Where Need Meets Silence

Why do some Israeli communities receive far fewer disability benefits than their conditions would predict?

TovTech Research Group  |  National Insurance Institute data, Dec 2024  |  278 localities  |  4 research questions

1. People Who Qualify for Disability Benefits Are Not Receiving Them

Israel’s National Insurance Institute pays disability benefits to hundreds of thousands of people. But in some localities, far fewer people claim than we would expect given their socio-economic conditions. We analyzed 278 localities with 15 indicators to find out where — and why.

What we did

We trained machine learning models to predict disability benefit rates from socio-economic data (income, education, demographics, geography). Localities where actual claiming is far below the prediction are potential under-utilization pockets — places where eligible people may face barriers to access.

278
Localities Analyzed
Across all regions and population groups
15
Socio-Economic Indicators
Income, education, demographics, geography
4
Research Questions
Under-utilization, intergenerational, conflict, distance
4
ML Models
Random Forest, XGBoost, TabPFN, Linear Regression

2. Research Question 1 Localities That Claim Far Less Than Their Conditions Predict

Two independent methods — a non-linear ensemble and a linear regression — predict disability rates from socio-economic data. Localities beyond ±1.5σ are flagged as anomalies.

2.1 Expected vs Observed Disability Rate (Ensemble: RF + XGBoost + TabPFN)
Green diamonds = under-utilization. Red crosses = hidden burden. Dashed bands = ±1.5σ (2.2 pp).
6%
Arab under-utilization
1 of 17 · click to view
35%
Haredi under-utilization
6 of 17 · click to view
59%
Other under-utilization
10 of 17 · click to view

Note: ensemble R² < 0 for Haredi sector — Haredi flags may be unreliable.

