Life expectancy of population of the northern regions in the Russian Federation: Tendencies and potential for growth

The article is devoted to the tendencies in life expectancy of population of the northern regions of Russia in the context of growth and regional convergence indicator in the early 2000s and possibilities for its further growth. The sources of information are the official Rosstat data. Life expectancy in the North has been found to be largely subordinate to the Russian-wide patterns of the regional convergence: the compaction of the northern constituent entities to the national average level occurred at both the top and bottom levels. Both the Khanty-Mansiysk and Yamal-Nenets Autonomous Districts experienced a significant decline, as did the gap in most regions with life expectancy below that of the Russian Federation. Only Kamchatka Krai and Magadan Oblast increased the lag, while maintaining group affiliation in the regional grouping in terms of life expectancy. The potential for the further growth in life expectancy in the North is being determined by the insufficient reduction in mortality caused by the circulatory system diseases and increase in the neoplasm mortality within the period of 2003–2019, and environmental and behavioral risk factors reflected in the differences in life expectancy in different settlements, its gender differentiation and the high level of mortality from external causes. The large difference in life expectancy between urban and rural areas makes the large potential in the northern regions except Murmansk Oblast and partly the Sakha Republic (Yakutia). Almost all northern constituent entities have a significant potential posed by the male under-representation indicator. Despite a significant rate of decline, external causes of death and their share in cause-related mortality are widespread in the North. With the exception of the Chukotka Autonomous District, within recent years, infant mortality rate in the North has been fairly good — it can no longer be considered as a potential for the life expectancy growth of population.

Examining the Economic Perspective of Treatable Mortality: The Role of Health Care Financing and the Importance for Economic Prosperity

Health is an essential element of economic life and is therefore considered a source of comparative economic development of countries. The aim of the study was to examine the associations between health care financing, specific treatable mortality of males and females of working age, and economic prosperity, taking into account to the classification of health systems applied in the countries of the Organization for Economic Co-operation and Development (OECD). An insurance-based health system and a tax-based health system were identified in these countries, and data were collected for the period 1994–2016. Descriptive analysis, panel regression analysis and cluster analysis were used to achieve the aim. The analytical process included economic indicators [health expenditure, gross domestic product (GDP)] and health indicators (treatable mortality from circulatory system diseases and endocrine, nutritional and metabolic diseases). The results revealed significant negative associations of health care financing with treatable mortality from circulatory system diseases and endocrine, nutritional, and metabolic diseases in both health systems and both gender categories. There were also negative associations between treatable mortality in both diagnosis groups and economic prosperity. These results have shown that health care financing is linked to economic prosperity also through health variability in the working age population. In terms of assessing economic and health outcomes, less positive and more positive countries were identified using cluster analysis. Countries such as Latvia with a tax-based health system and Hungary, Lithuania, Estonia with an insurance-based health system were characterized by great potential for improvements. Although reducing treatable mortality is a great motivation for public health leaders to increase health care financing, the importance for economic prosperity may be a more compelling argument. Effective interventions should be considered in the light of their regional, social and economic contexts.

Concomitant diseases in COVID-19 and their impact on the risks of adverse outcomes

Aim. To analyze COVID-19 comorbidities and their impact on disease course and the risk for unfavorable outcomes. Methods. This study examined a group of 110 patients aged 32 to 97 who were admitted to the intensive care unit of the Pskov Regional Infectious Diseases Hospital in the period from October 7, 2020 to March 23, 2021. The mean age of patients was 65 years, 51% (56 people) were male. The study recorded age, comorbidities on a binary scale (yes no), course of the disease, the degree of lung injury, hospital length of stay, treatment outcome. The impact of comorbidities on the disease severity and outcomes was assessed by using logistic regression analysis. Results. It was shown that a regional sample of patients showed an increased hospital mortality rate compared with the data of the ACTIV registry (33.5 versus 7.6%). Chronic respiratory diseases in patients with COVID-19 regional cohorts affected the fatal outcome 2.7 times less than those registered in the Russian register. The presence of endocrine and thrombotic circulatory system diseases was generally close to the register. Concomitant cardiovascular diseases in patients of the regional cohort affected the mortality of COVID-19 outcomes two times less (in patients of the region, the risk of mortality increased by 2.066 times) than in the registry. The reliability of the conclusions is confirmed by testing statistical hypotheses and reliability coefficients below 5%. Conclusion. The study shows the statistically significant effect of comorbidities on the COVID-19 outcomes; the specificity of the results related to the sampling characteristics and the regional component.

