Socio-economic factors of health and disease at the present stage. Influence of socio-economic factors on human health

We all live in a society. Its impact on our health and development is ambiguous. main role social factors play a role in shaping health. What is a social factor? This is any component in a person's environment that significantly affects his behavior, health, and well-being. This is proved by the differences in the levels of public health depending on the socio-economic development of the state. As practice shows, the higher the level of economic development of the country, the better performance individual health and public health, and vice versa.

A clear example of the strong influence social conditions health can serve as a crisis and the fall of the economy in Russia.

The result of this was a drop in the level of public health, and the demographic situation can be safely called a crisis.

Based on the foregoing, we can say that the influence of social factors on a person is directly dependent on the state of his health. This means that social factors through lifestyle, state environment, the state of health in general is formed by individual, public and group health.

Man is a social being, and it is not surprising that the factors of social influence that have a regular impact on human development and health are of leading importance.

Social factors depend on the socio-economic structure of society, the level of culture, education, customs, traditions, industrial relations between colleagues at work, social intra-family attitudes. Most of these factors are included in the general concept of "lifestyle". Its impact on human development and health is over 50% of all factors.

Characteristics of social factors influencing human health

Social factors are directly related to the life of people, with their relationships in society. This concept includes the real relationship of people to each other, to nature, that is, class, family, labor, national, production, household, and their material aspects.

Let us reflect what and what is the influence of social factors on human health and development.

Socio-medical. The development of medicine and the laws of the country provide regular medical examinations the state of health of an able-bodied citizen. Accordingly, factors contributing to health promotion from the point of view of medicine are highlighted and recommendations are developed for a healthy lifestyle and disease prevention.

Legal. Regularly developed and reviewed the legislative framework aimed at providing citizens with the right to health.

Socio-economic. The state monitors the observance of labor protection at all enterprises. Thus, types of participation and responsibility of all constituent socio-economic structures are formed to strengthen and preserve the health of citizens.

Socio-biological. The legislation of the country provides for the retirement of citizens earlier due to disability, depending on work in difficult conditions, depending on gender ... So such factors consider the state of human health depending on age, heredity, gender.

Ecological. The state controls environmental pollution. Factors control the environmental conditions appropriate for a healthy lifestyle and competent use natural resources.

Sociocultural. Addiction good results work from rest no one will dispute. Therefore, these factors are associated with the organization of leisure of citizens, the formation of the desire for a healthy lifestyle.

Personal. The health of every able-bodied citizen reduces the number of sick days and production downtime. Therefore, there are also factors that orient each person to the formation, strengthening and preservation of their health.

Groups of social factors affecting the health and development of groups of people

Socio-medical. This quality medical services, their accessibility to all segments of the population

Legal. This state legal framework in a health care environment.

Socio-economic. This includes qualifications, working conditions, income (if any), level of education and organization of leisure, the formation of a middle class stratum.

Socio-biological. These include age, gender, heredity.

Ecological. This is the state of soil, water, air; features of the climatic zone.

Sociocultural. This includes hygienic training and education, the level of education.

Personal. These include the level of general culture of the population and responsibility for personal health.

Now consider these groups in more detail in terms of harm or benefit to humans.

1. Socio-medical.

Of course, the health of the population is in direct parallel with the quality of medical services provided. It's no secret that paid medicine is closer to caring for a particular person and the people as a whole. This is immediately visible. No need to sit in line for hours at the doctor, endure sometimes boorish attitude towards yourself. Level laboratory examination, the possibility of complex analyzes directly depends on the possibility of acquiring expensive reagents ... Accordingly, more precisely the result survey, higher treatment outcome. However, it is also more expensive ... After all, pensioners most often turn to the clinic, it is physically difficult for them.

To resolve this situation, we must strive to make medical services more accessible to all segments of the population.

2. Legal.

A person must be sure that in case of failure to provide him with a qualified medical care or providing it in insufficient volume, he has where to turn with a complaint. He must know that they will respond to his appeal and receive help from doctors.

This gives confidence in next day and stability. Undoubtedly, it benefits people.

3. Socio-economic.

The well-being and mood of the employee depends on the working conditions. So, in a dark, cold basement with minimal living conditions, people will be harmed. On the contrary, in a bright, warm, even a small room, workers will feel better and labor productivity will increase accordingly.

The organization of recreation depends on the amount of income. Low salary - unbalanced diet, low-quality clothes, the inability to go to the sea. Consequently, human health is damaged. And vice versa.

More salary - less smokers, more time is devoted to work. Taking care of your health is directly proportional to the amount of wages. No smoke breaks - no shirking from work reaching 2-4 hours a day!

4. Environmental.

The condition of the soil, water and air greatly affect the well-being of people.

Those who are in poor health should consider moving to the countryside. There is cleaner than in the metropolis air, unpolluted soil and water that does not need to be filtered.

5. Sociocultural.

The level of education also has an impact on human development. Yes, with higher education more likely to find a prestigious, well-paid job, and, consequently, to secure a high standard of living. It also increases the chances of quick retraining and on-the-job learning.

6. Personal.

Responsibility for personal health has a powerful impact on a person's well-being. You need to start looking after your health as early as possible, since many diseases are asymptomatic, and diagnostics are needed. People are aware of this. You work - you get a salary, you don't let other production chains down. You take sick leave - you fail. If you drink, you also fail, as the quality suffers in most cases. And these are losses. For a person over time - the loss of work with all the ensuing consequences. Understanding this motivates us to realize that everyone is guilty of the failure of production, the deterioration of their health.

7. Socio-biological.

Age, gender and heredity influence individual, small group people, but do not have a significant impact on the development and health of the whole society.

