into a state service. Part of our job is to be there first, so the state can later institutionalize what people already need.”
Nahum points to the association’s Choice Center, a program for people aged 12 to 35 and, she said, the first to treat PTSD and addiction together rather than as separate problems. “The Oct. 7 attacks and the war that followed left a great many people traumatized, and a share of them have turned to substances or to compulsive behaviors,” she said. “Our data show a sharp rise in addictive patterns since Oct. 7, and the people arriving are younger than they used to be.”
“Our other programs would take people only from eighteen. Choice Center was founded to close that gap - so younger people would have a place to go before they arrived later than they should, and in worse condition: more addicted, more traumatized. We had seen that gap for years. After Oct. 7, it became impossible to leave it open. If we did not open Choice, the consequences would be dire. No one else was going to build a service that treats both, and at that age.”
Founded several months ago with support from the National Insurance Institute (Bituach Leumi), Choice Center is already operating at nearly full capacity, a measure of demand among young people who have few other places to go.
Nahum expects that within several years the Ministry of Health or the Ministry of Defense - or one of the health funds - will adopt and finance the Choice Center.
One of the most pressing challenges facing the association is the rise in dependence on prescription opioids. In 2020, international comparisons cited by Israeli researchers put Israel first in the world in per-capita consumption of prescription opioids, ahead of the United States. Use has continued to climb. “The central problem now is addiction to prescribed medication, especially opioid painkillers,” Nahum said. “That dependence can be as dangerous as heroin, and sometimes more damaging.” She also said that people who undergo surgery or hospitalization, or who suffer a serious injury, can become addicted to the medication prescribed during treatment.
In the past two years, the Israel Public Health Association has opened 17 clinics in health funds and hospitals to treat dependence on opioid painkillers. At the same time, the association is trying to reduce stigma: “We do not call them drug clinics or rehab wards. Instead they are clinics for consultation on painkiller use,” she said.
Nahum, a mother of five, began her career as a lawyer before moving into public health. In addition to heading the association, she serves on the Jerusalem Municipality’s Health Council. She also chairs the PAT Forum - a coalition of 20 major organizations promoting occupational rehabilitation for people with disabilities. “Wherever we can advance health services, we will be there,” she said. “Our partnerships have given us a chance to build services the public actually needs. That is our privilege.”
Written in collaboration with Israel Public Health Association