2.2 Expected vs Observed Disability Rate (Linear Regression, R² = 0.699)
46%
Arab under-utilization
6 of 13 · click to view
54%
Other under-utilization
7 of 13 · click to view
1
Flagged by both methods
בסמ"ה
Explore All 278 Localities
Locality ▲▼ Actual ▲▼ Expected (Ensemble) ▲▼ Gap (Ensemble) ▲▼ Population ▲▼ Group ▲▼ Ensemble OLS
ברוכין 0.5% 4.5% +4.0 2,637 Other Under-util
בית שמש 5.9% 9.1% +3.3 175,767 Haredi Under-util
ברכה 2.3% 5.5% +3.2 3,199 Other Under-util
אשדוד 6.8% 9.9% +3.1 227,285 Other Under-util
יד בנימין 3.0% 5.9% +3.0 4,326 Other Under-util
עלי זהב 1.7% 4.6% +2.9 5,354 Other Under-util Hidden
טלמון 2.4% 5.2% +2.9 5,886 Other Under-util
גבעת זאב 4.7% 7.5% +2.8 23,424 Haredi Under-util
רבבה 2.1% 4.7% +2.6 3,157 Other Under-util
ירושלים 5.4% 8.0% +2.6 1,014,874 Other Under-util
קריית יערים 4.1% 6.6% +2.5 7,036 Haredi Under-util
אלעד 4.9% 7.4% +2.4 49,582 Haredi Under-util
מודיעין עילית 5.0% 7.4% +2.4 86,326 Haredi Under-util
כפר חב"ד 4.0% 6.4% +2.3 6,557 Haredi Under-util
בסמ"ה 5.1% 7.4% +2.3 11,698 Arab Under-util Under-util
לוד 7.4% 9.6% +2.2 89,230 Other Under-util
צור יצחק 3.4% 5.6% +2.2 7,047 Other Under-util
עין נקובא 3.8% 6.0% +2.2 3,799 Arab Under-util
זמר 5.1% 7.2% +2.1 7,518 Arab
גדרה 4.2% 6.3% +2.0 29,884 Other
מעלה אדומים 5.0% 7.0% +2.0 37,165 Other
גן יבנה 4.2% 6.2% +2.0 24,777 Other
גבע בנימין 5.2% 7.1% +1.9 5,997 Other
באר יעקב 4.1% 6.0% +1.9 33,689 Other
אלעזר 2.9% 4.8% +1.9 2,735 Other
ברקת 4.2% 6.1% +1.9 2,097 Other Under-util
כוכב השחר 3.2% 5.1% +1.9 2,850 Other
ביתר עילית 5.8% 7.6% +1.8 71,073 Haredi
מעלה עירון 6.0% 7.8% +1.8 16,152 Arab
חריש 6.8% 8.6% +1.8 37,909 Other
פוריידיס 6.1% 7.8% +1.7 13,838 Arab
באר גנים 2.8% 4.5% +1.7 2,292 Other
אור עקיבא 7.2% 8.9% +1.7 24,165 Other
עלי 2.6% 4.2% +1.7 4,585 Other
אבן שמואל 3.7% 5.4% +1.7 2,065 Other
ראשון לציון 5.7% 7.4% +1.6 254,174 Other
הושעיה 2.1% 3.7% +1.6 2,052 Other
מודיעין-מכבים-רעות 3.2% 4.8% +1.6 100,113 Other
יקיר 2.2% 3.8% +1.6 2,793 Other
כוכב יעקב 4.9% 6.5% +1.6 3,485 Haredi
מזרעה 5.9% 7.5% +1.6 4,149 Arab
נוקדים 3.6% 5.2% +1.6 3,197 Other
ע'ג'ר 5.0% 6.5% +1.6 2,887 Arab
אריאל 5.4% 7.0% +1.5 19,128 Other
בית אל 3.8% 5.3% +1.5 6,722 Other Under-util
ערערה 6.1% 7.6% +1.5 21,203 Arab
רמלה 8.1% 9.5% +1.5 82,371 Other
בית אריה-עופרים 4.3% 5.7% +1.4 5,503 Other
בת ים 8.3% 9.7% +1.4 124,600 Other
בני ברק 6.8% 8.1% +1.4 223,585 Haredi
ניצן 3.1% 4.5% +1.3 2,563 Other
אחיעזר 4.3% 5.6% +1.3 2,059 Other
רעננה 4.7% 6.0% +1.3 82,844 Other
פדואל 2.4% 3.7% +1.3 2,223 Other
שוהם 2.9% 4.2% +1.3 23,519 Other
מיתר 2.8% 4.1% +1.3 11,790 Other
נעלה 4.1% 5.4% +1.3 2,794 Other
מתתיהו 5.2% 6.5% +1.3 3,437 Haredi
רחובות 6.4% 7.6% +1.3 149,399 Other
יבנה 5.7% 7.0% +1.3 56,921 Other
קריית גת 8.7% 10.0% +1.3 70,214 Other
בני עי"ש 7.0% 8.3% +1.2 6,515 Other Under-util
שבלי - אום אל-גנם 6.8% 8.1% +1.2 6,830 Arab
ג'ת 4.5% 5.7% +1.2 9,384 Arab
עפרה 3.0% 4.2% +1.2 3,210 Other Under-util
פתח תקווה 6.3% 7.5% +1.2 255,952 Other
מבוא חורון 3.7% 4.9% +1.2 2,630 Other
באקה אל-גרביה 6.1% 7.3% +1.2 35,170 Arab
רמת השרון 4.6% 5.7% +1.1 45,758 Other
ניל"י 2.3% 3.4% +1.1 2,150 Other
צור משה 2.8% 3.9% +1.1 2,617 Other
קרני שומרון 5.4% 6.5% +1.1 10,551 Other
קריית עקרון 7.7% 8.8% +1.1 10,888 Other
אליכין 4.0% 5.1% +1.1 3,485 Other Under-util
כפר אדומים 2.4% 3.5% +1.1 4,738 Other
ראש העין 5.1% 6.1% +1.0 74,367 Other
אפרת 4.1% 5.1% +1.0 12,746 Other
טייבה 6.5% 7.5% +1.0 47,069 Arab
יפיע 6.7% 7.7% +1.0 19,976 Arab
מג'ד אל-כרום 6.0% 7.0% +1.0 21,794 Arab
כפר האורנים 1.8% 2.8% +1.0 2,114 Other
קיסריה 3.3% 4.2% +1.0 6,031 Other
אום אל-פחם 6.8% 7.8% +1.0 60,641 Arab
חולון 7.3% 8.3% +1.0 187,734 Other