Thus, we were convinced that there are influences of social factors on the development and health of society and a person, in particular. And it is in our power to weaken or strengthen this action.

Ministry of Health and social development Russian Federation State educational institution
Higher professional education
Saratov State Medical University
named after V.I. Razumovsky

Department: "Organization of healthcare, public health and medical
rights"

Head department - associate professor M.V. Yerugina
Curator - Art. teacher G.N.Bochkareva

COURSE WORK

On the topic: "Socio-economic factors of health"

Made by Eremina V.A.

Saratov - 2013
Content

Introduction ............................................................... .................................... ................. ............. ...................3
1. Health as a socio-economic category .............................................. ......... .......four
2. Influence of socio-economic factors on health ............................................................... . ..eleven
2.1 Peculiarities of the analysis of socio-economic factors of health ...............................................11
2.2 Characteristics of socio-economic factors of health ....................... ..... .12
2.3 The state of the Russian economy and the health of the population .............................................. .....22
Conclusion.................... ............................. . ............................. ................... ......................28
List of sources used .............................................................. ... .............................. ....thirty

Introduction
Health is a natural, absolute and enduring life value,
occupying the highest rung on the hierarchical ladder of values, as well as in
system of such categories of human existence as interests and ideals, harmony,
beauty, meaning and happiness of life, creative work, program and rhythm of life.
As shown by the data of numerous medical and sociological studies devoted to the problems of public health, health occupies one of the central positions in the hierarchy of human values. The importance of maintaining health is steadily increasing as the impact of the technological environment on the human body. Good health is the greatest social good and affects every area of ​​people's lives. It acts as one of the necessary and essential conditions active, creative and full life person in society. It was precisely this that K. Marx drew attention to in his time, presenting the disease as a life constrained in its freedom.
Insufficient health negatively affects the social, labor and economic activity of people, reducing the level of labor productivity, lowering the health indicators of the future generation, and also significantly reducing the overall satisfaction of a person with his life.
Thus, health is the main resource, the degree of possession of which determines the satisfaction of almost all human needs, it is reflected in the lifestyle and lifestyle, migratory mobility of people, their familiarization with modern achievements in culture, science, art, technology, the nature and ways of spending leisure time and recreation. However, it must be remembered that the level of health, in turn, is dependent on socio-economic factors.
Thus, the main purpose of the presented course work is to characterize the socio-economic factors that affect health in modern conditions.

Reshetnikov A.V. Sociology of Medicine (Introduction to the Scientific Discipline): A Guide. – M.: Medicine, 2002.-976s.
Human valeology. Health - Love - Beauty / Ed. Petlenko V.P. SPb.: 1997, V.5
Marx K., Engels F. Works. T.25.S.385

