International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum |
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Plenary session
Circumpolar social-medical studies largely lack comprehensiveness. Restricted to narrow specialty topics, they fail to be of use when large-scale, comprehensive conclusions about general status of circumpolar hygiene are needed. So, circumpolar health problems remain scantily explored.
We studied trends in key health indicators in Yakutia for the last 15 years, from 1989 to 2004. The analysis of health indicators was done for the all-republican level and for various social-economic zones: arctic, agricultural, industrial, and mixed. The republic’s territory is 3.2 million km2. Population was 950.2 thousand people in 2004. Numbers of Yakuts, minority northern peoples and foreign-born people were 441.5, 31.1 and 477.6 thousand, respectfully. It need not be debated that social-economic crisis together with the adverse natural and weather conditions had formed a harsh alliance which had brought many losses.
Through the study period, total natality decreased by a factor of 2.4 (2.1, 1.8 and 4.9 in Yakuts, minority, and foreign-born, accordingly). In 2004, despite the dicrease, this indicator remained positive in respectful ethnic groups: 8.5 (Yakuts; per 1000 population), 12.0 (minority peoples of the north), and 1.9 (foreign-born peoples).
Mortality rates were carefully analyzed: richly detailed, they include over 200 nosologic units in causes of death and more than 20 age and sex-specific groups. We analysed all 145.448 deaths for 1989-2004.
Increase in overall mortality was 58.0% (69.2%, 44.5% in men, women). The highest increases were found in the arctic (x2.4), industrial (x2), and mixed (x1.8) social-economic zones. Pace of increase varied considerably between causes of death. Mortality increased most rapidly in cardiovascular and gastrointestinal diseases, homicides and suicides (x1.8-2). Mortality due to cancer, infectious, airway and other diseases remained either unchanged or reduced slightly. Mortality trends in women and men were similar, but by 2004 the percent of dicrease among women reached 40.5% (23-25% in cardiovascular diseases and cancer; 4.5% in injuries, homicides and suicides).
Trends in health indicators depended mostly on shifts in social sphere, although demographic changes, effectiveness of health care, and life styles also played a role. We found out, that impact on mental health was the most negative aftereffect of social-economic crisis: many deaths were associated with the temporarily insane or distressed state of mind. Natural deaths i.e. deaths due to hereditary and biological causes had no tendency to increasing.
The study helped to formulate answers to many more theoretical and practical questions in public health.
Note. Abstracts are published in author's edition
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