DETERMINANTS OF THE MORBIDITY RATE OF THE RURAL POPULATION IN THE RUSSIAN FEDERATION UNDER REGIONAL DIFFERENTIATION

Abstract

BACKGROUND: Analysis of the dependence of the morbidity of the rural population on various environmental factors will allow us not only to assess the level of social and demographic problems in the regions of the Russian Federation, but also to determine the directions for the development of state regional policy to achieve national development goals. AIM: Determination of the determinants of the morbidity rate of the rural population in the Russian Federation, including the main classes of diseases, among environmental factors in the context of the COVID 19 pandemic. METHODS: The initial data for the study were materials from the Federal State Statistics Service, as well as statistical materials from the digest “Rural Healthcare in Russia in 2021”, provided by the Federal State Budgetary Institution “Russian Research Institute of Health” of the Russian Ministry of Health. The following methods were used in the research process: Pearson correlation, factor analysis (principal component method), hierarchical cluster analysis, multiple linear regression (elimination method). Calculations were performed in the STATISTICA 10 system (StatSoft, USA). Results. Six typological groups of regions of the Russian Federation were distinguished. They differ in the morbidity rate of the rural population by the main classes of diseases: some infectious and parasitic diseases, neoplasms, diseases of the circulatory system, diseases of the respiratory system, digestive system, and some consequences of external causes. It has been established that there is differentiation in the regions of the Russian Federation according to the factors influencing the morbidity rate of the rural population by the main classes of diseases during the COVID 19 pandemic in 2021. It has been shown that the state of the healthcare system and medical and social factors have the greatest impact on the overall morbidity rate in the regions of the fourth and fifth classification groups, on the detection of some infectious and parasitic diseases in the regions of the second, fifth and sixth groups, and respiratory and digestive diseases in the third classification group. The housing quality in the regions of almost all groups is one of the most significant social factors. Economic conditions have a significant impact on the incidence of certain infectious and parasitic diseases in the regions of the third and sixth groups, as well as on the level of injuries and some consequences of external causes in the regions of the first and third groups. Environmental factors are significant in the regions of the fifth group. At the same time, regression dependencies on selected factors for all classification groups of regions of the Russian Federation were obtained only for some infectious and parasitic diseases. The smallest number of models has been defined for the incidence of neoplasms and circulatory organs. Conclusion. The significance and contribution of social and economic, demographic, environmental and natural factors in the formation of public health of the rural population should determine the strategy and tactics of state regional policy aimed at developing rural healthcare, taking into account regional characteristics.