להבים 3.0% 4.0% +0.9 7,241 Other
אלקנה 2.5% 3.4% +0.9 4,565 Other
אלון מורה 3.0% 3.9% +0.9 2,085 Other
קצר א-סר 3.6% 4.5% +0.9 2,704 Arab Under-util
אילת 7.9% 8.8% +0.9 57,781 Other
שייח' דנון 5.9% 6.8% +0.9 2,946 Arab
כפר ורדים 4.5% 5.4% +0.9 5,549 Other
הר אדר 2.2% 3.1% +0.9 3,966 Other
אשקלון 8.2% 9.0% +0.8 160,929 Other
מרכז שפירא 3.8% 4.6% +0.8 3,058 Other
קריית מלאכי 9.1% 9.9% +0.8 27,668 Other
מעלות-תרשיחא 6.5% 7.3% +0.8 23,448 Other Under-util
כפר קאסם 6.6% 7.4% +0.8 26,353 Arab
שילה 3.5% 4.2% +0.8 5,767 Other
אזור 6.2% 7.0% +0.8 12,496 Other
ג'ש (גוש חלב) 4.7% 5.4% +0.8 3,111 Arab
שדרות 7.4% 8.1% +0.8 35,796 Other
שלומי 6.8% 7.6% +0.8 8,093 Other
יצהר 3.2% 4.0% +0.8 2,426 Other
גבעתיים 4.0% 4.8% +0.8 57,327 Other
שמשית 2.7% 3.4% +0.8 2,279 Other
גבעת שמואל 4.0% 4.8% +0.7 29,004 Other
צור הדסה 2.9% 3.7% +0.7 10,083 Other
בית דגן 5.2% 5.9% +0.7 7,226 Other
תל אביב -יפו 5.3% 6.0% +0.7 461,649 Other
קלנסווה 7.0% 7.7% +0.7 24,627 Arab
סביון 2.4% 3.1% +0.7 4,176 Other
מעלה מכמש 3.7% 4.4% +0.7 2,116 Other
עתלית 4.6% 5.2% +0.7 10,912 Other
נס ציונה 4.3% 5.0% +0.7 45,315 Other
נופית 3.1% 3.8% +0.6 2,402 Other
אור יהודה 8.1% 8.7% +0.6 39,382 Other
כוכב יאיר 3.9% 4.5% +0.6 9,796 Other
כעביה-טבאש-חג'אג'רה 6.9% 7.5% +0.6 6,291 Arab
אכסאל 7.0% 7.6% +0.6 15,791 Arab
ג'לג'וליה 7.0% 7.6% +0.6 10,877 Arab
מתן 2.4% 2.9% +0.6 3,197 Other
קריית אונו 4.2% 4.8% +0.6 42,385 Other
גבעת ברנר 3.5% 4.1% +0.5 2,234 Other
גני תקווה 3.9% 4.5% +0.5 24,163 Other
יהוד 5.1% 5.6% +0.5 31,324 Other
אלון שבות 4.2% 4.7% +0.5 3,290 Other
מעיליא 4.2% 4.7% +0.5 3,165 Arab Under-util
פקיעין (בוקייעה) 5.4% 5.9% +0.5 6,114 Arab Under-util
זכרון יעקב 4.4% 4.8% +0.5 23,877 Other
עמנואל 7.0% 7.4% +0.5 5,569 Haredi
שגב-שלום 6.1% 6.6% +0.5 13,396 Arab
פסגות 3.3% 3.7% +0.5 2,365 Other
נווה דניאל 4.1% 4.5% +0.4 2,568 Other
פרדסייה 3.3% 3.8% +0.4 7,755 Other
תקוע 3.6% 4.0% +0.4 4,465 Other
עכו 8.4% 8.7% +0.4 53,986 Other
יקנעם עילית 5.6% 5.9% +0.3 24,749 Other
נהרייה 6.9% 7.2% +0.3 67,695 Other
מבשרת ציון 4.9% 5.2% +0.3 26,097 Other
נאעורה 6.0% 6.4% +0.3 3,169 Arab
כפר מנדא 7.7% 8.0% +0.3 22,269 Arab
כאוכב אבו אל-היג'א 6.0% 6.3% +0.3 3,658 Arab
אלפי מנשה 4.2% 4.5% +0.3 7,940 Other
בית שאן 9.9% 10.2% +0.3 21,317 Other
אחוזת ברק 3.5% 3.7% +0.2 2,446 Other
בנימינה-גבעת עדה 4.2% 4.4% +0.2 15,029 Other
פסוטה 4.8% 5.0% +0.2 3,431 Arab
מזכרת בתיה 4.1% 4.3% +0.2 16,185 Other
ג'ולס 6.4% 6.6% +0.2 6,871 Arab
מצפה יריחו 4.6% 4.7% +0.1 2,753 Other
חורפיש 4.8% 5.0% +0.1 6,794 Arab
גן נר 4.8% 4.9% +0.1 2,642 Other
הוד השרון 4.8% 4.9% +0.1 63,403 Other
כפר קרע 6.2% 6.3% +0.0 20,799 Arab
רמת גן 5.3% 5.3% +0.0 162,214 Other
הרצלייה 5.1% 5.1% +0.0 104,165 Other
אבן יהודה 3.5% 3.5% +0.0 14,088 Other
כסיפה 6.2% 6.2% -0.0 21,654 Arab
קדומים 3.6% 3.6% -0.0 4,871 Other
רמת ישי 4.5% 4.4% -0.0 7,841 Other
אורנית 3.5% 3.4% -0.1 9,317 Other
תל מונד 3.8% 3.7% -0.1 14,760 Other
ג'דיידה-מכר 7.1% 7.0% -0.1 21,134 Arab
דאלית אל-כרמל 7.8% 7.7% -0.1 20,395 Arab
נוף איילון 3.0% 2.9% -0.1 2,134 Other
מייסר 5.7% 5.5% -0.1 2,064 Arab
בית יצחק-שער חפר 3.2% 3.0% -0.2 2,142 Other
דימונה 9.5% 9.3% -0.2 41,136 Other
לקיה 6.4% 6.2% -0.2 18,401 Arab
כפר תבור 5.0% 4.8% -0.2 4,516 Other
בית חשמונאי 3.0% 2.8% -0.2 2,093 Other
סעוה 4.9% 4.7% -0.2 2,332 Arab
טורעאן 6.4% 6.2% -0.2 15,136 Arab
לפיד 3.1% 2.9% -0.2 2,108 Other
חדרה 7.5% 7.3% -0.2 103,959 Other
קדימה-צורן 4.6% 4.3% -0.2 22,017 Other
ביר הדאג' 4.7% 4.5% -0.3 3,666 Arab Under-util
כפר ברא 6.4% 6.0% -0.3 4,148 Arab
כפר כמא 6.5% 6.2% -0.3 3,583 Arab
נתניה 7.3% 6.9% -0.4 226,189 Other
חורה 6.6% 6.3% -0.4 23,033 Arab
גבעת אבני 5.4% 5.0% -0.4 2,155 Other
