Mortality In Region Research Articles

Estudio comparativo de muertes relacionadas con el COVID-19, homicidios y contaminación del aire en la región transfronteriza Mexicali-Imperial County (2018–2020)

This comparative study analyzes the absolute numbers and death rates of air pollution-related fatal victims, intentional homicides, and COVID-19 losses from 2018 to 2020 in the Mexicali (Baja California, Mexico) and Imperial County (California, United States) cross-border region. The analysis is nourished with quantitative data from secondary sources, systematized by all three levels of government authorities in the case of Mexicali and federal authorities in the Imperial County case. Evidence reveals that air pollution, homicides, and COVID-19 have had a differential impact on both sides of the border. While the COVID-19 pandemic was devastating in multiple aspects, air pollution-related mortality rates in the Mexicali-Imperial County cross-border region were five times higher than those of COVID-19. Mexicali was the most distressed “side” of the border in absolute numbers. However, by population rate, Imperial County was the most disturbed. Therefore, this situation reflects a shared priority for state and municipal authorities on both sides of the border.

The Impact of the Supply of Oncologists on Mortality from Neoplasms in the Regions of Russia

How does one calculate the ideal number of oncologists for a region? The significance of this study is determined by the differences in these indicators observed across different regions within the Russian Federation. In 2021, the mortality rate from oncological diseases ranged from 54 to 270 per 100,000 people, with the lowest rate in the Republic of Ingushetia and the highest in the Tula Oblast. Furthermore, the level of oncologist availability varies up to fourfold between different regions. The study aims to simulate the effect of the availability of oncologist care on the cancer mortality rates in the Russian Federation's regions, with the intention of determining the ideal number of specialist doctors. The author supposes that there may be an underestimation of the negative impact of physicians on mortality rates due to false positive relationships between the variables under consideration. In addition, the author suggests that there may be diminishing returns from hiring additional physicians as the level of specialist personnel availability increases. The research project is designed to employ a regression analysis using the quasi-experimental instrumental variable method to address reverse causality and omitted variables. Models based on spatial sampling and panel data are employed to derive a function that describes the number of saved lives by means of hiring additional doctors. The results indicate that on average, a 1% increase in the availability of oncologists leads to a reduction in neoplasm mortality of at least 0.4%. At a provision level of 1 oncologist per 100,000 individuals, their marginal contribution to the number of saved lives is no less than 96 per 100,000 people. This contribution reduces by an additional 14 people as the provision level increases by 1 unit. The study's outcomes may assist in ascertaining the ideal quantity of oncologists within the region, and aid in allotting financial resources for hiring medical professionals in diverse specialties or other expenses amid resource constraints.

Assessing SARS-CoV-2-related mortality rate in Russian regions, based on the econometric model

The objects of the study were the daily data on the population morbidity and mortality due to coronavirus disease 2019 (COVID-19) in Russian regions, as well as regional medical, demographic and environmental data recorded in recent years. COVID-19 is a contagious disease caused by the novel coronavirus (SARS-CoV-2). The mathematical methods consist of correlation and regression analysis, methods of testing statistical hypotheses. First, a multiple Variable Structure Regression should be specified. The intercept in the model differs from region to region, depending on the combination of values for dummy variables. The role of the dependent variable Y t was chosen as the cumulative mortality published by the operational headquarters for the regions that has been linked to day t, so that COVID-19 was considered the main cause of death. The complex of explanatory variables included two factorial variables that changed daily, and had a lag relative to t value. Also, this complex included a number of variables that did not change with the growth of t: the explanatory variable with the regions availability with doctors of certain specialties; and four dummy variables. One of them coded the regions belonging to the two southern Russian Federal Districts. Three other variables characterized the increased air pollution in settlements recorded in recent years, as well as the level of radiation pollution of the regions territory and the population health estimated for 10 classes of diseases (for the circulatory system, endocrine system, etc.). The values of such dummy variables were obtained from open data from the Federal State Statistics Service (Rosstat) etc. The model parameters were estimated by the least squares method using the training table, which included 40 Russias regions, the t parameter for variable Y t was assessed starting from November, 1, 2021. As a result, a statistical model was built with an approximation error equal to 3%. For regions of the regions examined this error was 1.94 (1.5)% for the value Y t that has been fixed on the 1st Nov. The plots show daily prediction for mortality rate due to COVID-19 in the first half of November for seven Russian regions compared with actual data. The model can be useful in development of medical and demographic policy in geographic regions, as well as generating adjusted compartment models that based on systems of differential equations (SEIRF, SIRD, etc.).