The problems of the quality of health of the population of various countries are constantly in the center of attention of scientists and politicians around the world. The Universal Declaration of Human Rights, adopted by the United Nations in 1948, stated that "everyone has the right to a standard of living which includes food, clothing, medical care and social services necessary for the maintenance of the health and well-being of himself and his family..." Thirty-eight years later, scientists meeting in Canada under the leadership of the World Health Organization (WHO) adopted the "Ottawa Charter for the Promotion (Further Improvement) of Health", in which emphasized that "good health is the main resource for the social and economic development of both society as a whole and the individual and is the most important criterion for the quality of life. In order to further improve health, efforts must be concentrated in five areas, public policy, physical and social environments , on the direct conditions of the local environment, on improving personal skills to choose a healthy lifestyle and on medical care. " Many domestic doctors - clinicians and hygienists paid close attention to public health issues (Davydovsky, 1962; Poor, 1972; Tsaregorodtsev, 1973; Komarov, 1984 ; Venediktov, 1987; Lisitsyn, 198 9 etc.).
The need for health is universal, it is inherent not only to individuals, but also to society as a whole. Being the most important property of labor resources, public health has a huge impact on socio-economic development, acquiring, along with such qualitative characteristics of the labor force as education, qualifications, the role of a leading factor in economic growth.
In our country, when developing federal and regional programs for scientific, technical and economic development, the quality of the population, including the quality of public health, is usually not taken into account. Ignoring the human factor can have very negative consequences for the modernization of the country and its individual regions. However, many politicians who operate with such "global" categories as "economic situation", "sustainable development", "prosperity growth", "defense capability", "competitiveness" have a different attitude to this issue. They still continue to believe that it is wrong to put forward the problem of ensuring the health of the people as the main one in modern conditions. At the same time, it is understood that Russia has other, more important, priorities of a military, state, and economic nature. The most significant role that modern political thinking
allocates to health - this is the role of one of the elements of the country's national security system.
We have to constantly emphasize that the nature of public health is manifested in its close connection with the ability to work, active life, social well-being of a person and family, the cost of treatment and prevention of diseases (Prokhorov, 1993a. 19936, 1994, 1995, 19956, 1996, 1997, 1999 2006; Prokhorov and Gorshkova, 1999). It is very important to consider health as a phenomenon with pronounced temporal relationships and consequences.
Today's health of people leaves a huge imprint not only on their own tomorrow's health, but also has a pronounced hereditary effect, influencing and even predetermining the health of future generations. Considering and taking into account the social consequences of a decline in the level of health of the modern population, one has to take into account the inevitable losses of future generations due to the underestimation of the health factor at the present time. It should be borne in mind the irreversibility of the negative processes associated with the spread of certain types of diseases.
The definition of the concept of "health" has been at the center of attention of physicians since the advent of scientific medicine and to this day remains the subject of discussion. We can say that health is the absence of disease. This is how health is understood at the household level. individual person- Today you are not sick, therefore you are healthy. The famous physician Galen from Pergamum wrote back in the 2nd century that health is the state in which we do not suffer from pain and are not limited in our life. But the absence of external symptoms of the disease is not at all a guarantee that the pathological process is no longer going on or starting in the human body. The World Health Organization (WHO) considers health as a positive state that characterizes the person as a whole, and defines it as a state of complete physical, spiritual (psychological) and social well-being, and not just the absence of disease and disability.
The definition contained in the WHO Constitution is of a qualitative nature and therefore cannot be considered exhaustive and clear. Firstly, it is too general, describing an ideal situation, and secondly, within the framework of this definition, a healthy person is considered essentially as a static system, and his state of health as an established one corresponding to a predetermined level. Meanwhile, a person is constantly developing, changing, and
this dynamic is a prerequisite for physical and mental health.
In medical science, the point of view has become widespread, according to which the health of an individual is defined as a state (process) of the preservation and development of biological, physiological and mental functions, optimal working capacity and social activity with a maximum life expectancy. Yu.V. Shilenko (2000) proposes a modification of this concept. “Health in the medical and biological aspect is a state of the body in which the subject is capable of self-improvement, the development of his biophysiological functions and effective activity in changing environmental conditions in the absence of stable and threatening organs and systems of changes in the internal environment, the body.”
Health in the psychological and hygienic aspect is the ability of the subject to a holistic, integrated behavior that is not accompanied by insoluble internal conflicts and is aimed at satisfying one's own needs (including the need for search and self-development, while taking into account the legitimate requirements of the social environment, state, society).
The individual health of an individual is a phenomenon, to a large extent, random. It can be caused mainly by endogenous factors and depends on many random external processes and phenomena. Options individual health cannot serve as a basis for making decisions aimed at optimizing living conditions large groups population. The level of health of a sufficiently representative group of people (average level of health) always serves as an indicator of a beneficial or negative impact environment per population. To solve social, economic, political problems, in which it is necessary to take into account the quality of health of the entire population, the concept of public (or population) health is used.
Public health is the main feature, the main property of the human community, its natural state, reflecting the individual adaptive reactions of each member of the community of people and the ability of the entire community in specific conditions to most effectively carry out its social and biological functions.
In various socio-economic, environmental, hygienic, natural conditions, the parameters of public health can differ significantly from each other. This circumstance allows us to speak about the different quality of public health. The specificity of regional living conditions determines the degree of probability for each person to achieve the best level of health and creative performance during the maximum extended individual life.
Public health also characterizes the viability of the whole society as a social organism and its possibilities for continuous harmonious growth and socio-economic development. The level of public health is the most striking and comprehensive indicator of living conditions and at the same time depends on them.
Population health is not something frozen, stationary, it is a constantly ongoing process. Describing a certain level of health in any community, we take a "snapshot" and characterize a brief phase of the medical and demographic process. The dynamics of the loss of vital potential, the transformation of nosological profiles, changes in life expectancy over a number of periods of time for the regions of Russia are a series of such snapshots and they allow us to understand the essence of ongoing medical and demographic phenomena and, ultimately, find ways to objectively predict the state of public health and on this basis to develop life-saving measures.
The problems of determining the quality of public health are inseparable from the problem of the living standards of the population. It is well known that the state of health is determined not only and not so much by the health care system itself, but to a large extent depends on the living conditions existing in the country and on their dynamics. The modern standard of living includes indicators that characterize employment and social protection of the population, individual status and freedom of the individual, ethical, legal, social and medical norms, the level of education and culture, providing citizens with basic material and spiritual benefits, including sanitary and environmental protection. Of great importance is the self-preserving behavior of the population - the attitude of people to their health and the health of their loved ones.
More than 100 years ago, in 1897, the outstanding hygienist G.V. Khlopin wrote: “The realization that health is a public good subject to the protection of society or the state appeared before each member of society, from a developed sense of self-preservation, learned to value health for himself personally.” This statement of a prominent scientist is extremely relevant today, when both the state and the population itself are very careless about the health of the nation and their own health.
Attention to one's own health, the ability to provide individual prevention of its violations, a conscious orientation towards a healthy lifestyle various forms life - all this can serve as an indicator not only of sanitary and hygienic literacy, but also of the general culture of a person. Public health is not only a set of characteristics and signs of individual health, but also the integration of socio-economic features that make it a vital part of the social organism that society is.
Within the framework of the problem of interest to us, it is necessary to consider the health of the population as a socio-economic category associated with lifestyle. This relationship is twofold.
Firstly, health is a natural, absolute and enduring good, occupying the upper rungs of the hierarchical ladder of values ​​that are significant for all people without exception. This view of health as the highest value good has a thousand-year tradition. The influence of health permeates all spheres of human life. The completeness and intensity of the diverse manifestations of human life, not to mention their very possibility, are directly dependent on the quality of health. The high potential of physical and mental capacity is the most important guarantee of a full-fledged human life. And vice versa, the state opposite to health - illness - is, according to the figurative expression of K. Marx, "a life constrained in its freedom."
Secondly, health is included as an integral part of the economic factor of labor, it represents a resource of working capacity, on which labor productivity depends, and with it the level of satisfaction of almost all needs. Health determines the possibility of engaging in labor and using it as a source of material well-being.
The implementation of such an important social task as the formation of a comprehensively and harmoniously developed personality requires the preservation and strengthening of public health as the main prerequisite (Lisitsyn, Sakhno, 1989).
The essence of health as a socio-economic category is also manifested in the fact that any loss of health leads to inevitable costs for its restoration and economic losses due to a decrease in the opportunities for socially useful activities.
Exceptionally high humanistic value of health. The scale of the state's concern for the health of its citizens, real efforts and achievements in this area can be considered as a measure of the social and ethical maturity of society, the level of its humanism, and the perfection of the entire state system.
Conditions, circumstances, specific causes, more than others responsible for the quality of public health, for the occurrence and development of diseases are called risk factors. The "projection" of risk factors on the causes of premature death of people, developed by WHO experts, confirms the presence of fairly clear correlations between the share of participation of one or another risk factor and changes in the level of public health.
Science, technology, architecture, vehicles, sanitary infrastructure contributed to the creation of the "armor of civilization", which should protect a person from the negative effects of the environment. But even now, public health is affected by both biological properties each individual person, various components of the environment, and their totality (Fig. 1).