עוזייר 8.2% 7.8% -0.4 3,641 Arab
ערד 10.4% 10.0% -0.4 31,958 Other
עומר 4.5% 4.1% -0.4 8,464 Other
בית ג'ן 6.8% 6.4% -0.4 12,896 Arab
יאנוח-ג'ת 6.7% 6.2% -0.5 6,969 Arab
מסעדה 7.3% 6.9% -0.5 4,198 Arab
נצרת 7.9% 7.4% -0.5 78,999 Arab
ברקן 4.5% 4.0% -0.5 2,068 Other
כרמיאל 7.8% 7.3% -0.5 47,769 Other
אבו סנאן 7.8% 7.3% -0.5 14,502 Arab
דייר אל-אסד 6.5% 6.0% -0.5 10,052 Arab
אופקים 8.8% 8.3% -0.5 40,184 Other
אבו גוש 8.0% 7.5% -0.5 8,426 Arab
ירוחם 8.2% 7.6% -0.6 12,061 Other
ריינה 8.1% 7.5% -0.6 17,247 Arab
רהט 7.0% 6.4% -0.7 79,100 Arab
ניין 7.2% 6.5% -0.7 2,016 Arab
בת חפר 3.4% 2.7% -0.7 5,117 Other
אבו תלול 5.9% 5.1% -0.7 2,867 Arab
סלמה 8.6% 7.8% -0.7 3,681 Arab Hidden
טירת כרמל 9.2% 8.5% -0.7 30,938 Other
אל סייד 5.6% 4.8% -0.7 3,407 Arab
קציר 6.1% 5.3% -0.8 2,678 Other
טירה 7.6% 6.8% -0.8 26,833 Arab
סח'נין 7.5% 6.7% -0.8 35,524 Arab
ראמה 7.7% 6.9% -0.8 8,469 Arab
כסרא-סמיע 7.0% 6.1% -0.8 9,582 Arab
כפר מצר 6.8% 5.9% -0.8 2,814 Arab
אעבלין 7.7% 6.9% -0.8 13,228 Arab
נוף הגליל 9.1% 8.3% -0.9 47,542 Other
צופים 4.6% 3.7% -0.9 2,628 Other
עילוט 8.1% 7.2% -0.9 9,163 Arab
דבורייה 7.1% 6.2% -0.9 11,265 Arab
תל שבע 7.6% 6.7% -0.9 24,242 Arab
בועיינה-נוג'ידאת 7.8% 6.9% -0.9 10,969 Arab
שפרעם 8.4% 7.4% -0.9 43,185 Arab
ערערה-בנגב 7.5% 6.5% -1.0 21,590 Arab
חשמונאים 4.8% 3.8% -1.0 3,186 Other
בסמת טבעון 8.0% 7.0% -1.0 8,245 Arab
נתיבות 7.4% 6.4% -1.0 54,781 Other
כפר יונה 5.7% 4.7% -1.0 28,151 Other
עין מאהל 7.5% 6.4% -1.1 14,404 Arab
גני מודיעין 8.0% 6.9% -1.1 3,084 Haredi Hidden
נשר 7.6% 6.5% -1.1 21,881 Other
דייר חנא 8.7% 7.6% -1.1 11,279 Arab
רכסים 6.9% 5.8% -1.1 14,689 Haredi
עראבה 7.9% 6.8% -1.1 28,010 Arab
בוקעאתא 7.8% 6.7% -1.1 7,024 Arab
מוקייבלה 7.5% 6.3% -1.2 4,530 Arab
מג'דל שמס 7.6% 6.4% -1.2 11,660 Arab
רומת הייב 7.3% 6.1% -1.2 2,182 Arab
קריית ארבע 6.2% 5.0% -1.2 7,910 Other
כפר יאסיף 7.0% 5.8% -1.2 10,620 Arab
כפר סבא 6.6% 5.4% -1.2 99,158 Other
ביר אל-מכסור 8.1% 6.8% -1.3 11,104 Arab
קריית ים 10.2% 8.9% -1.3 41,520 Other
עספיא 8.7% 7.4% -1.3 11,058 Arab Hidden
בענה 7.9% 6.6% -1.3 6,611 Arab
טמרה 8.0% 6.7% -1.3 36,657 Arab
פרדס חנה-כרכור 6.7% 5.3% -1.4 45,270 Other
כפר כנא 7.9% 6.5% -1.4 24,636 Arab
קריית אתא 9.3% 7.9% -1.4 61,710 Other
זרזיר 8.8% 7.3% -1.5 9,299 Arab
חצור הגלילית 11.1% 9.6% -1.5 11,134 Other Hidden
קריית שמונה 11.1% 9.4% -1.6 24,400 Other
משהד 7.9% 6.2% -1.7 8,900 Arab
אום בטין 7.7% 6.0% -1.7 4,371 Arab
אבני חפץ 4.9% 3.2% -1.7 2,537 Other
נחף 8.7% 6.9% -1.8 14,252 Arab
מצפה רמון 8.6% 6.7% -1.8 5,687 Other
חיפה 8.7% 6.8% -1.8 279,968 Other
מגדל העמק 10.5% 8.6% -1.9 28,708 Other
אבטין 9.6% 7.7% -1.9 2,931 Arab
קריית מוצקין 8.1% 6.2% -1.9 50,191 Other
סולם 8.8% 6.9% -1.9 3,065 Arab
טובא-זנגרייה 9.1% 7.1% -1.9 6,905 Arab Hidden
מעגן מיכאל 6.5% 4.5% -2.0 2,017 Other Under-util
כאבול 8.7% 6.7% -2.0 13,190 Arab
עיילבון 8.9% 6.9% -2.0 5,706 Arab Hidden
ירכא 9.3% 7.1% -2.2 17,188 Arab Hidden
תפרח 8.0% 5.8% -2.2 2,277 Haredi
קריית ביאליק 8.8% 6.5% -2.2 45,354 Other
עפולה 11.2% 9.0% -2.2 65,478 Other Hidden Hidden
סאג'ור 8.2% 5.9% -2.3 4,587 Arab Hidden Hidden
קצרין 9.6% 7.3% -2.3 8,380 Other Hidden
שעב 9.1% 6.6% -2.4 7,869 Arab Hidden
עין קנייא 8.6% 6.1% -2.5 2,392 Arab Hidden
באר שבע 10.3% 7.6% -2.7 214,661 Other Hidden Hidden
ג'סר א-זרקא 10.1% 7.3% -2.9 15,778 Arab Hidden Hidden
קריית טבעון 7.2% 4.3% -3.0 17,981 Other Hidden
מגאר 10.3% 7.1% -3.1 24,667 Arab Hidden Hidden
צפת 12.7% 9.1% -3.6 39,301 Haredi Hidden Hidden
ראש פינה 9.3% 4.8% -4.6 3,175 Other Hidden
טבריה 14.8% 10.0% -4.9 52,388 Other Hidden Hidden
יבנאל 13.3% 7.8% -5.5 4,502 Haredi Hidden Hidden
מגדל 13.4% 7.5% -5.9 2,076 Other Hidden