Gender-related differentially expressed genes in pancreatic cancer: possible culprits or accomplices?

Pancreatic cancer (PC) is one of the leading causes of cancer mortality worldwide, and its incidence and mortality rate in several regions is higher in male patients. Although numerous efforts have been made to enhance the clinical outcomes of existing therapeutic regimens, their efficiency is still low, and drug resistance usually occurs in many patients. In addition, the exact underlying molecular basis that makes PC slightly more prevalent among males remains unknown. Providing information regarding the possible association between gender and PC tumorigenesis may offer important clues for how certain molecular cross-talks can affect PC initiation and/or progression. In this study, we used several microarray expression data to identify the common up- and downregulated genes within one specific gender, which were also specified to have binding sites for androgen and/or estrogen receptors. Using functional enrichment analysis among the others, for all the gene sets found in this study, we have shed light on the plausible importance of the androgenic effectors in tumorigenesis, such as the androgen-regulated expression of the GLI transcription factor and the potential role of testosterone in the extracellular matrix (ECM)-cell interaction, which are known for their importance in tumorigenesis. Moreover, we demonstrated that the biological process axon guidance was highlighted regarding the upregulated genes in male patients. Overall, identification of gene candidates as the possible link between gender and PC progression or survival rates may help in developing strategies to reduce the incidence of this cancer.

Notes on early childhood diets in early modern Oulu, Finland, based on the stable isotope case studies of archeological dentin

AbstractIn mid‐18th‐century Sweden, the newly enhanced census records revealed higher‐than‐expected infant mortality rates in certain regions of the kingdom. This convinced contemporary elite men of common women deliberately refusing to breastfeed out of vanity and lack of care. One of the worst regions in terms of infant mortality was the province of Ostrobothnia, located in the area of what is now Finland. To explore the allegations, we measured the carbon (δ13C) and nitrogen (δ15N) stable isotope ratios in the collagen of incremental crown dentin segments of the permanent first molars (M1) of six individuals excavated from the early modern churchyard of the town of Oulu, Ostrobothnia. The results do not directly support the worries over the lack of breastfeeding but imply a variety of related practices in Oulu at the time.

Lung cancer incidence and mortality in China: Updated statistics and an overview of temporal trends from 2000 to 2016

BackgroundUpdated systematic statistics on lung cancer are the underpinning cornerstones for formulating prevention and control strategies for the disease. The incidence and mortality data of lung cancer in China in 2016 were estimated, and also used to analyze the temporal trends of lung cancer from 2000 up to 2016 in this study. MethodsThe burden of lung cancer in China in 2016 was estimated using data from 487 cancer registries, which were abstracted from the database of the National Cancer Center of China (NCC). The temporal trends were estimated with the data of 2000 to 2016 from 22 cancer registries. ResultsAbout 828,100 new lung cancer cases and 657,000 lung cancer deaths were estimated in China in 2016. The crude incidence and mortality rates in the eastern region were the highest nationwide. The incidence and mortality of lung cancer increased with age, and most of the new cases occurred in the age group of over 60 years. The age-standardized incidence increased by about 0.8% per year during 2000 to 2016, especially in woman, whose annual increase rate reached 2.1%. The age-standardized mortality rate decreased by about 0.6% per year, with a decrease of 1.3% per year in urban areas and an increase of 2.3% per year in rural areas. The numbers of new cases and deaths increased by 162.6% and 123.6%, respectively, during 2000 to 2016, which can be explained mainly by the change of the age structure. ConclusionsThe burden of lung cancer is serious in China, and increased especially rapidly for women in rural areas. The disease is expected to threaten the lives of more people in the future due to factors such as aging and population growth. Lung cancer prevention and control strategies and resources should be leveraged toward women and rural areas in the future.