Comparative analysis of population mortality in the cities of Severodvinsk and Arkhangelsk

Increasing use of ionizing radiation sources in different spheres of human life dictates the need for investigating the effects of low-dose radiation on mortality and morbidity. The aim of this study was to compare mortality from the most common non-communicable diseases in the cities of Severodvinsk and Arkhangelsk. We analyzed the rates of age- and sex-specific mortality from circulatory system diseases (CSD), malignancies, digestive system disorders, respiratory system diseases, and external causes. CSD-related mortality among men and women past working age was higher in Severodvinsk than in Arkhangelsk (median (Q1; Q3): 3,349 (3,271; 3,458) vs 2,651 (2,618; 2,756), p < 0.012; 1,947 (1,890; 2,022) vs 1,753 (1,727; 1,809), p < 0.012; 292 (281; 342) vs 265 (253; 274), p < 0.025, respectively). For other causes of death, mortality rates in Severodvinsk did not exceed those in Arkhangelsk. Increased mortality from CSD in Severodvinsk cannot be linked to socioeconomic conditions or chemical air pollution because the standard of living is higher in Severodvinsk than in Arkhangelsk, whereas the level of chemical pollution is lower. At the same time, the presence of the nuclear shipyard and radioactive waste repository in Severodvinsk could cause chronic exposure to low-dose radiation. It is important to expand preventive measures aimed at early detection of vascular damage in nuclear workers and general groups of population residing in the vicinity of hazardous radiation sites.

Assessment of the impact of the quality of drinking water on the primary morbidity of children in the Altai Territory

The number of environmental factors that adversely affect the health of children is growing every year, their combination is different in each territory. It is the child’s body that is most sensitive to changes in environmental conditions, reacting to this with a deterioration in health. Currently, there is a tendency to study the regional characteristics of the interaction of a set of environmental factors with the child’s body. The aim of the work was to identify trends in the primary non-infectious morbidity among children in the Altai Territory, as well as to assess the possible impact of the state of drinking water on the morbidity of children in the region. In the region, an unfavorable tendency was revealed in such groups of nosologies as neoplasms, diseases of the endocrine system, diseases of the circulatory system, diseases of the digestive system, diseases of the genitourinary system, congenital anomalies, and diseases of the respiratory system. The regularity of distribution over the territory of the region of administrative-territorial formations with a high incidence rate was revealed. The analysis of associations of morbidity in children with average annual concentrations of substances polluting the atmospheric air and drinking water showed the presence of reliable correlations in areas of critical and stressful environmental quality. The results obtained indicate the need for a detailed assessment of the influence of environmental factors on the incidence rate of children in the regional aspect, the formation of a database and the development of automated programs capable of predicting the incidence rate in each specific territory. This will improve the efficiency, including the economic, of preventive measures.

Organization of research activity in a polyclinic using medical information system

Introduction. The article considers an approach to organization of research activity using medical information system. Materials and methods. Authors carried out retrospective analytical cohort study of adults with temporary incapacity to work based on the data from the State Medical Institution Galichskaya District Hospital (Kostroma Region of the Russian Federation) for a period 2014–2019. Sampling was done using the medical information system. Results. As the medical information system has been operating for many years and is designed in the way that the key information gaps should be filled, we consider the results of our study on research activity in a polyclinic using medical information system successful. Discussion. The organization of research activity is discussed using results of an epidemiological study aimed at identifying the correlation between the incidence of acute respiratory diseases and further development of circulatory system diseases carried out in Galichskaya District Hospital.

Peculiarities of administration of medications to patients with circulatory system diseases within the framework of the federal program of preferential provision of medicines

Objective: to analyse of medicines prescriptions for federal beneficiaries with circulatory system diseases and to identify the main trends in the implementation of the federal program for the provision of necessary medicines in the Samara Region in 2014–2017.Material and methods. The authors reviewed the nomenclature of medicines used to treat circulatory system diseases (CSDs) and distributed to the population of the Samara Region as part of the federal program for the provision of necessary medicines for the period from 2014 to 2017. The methods of comparative, retrospective, logical, graphical and content analysis, the method of data grouping according to Anatomical Therapeutic Chemical classification and methods of descriptive statistics were used.Results. In 2014–2017 the share of financial costs for the purchase of medicines in the total budget of the federal program for the provision of necessary medicines in the Samara Region did not exceed 6%. Still, in physical terms (in terms of the number of packages) the share of medicines of this pharmacotherapeutic group in the federal program for the provision of necessary medicines averaged about 25%. Nomenclature of medicines of the analyzed group prescribed to federal beneficiaries in 2014–2017 ranged from 90 to 107 nomenclature items. The number of international nonproprietary names (INN) decreased from 51 in 2014 to 36 in 2017. During the period under review, there was a decrease in the acquisition cost of medicines for the treatment of circulatory system diseases and the weighted average cost of one package (by 63% and 53%, respectively).Conclusion. Perindopril-containing medicines occupied the maximum consumption volumes in monetary terms. There was a decrease in the average cost of one package in 2017, which may be associated with the replacement of original medicines with generics and a concomitant reduction in the number of INN within the subgroup.

