Holocaust survivors, while suffering from more chronic diseases and conditions, actually live longer compared to a similar age group that did not go through such a traumatic experience, according to research from Israel published Friday.

It’s unclear what the key is to this unexpected resiliency, said Dr. Gideon Koren, lead researcher of the study and a pediatrician by training. But he believes it’s a combination of genetics and purposeful living.

“There have been several studies that thought that people who had this terrible experience of the Holocaust may have more medical problems — of course we confirm that again,” Dr. Koren said in a phone interview from Israel.

“But then I had the hypothesis and life experience, indeed family and other people, that I thought I saw a lot of them surviving longer.”

Dr. Koren and his team looked at medical records for almost 38,600 Holocaust survivors living in Israel. Among them they had higher rates of many chronic diseases — such as high blood pressure, kidney disease, heart disease, cancer, obesity, dementia, among others, compared to native-born Israelis, the Holocaust survivors lived longer, living to almost 85 years old compared to an average of 78 among non-survivors.

“They do have more morbidities, as other people have shown, but they do survive more,” Dr. Koren said. “The results are unexpected, although I was not surprised.”

Israel in general ranks high among nations for the life expectancy, at around 82 years, and consistently ranks high on the United Nations Happiness Index, coming in 11th out of 156 countries in 2018.

By comparison, life expectancy in the U.S. in 2017 was around 79 years old, and is decreasing. The U.S. rates 18th on the U.N’s happiness index.

“It’s much higher than what you would think based on wars and lifestyle,” Dr. Koren remarked about living in the Jewish state.

At the end of 2016, there were an estimated 186,500 Holocaust survivors living in Israel, with about 30 percent of that population people who had survived the conditions of ghettos and hard labor and concentration camps, according to data from the Israeli Central Bureau of Statistics.

Longevity among this group — and in general among those 80 and older — is believed to be a function of good genetics, healthy lifestyle choices and positive psychological well-being.

In a separate study published in October by Israeli researchers, Holocaust survivors, when asked what the key to long life is, answered that the most important this is to take good care of one’s own health. This was different from the answers of a similar group, in age and immigration to Israel, but who did not go through the Holocaust. That group instead answered to enjoy life fully.

“It is very possible that because of their experience, they take a very different approach to life, they take better care of themselves,” Dr. Koren said. “We call it health literacy — they know more, they ask more, probably some of it or much of it is their experience.”

Although a positive attitude and gratitude is not to be discounted. Dr. Koren also pointed out that in research showed that soldiers who survived life-threatening war combat also showed resilience in enjoying their lives because they had survived combat.

“So I think it’s a combination of more than one thing. But it tells us something beyond the terrible Holocaust experience about the human experience in general,” he said.

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