Targeted approach to assessing the impact of living conditions and social factors of the habitat on the medico-demographic status of rural territories in the Arctic zone of the Russian Federation

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BACKGROUND: According to the Federal Law “On Sanitary-Epidemiological Well-being of the Population” the “environmental factors that have or may have an impact on humans and on health of future generations” along with chemical, physical and biological factors, also include “social factors". Within framework of section “State of Public Health in Connection with the State of Natural Environment and Living Conditions” of the system of state sanitary and epidemiological regulation, a significant number of normative and methodological documents have been approved aimed at assessing the impact of chemical, physical and biological environmental factors on population health, while not a single document has been developed concerning “social factors of habitat” or “living conditions”. In the “Strategy for the Development of the Arctic Zone of the Russian Federation (AZRF) until 2035” , the “main dangers, challenges and threats that form risks for development of AZRF” include clear signs of deterioration in medico-demographic situation, where, along with migration outflow, reduction of population number, high mortality rate, “lag behind all-Russian values of indicators characterizing quality of life”, poor state of social, housing, communal, transport infrastructure were noted.

OBJECTIVES: development of the concept of “living conditions” as a set of “social factors of habitat” formed by “social infrastructure” of a settlement; development of conceptual model of determinants of human health, indicating place of living conditions (social infrastructure) in the frame of habitat; scientific substantiation of concept of “harmful effects of social factors of habitat”; development of targeted approach to assessing the impact of living conditions on medico-demographic status of rural areas of AZRF using scoring system for assessing living conditions, which makes it possible to rank individual villages according to the value of infrastructure indices and the integral index of living conditions (IILC).

PRACTICAL SIGNIFICANCE: Implementation in practice of the proposed targeted methodological approach will make it possible to scientifically substantiate the need to take differentiated measures (managerial decisions) in relation to the identified “risk territorie”, “risk group”, and “risk pathologies”, aimed at improving living conditions, preserving public health, ensuring sanitary-epidemiological well-being, reducing the intensity of negative trends in demographic processes in the regions of AZRF.

About the authors

Alexey A. Dudarev

North-West Public Health Research Center

Author for correspondence.
Email: alexey.d@inbox.ru
ORCID iD: 0000-0003-0079-8772
SPIN-code: 1683-1401

PhD, Dr. Sci. (Med.)

Russian Federation, St. Petersburg

Alexey V. Dozhdikov

North-West Public Health Research Center

Email: aleksejdozhdikov@yandex.ru
ORCID iD: 0000-0001-7286-7648
SPIN-code: 9959-9339
Russian Federation, St. Petersburg

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2. Supplement 1.
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3. Fig. 1. Model of determinants of human health, positioning living conditions in the structure of the habitat.

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4. Fig. 2. Living conditions in a settlement as a set of components of social infrastructure (social factors of the habitat) at the junction of the natural and anthropogenic environments.

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