2.3 What the Model Uses & What It Found

To explain the general disability benefit rate across localities, I used eight explanatory variables: log salary, peripherality index, income support rate, share of population aged 65+, labour participation rate, dependency ratio, and two dummy variables — Arab-majority locality and Haredi-majority locality (OLS with HC3 robust standard errors; N = 263, R² = 0.698).

Five of these variables are statistically significant (p < 0.05): log salary (β = −5.964, p < 0.001), Arab-majority locality (β = −1.414, p = 0.004), share 65+ (β = +0.175, p < 0.001), dependency ratio (β = −0.029, p < 0.001), and peripherality index (β = −0.236, p = 0.005). In plain terms: a locality with an Arab majority is associated with a 1.41 percentage-point lower disability rate, all else equal; a one-percentage-point increase in the share of residents aged 65 and above is associated with a 0.175 pp higher disability-benefit rate on average; and a 1% increase in average salary is associated with a 0.060 pp lower disability rate (Level-Log model: β / 100 = −5.964 / 100).

Variable β (coef.) Std. Error p-value Significance Interpretation (1 unit / dummy)
Log Salary −5.964 0.482 < 0.001 ★★★ +1% in avg. salary → −0.060 pp disability rate (Level-Log: β/100)
Arab-majority (dummy) −1.414 0.492 0.004 ★★ Arab-majority locality → −1.41 pp disability rate, all else equal
Population 65+ % +0.175 0.031 < 0.001 ★★★ +1 pp in share of 65+ → +0.175 pp disability rate
Dependency Ratio −0.029 0.006 < 0.001 ★★★ +1 unit in dependency ratio → −0.029 pp disability rate
Peripherality Index −0.236 0.084 0.005 ★★ +1 unit in peripherality index → −0.236 pp disability rate
Labour Participation −0.071 0.041 0.080 n.s. Not statistically significant (p = 0.080)
Income Support Rate +0.139 0.163 0.394 n.s. Not statistically significant (p = 0.394)
Haredi-majority (dummy) +0.342 0.789 0.665 n.s. Not statistically significant (p = 0.665)

Variables are in their original (unstandardised) units. Coefficients reflect the change in the disability rate (percentage points) per one-unit increase in the explanatory variable. Dummy variables reflect the level difference relative to the reference group (non-Arab, non-Haredi localities). HC3 heteroscedasticity-robust standard errors. ★★★ p < 0.001  |  ★★ p < 0.01  |  ★ p < 0.05  |  n.s. not significant.

3. Research Question 2 The Further from the Center, the Tighter the Intergenerational Disability Trap

Child disability rates correlate with adult disability rates across all socio-economic and geographic contexts.

3.2 Robustness Check: Does the Child–Adult Disability Link Survive Controls?

Five nested OLS models — HC3 robust standard errors, N = 263. Models 1–4: original (unstandardised) units. Model 5 (interaction): all continuous variables standardised to Z-scores (mean = 0, SD = 1) before constructing the interaction term.

Model 1 — Base

Tests the raw, direct relationship between the child disability rate and the adult disability rate — no controls. Establishes the baseline signal.

R² = 0.242
Model 2 — Structural

Adds economic and geographic controls: log salary, peripherality index, income support rate, share 65+, labour participation, dependency ratio. Tests whether the relationship survives controlling for poverty and distance from the centre.

R² = 0.767
Model 3 — District Fixed Effects

Adds district fixed effects (7 districts) on top of Model 2. Absorbs all unmeasured district-level differences in policy, infrastructure, and resources — identification comes from within-district variation only.

R² = 0.782
Model 4 — Sector Fixed Effects

Adds sector fixed effects (Arab / Haredi / Secular) on top of Model 2. Controls for all unmeasured cultural, institutional, and rights-access differences across population groups.

R² = 0.769
Model 5 — + Child×Peripherality

Extends Model 2 with an interaction term disabled_child_benefit_rate × peripherality_index_score. Tests whether the child–adult disability link is moderated by a locality's geographic peripherality.

R² = 0.773
The child disability rate remains significant across all four models (p < 0.001)

Even after controlling for salary, peripherality, labour market participation, demographics, district identity, and sector identity, disabled_child_benefit_rate continues to significantly predict the adult disability rate. Its coefficient drops from β = 0.744 (Model 1) to β = 0.581 (Model 2), β = 0.584 (Model 3, district FE), and β = 0.565 (Model 4, sector FE) — highly significant in every specification. This is the core evidence for an intergenerational disability cycle that operates independently of geography, socio-economic conditions, and cultural context.

Notable: In Model 3, the peripherality index attenuates to insignificance (β = −0.103, n.s.) — suggesting that peripherality's effect on adult disability operates partly through district-level differences in resources, not locality-level geography alone.

Variable Model 1
Base
Model 2
Structural
Model 3
+ District FE
Model 4
+ Sector FE
Model 5
+ Child×Periph
(Z-scored)
disabled_child_benefit_rate ← variable of interest 0.744***
(0.091)
0.581***
(0.080)
0.584***
(0.079)
0.565***
(0.091)
0.812***
(0.089)
Log Salary −4.291***
(0.343)
−4.037***
(0.344)
−4.190***
(0.450)
−1.429***
(0.115)
Peripherality Index −0.334***
(0.081)
−0.141 (n.s.)
(0.113)
−0.338***
(0.083)
−0.275***
(0.089)
Income Support Rate −0.005 (n.s.)
(0.103)
+0.030 (n.s.)
(0.105)
+0.047 (n.s.)
(0.111)
+0.020 (n.s.)
(0.102)
Population 65+ % +0.114***
(0.021)
+0.100***
(0.020)
+0.115***
(0.023)
+0.694***
(0.113)
Labour Participation −0.062***
(0.016)
−0.046**
(0.015)
−0.062**
(0.021)
−0.445***
(0.105)
Dependency Ratio −0.018***
(0.004)
−0.010 (n.s.)
(0.005)
−0.021***
(0.005)
−0.406***
(0.075)
Child Disability Rate × Peripherality (interaction term, Z-scored) −0.203**
(0.075)
District fixed effects (7) ✓ included
Sector fixed effects (Arab / Haredi / Secular) ✓ included
N 263 263 263 263 263
0.242 0.767 0.782 0.769 0.773
Adj. R² 0.239 0.761 0.770 0.761 0.766

Standard errors in parentheses. *** p < 0.001  |  ** p < 0.01  |  * p < 0.05  |  n.s. not significant. Models 1–4: variables in original (unstandardised) units. HC3 heteroscedasticity-robust standard errors throughout. Model 5: all continuous predictors standardised to Z-scores before estimation; coefficients represent effects in units of the outcome per 1-SD change in each predictor. Model 3 includes 7 district fixed effects (one per CBS district); individual district coefficients are not reported — fixed effects serve as controls, not results of interest. Model 4 includes sector fixed effects (Arab / Haredi / Secular); neither dummy reaches significance after controlling for salary, peripherality, and demographics.

