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Introduction: Inadequate physical activity, eating disorders, irrational factors of the educational environment and a poor motivation for a healthy lifestyle are often observed among youngsters and act as their health risk factors. At the present stage, they hamper ensuring optimal living conditions and achieving better health of schoolchildren and require a new approach to solving the tasks. The objective of the study was to assess provision of sanitary and epidemiologic wellbeing at schools and health of schoolchildren to substantiate priorities for management decision making. Materials and methods: The study was conducted in two comprehensive schools of the city of Penza and involved 2,672 children and 720 parents. We used sanitary, hygienic, physiological, sociological, and statistical methods of research. Results: The level of sanitary and epidemiologic wellbeing in the experimental school with an up-to-date model of hygienic education and development of a healthy lifestyle integrated in the educational process where students have the opportunity to receive health-improving and rehabilitation medical care, was significantly higher than in the control one. Introduction of the new model of upbringing and functioning of the department for disease prevention and rehabilitation contributed to an increase in students’ motivation for a healthy lifestyle and skill consolidation in the behavior of youngsters as confirmed by a larger proportion of such students in the experimental school compared with the control one (75–89% against 50–74%, respectively; p < 0.001). Conclusion: Implementation of management decisions including the upgrade of the system of hygiene education, creation of a healthy lifestyle of students, and organization of the department for disease prevention and rehabilitation on the basis of the educational establishment had a positive effect on students’ health.

We questioned 1,064 school students from 5-11 grades and 720 parents of schoolchildren from 1-4 grades and assessed health of 2,512 children and teenagers via comparative examination performed in two secondary schools with similar sanitary-epidemiologic situation in them but different preventive activities accomplished and different medical care provided. The results we obtained via questioning and examination revealed that school children's health is preserved and improved due to targeted development of preventive activities and medical care, better nutrition in school, an increase in physical activities, and a growth in number of children who wish to pursue health-preserving behavior patterns. When a prevention and rehabilitation unit was established in a school it allowed to improve medical care and achieve a substantial decrease in morbidity among school children, first of all, with respiratory organs diseases which were a basic reason for absence from classes. Most children (77.5 %) who were made healthier or recovered in school had suffered from respiratory organs diseases. Improvement of preventive activities aimed at creating health culture and attitudes towards healthy life style had positive influence on children's motivation and formation of such behavior stereotypes that helped to preserve their health. It was confirmed by questioning results as well as by lower levels of common and primary morbidity and better physical development. Share of practically healthy school students without any risk factors (the 1st health group) increased from 5.61 % in 2009 to 8.54 % in 2017; share of school students who were in the 2nd health group (had functional deviations or ran risks of chronic pathology development) decreased from 86.28 to 83.98 % (р < 0.05).

Negative trends in incidence rates of children and adolescents of the city of Penza are due to the influence of both environmental factors as well as the educational process. Hygienic trouble in the city of Penza determines air pollution emissions of road transport, as evidenced by the high levels of morbidity rate in children and adolescents. The priorities for the correction factors are conditions and the organization of nutrition, physical education. There are identified the most important lifestyle factors for senior pupils that need the solution.

Рост промышленного производства в стра-не не всегда сопровождается существенным улучшением качества среды обитания и, как следствие, уровень защиты населения и окру-жающей среды не достигает состояния, при ко-тором отсутствуют недопустимые риски причи-нения вреда от воздействия опасных химических и биологических факторов [1, 4,7, 9]. Вклад за-грязнения атмосферного воздуха, питьевых вод, почвы химическими компонентами в смертность населения составляет в среднем 11,4 %, в забо-леваемость -12,5 % [7].В последнее десятилетие в гигиенических исследованиях при оценке влияния среды оби-тания на здоровье все большее внимание уде-ляется расчетам рисков и ущербов здоровью населения, необходимых для обоснования при-нятия управленческих решений [3,6, 8,[12][13][14][15].Методология оценки риска имеет особое зна-чение при определении значимости для орга-низма детей длительного воздействия химиче-ских веществ на уровнях ниже регламентируе-мых. Показано, что даже при концентрации химического вещества в объектах среды на уровне гигиенического регламента величина риска для здоровья детского населения может быть достаточно высокой [2, 4,11]. Поэтому вероятность возникновения неблагоприятных эффектов при воздействии веществ, загряз-няющих окружающую среду, определяемую как уровень риска для здоровья, целесообразно применять для обоснования разработки профи-лактических мероприятий в конкретном регио-не и населенном пункте [6,10].По итогам 2014 г. Пензенская область от-несена к группе регионов с довольно благопри-__________________________