The development of medicine as a factor of «epidemic transition» in the urban population of the Middle Volga region

In the paper the author considers the development of medicine in the twentieth century as a factor that significantly changed the morbidity and mortality of the population of the Middle Volga region. The emergence of penicillin and streptomycin, mass vaccination campaigns and promotion of healthy work and life, vector control and advances in medical science, an increase in the number of doctors and hospital beds per capita and affordable free medical care led to a significant reduction in the number of dangerous epidemics in the country. The urban population of the Middle Volga region faced these processes, too. Cases of polio and malaria, anthrax and tularemia, plague and diphtheria, smallpox and cholera were reduced to a few ones, cases of typhus and dysentery decreased significantly, which inevitably led to a shift in the structure of mortality in the region, exogenous mortality factors gave way to endogenous ones. The shift of morbidity towards neoplasm’s and cardiovascular diseases was also a trend of the time. And it was the process of «epidemic transition» that occurred in the second half of the last century, as part of the demographic transition, that determined the current trends in morbidity and mortality of the region’s population.