[Statistical modeling of the fact and requests frequency for emergency medical care by primary care different age groups patients.]

The frequency of seeking emergency medical care (EC) can be mediated by the characteristics of the patient's social status, his health literacy (HL) but not only by the clinical signs of the disease, health status. The goal of the cross-sectional survey was to identify factors determining the frequency of applying for EC by the young-aged, middle-aged (18-59 years) and elderly (60-74 years) patients of the primary health organizations in the Arkhangelsk Region and the Komi Republic (North-West Russia). Logistic regression (LR) was used to identify factors mediating the fact of applying for EC; zero-inflated negative binomial regression (ZINB) - to identify factors mediating the frequency of appeals. The majority of elderly respondents in the Arkhangelsk Region (72,5%) and the Komi Republic (74,1%) applied for EC at least once during the calendar year; among the young-aged and middle-aged respondents - 45,3% and 52,1% respectively. In the group of young-aged and middle-aged respondents, a higher frequency of appeals for EC is mediated by the age, low self-esteem of the well-being and health status, a chronic disease(s) affecting daily well-being in anamnesis, a low level of HL; in the group of the elderly respondents - by the fact of absence of a spouse, low self-esteem of the well-being, a chronic disease(s) affecting daily well-being in anamnesis, low levels of HL respectively. The obtained results obtained can be used to identify the «risk group¼ of patients of the primary health organizations who have a higher probability of applying for EC, and to organize additional preventive work with the min primary health organizations.

[The determinants of vaccination against the new coronavirus infection (COVID-19) of residents of the circumpolar region of Russia].

The maintenance of health of residents of the Northern Regions of Russia, including those living in the Arctic zone of the cbountry, is a condition of its advance development in XXI century. The percentage of Russian citizen vaccinated against the new coronavirus infection (COVID-19) does not exceed 50% after beginning of implementation of vaccination program. It can be conditioned by lower level of both of credence of citizen to health care system and health literacy.Purpose of the study is to establish determinants of vaccination of population against COVID-19 in circumpolar region of Russia as exemplified by the Arkhangelsk Oblast.The sociological survey was carried out using the interview technique of patients of medical organizations (n=433) and conditionally healthy residents of the Arkhangelsk Oblast (n=139). To evaluate the level of general health literacy the Russian version of questionnaire HLS19 - Q22-RU was applied. The most of conditionally healthy respondents and consumers of medical services looked for information about methods of prevention and treatment (80.4% and 58.2% correspondingly), had an experience of vaccination against COVID-19 (79% and 56.3% correspondingly). The relative chances of conditionally healthy respondents, women, and respondents having no children and no credence to national health care system to independently look for information related to COVID-19 is higher at 2.94, 2.08, 1.55 and 1.48-1.57 times correspondingly. The relative chances of conditionally healthy respondents having no children in family and assessing one's economic status as "higher than average" to be vaccinated against COVID-19 is higher at 4.02, 1.52, 1.53 times correspondingly. Availability of experience of vaccination against COVID-19 is conditioned by higher level of general health literacy.In the Arkhangelsk Oblast and other circumpolar regions of Russia the programs of increasing loyalty of citizen to measures of population prevention, including vaccine prevention, is to be implemented with consideration of established determinants of of vaccinations against COVID-19.

[The dynamics of demographic situation and state of reproductive health of population of circumpolar region of the Russian Federation].

The priority of state policy of the Russian Federation is to make conditions for sustainable social economic development of national regions, including the territories of the Arctic Zone. The successful solution of these tasks is possible only if there is sufficient amount of labor resources and at achieving positive dynamics of main demographic processes. The purpose of the study is to establish characteristics of both dynamics of main demographic processes and reproductive health of Northerners as exemplified by the Republic of Komi. MATERIALS AND METHODS: The retrospective ecological epidemiological study was carried out using reports of the Federal statistical observation. To evaluate demographic processes the values of main demographic parameters were calculated. To analyze dynamics of demographic processes time series of demographic coefficients were constructed and values of growth rate indicators were calculated. RESULTS: The number of male and female population of the Komi Republic in 1990-2023 decreased by 46.5% and 37.1%. The specific weight of people older than able-bodied age increased in males from 4.9% to 14.7% and in females from 15.7% to 31.6%. The number of females of fertile age (16-49 years) in the Komi Republic decreased by 152.602 people (-47.5%) and their general fertility rate decreased by 33.3%. The birth rate in the group of young women aged 15-19 years decreased in 1990-2021 by 80.1%; and of women aged 20-24 years decreased by 60.4%. The frequency of abortions tends to decrease, but significantly exceeds the national average values. CONCLUSION: The replacement-level fertility is not achieved in the Komi Republic. Taking into account the peculiarities of demographic, social economic processes, it is necessary to develop and to implement regional program of reproductive health improvement.

