Evaluation of the impact of living conditions, as a set of social factors of the habitat, on mortality rates of the rural and urban population of the Nenets autonomous okrug (in the period 2000-2019)

Abstract

Background: Currently, in the Arctic zone of the Russian Federation (AZRF), there are clear signs of a deterioration in the medico-demographic situation against the backdrop of a low level of development of social infrastructure. The study of the influence of living conditions, as a set of social factors of the habitat, formed by social infrastructure, on the mortality rates of the population of one of the AZRF regions, was carried out for the first time. Aim: To assess the impact of living conditions, as a set of social factors of the habitat, on the mortality rates of the rural and urban population of the Nenets autonomous okrug (NAO) in the period 2000-2019. Materials and methods: The databases “Housing and communal services and social infrastructure in NAO in 2000-2019” and “Death cases in NAO in 2000-2019” (including information on the population number and age-sex structure) of the NAO population in the context of individual settlements have been generated. Using the developed scoring system for assessing living conditions, a ranking (division into tertiles) of all rural NAO settlements was carried out according to the value of the integral index of living conditions (IILC). A comparative analysis (tertiles with the city, and tertiles with each other) of average annual age-standardized rates of overall mortality, mortality from the main causes and structural components of external causes (EC) of mortality was carried out. Relative epidemiological risks were calculated as the ratio of mortality rates in each tertile to the corresponding indicator for the urban population. Results: Average annual standardized rates (and relative risks) of mortality (total, EC, drowning, freezing, alcohol poisoning and transport accidents) of the NAO population “step by step” increase in the sequence “city - highest tertile - middle tertile - lowest tertile”, i.e. as living conditions worsen (as the IILC decreases). Statistically significant differences were identified between the city and tertiles, as well as between the highest (“favorable” living conditions) and lowest (“unfavorable” living conditions) tertiles in terms of total mortality, mortality from EC, drowning and freezing. Mortality rates from alcohol poisoning and transport accidents also increase (but not statistically significant) as living conditions worsen. With the exception of suicides, the relative risks of mortality for individual EC reach maximum values in the lowest tertile. Conclusion: Statistically significant inverse relationships have been identified between rates of total mortality, mortality from external causes (and its main structural components), and the values of the integral index of living conditions of the rural NAO population: as living conditions worsen, mortality rates (and relative risks) increase.