Evaluating Occupational Morbidity Among Energy Enterprise Employees In Industrial Region Of Kazakhstan

Our research project was aimed at studying the effects of an electromagnetic field of industrial frequency (EMF-IF) on employees of an energy company in Kazakhstan. Material and Methods — The object of our study was the health status of electricians (morbidity with temporary disability – MTD), engaged in the maintenance of power lines, relay protection systems and substations (220 and 500 kV) at an energy enterprise in Kazakhstan. The interrelation and dependence of the intensive MTD indicators on the hygienic factors at the workplace were determined, and the risks were calculated from the obtained data. Results — Unfavorable workplace conditions caused an increase in disorders of the musculoskeletal system (up to 77%), blood circulation (up to 65%), nervous system (up to 52%), skin diseases (up to 46.4%), as well as the manifold rise of the likelihood of neoplasm growth and respiratory diseases. For electricians, the relationships between the nervous system disorders (r=0.792), the circulatory system diseases (r=0.573), the musculoskeletal system ailments (r=0.672) and the EMF-IF parameters were discovered. At the same time, the dependence of the incidence rates of various diseases in workers on EMF, as well as moderate to high computed relative risks, implied the occupational genesis of worklace ailments: for nervous system – R2=0.628, cardiovascular system – R2=0.709, skin – R2=0.729, and musculoskeletal system – R2=0.413. Conclusion — As preventive measures for electricians, we recommended to wear individual exposure meters, to limit work in contact with EMF, to include an oncologist in the medical commission, and for trainees, to screen for oxidative stress proteins and chaperone proteins to exclude a predisposition to oncogenesis.

Avoidable mortality from circulatory system diseases in Moldova

Mortality from avoidable circulatory system diseases causes one of the major losses in life expectancy, especially in males and population of working ages. The main contributors are the deaths caused by ischaemic heart diseases, cerebrovascular diseases, and hypertensive diseases. This article analyses the trends in avoidable mortality caused by diseases of the circulatory system and estimates the possible increases in life expectancy due to the elimination of these causes of death. In this regard, the author uses methods of standardization, mortality decomposition and cause-elimination model. The study shows a decline in avoidable mortality from circulatory system diseases during the analyzed period, especially for earlier ages. At the same time, there is a significant differentiation in mortality dynamics depending on sex. In 2016–2018, avoiding these deaths could assure an increase in life expectancy by 3.8 years in males and 2.8 years in females. This possible increase in life expectancy could be partially achieved by improving the quality of the health care system and introducing policies and programs aimed at improving the health of the population. Moreover, programs aimed at preventing diseases of the circulatory system might influence on mortality diminution from other non-communicable diseases and external causes of death.

How Has the Current Curative Expenditure of Noncommunicable Diseases Changed? Evidence From China in 2017-2019

Background: Noncommunicable diseases (NCDs) are the leading causes of morbidity and mortality worldwide. Understanding the distribution of diseases can provide a basis for policy formulation and intervention. This study analyses the current curative expenditure (CCE) of NCDs in China to provide health policy advice.Methods: Data were collected by multi-stage stratified random sampling from 2017-2019. The medical expenses of patients with NCDs were calculated based on “System of Health Accounts 2011”(SHA 2011), Analyze from funding sources, dimensions of institutional flow, and financing scheme. Linear regression analysis was conducted by controlling factors influencing hospitalization expenses. All analyses were performed by STATA 15.0.Results: 408 institutions and 8,104,233 valid items were included in the study. The CCE of NCDs was 14.205 billion China Yuan (CNY) in 2017, 15.914 billion CNY in 2018, and 18.055 billion CNY in 2019. More than 60% came from public financing. The proportion of family health financing continued to decline, reaching 31.16% in 2019. The expenditures were mainly in general hospitals, above 70%. Elderly patients account for the majority. Diseases of the circulatory system, Diseases of the digestive system, and Neoplasms were the main NCDs. Year, age, gender, length of stay, surgery, insurance, and institution level were the factors affecting hospitalization expenses.Conclusions: NCDs are the main CCE of diseases in China, and their resources are not allocated reasonably. To reduce the CCE of NCDs, the government needs to optimize resource allocation and rationalize institutional flows and functions.