Figure 1 - The role of external and internal factors in the formation of public health. WHO Expert Model:
1. Health care; 2. Biological properties of the organism; 3. Pollution and degradation of the environment; 4. Socio-economic conditions and lifestyle

Yu.P. Lisitsyn (1987) proposed, following the WHO experts, to group risk factors into several blocks, roughly determining for each group its share in the impact on public health (Table 1).

Table 1 - Grouping of risk factors

The table below shows that the decline in health largely depends on socio-economic factors, people's lifestyle, the state of the environment and heredity. But natural conditions, which are hidden in the lines "lifestyle" and "environment", determine many features of the level of population health.
Thus, the leading role in the impact on the level of public health belongs to socio-economic factors, which include:
- living conditions, including the size and quality of housing, the availability of district heating, water supply and sewerage;
- improvement of the territory;
- the degree of urbanization of the territory;
- quality of recreational resources;
- bad habits - alcoholism, smoking, drug addiction;
- Quantity and balance of food rations;
- the amount of income of the population;
- development of social assistance to needy groups of the population;
- the presence or absence of decent work;
- availability and quality of education;
- tension of the information field in the environment - the impact of "information noise" on people's psyche,
- family and moral problems - divorces, abortions, suicides, crime, including murders,
- migratory mobility (for example, moving from the countryside to the city);
- the specificity of the way of life in regions with different natural, social, ethnic, religious characteristics.

2. Impact of socio-economic factors on health
2.1 Features of the analysis of socio-economic factors of health

The most studied factors that shape the health of the population are socio-economic. Their research is conducted both on national samples and at the regional and municipal levels. The most complete and substantiated data in this area were obtained by participants in the monitoring of the economic situation and health of the population of Russia (RLMS), conducted by the Institute of Sociology of the Russian Academy of Sciences (headed by P. M. Kozyreva, M. S. Kosolapov) together with a number of Russian and foreign organizations over the past 17 years. years in a national sample.
Within the framework of 12 waves of research (each wave included a survey of about 10 thousand respondents of working age), the population's health was measured by a significant number of parameters. The most indicative for the characteristics of self-preserving behavior was the relationship between the state of health of the population and socio-demographic (gender, age, nationality, place of residence), economic (education, income, employment), social and behavioral (alcohol consumption, smoking, physical education, nutrition). , weight control, treatment medical institutions) factors. The data obtained by RLMS are widely analyzed by various researchers.
The complexity of the analysis of socio-economic factors of health lies in the fact that the materialistic explanation does not make it possible to understand exactly how they predetermine one or another level of health in different social groups. It is understandable why the health status of the economically disadvantaged segments of the population is worse (harmful working conditions, poor housing conditions, poor quality food, etc.). But this mechanism of explanation fails when it comes to understanding the causes of health inequalities within the middle class. Then, explanations related to differences in lifestyle, social conditions and behavioral acts, that is, cultural characteristics, come to the fore.

