The research focuses on classifying Russian regions as per their sanitary-hygienic and social-economic welfare, as well as on assessing (for certain nosologies) correlations between heterogeneous risk factors and morbidity with temporary disability among working population. The RF regions were classified (with k-average cluster analysis) as per their sanitaryhygienic and social-economic welfare in order to spot out territories with similar "background" for formation of working population health.We used data provided by the Federal Statistic Service (as per the RF regions) collected in 2016 as our empiric base. As per cluster analysis results, we assigned the RF regions into four specific categories, namely "ill-being", "moderately ill-being", "moderately well-being", and "well-being" (the obtained data are visualized on the map of the country).The performed correlation-regression analysis allowed us to obtain more than twenty authentic models that described correlations between various factors and morbidity with temporary disability among working population.We calculated determination coefficient R 2 for each model that characterized a share of explained variation in a health parameter caused by a factor that was considered in a model.We paid special attention to the 1st cluster that had the least favorable background for health formation (here we detected most apparent influence exerted by social and economic factors on analyzed health parameters of working population). The 2 nd clyster was also examined thoroughly as it was characterized with the highest morbidity among working population (we revealed that social-hygienic welfare on territories belonging to this cluster had greater influence on health parameters than social and economic one).Our data can be appliedto create federal and regional programs aimed at preserving and improving working population health.
The article proposes the algorithm and methods for assessing the risks of the population health deterioration associated with impact of social and economic factors at the macro level. The methods are tested on the materials under 78 entities of the Russian Federation for 2010-2013. The high level of risk in relation to indicators "infant mortality", "morbidity with the blood circulatory system diseases" and "mortality of population from infectious and parasitic diseases" is established in a number of regions of the Russian Federation. It is demonstrated that the socially determined health risk in the most entities of the Russian Federation is at medium level that determines the need for operative measures on its mitigation.
The authors highlight that contemporary social and economic processes require development of a new paradigm for discussing human health risks caused by food products distribution (risk-communications). Today such a model is replaced with a "prototype" of risk-communication, or simple informing. And as there is no "feedback" from risk recipients, it is impossible to adequately adjust information flows or assess their efficiency. Consequently, risks tend to be underestimated or aggravated by consumers. Working our decisions on managing risks and plans how to implement them are to be solved jointly by experts, authorities, and population.It is shown that there are some basic ways to build up an efficient risk-communications system in the sphere of food products safety; to do that, we need to achieve greater information activity and interest of population in issues related to products quality and safety; to form a stable attitude towards self-preserving behavior among people; to improve a state system for interaction between all the concerned parties on issues related to population health and food products safety. It is extremely important to fully use channels for information dissemination that are in demand by a target audience (for example, active application of social media) and to created conditions for public discussions about risks. Tactical tasks are methodical guidance on forms and means of providing information about health risks as they are to be relevant for a target audience. Expert community involvement into a constructive risk dialogue is a significant tool for increasing riskcommunications efficiency. As population tends to trust scientists, experts, and doctors more than public persons, representatives from these expert groups are to play a significant social role in a system of efficient risk-communications.
Nowadays intense urbanization is taking place, cities with a number of dwellers over a million and urban agglomerations appear, and it calls for new ways how to preserve and improve health of urban population who are exposed to various risk factors, primarily environmental and behavioral ones. One of such ways could be development of a city as health-oriented physical, social, and semantic space; that is, it should be an environment that has natural, material, socio-cultural and other resources and they are used to create possibilities for individuals and social groups to preserve and improve their health. Parameters of a physical component in health-oriented space and their possible indicators can be found in foreign concepts and international projects ("healthy city", "active city", "age-friendly city"), as well as in Russian management practices ("Creation of comfortable urban environment" project, a concept of urban space quality). This article focuses on a detailed system of indicators that can be applied to assess whether a health-oriented urban environment is welldeveloped; the system is based on risk-oriented approach and includes two groups of indicators. The first one comprises indicators that describe a health-preserving component in urban space that allows to control health risk factors better; the second one includes indicators that are related to a health-improving component that helps to improve health and to promote stability. As morbidity and mortality among urban population vary greatly in their structure depending on countries and regions, health-oriented urban space should be created taking into account health peculiarities of population living on a specific territory. In other words, detected leading causes for mortality and morbidity among urban population in Russia as well as manageable risk factors that cause them should serve as grounds for a creation of such a body-space urban environment that will be oriented at reduction in negative impacts exerted by chemical contamination of the environment on population health (planting, alternative transport infrastructure, compliance of drinking water sources with sanitary-epidemiologic requirements, quality of water supplies and distribution systems); such system will also provide conditions for sufficient physical activity and health nutrition.
Предложены алгоритм и методы полуколичественной оценки риска, связанного с воздействием поведенческих факторов на здоровье, в отношении которых недостаточно данных для количественной параметризации связи «фактор-ответ». К числу данных факторов отнесены, в первую очередь, безответственное медицинское и гигиеническое поведение, нарушения режима труда и отдыха, сна и бодрствования. Показано, что полуколичественная оценка риска предполагает разработку частных балльных шкал для каждого оцениваемого поведенческого фактора, выбор способа интеграции балльных оценок, выбор способа установления тяжести негативных эффектов, формирование матрицы риска. На примере фактора «безответственное медицинское поведение» показан способ балльной характеристики рискогенного потенциала отдельных компонентов фактора для использования при расчете частных и интегральных индексов вероятности нарушения здоровья. Произведен учет таких компонентов, как: а) своевременность обращения к врачу; б) практики прохождения профилактических осмотров; в) комплаентность (приверженность к назначенному врачом лечению); г) прием лекарственных препаратов без назначения врача; д) обращение за рекомендацией о лекарственных препаратах и методах лечения к кому-то, кроме врача. Предложена логическая схема анализа поведенческого фактора риска на индивидуальном уровне для использования на этапе оценки экспозиции. Показано, что инструментарий, применяемый для характеристики экспозиции, должен давать возможность оценки типичности и устойчивости реализуемых индивидом или группой поведенческих паттернов. Рекомендована матрица для полуколичественной оценки рисков здоровью, связанных с действием поведенческих факторов, соединяющая в себе два типа дескрипторов-характеризующих полуколичественную оценку вероятности и оценку тяжести вредного эффекта. Ключевые слова: риск здоровью, полуколичественная оценка риска, поведенческие факторы, коэффициент тяжести негативных эффектов, оценка экспозиции, матрица риска.
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