Updated International Society of Geriatric Oncology COVID-19 working group recommendations on COVID-19 vaccination among older adults with cancer

Updated International Society of Geriatric Oncology COVID-19 working group recommendations on COVID-19 vaccination among older adults with cancer

Where did it hit harder? Understanding the geography of excess mortality during the COVID-19 pandemic.

The health impact of the COVID‐19 pandemic across OECD (Organisation for Economic Co‐operation and Development) and European regions has been strikingly uneven. In 2020, excess mortality rates in the hardest‐hit regions were, on average, 17 percentage points higher than those in the least affected regions of the same country. This paper shows that low health system capacity, followed by population density, air pollution, the share of elderly people, and low institutional quality were associated with higher excess mortality during the first year of the pandemic. Finally, reduced home‐to‐work mobility, following governments' COVID‐19 responses, was associated with lower excess mortality 2 months after implementation of the measures.

Five Draft Genome Sequences of Historical Yersinia pestis Strains of Phylogroups 2.MED4 and 2.MED1 of the Medieval Biovar.

ABSTRACTWe announce the genome sequences of five historical highly virulent Yersinia pestis strains of the phylogroups 2.MED4 and 2.MED1 of the medieval biovar. They were the etiological agents of plague outbreaks with high mortality rates in the Northern Caspian Sea region at the end of the 19th century and beginning of the 20th.

Socioeconomic variations in rates of hospitalisation and mortality from COVID-19 in England

Background/Aims As well as age and presence of comorbidities, research has suggested that socioeconomic factors, such as income and ethnicity, may affect an individual's risk of severe COVID-19. This study looked at the geographical variations in rates of hospitalisation and death from COVID-19, exploring whether socioeconomic factors were linked to these variations. Methods A cross-sectional retrospective quantitative study was conducted using data regarding the number of cases of COVID-19 cases during the first wave of the pandemic in England (March–July 2020). A total of 242 624 confirmed cases of COVID-19 from across England were analysed. The extent to which predisposing factors, such as population density, age and comorbities, affected morbidity and mortality rates in the different regions was calculated. The impact of socioeconomic factors, such as employment status and ethnicity, were also analysed. Results There was a significant association between long unemployment and likelihood of death from COVID-19. Areas with higher proportions of individuals from Black, Asian and ethnic minority backgrounds were also more likely to have higher rates of hospitalisations and deaths from COVID-19. Overall, London was the region with the highest standardised rates of hospitalisation (67.73%) and mortality (20%). Conclusions Socioeconomic factors have contributed to the geographical variations in COVID-19 mortality across different areas of England. This implies that these factors should be taken into account when planning healthcare and public health strategies.

Injury burden in individuals aged 50 years or older in the Eastern Mediterranean region, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