2.2 Characterization of socioeconomic factors of health

Let us consider the nature of the influence of the main socio-economic factors on health.
The level of well-being affects the health of the population. Here the main role is played not so much by the quantity as by the structure of consumption, primarily the quality of food.
The quality of nutrition is its balance in terms of the required level of calories and the optimal ratio of the main components: proteins, carbohydrates, fats, vitamins.
An analysis of data characterizing the level of health and nutrition quality assessment reveals a direct relationship between them: quality characteristics nutritional status is relatively poorer among individuals with low health scores than among those with relatively high health levels. The direct nature of the relationship between nutrition and health scores indicates that in most cases, nutritional conditions remain unchanged at the time of the survey compared to those that had an impact on health. In the opposite situation - if the majority of those who experienced a negative impact on their health had improved their nutritional conditions by the time of the survey - the relationship between the indicators under consideration would have become inverse. However, in this case in contrast to the previous one (i.e. the relationship with the health of housing conditions), the possibility of a shorter time period in the manifestation of the health effects of qualitative characteristics of nutrition cannot be ruled out.
Another difference between these two factors, which is important for socio-economic analysis, is related to the presence in the characteristics of nutrition of a significant influence of individual (or family) tastes and preferences. Since these preferences do not always correspond to the criteria of health rationality, the “responsibility” for the negative impact of the qualitative structure of nutrition on health lies with the individual himself and his family (to the extent that this structure is determined by family-wide traditions or individual tastes). In the same way, the regulation of conditions and diet in accordance with changed health can to a certain extent depend on individuals, on their degree of awareness of the causal relationships between health and nutrition, on their ability and willingness to subordinate their behavior, in particular in the field of nutrition structure, to the interests of improvement. health.
However, there are also a number of factors of an objective nature that do not depend on the family and its members, which may limit the ability to regulate the qualitative composition of nutrition and its adaptation to changes in health. These factors include the structure of the market supply of food products, the degree to which it corresponds to the structure of population demand and the requirements for optimizing the set of products from the point of view of health. An objective factor that has a certain impact on the qualitative structure of nutrition is the level of material well-being of the population, expressed by the amount of income. Its significance to a certain extent increases in the conditions of scarcity of certain foodstuffs in the sphere of retail, especially those on which the provision of rational (in terms of health) nutrition depends to the greatest extent. In this case, the influence of income is manifested in the degree to which their level determines the structure of sources of acquisition. necessary products nutrition, i.e. correlation between retail, cooperative and collective farm trade. A certain dependence of the qualitative composition of nutrition on the size of family income is found, characterized by a tendency for the average assessment of the quality of nutrition to increase from the lowest income groups of the population to the highest until reaching a certain threshold level, after which this assessment practically stabilizes as incomes further increase.
At the same time, the possibilities for improving nutrition, in particular the availability of high-quality food products, are limited not only, and sometimes not so much by the material resources of the population (which should follow from the requirements and patterns of the functioning of the system of commodity-money relations), but by factors that rather reflect the dysfunction of this system. systems. Thus, the qualitative level of nutrition reveals the greatest degree of dependence on social status family, determined by the professional or industry affiliation of working members. The lowest assessment of nutrition is observed in the families of pensioners, in the families of low-skilled workers, and the highest assessments are in the families of persons employed in the service sector.
Thus, it can be assumed that the possibilities of regulating the qualitative characteristics of nutrition for health purposes depend to a greater extent on factors of an objective nature than those related to the individual and his family. In support of this hypothesis, we can cite the survey data that reflect the opinion of the population about the role of health improvement factors. According to them, one of the most urgent problems is improving the quality of nutrition (judging by the frequency of respondents' answers, the factor of improving the quality of nutrition occupies the second position, yielding to the first factor of increasing free time and slightly ahead of such a factor as improving living conditions). The proportion of people who noted the quality of nutrition as an indispensable condition for improving health is the least differentiated in comparison with other factors in the context age groups(this proportion is slightly increased only in the group of the elderly). This is an indication of the dependence of solving the problem of improving the quality of nutrition at various stages of individual and family life. life cycle from measures that are not so much targeted (for certain groups of the population), but of a general nature (we are talking, first of all, about expanding the volume of market supply of food products, about saturating the market with products necessary to form an optimal nutrition structure from the point of view of health).
The system of direct and feedback connects individual health and living conditions. A comparative assessment of the significance of this factor shows that in terms of the strength of its influence and the degree of involvement of the population in the sphere of this influence, housing conditions are second only to the labor factor.
The influence of this factor on health is very multifaceted. Research by physicians, physiologists, and hygienists establishes the nature of pathological changes in health caused by the impact of various components of housing provision, primarily its qualitative parameters.
An analysis of the interdependence of health and housing conditions reveals a varying degrees severity, but a common pattern for all age groups of the population: unsatisfactory housing conditions are more often combined with low health scores than with medium and high ones, and, conversely, people with high potential health have, as a rule, and good living conditions. In more general view the noted regularity manifests itself in the trend of decreasing the average assessment of housing provision as we move from population groups with a relatively high level of health to groups with a lower assessment of it. Survey materials reveal the direct nature of the relationship between integral assessments of individual health and integrated assessments housing security for families. While stating this fact, we cannot, however, confine ourselves to considering the impact of housing conditions on health. With sufficient reason, the reverse nature of the relationship between the studied indicators, fixed simultaneously, is also revealed. This connection is
etc.................

As a result of studying the chapter, the student must:

know

• groups of social factors affecting human health;
• the influence of factors of the working environment on the health of workers;

be able to

Reveal the relationship between social changes in the environment and public health;

own

• the basics of medical and social analysis of social phenomena and processes;
• skills to study medical and social problems in modern society.

Characterization of social factors affecting health

Social factors are connected with the life of people, with their relationships in society. This concept reflects the really existing relationship of people to nature and to each other, i.e. labor, production, class, national, family, household and other relations, their material aspects. Social factors affecting the health of the population can be represented in the form of several groups:

• - socio-economic, determining the types, forms of participation and responsibility of various parts of socio-economic structures in preserving and strengthening the health of their members, creating regulatory conditions for professional activity;
• - legal, aimed at legal support of the rights of citizens to health and regulatory mechanisms for their implementation through state and non-state economic and social institutions at the federal, territorial and municipal levels with the participation of the citizens themselves;
• - socio-medical, providing diagnostics of the state of health, development of recommendations for the formation of a healthy lifestyle and effective prevention diseases;
• - socio-biological, considering the state of health depending on gender, age, heredity;
• - socio-cultural, related to the formation of a culture of health, the organization of leisure activities for the population, the popularization of a lifestyle adequate to health, taking into account ethnic, community, national, religious and other ideas, traditions and rituals;
• - ecological, which determine the state of the environment adequate for a healthy lifestyle and rational nature management;
• - personal, orienting each person to the formation, preservation and strengthening of their health, closely related to the development of a common culture and understanding of personal responsibility for their health.

Table 4.1

Groups of social factors affecting health

The quality of health and its integral expression - life expectancy - depend on various factors: natural, environmental-hygienic, industrial, but primarily from socio-economic. Experts also point to this fact. international organizations. At the 52nd session of WHO, it was emphasized that the main determinants of health are associated with socio-economic factors; relationship between health status and employment, income level, social protection, housing conditions and education can be clearly seen in all European states.

A correct idea of ​​the quality of public health can be obtained by studying the factors that determine one or another life expectancy or serve as its indicators.

A study of the relationship between health indicators (infant mortality, life expectancy for men and women) and gross domestic product per capita at parity purchasing power in 198 countries of the world showed a close relationship between these indicators.

