Standardized mortality ratios (SMRs) for Jews are presented by cause and district for the years 1969-78. District SMRs ranged from 94 in Petah Tikva to 115 in Beersheba. These differences may be due to direct and indirect ethnic, genetic, socioeconomic, occupational and environmental effects, as well as to possible health service supply differences. SMRs can be used to indicate districts where investigations should be carried out to search for the underlying determinants of relatively high mortality from specific causes. In addition, SMRs can be used as a global measure of all these causes in a budgetary allocation formula. However, objections arise as to whether SMRs are a good indicator of the need for health services. SMRs can also be used as a cause-related monitoring tool, thus warranting their routine calculation as one measure of the output performance of the health service system in Israel.