Does the child–adult disability link strengthen as the peripherality index decreases?

Yes — the interaction effect is statistically significant (β = −0.203, SE = 0.075, p < 0.01). The conditional slope of the child disability rate on the adult disability rate is: 0.812 − 0.203 × PeripheralityZ. Because a lower peripherality index score indicates a more peripheral locality, PeripheralityZ is negative in peripheral localities, making the product −0.203 × PeripheralityZ positive and pushing the conditional slope above its baseline of 0.812. Conversely, in more central localities (higher peripherality index, positive PeripheralityZ), the conditional slope falls below 0.812.

In other words, the intergenerational disability link is stronger in more peripheral localities and attenuates as localities become more central. This is consistent with a resources-moderation mechanism: central localities have better access to early intervention services, rehabilitation programmes, and social support networks that can partially decouple child from adult disability outcomes. In the periphery, these buffering mechanisms are weaker, allowing the disability cycle to transmit more fully across generations.

3.3 Statistical Comparison: High-Risk vs Rest (Welch’s T-test)

32
localities (11.5%) where both adult and child disability rates exceed the 75th percentile — potential intergenerational disability traps

Mean values compared between the 32 High-Risk localities and the remaining 246. Only indicators with p < 0.05 are statistically significant.

Socio-Economic Score

scale ~-3 to +3

-0.42
High-Risk
vs
-0.06
Rest
Δ = -0.36  |  t = -2.91  |  p = 0.0049 ✓

Peripherality Score

lower = more peripheral

0.05
High-Risk
vs
0.36
Rest
Δ = -0.31  |  t = -1.55  |  p = 0.1286 (n.s.)

Avg Salary (NIS)

monthly

11480
High-Risk
vs
13429
Rest
Δ = -1949  |  t = -4.66  |  p = 0.0000 ✓

Income Support Rate

% of working-age pop.

1.64
High-Risk
vs
1.03
Rest
Δ = +0.61  |  t = 4.02  |  p = 0.0002 ✓

Labor Participation

% of working-age + 65+ pop.

72.41
High-Risk
vs
75.72
Rest
Δ = -3.32 pp  |  t = -3.64  |  p = 0.0006 ✓

Bagrut Eligibility

% of students

72.40
High-Risk
vs
77.57
Rest
Δ = -5.17  |  t = -2.08  |  p = 0.0422 ✓

Academic Degree

% of pop. 25-65

23.83
High-Risk
vs
31.28
Rest
Δ = -7.45  |  t = -3.92  |  p = 0.0002 ✓

Peripherality Amplifies the Intergenerational Disability Cycle

In peripheral localities — where economic and social disadvantage are already most acute — the child–adult disability link is significantly stronger (interaction β = −0.203, p < 0.01, Model 5). Where support resources are thinnest, the intergenerational cycle transmits most fully. In a well-funded welfare state, targeted services should moderate this transmission. The data show they do not: geography shapes the intensity of the cycle, but cannot break it.

Overall Picture

High-Risk localities combine: lower socio-economic standing (−0.42 vs −0.06), lower wages (₪11,480 vs ₪13,429, −14.5%), higher income support dependence (1.64% vs 1.03%), weaker labor participation (72.41% vs 75.72%), and lower academic attainment (23.83% vs 31.28%) — creating a self-reinforcing environment where both adults and children depend on disability benefits. 6 of 7 indicators show statistically significant differences (Welch’s T-test p < 0.05). Targeted holistic family rehabilitation programs are needed.

What This Means for Policy

The 32 high-risk localities need holistic family-level rehabilitation programs, not individual disability support alone. Breaking the intergenerational cycle requires simultaneous intervention in education, employment, and healthcare access.

4. Every Model We Tried Hit the Same Wall

We tested Random Forest, XGBoost, TabPFN, and Linear Regression. All four models explain disability patterns well for most localities — and fail for Arab communities.

~82%
of the variance in Arab disability claiming cannot be explained by any combination of 15 socio-economic indicators
4.1 Model R² by Population Sector
R² = 0.177 for Arab localities, 0.420 for Haredi, 0.771 for Secular. The Arab wall is consistent across all model architectures.
“It’s Disgraceful Going through All this for Being an Arab and Disabled”
Alhuzeel et al. (2023) — Scandinavian Journal of Disability Research. Interviews with 15 Arab Israelis revealed multi-level barriers: language (Hebrew-only forms and committees), excessive bureaucracy (3 medical committees vs 1), lack of information about rights in Arabic, and cultural stigma within the community itself.
Arab self-reported disability prevalence: 21% — Jewish: 19%. Yet benefit claiming is lower. 35% of approved beneficiaries never exercised eligibility.
Brookdale Institute (2024) — People with Disabilities in the Arab Population

4.2 We Removed the Arab Variable — Nothing Changed

We re-ran the ensemble without arab_population_percentage. The under-utilization list stayed identical. The model doesn’t need an “Arab” label — it reconstructs the group from the remaining 14 indicators: low SES, low salary, zero Haredi %, specific peripherality and education patterns. No single variable carries the signal; it is distributed across the entire socio-economic profile.

This means the model normalizes the under-claiming pattern. It learns “localities that look like this tend to claim less” and adjusts its prediction downward — turning systemic access barriers into a statistical baseline. The discrimination is not in one column; it is woven into the structure of the data.