Life expectancy is related to the subsistence level. This indicator reflects the valuation of the natural set of food products necessary to maintain human health and ensure its livelihoods, as well as the cost of non-food products and services, taxes and mandatory payments, based on the share of costs for these purposes of low-income population groups.

For the non-working population minimum consumer basket– This is the amount of funds that allow maintaining the viability of a person. It should be noted that the living wage in each region is approved by law. Differences in the values ​​of the subsistence minimum here depend primarily on the difference in prices for food and non-food consumer goods. In fact, the cost of living is the price of survival.

The impact of heavy physical labor on the health of the population has long been noted in works on occupational health. It has been established that persons engaged in heavy physical, often irregular, labor in combination with low level education, inability to rationally use free time have a low life expectancy.

The economic difficulties of the transition period in Russia were reflected in the nature of nutrition. AT last years in the majority of the population, the actual consumption of the most important products for the body turned out to be very low. The structure of the diet in Russia is much worse. Lack of valuable food products with a high protein content is replaced by foods high in carbohydrates (bread, potatoes), the excess of which in the diet poses a certain danger to public health.

In parallel with the fall in the standard of living of people after 1991, there was a reduction in meat consumption, meat products, milk and eggs while increasing the consumption of potatoes and flour products, primarily bread.

The set and quantity of products in the diet of the vast majority of the Russian population not only do not meet the requirements for the structure balanced nutrition, but they do not always meet hygienic standards. Every year, from 4 to 6% of food samples do not meet the standards for sanitary and chemical indicators, and from 6 to 7% - for sanitary and microbiological indicators.

Living conditions have a great influence on the state of human health. An analysis of the relationship between home improvement indicators and regional differences in life expectancy showed that life expectancy was most affected by the presence of running water, central heating and gas in homes. At the same time, the latter indicator is most closely related to the life expectancy of women.

In Russia, there is a gradual improvement in the improvement of settlements. At the same time, the degree of improvement in the villages does not yet meet sanitary and hygienic requirements.

The considered problems of the relationship between public health and the quality of public utilities and sanitary infrastructures, according to O. S. Pchelintsev (2004), are implemented through the functions of organizing the reproduction of high-quality resources by methods of territory development and infrastructure development (taking into account the socially guaranteed minimum of free provision of services).

The development of the process in the opposite direction, i.e. deterioration of living conditions, dilapidation and destruction of housing stock, growth of payment for housing and communal services, low wages in public sector institutions and pensions lead to social marginalization of the poorest sections of the population. This in turn causes a reverse epidemiological transition.

According to V. G. Semenova, in the post-Soviet period, the main source of health losses was the growth of marginalized strata of the population and an increase in their risks of mortality from exogenous and external causes(tuberculosis, pneumonia, cirrhosis of various etiologies, injuries with undetermined intentions, accidental alcohol poisoning, as well as from ill-defined symptoms, signs and conditions), and in young age this whole range of causes is almost entirely determined by idle and low-skilled workers.

An important indicator of the socio-psychological situation is the level of crime. In the reports of Russian zemstvo doctors late XIX in. you can find such a section as moral statistics. It included data on the number of domestic and criminal crimes, divorces, the number of prisoners, etc.

Yu. F. Florinskaya (1997) refers to the group of factors that determine the moral situation in Russia, such indicators as the number of registered crimes, the number of murders, suicides, the incidence of alcoholism and alcoholic psychosis, drug addiction and substance abuse, the number of patients with syphilis and gonorrhea.

The number of deaths from external causes and their proportion among all causes of death in Russia are enormous. Considering the hypothetical gain in medium duration of life while eliminating individual causes of death, then, for example, eliminating injuries in men gives a much larger gain than eliminating cancer.

The number of reported crimes and the number of convicts is highly correlated with the life expectancy of women compared to men. There is also a certain relationship between the number of convicts and the proportion of unprofitable enterprises in industry. Although there is a noticeable relationship between this indicator and life expectancy, it is not stable over time, so the crime rate is used as the main indicator.

The increase in crime is largely due to the level of unemployment and, accordingly, the lack of a permanent source of income for large groups of the population, especially in countryside, in small towns.

The high proportion of murders and infliction of grievous bodily harm indicates a high aggressiveness of the population, which negatively affects its life expectancy. At the same time, the proportion of crimes in the economic sphere is high.

In the structure of crime, there are two types that have a very high degree of stability due to the life expectancy of the population. The first type of crimes is associated with the intentional infliction of grievous bodily harm, and the second - with the sphere of the economy. However, the degree of influence of these factors is different and ambiguous.

Life expectancy also correlates with other factors, even with those that, it would seem, do not directly affect the quality of health, but may be indicators of the general social situation in the region.

These include the density of paved roads per 1000 sq. km. km of territory. All this indicates that a well-developed road network indirectly reflects enough high density location of settlements on the territory, which is typical for long-settled areas, the most suitable in terms of their conditions for the life of the population.

Based on the assessment of the impact of natural conditions on the health of the population, a classification of the comfort of Russian regions has been developed, which are divided into five groups - from comfortable to extreme. An assessment of the level of climate comfort (the leading factor in determining the comfort of natural conditions) in connection with health is given in the electronic version of the web-atlas "Environment and Public Health" (1998).

The northern and mountainous taiga regions of Russia, which are characterized by uncomfortable and extreme natural conditions, are characterized by a lower life expectancy compared to the national average and even more. low scores compared to areas with favorable natural conditions.

People living in harsh natural conditions have worse health indicators than those living in areas with a temperate climate. Attention is drawn to the fact that women suffer the most from adverse natural conditions. This is not surprising due to the fact that in extreme and uncomfortable areas the social infrastructure is especially poorly developed.