SummaryBackgroundInjury poses a major threat to health and longevity in adults aged 50 years or older. The increased life expectancy in the Eastern Mediterranean region warrants a further understanding of the ageing population's inevitable changing health demands and challenges. We aimed to examine injury-related morbidity and mortality among adults aged 50 years or older in 22 Eastern Mediterranean countries.MethodsDrawing on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we categorised the population into adults aged 50–69 years and adults aged 70 years and older. We examined estimates for transport injuries, self-harm injuries, and unintentional injuries for both age groups, with sex differences reported, and analysed the percentage changes from 1990 to 2019. We reported injury-related mortality rates and disability-adjusted life-years (DALYs). The Socio-demographic Index (SDI) and the Healthcare Access and Quality (HAQ) Index were used to better understand the association of socioeconomic factors and health-care system performance, respectively, with injuries and health status in older people. Healthy life expectancy (HALE) was compared with injury-related deaths and DALYs and to the SDI and HAQ Index to understand the effect of injuries on healthy ageing. Finally, risk factors for injury deaths between 1990 and 2019 were assessed. 95% uncertainty intervals (UIs) are given for all estimates.FindingsEstimated injury mortality rates in the Eastern Mediterranean region exceeded the global rates in 2019, with higher injury mortality rates in males than in females for both age groups. Transport injuries were the leading cause of deaths in adults aged 50–69 years (43·0 [95% UI 31·0–51·8] per 100 000 population) and in adults aged 70 years or older (66·2 [52·5–75·5] per 100 000 population), closely followed by conflict and terrorism for both age groups (10·2 [9·3–11·3] deaths per 100 000 population for 50–69 years and 45·7 [41·5–50·3] deaths per 100 000 population for ≥70 years). The highest annual percentage change in mortality rates due to injury was observed in Afghanistan among people aged 70 years or older (400·4% increase; mortality rate 1109·7 [1017·7–1214·7] per 100 000 population). The leading cause of DALYs was transport injuries for people aged 50–69 years (1798·8 [1394·1–2116·0] per 100 000 population) and unintentional injuries for those aged 70 years or older (2013·2 [1682·2–2408·7] per 100 000 population). The estimates for HALE at 50 years and at 70 years in the Eastern Mediterranean region were lower than global estimates. Eastern Mediterranean countries with the lowest SDIs and HAQ Index values had high prevalence of injury DALYs and ranked the lowest for HALE at 50 years of age and HALE at 70 years. The leading injury mortality risk factors were occupational exposure in people aged 50–69 years and low bone mineral density in those aged 70 years or older.InterpretationInjuries still pose a real threat to people aged 50 years or older living in the Eastern Mediterranean region, mainly due to transport and violence-related injuries. Dedicated efforts should be implemented to devise injury prevention strategies that are appropriate for older adults and cost-effective injury programmes tailored to the needs and resources of local health-care systems, and to curtail injury-associated risk and promote healthy ageing.FundingBill & Melinda Gates Foundation.

Prevalence and risk of COVID-19 in patients with rheumatic diseases: a systematic review and meta-analysis.

ObjectivesCOVID-19 pandemic has already had a tremendous impact on the process of human society; the survival of mankind and the healthy living environment deterioration with the influence will last for many years. This meta-analysis aims to assess the risk of COVID-19 in patients with rheumatic diseases.MethodsPubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical Database (CBM) were systematically searched with no language restriction up to July 5, 2021. The pooled rates were synthesized by fixed effect model or random effect model depending on heterogeneity.ResultsA total of 83 articles were included in this meta-analysis. The incidence of COVID-19 in patient with rheumatic diseases was 0.0190 (95% CI: 0.0136-0.0252), and the hospitalization rate, intensive care unit admission rate, mechanical ventilation rate, and case fatality rate of patients with rheumatic diseases infected with COVID-19 were 0.4396 (95% CI: 0.3899-0.4898), 0.0635 (95% CI: 0.0453-0.0836), 0.0461 (95% CI: 0.0330-0.0609), and 0.0346 (95% CI: 0.0218-0.0493), respectively.ConclusionsOur research shows that patients with rheumatic diseases have great risk of COVID-19. Differences in COVID-19 incidence, hospitalization rates, and mortality rates in regions were statistically significant. We still need to pay attention to the risk of COVID-19 in patients with rheumatic diseases.Key Points • Although the risk of COVID-19 in patients with rheumatic diseases has been discussed in previous meta-analysis, their research directions were inconsistent, and few studies focus on prevalence or serious outcomes of COVID-19 in patient with rheumatic diseases, while the quality of these articles was variable. • The incidence of COVID-19 and serious clinical outcomes in patients with rheumatic diseases were still high along with differential risks in most regions. • The use of glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs did not affect the hospitalization rate and mortality in rheumatism patients with COVID-19. Supplementary InformationThe online version contains supplementary material available at 10.1007/s10067-022-06087-1.