4.3 This Has Happened Before

Obermeyer et al. (2019, Science): A US healthcare algorithm trained on 200 million patients used cost as proxy for need. Because the system spent less on Black patients with equivalent illness, the algorithm concluded they were healthier.

Our case is analogous: NII data records benefit receipt as proxy for disability prevalence. In communities facing access barriers, fewer people claim — creating the illusion of lower need.

4.4 Convergence of Evidence

Our data, the qualitative research, and the international precedent all point to the same conclusion:

  • The R² wall (best model explains 63% overall but only 17% for Arab localities) = socio-economic variables capture the general pattern but miss Arab-specific barriers
  • The under-utilization clusters (6% Arab-majority) = families not claiming despite need
  • The hidden burden clusters (36% Arab-majority) = mostly non-Arab; the Arab gap is about access, not over-diagnosis
  • The intergenerational pattern (ρ = 0.461, child–adult disability link survives all 5 regression specifications) = access failure starts in childhood and strengthens in peripheral localities (interaction p < 0.01)

5. It's Not the War. It's Not the Distance.

Two alternative explanations tested and rejected: the Swords of Iron conflict and physical distance to National Insurance Institute (NII) branches.

5.1 Research Question 3 Did the Conflict Create a Disability Crisis?

+0.39 pp
Gaza Envelope — N=5 localities (2023→2025)
4.08% → 4.47%
+0.40 pp
Northern Frontline — N=21 localities (2023→2025)
4.11% → 4.51%
+0.32 pp
Other Population — N=170 localities (2023→2025)
3.41% → 3.73%
Gaza Envelope — 5 localities
Ashkelon, Netivot, Ofakim, Sderot, Tifrah
Northern Frontline — 21 localities
Beit Jann, Buq‘ata, Ein Qiniyye, Fasuta, Ghajar, Hurfeish, Jish (Gush Halav), Katzrin, Kfar Vradim, Kiryat Shmona, Kisra-Sume‘a, Ma‘alot-Tarshiha, Ma‘alya, Majdal Shams, Mas‘ada, Mazra‘a, Nahariya, Peqi‘in (Buq‘ei‘a), Sheikh Dannun, Shlomi, Yanuh-Jat
Other Population — 168 localities
All remaining localities in the balanced panel
5.2 Disability Recipient Rate: Gaza Envelope vs Northern Frontline vs Other Population
Rates rose at a similar pace across all groups. The gaps between groups remain stable, suggesting frontline status is not a dynamic driver of change.

Note: The disability rate here is the general disability pension rate calculated relative to the total population (number of pension recipients in a locality divided by total population). This differs from the adult disability rate used in previous sections of this presentation, where the denominator was the working-age population (ages 18–64).

Conclusion: Disability rates increased at a similar pace across all regions, with no distinct spike in the Gaza Envelope or Northern Frontline. The gaps between regions remained largely stable over time, suggesting that the observed differences are not primarily driven by short-term shocks during the period, and are likely related to underlying structural factors.

5.3 Research Question 4 Is Physical Distance the Barrier?

5.4 Disability Rate vs Distance to Nearest National Insurance Institute (NII) Branch (km)
Each dot is a locality.

The graph shows a negative correlation between distance to National Insurance branches and disability benefit rates when considering distance to any branch (Pearson r≈−0.34), but almost no relationship when considering distance to a central branch only (r≈0.01). These findings indicate a moderate relationship that depends on how accessibility is defined, and likely reflects underlying socio-economic differences rather than a direct effect of distance.

5.4b OLS Regression: Distance to Medical Board Controlling for Socio-Economic Variables
Dependent variable: general disability rate. The key variable of interest is dist_central_branch_km (distance to nearest medical committee / central NII branch). Controls: labor participation, log salary, income support rate, dependency ratio, Arab-majority, Haredi-majority localities.
Variable Coef. Std Err z P>|z| [0.025 0.975]
const 74.760 6.421 11.643 0.000 62.174 87.345
dist_central_branch_km −0.0054 0.013 −0.432 0.666 −0.030 0.019
labor_participation −0.1376 0.046 −3.011 0.003 −0.227 −0.048
log_salary −5.6499 0.527 −10.725 0.000 −6.682 −4.617
income_support_rate 0.0930 0.201 0.462 0.644 −0.301 0.487
dependency_ratio −0.0484 0.006 −7.776 0.000 −0.061 −0.036
is_arab −2.8397 0.425 −6.681 0.000 −3.673 −2.007
is_haredi −0.4542 0.815 −0.557 0.577 −2.052 1.144
Omnibus: 29.370  |  Prob(Omnibus): 0.000  |  Durbin-Watson: 1.796  |  Jarque-Bera (JB): 111.614
Answer to Research Question 4: The hypothesis predicts that dist_central_branch_km will carry a negative and statistically significant coefficient. The coefficient is indeed negative (β = −0.005), consistent with the hypothesized direction, but it is not statistically significant (p = 0.666; 95% CI: −0.030 to +0.019). The confidence interval straddles zero, meaning we cannot distinguish the effect from chance. Once salary, dependency ratio, labour participation, and population composition are held constant, geographical distance to medical committee centres explains no independent variance in the disability benefit rate.

Conclusion: The research hypothesis is not supported. Distance is not a meaningful barrier to claiming disability benefits once structural socio-economic conditions are controlled. The bottleneck lies elsewhere — in information, language, bureaucratic capacity, and institutional trust — not in kilometres to the nearest branch.
5.5 Same Scale Comparison: SES (slope -1.14) vs Distance (slope -0.82)
SES is a strong predictor; distance is nearly flat.
Conclusion: Physical distance to National Insurance Institute (NII) branches explains almost nothing. The barrier is not geographic — it is informational, linguistic, cultural, and institutional.