In the process of strengthening the differentiation of the population according to income groups, there is an increase in social stratification, a deterioration in the main social characteristics: a decrease in average life expectancy; increase in mortality in working age; the accelerated spread of socially significant diseases, the spread of mass alcoholism; Availability high level crime, there is an increase in serious and especially serious crimes.

These social characteristics are closely related to each other. The greatest negative relationship is observed between the life expectancy of the population and morbidity active tuberculosis and alcoholism, the number of reported crimes, the number of crimes involving intentional grievous bodily harm in the amount of reported crimes, the number of workers, commas hard manual labor, and the share of dilapidated housing stock in the total housing stock.

These indicators represent a set of negative social characteristics. The higher their level, the lower the life expectancy. The most striking action negative factors manifests itself in regions with uncomfortable natural conditions.

Regions with a satisfactory level of life expectancy of the population are characterized by the presence of:

• – relative stability of the level and quality of life, determined in many respects by the low share of unprofitable enterprises;
• - a high level of improvement of the housing stock, which has a positive effect on life expectancy, especially in the presence of central heating and water supply in houses, as well as gas;
• – the average size of pensions, which significantly exceeds the subsistence minimum for pensioners;
• - developed market relations, which is determined by a high share of income from business and property in total income.

The number of factors influencing the state of public health, including life expectancy, is very large. In addition to the factors listed above, there are various natural factors, and environmental pollution, and the quality of medical care, the level of education of the population, etc.

The artificial environment created by man himself also requires adaptation, which occurs mainly through illness. The causes of diseases, in this case, are as follows: physical inactivity, overeating, information abundance, psycho-emotional stress.

From the point of view of biomedical positions, the influence of socio-ecological factors on physical development and adaptive properties of the organism can be considered on the example of the following phenomena:

1) acceleration process

Acceleration is the acceleration of the development of individual organs or parts of the body compared to a certain biological norm(increase in body size and earlier puberty).

Scientists believe that this is an evolutionary transition in human life, caused by improving living conditions: good nutrition, which “removed” the limiting effect of food resources, which provoked selection processes that caused acceleration.

2) violation of biorhythms

Violation of biological rhythms - the most important mechanisms for regulating the functions of biological systems, which in urban life can be caused by the emergence of new negative environmental factors. This primarily refers to the appearance of the so-called circadian rhythms in the biosystem of the body. This is a kind of adaptation of the body systems to the environment. For example, electric lighting appeared, which extended daylight hours. At the same time, our biosystem adapts to new living conditions. As a result, the former biorhythms become chaotized, which leads the organism to a new rhythmic stereotype. Unfortunately, these processes cause diseases both in humans and in representatives of living organisms.

In connection with the change in the photoperiod, scientists have found that the growth of allergic reactions and allergic diseases, eye diseases, mental disorders, etc. has increased.

4. Socio-economic factors

Socio-economic factors are decisive and are determined by industrial relations or, for students, the period of study at a university. These include:

Legal and regulatory (labor legislation and the practice of state and public control over its observance);

Socio-psychological factors that can be characterized by the attitude of an employee to work or a student to learning activities, obtaining a specialty and its prestige, the psychological climate in the student team;

Economic factors (material incentives, system of benefits and compensations for work in unfavorable conditions).

Technical and organizational factors have an impact on the creation of material and material conditions of work (means, objects and tools of labor, technological processes, organization of production, etc.).

In real conditions, this complex set of factors that shape working conditions is united by diverse mutual links. Life has an impact through housing, clothing, food, water supply, the development of the infrastructure of the service sector, the provision of recreation and the conditions for its implementation, etc. The socio-economic structure affects a person through the social and legal status, material security, level of culture and education.

In this regard, in the 1980s I.I. Brekhman proposed a new scientific term valueology, which includes a body of knowledge about the genetic, physiological reserves of the body, ensuring the stability of physical, biological, psychological, socio-cultural development and maintaining health under the influence of changing factors of the external and internal environment on the body.

Valeology involves taking into account the gene pool of an individual, his psychophysiological characteristics, lifestyle, habitat, ecology, and professional activity.

In this regard, it can be concluded that no society has been able to completely eliminate the dangers to human health arising from the age-old and new environmental conditions. Most developed modern societies have already markedly reduced the damage from traditional deadly diseases, but they have also created lifestyles and techniques that pose new threats to health. All forms of life arose as a result of natural evolution, and their maintenance is determined by biological, geological and chemical cycles. However, Homo sapiens is the first species able and willing to significantly change the natural systems of life support and striving to become the dominant evolutionary force acting in its own interests. By mining, producing and burning natural substances, we disrupt the flow of elements through soils, oceans, flora, fauna and atmosphere; we are changing the biological and geological face of the Earth; we are changing the climate more and more, faster and faster we are depriving plant and animal species of their familiar environment. Humanity is now creating new elements and compounds; new discoveries in genetics and technology make it possible to bring to life new dangerous agents.

Many environmental changes have made it possible to create comfortable conditions to increase life expectancy. But mankind did not conquer the forces of nature and did not come to their full understanding: many inventions and interventions in nature occur without considering the possible consequences. Some of them have already caused disastrous returns.

The surest way to avoid insidious environmental changes is to reduce ecosystem changes and human intervention in nature, taking into account the state of his knowledge of the world around him.

In conclusion, it can be noted that medical science considers the human body in unity with external nature and the social environment.

The external environment in general can be represented by a model consisting of three interacting elements: the physical environment (atmosphere, water, soil, solar energy); biological environment (animal and plant world); social environment(man and human society).