Perinatal mortality after the Fukushima nuclear accident: An ecological study.

ObjectiveThis study continues former studies on perinatal mortality in Japan after the Fukushima Daiichi nuclear power plant (FDNPP) accident in March 2011. An increased study region is chosen, and the study period is extended to 2019.MethodsJapanese monthly perinatal mortality data are provided on a prefecture level by the Japanese government. The study region consists of 12 prefectures around the FDNPP; the rest of Japan is used as the control region. A combined non-linear regression of perinatal mortality rates in the study- and control regions is conducted. The regression model allows for a common asymptotic lower limit of perinatal mortality, seasonal variations, and periodic peaks in 2012–2019 in the study region. To determine the dependency of the effect on distance from the FDNPP, the study region is divided into four core prefectures and eight prefectures surrounding the core prefectures.ResultsPerinatal mortality rates in the study region show a significant 6.4% (95% CI: 1.8%, 13.4%) overall increase in 2012–2019 relative to the trend in preceding years with no attenuation during 2012–19. The increase translates to 590 (165, 1226) excess perinatal deaths (p = 0.016). It is characterized by annual peaks with maxima in April. A 13.6% increase is determined in the four core prefectures and a 4.3% increase in eight prefectures surrounding the core prefectures. Before 2012, there is a peak around April 2011 and a decline in October 2011; another significant peak is detected in November 2012. In the 4 core prefectures, large increases are found in the first quarter of 2018 (+70%) and in May 2019 (+130%).ConclusionThis study finds periodic peaks in perinatal mortality in spring 2012–2019 in 12 prefectures of Japan surrounding the FDNPP. In light of massive increases in 2018 and 2019 in the four core prefectures, continued investigation of perinatal mortality in contaminated regions of Japan is recommended.

ANALYSIS OF THYROID CANCER INCIDENCE AND MORTALITY TRENDS AMONG THE RESIDENTS OF THE SUMY REGION

Introduction. Thyroid cancer ranks ninth in the structure of malignant neoplasms. Since the 1980s, most countries in the world have seen a rapid increase in the incidence rate and a relatively stable or even decreasing mortality rate. The objective of our study was to analyze the thyroid cancer morbidity and mortality trends in the Sumy region during 2014–2021, to study the prevalence of histological variants and sex-age-specific characteristics, and to compare them with all-Ukrainian and global data. Study results. According to the National Cancer Registry of Ukraine, 24,626 people were diagnosed with thyroid cancer between 2014 and 2021, including 4,556 men (18.5%) and 2,0070 women (81.5%). On average, 3078.25 ± 136.15 people were diagnosed per year. The incidence rate among women is 3.8 times higher than among men. The average incidence rate in Ukraine in 2014–2021 was 6.5 per 100,000 population, while in the Sumy region – 8.9 per 100,000 population. The average mortality rates among residents of the Sumy region and Ukraine did not differ and amounted to 0.4 per 100,000 population. A distinctive feature was represented by the lower male and higher female mortality rates in the Sumy region compared to all-Ukrainian indicators (0.2 versus 0.3 per 100,000 population and 0.6 versus 0.4 per 100,000 population, respectively). The study of histological types of thyroid malignancies demonstrated that papillary variant was most common (70.5 to 81.9%). The specific share of follicular cancer ranged from 12.8 to 19.2%. The medullary variant occured much less often – in 1.5 to 4.6% of cases, while undifferentiated and squamous cell cancer was extremely rare (0.2 to 3.3% of cases). In Buryn district, Velyka Pysarivka district, Konotop district, Krasnopillia district, Krolevets district, Lebedyn district, Nedrygailiv district, Putyvl district, Sumy district, Trostyanets district and the city of Sumy, a significantly higher incidence rate was observed. Women aged 50–64 and men aged 55–69 are most often affected in Ukraine. The highest mortality rate is reported for the age range of 70–84 years for both males and females. Conclusions. During 2014–2021, the incidence and mortality rates among the population of Ukraine remained at a stable level and were lower compared to global indicators. Since 2017, the Sumy region has been presenting with a decrease in the incidence rate, which corresponds to European trends. In the Sumy region, papillary thyroid cancer remains the most common histological variant. In general, the shares of papillary, follicular, medullary, and anaplastic cancers are consistent with the European figures. In general, the age trends in Ukraine and other countries of the world are similar.

