Cardiovascular diseases (CVDs) are the main group of diseases from which the population of Sumy region suffers. They have not only high rates of primary morbidity and prevalence, but also play the leading role among the causes of mortality in the region. The aim of the article is clarification of the geographical features of mortality of the population of Sumy region from diseases of the circulatory system. In 2018 compared to 2012 the mortality of the general population in Sumy region from this class of nosology decreased by 1.17%, although among the able-bodied population it grew by 1.94%. The geographicaldifferences of mortality (including separately the group of able-bodied population) from various CVDs: coronary heart disease, acute myocardial infarction, cerebrovascular disease, cerebral strokes and strokes with hypertension, were established. For determining the regional features of mortality of the population from cardiovascular diseases we used the integrated indicator «disease mortality risk assessment». This indicator takes into account the relationship between the primary morbidity, prevalence of diseases and the causes of mortality and makes it possible to assess the state of health of the population in terms of CVDs. It was found that the inhabitants of Sumy, Romny, Nedryhailiv, Putyvl’ and Lypova Dolyna districts, where the highest integrated indicator value was observed , have a high risk of dying from diseases of the cardiovascular system,. At the same time for the city of Sumy, Bilopillia and Krasnopillia districts, a low level of the mortality risk from CVDs is characteristic. Among the able-bodied population of Sumy region, the inhabitants of Seredyna-Buda and Yampil’ districts are at the highest risk of mortality from CVDs. A forecast of the mortality of the population of Sumy region before 2023 was made. The baseline scenario showed a decrease of mortality from CVDs by 2.1 %. From the optimistic forecast (lower 95% confidence bound) the mortality rate from CVDs for 2023 will fall by 19.4%, while the pessimistic forecast (upper 95% confidence bound) shows an increase in the mortality rate by 13.3 %. As a result of ranking the values of the integrated indicator of mortality from cardiovascular diseases, it was found that in the first place is the risk of dying from a stroke, in the second place – from cerebrovascular diseases, and in third place – from strokes with hypertension. Next are the risks of dying from coronary heart disease and myocardial infarction. The results of the study can be used by local authorities to prevent the growth of morbidity and mortality from diseases of this nosological class, as well as for development of preventive measures and stabilization of the health status of the population of Sumy region.

Analyzed the level of primary morbidity of population and prevalence of the osteo-muscular system diseases and of the connective tissue diseases among the residents of the Sumy region. It is established that nosologies of this class are occupy a prominent place in the overall structure of disease's prevalence among the inhabitants of the Sumy region. The percentage of above mentioned nosologies in total structure of Sumy region population morbidity has been exceed 5 %. The dynamics of primary morbidity and prevalence of diseases was separately examined during 2005–2016. Moreover, it was revealed that the situation with the morbidity by nosologies of this group during 2005–2016 has been deteriorating. For example, the primary morbidity of population of the Sumy region by diseases of osteomuscular system and of the connective tissue decreased by 6.5 %, but the prevalence of orthopedics pathologies among inhabitants ofthe Sumy region for the above indicated period increased by 11.0 %. It is established that in the structure of prevalence of the osteomuscular system diseases and of the connective tissue diseases on the first place are arthrosis diseases, which demonstrated the high levels of primary morbidity's growth during 2005–2016, which in some regions exceed 50–80 %. The morbidity of population by the arthritis diseases in the Sumy region for the same period increased by 30.8 %, and their prevalence by 34.4 %, but the highest tempo of growth in the rates of primary morbidity and prevalence are characteristic for saline arthropathies – 25.7 % and 12.0 % respectively. The benefit of this study is analyses of the geographical patterns of morbidity of the population as well as prevalence of the osteomuscular system diseases and of the connective tissue diseases among the inhabitants of the region.With help the quantitative analysis methods, the groups of districts with different rates of morbidity of population, prevalence of diseases of the skeleton/muscular apparatus and connective tissue and different level of provision of the Sumy region population by medical institutions and specialists of the appropriate profile were identified. The geographical discrepancies between the level of the morbidity of population and the level of specialized medical-orthopedically care is revealed. It has been established that in many administrative districts of the region there are no orthopedist at all among the specialists providing medical assistance, and beds for orthopedic patients (or both) are absent in medical and preventive institutions. Consequently the population is not provided with the proper level of orthopedic care.

