1. Improvement approaches to regional
socio-economic policy in public health in Russia
Shibalkov Ivan Petrovich
assistant of economics department
Tomsk
2017

2. Problem Statement and Purpose of the Study
2) expanding the approach to understanding the population health
1) demographic situation in Russia:
regional differentiation, population aging, high mortality
ecology
health care
20%
Death rate
(the number of deaths per 1000)
10%
50%
lifestyle choices
20%
genetics
Population of Russia over the age of 60 years, %
Russia USA Canada India China Brazil
World Bank, 2015
Russian Federal State Statistics Service
The purpose of the study is to investigate socio-economic factors of the state of population health in the regions of Russia and to develop conceptual bases of socio-economic policy aimed at the formation of public health (increasing life expectancy) with considering regional differentiation. 2

3. The Health Determinants
SES
Education
Occupation
Income
Controlled determinants of health are largely determined by the socio-economic status of the individual (SES)
quality of the physical environment
quality of housing
overcrowding
noise level
intensity of social interaction
models of social interaction
trust level
relative deprivation
access to health services
choice between public and private medicine
relationship with a doctor
social networks of alternative counseling on health issues
physical culture
diet
alcohol, tobacco
HEALTH
Environment
Health Behavior
Access to health care
Degree of controllability
high
mean
Genetic
factors
Inequality in SES leads to a significant Inequalities in health 3
low

4. from infectious and parasitic diseases
Improvement approaches to regional
socio-economic policy in public health in Russia
The significant differentiation of socio-economic characteristics of Russian regions indicates considerable regional differences in the initial conditions of demographic development
Distribution of Russian regions by the level of deviation of the death rate per 1000 from the average Russian indicator value
deviation: more than 30%
deviation: from 10% to 30%
deviation: less than 30%
from infectious and parasitic diseases
from external
causes
2011
2015
2011
2015 4

5. Improvement approaches to regional
socio-economic policy in public health in Russia
We proposed and tested a methodology for assessing the impact of socio-economic parameters of regions on the state of population health (on the basis of factor and cluster analysis).
Steps to assess the impact of socio-economic parameters of the regions on the state of population health:
1. the formation of the indicators system;
2. factor analysis of indicators (principal component analysis) and economic interpretation of factors;
3. typology of the investigated objects on the basis of cluster analysis and economic interpretation of the obtained groups, with considering the results of factor analysis;
4. regression and variance analysis of trend dynamics of indicators, calculation of the coefficient of determination to establish the strength of the relationship between the indicators. 5

6. 6 Improvement approaches to regional
socio-economic policy in public health in Russia
Based on socio-economic and historical-geographical characteristics, clusters isolated through statistical analysis were combined into 4 groups:
1. Relatively prosperous regions of Central Russia, the Volga region, the North-West, as well as the industrialized regions of the Ural, Siberia, and the Far East, characterized by medium or high standard of living and life expectancy.
2. Relatively problematic regions of various districts of the country, which are at the same stage of the epidemiological transition as the regions of the first group, but have some developmental lag - a lower standard of living.
3. Republics of the North Caucasus are regions with unique natural and climatic conditions of life, characterized by high life expectancy despite the low living standards of the population.
4. Hard problematic regions of Siberia, the Far East and other regions, lags far behind in its development of the national average, characterized by low life expectancy and low standard of living, but also the apparent incompleteness of the epidemiological transition.
For each of these groups there are some recommendations on socio-economic policies aimed at increasing the average life expectancy with considering the demographic situation from the position of the epidemiological transition theory and successful experience in managing public health. 6

7. increase the average age of death from various causes
Improvement approaches to regional
socio-economic policy in public health in Russia
1st group (25 regions)
So-called avoidable mortality methodology is recommended: it’s an opportunity to reduce the loss of population from causes that are susceptible to influence by health institutions.
The most effective strategy for the improvement of public health for these regions is to concentrate efforts on reducing preventable losses through:
medico-social prevention and rehabilitation,
the introduction of high-tech methods of treatment,
the revitalization of lifestyle activities.
Moscow, Saint Petersburg, Nizhny Novgorod Oblast, Tomsk Oblast, Sverdlovsk Oblast etc.
closest to the end of the epidemiological transition
  a large proportion of deaths occur in causes strongly associated with age
 overmortality of men of working age
increase the average age of death from various causes 7

8. definition and elimination of “bottlenecks” in development
Improvement approaches to regional
socio-economic policy in public health in Russia
2nd group (33 regions)
Ivanovo Oblast, Ryazan Oblast, Kaliningrad Oblast, Krasnodar Krai, Altai Krai etc.
closest to the end of the epidemiological transition
  have some lag in development - a lower standard of living
more thorough analysis of the mortality structure
factor analysis of the living standards of the population
application of best practices of neighboring regions having similar resource and economic potential
definition and elimination of “bottlenecks” in development
unresolved problems of socio-economic development hamper the success of measures taken to increase life expectancy 8

9. 3rd group (5 regions) 9 Republics of the North Caucasus
Improvement approaches to regional
socio-economic policy in public health in Russia
3rd group (5 regions)
Republics of the North Caucasus
unique natural and climatic conditions of life
  low mortality, high fertility
  high life expectancy, despite the low living standards of the population
  phenomenon of group longevity
The organization of safe working and resting conditions, the creation of a social environment with the opportunity to choose and achieve decent living conditions
Improving the quality of life
Alignment of municipalities in terms of level and quality of life
Raising the cultural level of the population
Development of health, education, physical culture and sports
Prevention of risky, aggressive behavior, programs to develop social skills
Investments in human capital are very promising.
achievement of the life expectancy level of developed countries
integrated development of socio-economic system 9

10. the mortality structure
Improvement approaches to regional
socio-economic policy in public health in Russia
4th group (20 regions)
Jewish Autonomous Oblast, Tuva Republic, Altai Republic, Kurgan Oblast, Kemerovo Oblast etc.
did not complete the epidemiological transition
  high mortality from external causes and infectious diseases
Point measures to reduce traumatic mortality, especially at working age:
organization of safe working conditions, rest, movement
creating a social environment with the opportunity to choose and achieve decent living conditions
strengthening the police and judiciary
measures for the formation of vital behavior among the population
antialcohol policy
using the Haddon matrix
Poverty reduction and inequality
Complex social and economic development of the territory and the development of a competent socio-demographic policy with measurable results.
bringing
the mortality structure
to normal 10

11. THANK
FOR YOUR
ATTENTION!