Israeli Holocaust survivors tend to live, on average, seven years longer than their fellow countrymen who were not persecuted during the WWII genocide. However, the survivors were also far more likely to suffer from chronic illness such as hypertension, coronary heart disease, or cancer. It’s not clear why the death rate is much lower in Holocaust survivors. The tesearchers believe that the longevity may be owed to genetic factors that kept them alive but also resilience gained by braving the trauma.

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The research team at the Kahn-Maccabi Institute of Research and Innovation, a medical research firm based in Tel Aviv, looked at health data for 39,000 Holocaust survivors who were born in Europe between 1911 and 1945, which they compared to 35,000 people born in Israel during the same period (at the time Israel was a territory of the British Empire).

Among the Holocaust survivors group, the researchers found higher rates of various chronic conditions — from bone fractures to obesity to cancer — than in the general population. For instance, 83% of Holocaust survivors had hypertension, compared to only 66.7% among the control group. Likewise, 30.9% of Holocaust survivors suffered from chronic kidney disease, while only 19.8% of the control group had the illness.

Yet, despite the higher incidence of chronic conditions, the Holocaust survivors had a much lower death rate than the control group — 25.3% compared to 41.1%. In absolute numbers, that’s 84.4 years of life, on average, for the Holocaust group and 77.7 years for the control group.

What can explain this huge discrepancy? It may be a dark and grueling one: the Holocaust group were forcefully selected through the hardship they had to endure. The old, frail, and weak were the first to be exterminated in Nazi concentration camps while the strongest were kept for work. The prisoners were further culled by the years and years of detention in the camps. At the end of the Holocaust, a select group of people emerged with qualities that enabled them to survive — and presumably helped them live longer than the general population (which didn’t live through a genocide).

Israel has one of the highest life expectancies in the world, and Holocaust survivors and their offspring (many of whom moved to Israel) make up an important chunk of the country’s population. It’s possible that the country’s longevity may be owed to the selected genetics of the Holocaust group.

Another factor that may explain the remarkable longevity of Holocaust survivors is their behavioral adaptations to their persecution during the Nazi hegemony. They say what doesn’t kill you makes you stronger, and that may well be the case here. Holocaust survivors are more likely to have coping skills, supportive social networks, and a focus on healthy behaviors than the general population. Holocaust survivors are also more likely to seek medical attention, due to their various sickness, which may also explain their longer longevity.

“Our study found higher rates of comorbidities and lower mortality among Holocaust survivors, which may be associated with improved health literacy and unique resilience characteristics among Holocaust survivors. More research is needed to explore the biologic and psychosocial basis for this resilience,” the authors wrote in their study.

These are also very interesting findings, which warrant more research. The Holocaust is a shameful stain on humanity’s long and rich history but if out of its many lessons — which we ought never to forget — perhaps we can learn to live longer without having to go through such terrible experiences.

The findings were reported in the journal JAMA.