The influence of the external environment on the human body is very multifaceted. The external natural environment and the social environment can have both beneficial and harmful effects on the body. From the external environment, the body receives all the substances necessary for life and development, at the same time it receives a numerous flow of irritations (temperature, humidity, solar radiation, industrial, professionally harmful effects, etc.), which tends to disrupt the constancy of the internal environment of the body.

The normal existence of a person in these conditions is possible only if the body responds in a timely manner to the effects of the external environment with appropriate adaptive reactions and maintains the constancy of its internal environment.

Environmental problems have a direct or indirect impact on the physical and moral condition of a person.

In the modern world, the problems of ecology - the interaction of the body with the environment - have become seriously aggravated.

According to the World Health Organization, 80% of human diseases are caused by environmental degradation.

A distinctive feature of a person is that he can consciously and actively change both external and social conditions in order to improve health, increase working capacity and prolong life. Undoubtedly, the relationship of society with the environment must be brought under stricter control.

The corresponding change external conditions a person can also influence his own state of health, physical development, physical fitness, mental and physical performance.

The health of an individual and society as a whole is determined by a number of factors that affect the human body, both positively and negatively. According to the conclusions of experts from the World Health Organization, four main groups of factors determining human health have been identified, each of which has a positive and bad influence, depending on application points:

• genetic inheritance;
• Medical support;
• Lifestyle;
• Environment.

The influence of each factor on human health is also determined by age, gender, individual characteristics organism.

Genetic factors that determine human health

A person's capabilities are largely determined by his genotype - a set of hereditary traits embedded in the individual DNA code long before birth. However, genotypic manifestations do not appear without certain favorable or negative conditions.

Critical terms of fetal development are due to violations of its gene apparatus during the laying of organs and body systems:

• 7 weeks pregnant: the cardiovascular system- manifested by the formation of heart defects;
• 12-14 weeks: nervous system- malformation of the neural tube leads to congenital pathology, most often as a result of neuroinfection - cerebral palsy, demyelinating diseases ( multiple sclerosis, BASF);
• 14-17 weeks: musculoskeletal system - hip dysplasia, myotrophic processes.

In addition to genetic changes great importance have epigenomic mechanisms as factors determining human health after birth. In these cases, the fetus does not inherit the disease, but, being exposed to harmful effects, perceives them as the norm, which subsequently affects his health. The most common example of such a pathology is maternal hypertension. Increased blood pressure in the "mother-placenta-fetus" system contributes to the development of vascular changes, preparing a person for living conditions with increased blood pressure i.e. the development of hypertension.

Hereditary diseases are divided into three groups:

• Gene and chromosomal abnormalities;
• Diseases associated with a violation of the synthesis of certain enzymes in conditions that require their increased production;
• hereditary predisposition.

Genetic and chromosomal abnormalities, such as phenylketonuria, hemophilia, Down syndrome, appear immediately after birth.

Fermentopathies, as factors that determine human health, begin to affect only in those cases when the body cannot cope with increased load. This is how diseases associated with metabolic disorders begin to appear: diabetes mellitus, gout, neuroses.

Hereditary predisposition appears under the influence of environmental factors. Unfavorable environmental and social conditions contribute to the development of hypertension, stomach ulcers and duodenum, bronchial asthma and other psychogenic disorders.

Social factors of human health

Social conditions largely determine the health of people. An important place is occupied by the level of economic development in the country of residence. Sufficient quantity money plays a dual role. On the one hand, all types of medical care are available to a rich person, on the other hand, health care is replaced by other things. Low-income people, oddly enough, are more likely to strengthen the immune system. Thus, the factors of human health do not depend on his financial situation.

The most important component of a healthy lifestyle is the correct psychological attitude aimed at a long life expectancy. People who want to be healthy exclude factors that destroy human health, considering them incompatible with the norms. Regardless of place of residence, ethnicity, income level, everyone has the right to choose. Being isolated from the blessings of civilization, or using them, people are equally capable of observing elementary rules personal hygiene. On the hazardous industries envisaged necessary measures personal safety, the observance of which leads to positive results.

The widely known concept of acceleration belongs to the social factors of human health. The child of the 21st century in terms of development is much superior to his peers of the 19th and early 20th centuries. Acceleration of development is directly related to achievements technical progress. The abundance of information encourages early development intelligence, skeleton and muscle mass. In this regard, in adolescents, there is a lag in the growth of blood vessels, which leads to early diseases.

Natural factors of human health

In addition to hereditary and constitutional features, environmental factors influence human health.

Natural effects on the body are divided into climatic and urban. The sun, air and water are far from the most important components of the environment. Energy impacts are of great importance: from the electromagnetic field of the earth to radiation.

People living in areas with a harsh climate have a greater margin of safety. However, the expenditure of vital energy in the struggle for survival among northerners is not comparable with those people who live in conditions where favorable natural factors of human health are combined, such as the action of a sea breeze, for example.

Environmental pollution due to the development of industry is capable of affecting at the gene level. And this action is almost never beneficial. Multiple factors that destroy human health contribute to shortening life, despite the fact that people try to lead correct image life. Impact harmful substances The environment is by far the main problem for the health of residents of megacities.

Constitutional factors of human health

Under the constitution of a person is meant a feature of the physique, which determines the tendency to certain diseases. In medicine, these types of human constitution are divided:

The most favorable type of physique is normosthenic.

People of the asthenic type of constitution are more prone to infections, weakly resistant to stress, therefore they more often develop diseases associated with impaired innervation: peptic ulcer, bronchial asthma.

Persons of the hypersthenic type are more prone to the development of cardiovascular diseases and metabolic disorders.

According to the WHO, the main (50-55%) factor influencing a person's health is his lifestyle and living conditions. Therefore, the prevention of morbidity in the population is a task not only medical workers, but also government agencies providing the level and duration of life of citizens.