[The development of first medical care support to victims of road traffic accidents: The publications review].

The medical and demographic losses because of road traffic accidents continue to be significant in most of economically developed and developing countries. The national strategies of reducing medical and demographic losses include two groups of measures, depending on object of exposure: (1) targeted to decreasing risk of road traffic accidents and (2) targeted to timely and adequate medical care support of victims. Beyond this classification are activities targeted to developing and improving in participants of road traffic skills of first self-care and mutual assistance. The availability of mentioned skills is important for saving lives and preventing permanent disability of victims of road traffic accidents.

[SATISFACTION OF THE RESIDENTS OF THE CIRCUMPOLAR REGION WITH THE STATE HEALTHCARE SYSTEM, DEPENDING ON THE LEVEL OF THEIR HEALTH LITERACY].

Regions of Arctic Zone and Far North of Russia have a weak social infrastructure, including regional segments of the state healthcare system. The study of citizens satisfaction with the healthcare system is one of the leading methods for assessing its effectiveness. Citizens satisfaction may be distorted by their health literacy (HL). Half of the 'healthy' citizens (51.1%) had an excellent or sufficient level of general GVH; 2/3 of the patients of medical organizations (70.4%) had an insufficient or problematic level of general HL. The level of citizens` satisfaction with domestic healthcare is determined by their clinical status - it is higher in the group of patients (60.1%) than in the group of 'healthy' people (31.0%). Patients evaluate it more loyally in comparison with health people. Respondents with an insufficient HL evaluate the health care system less loyally. The high level of HL allows patients to assess the results of the work of the domestic health care system more objectively in comparison with healthy citizens. The aim of this study is to assess the satisfaction of the residents of the circumpolar region of Russia (the Arkhangelsk Oblast) with the regional segment of the State Healthcare System, depending on the level of their HL.

[The competence in health issues of population of circumpolar region of the Russian Federation].

The health literacy of citizen is determined by a set of demographic and social factors. The deficiency of health literacy of population in the Russian Arctic Zone conditions delay in indicators characterizing population health from their all-Russian values and menaces ability to achieve the targets of the National Strategy of Development of Russian Arctic Zone and Ensuring National Security up to 2035.The purpose of the study is to assess level of health literacy of patients and healthy population residing in circumpolar territories of Russia (Arkhangelsk Oblast).The level of general health literacy in the subgroups of respondents varied in narrow range of 26.9-36.3 points. The most significant difference was established between scores of interactive health literacy (Δ = 4.1 points) and critical health literacy (Δ = 3.4 points), which were higher in group of healthy respondents. The predictors of level of general health literacy are clinical status (value of dependent variables in healthy respondents was on average higher on 0.75-1.73 points), self-assessment of one's positioning in society (every additional point increases average level of general health literacy by 0.47-0.79 points) and age (every additional year of life reduces level of general health literacy by 0.08 - 0.09 points). The results of the study indicate on dependency between clinical status and the level of health literacy, determine social characteristics of risk group with low health literacy as object of additional preventive measures directed at citizen residing in in circumpolar terrotories of The Russian Federation.

[The Dynamics of Morbidity of Mental and Behavioral Disorders Caused by Alcohol Consumption in Population of the European North of Russia in 2006-2015].

