Medical and Social Aspects of Mortality of the Working-Age Population (Based on Materials of the Ryazan Oblast)

The study is devoted to the analysis of medical and social aspects of mortality of the working-age population based on materials of the Ryazan Oblast. The work examines the dynamics and trends in mortality, causes of premature and violent mortality, and risk factors for men and women of working age. The author develops scientifically substantiated medical and social and organizational measures aimed at reducing mortality in urban and rural populations and assesses self-preservation behavior and medical activity of the population.

Relevance of the Problem. The socio-economic development of the country depends on the state of labor resources, the quality of which is largely determined by the level of health and the size of the working-age population (O.P. Shchepin et al., 2002; N.F. Izmerov, 2005). The prolonged increase in mortality at working age is one of the leading indicators of medical-demographic disadvantage in the Russian Federation, beginning from the late 1980s (Yu.V. Mikhailova, 2000; E.A. Tishuk, 2002; V.L. Krasnenkov, 2003). Over the period from 1989 to 2004, mortality in certain age groups of the working-age population of the country increased by 1.6-2.3 times among men and by 1.6-2.1 times among women. At the same time, age-specific mortality coefficients of men exceed the corresponding indicators for women by 3-4 times.

Mortality is a traditional indicator of health losses in the population, and its indicators are considered the most informative, as their study is carried out on the basis of state registration. It is very important to assess preventable mortality of the population, which should be considered from the perspective of identifying reserves for reducing mortality as a whole and increasing average life expectancy (L.V. Anokhin et al., 1999; S.P. Ermakov, 2001). Special attention deserves questions of violent mortality of the population, first and foremost, of working age (I.B. Boyko, 1998).

However, despite the great scientific and practical significance of the problem, to date there is a deficit of works devoted to the medical and social analysis of contemporary trends in mortality of the working-age population. This circumstance was taken into account when formulating the goal and objectives of the study, which was conducted within the framework of the Republican Scientific Program "Public Health and Healthcare" in accordance with the plan of NIR of the Ryazan State Medical University named after Academician I.P. Pavlov (state registration number No. 012002 02320).

The goal of the study was to develop scientifically substantiated medical and social and organizational measures aimed at reducing mortality of the urban and rural working-age population.

In accordance with this, the objectives of the study were:

• studying the dynamics and trends in mortality of men and women of working age in the Ryazan Oblast;

• analyzing the causes of violent mortality of the working-age population;

• assessing the medical and social risk factors of mortality of the working-age population;

• determining priority directions for reducing mortality of men and women at working age.

The scientific novelty of the work consists in the fact that:

• for the first time a detailed socio-hygienic characterization of the frequency and causes of mortality of men and women of working age is given on the model of a typical region of Central Russia;

• new information has been obtained on the leading risk factors of premature mortality of the urban and rural population;

• a complex of medical and social and organizational measures for the prevention of mortality of the working-age population in contemporary conditions has been developed.

The scientific and practical significance of the work is determined by the development and implementation of proposals for reducing mortality of men and women of working age based on the identified leading groups and risk factors. The obtained assessment of self-preservation behavior and medical activity of the working-age population makes it possible to conduct targeted measures among men and women belonging to high-risk groups.

Presentation of the Work. The materials of the dissertation were presented, reported, and discussed:

• at the VII Republican Scientific and Practical Conference with International Participation "Socio-Hygienic Monitoring of Population Health" (Ryazan, 2003);

• at the jubilee scientific conference dedicated to the 60th anniversary of the founding of the Ryazan State Medical University (Ryazan, 2004);

• at the annual scientific conference of the Ryazan State Medical University (Ryazan, 2005);

• at the interdepartmental meeting of the Ryazan State Medical University (Ryazan, 2005).

Main Propositions to be Defended

1. Dynamics and contemporary trends in mortality of men and women of working age.

2. Leading risk factors of violent mortality of the urban and rural population in contemporary socio-economic conditions.

3. Priority directions for reducing mortality of the working-age population taking into account regional features.