Convergencia en tasas de mortalidad infantil: el caso de las regiones españolas

This paper studies the evolution of infant mortality rates in Spanish regions. Our results allow us to reject the null hypothesis of convergence, but we find the presence of several convergence clubs, which implies the existence of different patterns of behavior. We also find some degree of connection between the Great Recession and the evolution of infant mortality rates. The popula-tion density, the evolution of the labor market and the percentage of the female population that admits to having drunk alcoholic beverages in the previous two weeks are the factors that help us to explain the forces that drive the creation of the clubs.

Maternal health care services in Nepal: A qualitative perspective based on the socio-ecological model

Nepal has a high Maternal Mortality Rates (MMR) in the South Asian region, partly due to the poor utilization of maternal and child healthcare services. The study aims to explore the influencing factors of maternal and child healthcare services among Nepalese women. Eighteen women, who had seven-days-old-children and those recently accessed maternal and child healthcare practices, were purposively selected. The face-to-face, In-depth-Interview (IDI) was applied to collect the information. The data were thematically analyzed, where Socio-Ecological Model (SEM) was applied as a theoretical framework. The study showed that the factors such as the knowledge of women, perception, and decision-making-autonomy at individual levels influenced maternal and child healthcare-seeking behaviors. Likewise, mothers-in-law and the role of husbands at intrapersonal levels, employment at institutional levels, peers and role of neighbors at community levels, and safe motherhood program at policy levels were significant factors for the utilization of maternal and child healthcare-seeking-behaviors. The negligence of women concerning pregnancy, inadequate health facilities, lack of specialist health workers with advanced equipment, and cultural taboos and beliefs were observed as score barriers for utilization of maternal and child health-seeking behaviors. The research strongly recommends that all women be aware of maternal and child healthcare and health-seeking behaviors at their initial ages.

Regional differences in cardiac mortality rates in Russia: the role of statistical features

Aim. To analyze the contribution of cardiac causes to all-cause mortality, to characterize the differences in standardized mortality rates (SMRs) in Russian regions, as well as to identify promising directions for improving establishment of cardiovascular death and its coding.Material and methods. We used the Federal State Statistics Service (Rosstat) data on the mortality rate and the average annual population in one-year age groups for 2019. To calculate the SMR, the European Standard Population was used. For each cardiac death, the SMR from 23 causes was calculated, which were combined into 4 groups, and for each of these groups, the regional mean and standard deviation of SMR in Russian regions were estimated.Results. In 2019, the cardiac SMR in Russian regions was 301,02±77,67, which corresponded to 30,5±5,8% of all death causes. At the same time, the coefficient of variation of regional cardiac SMR was 25,8%. In general, in 60,9±13,8% of cases, the cause of cardiac death was chronic diseases, mainly related to atherosclerosis. The proportion of deaths from acute types of coronary artery disease was 17,3±9,7%, deaths not associated with atherosclerosis (heart defects, myocardial diseases, etc.) — 17,5±8,2%, deaths associated with hypertension — 4,2±5,2%. The coefficient of variation of regional SMR was 34,66, 64,47, 50,99 and 122,7, respectively.Conclusion. Significant regional differences in SMR from certain cardiac causes and groups of causes, as well as their contribution to mortality pattern, were revealed. It is necessary to continue the research on the methodology of statistical recording of certain cardiovascular diseases.