The development of organization of narcological care to individuals abusing alcohol production and patients with alcoholism presupposes organization of monitoring and detailed analysis of incidence and prevalence of the given group of states. The purpose of study is to establish tendencies in dynamics of morbidity of mental and behavioral disorders caused by alcohol consumption in population of pre-arctic regions of the European part of Russia in 2006-2015. The study used data from annual forms # 11 "Information on morbidity of narcological disorders" of the Murmansk, Arkhangelsk oblasts and the Republic of Komi in 2006-2015. On the basis of this data the indices, including standardized ones, were calculated concerning primary and total population morbidity of mental and behavioral disorders caused by alcohol consumption. Since 2006, in pre-arctic regions a significant decreasing of incidence and prevalence of alcoholic psychoses (F10.4-7), alcoholism (F10.2, 3, 8, 9), alcohol consumption with unhealthy aftermaths (F10.1) was established. The discrepancy in ratio of rate of alcoholic psychoses prevalence (F10.4-7) and chronic alcoholism (F10.2, 3, 8, 9) in Murmansk, Arkhangelsk oblasts and the Republic of Komi is established that testifies a possible misrepresentation of statistical data. The established tendencies in dynamics of incidence and prevalence of mental and behavioral disorders caused by alcohol consumption indicate on ambiguous results of public anti-alcoholic policy in the European North of Russia and indirectly testify redistribution of patients between public and private narcological organizations.

[Demographic and social predictors of place of death in the group of elderly].

Analysis of data from the 2814 Medical certificates of death was performed to reveal socio-demographic characteristics of citizens who died at elderly age, depending on the place of death and alcohol anamnesis. Divorced or single elderly people with lower educational status had greater odds ratio to die «on the street¼ or «at home¼ rather than in a «medical organization¼ (respectively to characteristics of demographic status and the structure of causes of death). Clinically verified diagnosis of «Mental and behavioral disorders due to alcohol¼ (F10) in anamnesis was not associated with the «choice¼ of place of death among elderly people. Obtained results can be used to develop the regional programs in the field of public health.

[Alcohol anamnesis and a death place factor: Role in mortality rates due to leading cardiovascular diseases].

AIM: To reveal the specific features of marital status and educational level in people who have died of leading circulatory diseases (CDs) in Arkhangelsk in relation to the place of death, alcohol anamnesis, and demographic characteristics (gender, life span). Materials and methods. Data on the diagnosed underlying cause of death, marital status, educational level, and place of death were copied from 4137 medical death certificates (form 106/y-08) of all those who had died in Arkhangelsk in 1 July to 30 June 2012. Data on patients registered at a psychoneurology dispensary as having a diagnosis of alcohol-induced mental and behavioral disorders (F10) were copied. The data were statistically processed using the procedures of binary and multinomial logistic regression analysis. RESULTS: A total of 2101 people (50.8% of the total number of deaths) died of CDs (ICD-10 Class IX) in the study period. Male sex and a compromised alcohol anamnesis were associated with untimely death (less than 60 years of age) from acute conditions in ICD-10 Class IX. Male sex, a compromised alcohol anamnesis, and negative characteristics of marital and educational statuses were related to untimely death from chronic conditions in ICD-10 Class IX. Single people having a lower educational level and a compromised alcohol anamnesis statistically more frequently died of CDs outside a health care facility. CONCLUSION: The results of the investigation suggest that there is inequality in the excess risk of death from leading CDs among the representatives of different social population groups in Arkhangelsk, as well as nonequivalence in their interaction with the public health system.

[The structure of mortality of patients under dispensary supervision diagnosed with alcohol-related mental and behavioral disorders].

AIM: To identify the characteristics of mortality in patients under dispensary supervision with mental and behavioral disorders caused by alcohol (F10) in Arkhangelsk city. MATERIAL AND METHODS: Information obtained from certificates of death made out for people died in 2011-2012 who were registered in a regional psychoneurological dispensary was used. RESULTS: Mental and behavioral disorders caused by alcohol were diagnosed in 6,5% of patients, mean life longevity was 51,6 years while in others it was 67,8 years. Percentage of patients died from diseases of blood circulation system (40,6%) and tumors (13,8%) was relatively low while percentage of patients died from injuries, poisoning and other environmental factors was higher (28,6%). CONCLUSION: Alcohol abuse is a significant risk factor for population health of Arkhangelsk city. The structure of mortality of patients under dispensary supervision is characterized by the considerable prevalence of conditions that are potentially avertible. Differences in the approaches of forensic medicine experts and autopsists to the assessment of causes of death in these cases can lead to misrepresentation of statistical data on mortality structure.