6. Salary Is the Strongest Reducer of Disability Rates; Elderly Population the Strongest Booster

Knowing what drives disability tells us what to target. Two complementary views: Linear Regression shows direction (increases vs decreases), tree models show magnitude.

6.1 Linear Regression: Which Factors Increase or Decrease Disability?
Red bars = factor increases disability rate. Blue bars = factor decreases it. Salary is the strongest negative driver; population 65+ is the strongest positive driver. Income support rate, labour participation, and Haredi-majority are not statistically significant. R² = 0.698.
6.2 Tree Models: Which Factors Matter Most?
Importance regardless of direction. Averaged across Random Forest + XGBoost. Best ensemble R² = 0.626.
Both methods agree: salary and Arab population composition are the dominant factors. OLS identifies salary as the strongest single reducer and elderly population share as the strongest booster. Tree models additionally surface academic attainment, CBS socio-economic score, and child disability rate as major contributors — reinforcing the same socio-economic inequality axis and highlighting the intergenerational dimension of disability. Linear Regression tells us the direction (what to increase, what to decrease). Tree models tell us the importance (where to focus resources first). Together, they point directly to the actions in the last section.

7. Interaction Effects: When Context Changes the Rules

In this section the dependent variable is the income support rate — the share of residents receiving income support benefits per locality. Multivariate regression with interaction terms (inspired by O'Brien, 2019) shows that sector and geography moderate the relationship between labor market conditions and this rate — explaining 47% of variance, up from 34%.

Methodology: Z-Score Normalization

All continuous variables were standardized to Z-scores (mean = 0, SD = 1) before constructing interaction terms. This serves two purposes: (1) comparable coefficients — each coefficient represents the effect of a one-standard-deviation change, enabling direct comparison across variables with different units; (2) reduced multicollinearity — centering variables before multiplying them prevents the interaction term from being strongly correlated with its components.

0.336
Baseline Adj. R²
Unemployment, dependency ratio, peripherality, salary
0.357
+Haredi × Unemp
Interaction not significant — negligible gain
0.427
+Periph Interactions
dep×periph and salary×periph both p<0.001
0.470
+Arab × Unemp
Best model — +40% relative gain over baseline
Interaction Term Coefficient (β, standardized) p-value Significance Interpretation
Peripherality × Dependency Ratio −0.327 <0.001 *** highly significant Peripherality amplifies the dependency effect — need intensifies uptake at the margins
Log-Salary × Peripherality +0.267 <0.001 *** highly significant Higher wages partially buffer the peripherality disadvantage
Arab Sector × Unemployment −0.297 <0.001 *** highly significant Unemployment–benefit link is significantly weaker in Arab-majority localities
Haredi Sector × Unemployment +0.019 0.773 — not significant No differential unemployment effect detected in Haredi localities

Insight 1: The Periphery Trap

The interaction between peripherality and dependency ratio carries a standardized coefficient of −0.327 (p < 0.001). In peripheral localities with high dependency loads, income support rates are higher than the baseline model predicts — exactly as the burden of need would suggest. Peripherality does not simply add to disadvantage; it multiplies it, amplifying and intensifying the dependency burden precisely where dependent populations are most concentrated.

Insight 2: The Arab Sector Paradox

In the general population, higher unemployment predicts higher income support uptake. In Arab-majority localities, this relationship is significantly weaker: the Arab × Unemployment interaction is −0.297 (p < 0.001). This is consistent with the institutional barriers documented elsewhere in this research — language barriers, limited digital access, and reduced NII outreach — which decouple economic need from actual benefit receipt. Unemployment rises, but claims do not follow.

Insight 3: The Haredi Non-Finding

Unlike the Arab sector, the Haredi × Unemployment interaction is not statistically significant (β = 0.019, p = 0.773). Within Haredi communities the standard unemployment–income support relationship operates similarly to the general population. Distinct patterns observed for Haredi localities in other analyses are therefore not driven by a differential sensitivity to unemployment, pointing toward structural or cultural factors operating through different channels.

Bottom line: Interaction modeling raises explained variance from 33.6% to 47.0% — a 40% relative improvement. The Arab sector and periphery interactions are not statistical artifacts; they reflect real structural conditions that standard main-effects models miss entirely, and have direct implications for where targeted outreach will matter most.

8. Five Actions to Close the Gap

Each recommendation is tied to specific findings from this research.

1

8.1 Targeted Outreach in 17 Flagged Localities

From Q1: the 17 flagged localities should receive proactive information campaigns — in Arabic, with community-based intermediaries and local advocacy organizations. 6% are Arab-majority.

2

8.2 Simplify the Process

From The Wall: Bhargava & Manoli (2015) showed simplifying benefit language increased claiming by 6-8 pp. Show estimated benefit amounts, use plain language, reduce paperwork. 35% of approved beneficiaries never exercised eligibility.

3

8.3 Arabic-Language Services at NII

From The Wall: Alhuzeel (2023) identified multi-level barriers — Hebrew-only forms, excessive bureaucracy, and lack of Arabic-language information about rights. Ensure medical committees include Arabic-speaking professionals. Provide all forms, notifications, and digital services in Arabic.

4

8.4 Break the Intergenerational Cycle

From Q2: localities flagged for both child and adult disability (ρ = 0.461) need integrated family-level interventions, not separate programs. The pattern persists even in affluent areas (ρ = 0.715 in the center).

5

8.5 Annual Monitoring Dashboard

From Q3: re-run the model annually. Localities with persistent positive gaps across multiple years should be prioritized for field investigation. Track frontline communities (4 localities) for post-conflict effects.

Summary: Four questions, one conclusion: disability benefit under-utilization in Israel is concentrated, intergenerational, structural, and invisible to standard data. Our models explain ~63% of the variation overall (R² = 0.626) but hit a wall for Arab localities (R² = 0.18). The barriers are not in the data — they are linguistic, institutional, and cultural.