Improving the organizational structure of the population prevention in the megapolis

Highlights. A comparative analysis of the morbidity rate in the population in Moscow, the Central Federal District and the Russian Federation for the period from 2012 to 2019 depending on the age groups was carried out; performance of the Center for Prevention and Health Centers in Moscow and in its administrative districts was assessed; suggestions for improving the organizational structure of the population prevention in the megapolis were made.

Aim. To analyze and assess the organizational structure of population prevention in Moscow, and to suggest proposals for its improvement.

Methods. The data of the Ministry of Health of Russian Federation on the morbidity rate in the (general) population in Moscow, the Central Federal District and the Russian Federation, by age groups of the population was analyzed. The analysis and assessment of the performance was done for the following entities carrying out preventive programs in Moscow: the Center for Prevention (CP), 58 departments and 224 offices for prevention, 62 Health Centers (HC) and the performance of youth-friendly clinics in the Russian Federation. We used statistical, sociological, analytical research methods for the analysis.

Results. Total morbidity rate in the population of Moscow (2019) was lower than in the Central Federal District and in the Russian Federation, it amounted to 140,743.0 per  100  thousand  of  the  population,  in  the  Central  Federal  District  it  was 149701.0‰оо, and in the Russian Federation it was 164899.4‰оо.At the same time, total morbidity rate in children aged 14 years old in Moscow was higher than in the Russian Federation and in the Central Federal District; it amounted to 222946.1 per 100 thousand of the corresponding population, in the Russian Federation it was 219845.6‰оо, and the Central Federal District it was 211643.2‰оо. The analysis of total morbidity in children in Moscow by classes of diseases is given. The article analyzes the performance of CP and HC in Moscow and output of youth-friendly clinics in Russia. Suggestions for improving the organizational structure of the population prevention in the megapolis were made.

Conclusion. Total morbidity rate in the population in Moscow is lower than in the Central Federal District and the Russian Federation, however, the rates in children are higher than in the Russian Federation for a number of diseases. The results obtained should be taken into account in the development of the population-based prevention strategies for children. Based on the results of the study, it can be concluded that the Center and departments for prevention in Moscow are subject to reorganization; additional duties and responsibilities should be introduced and existing ones should be adjusted. It is necessary to organize the continuity and coordination in care provided by the CP, HC and primary health care physicians. It is recommended to create more youth-friendly clinics in the Russian Federation, in particular, in Moscow.

1. Prokofieva A.V., Lebedeva-Nesevrya N. A. Formation of a health-oriented urban space as a way of managing risks to public health. Health risk analysis. 2018; 3: 144-155. doi: 10.21668/health.risk/2018.3.16 (In Russian)

2. Conceptual vision of "Healthy Cities" World Health Organization. Available at: http: //www.who.int/ru/health-topics/environment-and-health/urban-health/who/european-health-cities-network/health-cities-vision (accessed 25.05.2021.) (In Russian)

3. Eckert S., Kohier S. Urbanization and health in developing countries: a systematic review. World health & Population. 2014; 15(1): 7-20. doi: 10.12927/whp.2014.23722.

4. Christiani Y., Byles J.E., Tavener M., Dugdale P. Do women in major cities experience better health? A comparison of chronic conditions and their riski factors between Women living and other edibles in major cities in Indonesia. Global Health Action. 2015; 8(1): 1-9. doi: 10.3402/gha.v8.28540.

5. Mozaffarian D., Hao T., Rimm E.B., Willett W.C., Hu E.B. Changes in diet and lifestyle and long-term weight gain in women and men. The New England Journal of Medicine. 2011; 364: 2392-2404. doi: 10.1056/NEJMoa1014296.

6. Rocha L.E., Thorson A.E., Lambiotte R. The Non-linear Health Consequences of Living in Larger Cities. Journal of Urban Health. 2015; 92(5): 785-799. doi: 10.1007/s11524-015-9976-x.

7. Dontsov V. I., Krutko V. N. Health-saving as a modern direction of preventive medicine (review). Bulletin of Restorative Medicine. 2016; 1: 2-9. (In Russian)

8. Sabgaida T. P., Pavlov N. B. The possibility of evaluating the effectiveness of medical prevention on the basis of statistical reporting data. Social aspects of public health. 2011; 1(17): 7-9. (In Russian)

9. Kalininskaya A.A., Kuznetsov S.I., Shlyafer S.I., Grechko A.V., Volkova N.V. Provision of the population with beds day hospitals in the Samara region. Glavvrach. 2002; 10: 20-22 (in Russian)

10. The overall incidence of the entire population of Russia in 2012. Statistical materials of the FSBI TsNIIOIZ of the Ministry of Health of the Russian Federation. Moscow; 2013. (In Russian)

11. The overall incidence of the entire population of Russia in 2013. Statistical materials of the FSBI TsNIIOIZ of the Ministry of Health of the Russian Federation. Moscow; 2014. (In Russian)

12. The overall incidence of the entire population of Russia in 2015. Statistical materials of the Federal State Budgetary Institution TsNIIOIZ of the Ministry of Health of the Russian Federation. Moscow; 2016. (In Russian)

13. The overall incidence of the entire population of Russia in 2017. Statistical materials of the Federal State Budgetary Institution TsNIIOIZ of the Ministry of Health of the Russian Federation. Moscow; 2018. (In Russian)

14. The overall incidence of the entire population of Russia in 2019. Statistical materials of the Federal State Budgetary Institution TsNIIOIZ of the Ministry of Health of the Russian Federation. Moscow; 2020. (In Russian)

15. Kalininskaya A. A., Terentyeva D. S., Sulkina F. A., Malikova L. M. Effective forms of preventive work with adolescents. Actual problems of population health management: Jubilee collection of scientific papers. Under the general editorship of I. A. Kamaev, V. M. Levanov. Nizhny Novgorod (Russia); 2017: pp. 73-76 (In Russian)