The article is devoted to consideration of the spatial-temporal structure of the primary morbidity and prevalence of the respiratory organs diseases among the population of the Sumy region. The article based on the data of annual statistical reports of medical institutions of Sumy region, which are subordinate to the Ministry of Public Health of Ukraine. The article used the methods of factor and correlation analysis, as well as methods of mathematical-statistical analysis, and ranking. The authors analyzed the spatial-temporal structure of respiratory organs pathology among the population and revealed the territorial differences and the dynamics of respiratory morbidity of the population. Nosogeographic assessment of territory of the Sumy region, which was carried out according to the integral respiratory diseases morbidity index (IMI), shows that today the highest values of IMI are obtained by analyzing the incidence rate in Putyvl’ (1.01), Krasnopillia (1.02), Konotop (1.11), Buryn’ (1.32) districts and in the city of Sumy (1.15). These are the districts where the incidence rate of respiratory diseases among the population has increased most of all during the study period. Low values of IMI are noted in Lypova Dolyna (0.63), Seredyna Buda (0.71), Velyka Pysarivka (0.72) and Nedryhailiv (0.79) districts. The higher is the IMI value, the worse the health level of the population. The average index storage respiratory diseases (ISD) in the Sumy region in 2017 was 1.27, with polarization ISD value in some areas from 1.19 in Shostka, 1.22 in Konotop, 1.23 in Yampil’ and Trostianets regions to 1.39 in Lebedyn, 1.42 in Romny and 1.61 in the Seredyna Buda districts. This indicates the predomination of chronic forms of diseases over acute ones and can be explained by the influence of environmental and socio-economic factors. It also points to the need to increase of attention of both the regional and state components of the health care system. Besides that, the issues of providing financial and human resources for the health care system in districts with high incidence rates of respiratory pathology require attention. The study of the primary morbidity and the prevalence of respiratory diseases trends is a prerequisite for the development of preventive measures in the Sumy region. They are also needed to assess the quality of medical care for residents who have the pulmonary diseases. The factor analysis results are confirmed the importance of environmental and technogenic factors in formation of the indicators of primary morbidity and prevalence of respiratory diseases among the residents of the Sumy region.

Проаналізовано рівень первинної захворюваності населення та поширеності хвороб системи кровообігу серед мешканців Сумської області. Встановлено, що нозології цього класу лідирують у загальній структурі поширеності хвороб серед населення Сумської області. Окремо розглянуто динаміку захворюваності та поширеності протягом 2005–2016 років. Виявлено, що протягом згаданого часу первинна захворюваність населення на хвороби системи кровообігу зросла на 24,9 %, а поширеність серцево-судинних патологій збільшилася на 19,4 %. З’ясовано, що у структурі розповсюдженості хвороб системи кровообігу на першому місці гіпертонічні хвороби, які демонструють і найвищі рівні зростання первинної захворюваності протягом 2005–2016 років, що в окремих районах перевищують 100 %. Захворюваність населення на ішемічні хвороби у Сумській області за цей же період зросла на 31,5 %, а їх поширеність – на 18,7 %, такі ж показники для цереброваскулярних хвороб становлять 25,7 % та 12,0 % відповідно. Охарактеризовано географічні закономірності захворюваності населення та поширеності серцево-судинних хвороб серед мешканців регіону. За допомогою кластерного аналізу виділено групи районів, які об’єднали адміністративні одиниці, що мають схожі показники захворюваності населення, поширеності хвороб системи кровообігу та рівня забезпеченості населення лікувальними закладами й фахівцями відповідного профілю. Виявлено географічні невідповідності між рівнями захворюваності населення та спеціалізованого медико-кардіологічного обслуговування.

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