РОЛЬ ИЕРАРХИЧЕСКИХ ИЗМЕНЕНИЙ ФАКТОРОВ ОКРУЖАЮЩЕЙ СРЕДЫ В ФОРМИРОВАНИИ НОЗОЛОГИЧЕСКОЙ СТРУКТУРЫ СМЕРТНОСТИ

Abstract

When identifying changes in the health status of the population, it is relevant to study the modern structure of diseases. The purpose of the study is to assess the quantitative and structural changes in mortality associated with factors of different origin in the process of evolution of the regional anthropological ecosystem. Material and methods. Rates and structure of male mortality in the Irkutsk region for the period from 1990 to 2020 have been analyzed. The study used standardized mortality rates according to the European standard population. The trends were evaluated through linear models using standard Excel tools. Significance of the trend equation was calculated using F-test (IBM SPSS Statistics 23). Results. At the 1st stage (1990-1991), the structure of mortality was dominated by: diseases of the circulatory system (34.9%), neoplasms (17.6%), external causes (27.7%), and respiratory diseases (7.4%). At the 2nd stage (1992-2005), the situation was mainly determined by psychogenic factors. Those impacts are indicated as follows: sharply increased mortality from acute vascular heart and brain damages, suicide, murder and accident. At the 3-d stage (2006-2019), along with improvements in the socio-economic situation, the mortality rate was decreasing, especially across the following disease classes: diseases of the circulatory system (from 1237.3 to 785.5o/oooo), external causes (from 553.3 to 228.4o/oooo), respiratory diseases (from 182.2 to 75.2o/oooo). A long-term trend towards increasing mortality from infectious and parasitic diseases was identified. No trend in the dynamics in mortality from diseases of the digestive system was registered. Significant changes in the structure of mortality were noted for infectious and parasitic diseases, respiratory diseases, and digestive diseases indicating a phenomena of pathomorphosis. Since 2020, a new socio-ecological situation has begun to take shape due to the COVID-19 pandemic. A new coronavirus infection has become a powerful factor of pathomorphosis and restructuring of the entire socio-ecological system. Conclusion. Disease development and the relevant mortality are associated with hierarchical changes in the impact of factors of different origin (socio-economic, psychogenic, epidemiological) on the population. Pathomorphosis suggests unfavorable structural changes in the medical, demographic and socio-ecological status of the population.