BackgroundSelf-rated health (SRH) has been widely studied to assess health inequalities in both developed and developing countries. However, no studies have been performed in Central Asia. The aim of the study was to assess gender-, ethnic-, and social inequalities in SRH in Almaty, Kazakhstan.MethodsAltogether, 1500 randomly selected adults aged 45 years or older were invited to participate in a cross-sectional study and 1199 agreed (response rate 80%). SRH was classified as poor, satisfactory, good and excellent. Multinomial logistic regression was applied to study associations between SRH and socio-demographic characteristics. Crude and adjusted odds ratios (OR) for poor vs. good and for satisfactory vs. good health were calculated with 95% confidence intervals (CI).ResultsAltogether, poor, satisfactory, good and excellent health was reported by 11.8%, 53.7%, 31.0% and 3.2% of the responders, respectively. Clear gradients in SRH were observed by age, education and self-reported material deprivation in both crude and adjusted analyses. Women were more likely to report poor (OR = 1.9, 95% CI: 1.2-3.1) or satisfactory (OR = 1.6, 95% CI: 1.2-2.1) than good health. Ethnic Russians and unmarried participants had greater odds for poor vs. good health (OR = 2.3, 95% CI: 1.5-3.7 and OR = 4.0, 95% CI: 2.7-6.1, respectively) and for satisfactory vs. good health (OR = 1.4, 95% CI: 1.1-1.9 and OR = 1.9, 95% CI: 1.4-2.5, respectively) in crude analysis, but the estimates were reduced to non-significant levels after adjustment. Unemployed and pensioners were less likely to report good health than white-collar workers while no difference in SRH was observed between white- and blue-collar workers.ConclusionConsiderable levels of inequalities in SRH by age, gender, education and particularly self-reported material deprivation, but not by ethnicity or marital status were found in Almaty, Kazakhstan. Further research is warranted to identify the factors behind the observed associations in Kazakhstan.

We studied the prevalence and determinants of smoking and desire to stop smoking in a cross-sectional study among 1174 randomly selected adults aged 45+ years in Almaty, Kazakhstan. Associations between smoking and its correlates were studied by multivariable Poisson regression. Prevalence ratios (PR) with 95 % confidence intervals (CI) were calculated. Among current smokers we also studied factors associated with their desire to quit. Altogether, 40.7 % of men were current smokers and 63.1 % of them desired to stop smoking. The corresponding numbers for women were 10.0 % and 72.1 %. Male gender (PR = 4.14; 95 % CI: 3.18-5.40), Russian ethnicity (PR = 1.56; 95 % CI: 1.23-1.97), secondary or less education (PR = 1.37; 95 % CI: 1.09-1.73) and having satisfactory or worse psychological family climate (PR = 1.84; 95 % CI: 1.26-2.67) were positively associated with smoking. Men who reported poor (PR = 1.24; 95 % CI: 1.11-1.38) or satisfactory (PR = 1.17; 95 % CI: 1.08-1.27) health, had very good psychological family climate (PR = 1.20; 95 % CI: 1.03-1.41), and smoked 10-19 cigarettes a day (PR = 1.29; 95 % CI: 1.17-1.41) were more likely to report a desire to quit smoking. Number of daily smoked cigarettes, self-rated health, and psychological family climate were associated with the desire to quit.

A survey of 1 194 respondents aged 45+ living in Almaty (Kazakhstan) to assess satisfaction with the quality of medical care was conducted. Specially trained interviewers visited respondents at home and filled questionnaires, which included questions on socio-demographic characteristics, the characteristics of medical care during the past year, bad habits, self-assessment of health, trust to doctors and the respondent's opinion on quality of health care. Binary logistic regression was used to analyze the data. Adjustment was performed for socio-demographic characteristics of respondents and the peculiarities of medical care. Altogether, 55.7 % (95 % CI 52.9; 58.5) of respondents were not satisfied with the quality of medical care. In multivariable analysis dissatisfaction with the quality of health care was associated with education, income, and self-, but the most influential factor was distrust of doctors (OR = 19, 95 % CI 12; 30). Thus, measures aimed at increasing the trust in doctors, especially the development of personalized medicine, have a potential increase the degree of satisfaction of the population with the quality of medical care. This study can serve as a start point for a panel study to monitor population's satisfaction with the quality of health care.

Background:We have analyzed the aged population disability processes to establish specifics and regularities of the causal structure of disability among the working and non-working aged population.Methods:In total, 1208 examination reports of the Medical & SocialExpert Commission have been subjected to excerption in Almaty.  Results:Persons having the second disability status prevail in the working aged contingent – 4,4%, which is much higher than the ratios for the first and second disability statuses (0,4%and 0,6%, respectively). Among the non-working population, persons having the second disability status largely prevail too - 8,1% (3,1%and 1,1%, respectively). The casual structure of disability among the non-working disabled persons includes as follows: blood circulatory system diseases (40%), malignant neoplasms (27,2%), and diseases of the eye and its appendages (10,2%). They are followed by endocrine diseases, nutritional and metabolic disturbances (7,6%), bodily injuries (3%),and urogenital system diseases with musculoskeletal system ones - 2,3% each.The data collection for the working aged populationcontingent has found out blood circulatory system diseases (47%) and malignant neoplasms (34,4%). Alongside with that, the distinctive feature among the said aged populationcohort is a substantial predominance of bodily injuries (7,4%), endocrine diseases, nutritional and metabolic disturbances (2,3%), and only 1,4% is accounted for diseases of the eye and its appendages.