Abstract 12877: National Trends of Atrial Fibrillation/Atrial Flutter Mortality in the United States From 1999 to 2019: Regional, Racial, and Gender Variations

Introduction: There is an emerging need to evaluate Atrial Fibrillation/Atrial Flutter (AF/AFL) mortality trends in different races and genders in different regions across the US. Methods: In an observational study utilizing the CDC WONDER database, age-adjusted mortality rates (AAMR) per 100,000 people for AF/AFL between 1999 and 2019 were investigated. Trends in AAMR were determined by evaluating average annual percentage changes (AAPC)s with Joinpoint regression analysis. Results: In the total US population from 1999 to 2019, AAMR due to AF/AFL has increased from 3.1 to 6.5 per 100,000 population. AF/AFL-related mortality rates have nearly doubled in all racial groups, ranging from an 84% increase in Black males (2.5 to 4.6 per 100,000) to a 123% increase in White males (3.1 to 6.9 per 100,000). AF/AFL-related mortality relative increase was highest in the West (140%) followed by Midwest (124%) and South (103%) while North East (81%) came last. Comparing white race mortality rates in different census regions, West demonstrated the highest increase in AAMR in the white population [170% in males, 138% in females]. Meanwhile, Midwest had the highest increase in the Black/African American population with a 111% increase in Females and 130% increase in Males. The Northeast showed the least increase in AAMR in both blacks and whites. Joinpoint analysis demonstrated that AF/AFL-related mortality rate has plateaued for black females and white males since 2017; the same plateau occurrence can be seen for white females since 2015 (Figure 1). Conclusion: The greatest increases in mortality occurred among white men and women and in Western states. AAMR increase has plateaued recently in white males as well as black and white females. AAPCs demonstrate that the rates of increases in AF mortality are greatest in Caucasians, followed by Asian and Black Americans.

Mortality Rates in Russian Regions in the Context of the COVID-19 Pandemic

Introduction. The COVID-19 (coronavirus) pandemic has had a strong impact on the socio-economic situation in the country, especially on demographic processes. The article analyzes the change in the mortality rates in Russian regions and assesses the influence of various factors on them during the pandemic. Materials and Methods. The paper examined data from the Federal State Statistics Service on mortality rates in Russian regions. Based on the graphs analyzed and regression equations built, the factors that determined the increase in mortality rates during the pandemic and the degree of their influence were identified. Results. Changes in the rates of morbidity and mortality in Russian regions depended on the development of the healthcare system, demographic, socio-economic, and geographical factors, as well as on the actions of regional and federal authorities. The geographical location of the regions turned out to be the determining factor. The highest mortality rates were found in the regions located in the center of the European part of Russia at the intersection of transport routes. In some months, high mortality rates were observed in the regions bordering China, Kazakhstan, and Finland. The proportion of pensioners and the degree of decline in personal income were also significant. Discussion and Conclusion. Calculations have shown that at the beginning of both waves of the pandemic, the increase in mortality rates depended on the provision of the population of the regions with doctors and hospital beds. In the spring, the restrictions imposed restrained the spread of the disease, but led to an economic recession and an increase in unemployment. In the autumn, less severe restrictions were introduced, which led to a significant increase in mortality rates and a slight decline in the economy. The research results can be used to optimize the managerial decisions in the field of medical and demographic policy.

Ecological situation: the role of education and spirituality in improving health of population

Human health is one of the most important issues for every period of society’s development. After all, the state of development of any country is determined by the level of health and literacy of the population living in the region. The article highlights the ecological situation, the role of knowledge and spirituality in strengthening the health of the population in Uzbekistan, the achievements of medicine, ecology, socio-demographic development in the country during the years of independence data on the reduction of infant and maternal mortality in the age group of the population are also presented. It is known that in more than a quarter of a century (1991-2019), the total mortality rate in the country's population decreased by 1.2% or decreased from 6.2 per thousand to 4.9 per thousand. However, there are still areas with high mortality rates (in Tashkent, Tashkent, and Andijan regions), which can be explained by their location at the transport hub and industrialization. The study and analysis of their regional aspects are some of the important aspects of geographical research. The article also focuses on the issues related to climate change and their impact on the nosoecological situation.