ПОПУЛЯЦИОННЫЕ СОЦИАЛЬНО-ЭКОНОМИЧЕСКИЕ ПРЕДИКТОРЫ ЗАБОЛЕВАЕМОСТИ ВЗРОСЛОГО НАСЕЛЕНИЯ ИНСУЛИННЕЗАВИCИМЫМ ДИАБЕТОМ В РЕГИОНАХ

Abstract

A steady increase in the incidence of type 2 diabetes and aggravation of socio-economic problems substantiate the need to analyze the population attributable risk factors for diabetes, determined by the status of the regional economy standard of living. The purpose of the study was to assess the socio-economic gradient of incidence of non-insulin dependent diabetes mellitus in adults in two regions within one federal district in Russia, differing in the level of economic performance and well-being of the population. Material and methods. The retrospective analysis for the period 2005-2019 includes official statistics on the gross regional product and average monthly income per capita, the share of persons with income below the subsistence minimum, the employment index, the share of employees with higher professional education, and Gini coefficient in the Republic of Tatarstan (RT) and the Republic of Mari El (RME). The study evaluated the normality of distribution, dynamics in indicators by the trendline coefficient of determination (R2), statistical significance of the differences in time series. The indicators were analyzed calculating the Spearman coefficient with a 95% confidence interval (CI) year-on-year and with a lag (lag effect). At all stages, the value of statistical probability (p) was indicated, the critical level of which was assumed to be 0.05. To identify multiple internal relationships between socio-economic indicators, they were grouped by the component method and factorial complexes were identified. Based on the results of the multiple correlation and regression analysis, models of impact of these complexes on type 2 diabetes incidence have been constructed. The study used Statistica 6 program and AtteStat Add-in Microsoft Excel, version 12.0.5. Results. In 2005-2019, the increase in type 2 diabetes incidence in adult population in the Mari El Republic was determined to be statistically significant and higher (p=0.01) than the one in the Republic of Tatarstan, where there was only an upward trend in the indicator. The socio-economic indicators of the Republic of Tatarstan were higher and characterized by higher growth rates than the ones in the Mari El Republic (p=0.0008) with a weak interregional convergence. Differences in the closeness and degree of significance of correlations between diabetes incidence in adult population and macroeconomic indicators between regions were determined to be insignificant. The main difference was the magnitude of the lag in incidence, reaching 9-10 years against the socio-economic indicators, the grouping of which by the component method in both regions combined into a generalizing economic factor, with the exception of Gini coefficient. The ranks and magnitude of the contribution of factorial complexes had the following interregional differences: in the Republic of Tatarstan, Gini coefficient was more significant in diabetes incidence, whereas in the Mari El Republic it was the generalizing economic factor. Conclusion. Results of the analysis of the nature of interrelations (strength, statistical significance, vector and prolongation) of the new cases of type 2 diabetes and socio-economic indicators in the regions, depending on the state of the economy and the standard of living, are the basis of the effective programs on decreasing morbidity.