Actual problems of maintaining and strengthening the health of the adult population. V. Improving the health of the population. Modern problems of prevention

Department of Public Health and Health with a course social work Theme: Improving the health of the population contemporary issues prevention. Socially significant diseases Lecture 6 for 3rd year students studying in the specialty Dentistry (full-time education) Candidate of Medical Sciences, Associate Professor, Kutumova O.Yu. Krasnoyarsk, 2013

LEARNING OBJECTIVE: Acquaintance of students with the problem of socially significant diseases and with the main types of socially significant diseases (diseases of the circulatory system, oncological diseases, injuries, sexually transmitted diseases, tuberculosis). Prevalence, mortality, problems of medical care and ways to reduce socially significant diseases.

Social diseases are “human diseases, the occurrence and spread of which to a certain extent depend on the influence of unfavorable socio-economic conditions (tuberculosis, venereal diseases, alcoholism, drug addiction, rickets, beriberi, and some occupational diseases)". Big Medical Encyclopedia

Criteria for the allocation of diseases to a group of socially significant ease and speed of spread and progression; high prevalence among the population (high rates of pathological susceptibility to any nosology); a significant contribution to the indicators of general and age-specific morbidity and mortality; a large proportion of cases of diseases occurring with disability (temporary or permanent); significant material damage caused by the totality of all cases of this disease at the state level; the possibility of influencing the occurrence and spread of these diseases directly through social factors.

In Russia and in the Krasnoyarsk Territory, for a number of years, the structure of the causes of mortality in the population has remained stable: 1st place is occupied by diseases of the circulatory system; 2nd place - accidents, injuries, poisoning; 3rd place - oncological diseases; 4th place is occupied by diseases of the respiratory system, among which a large proportion falls on chronic non-specific lung diseases (COPD)

DISEASES OF THE CIRCULATION SYSTEM When studying the incidence of diseases of the heart and blood vessels in the population, they include: coronary heart disease (angina pectoris, myocardial infarction and other forms); hypertension; vascular lesions brain (cerebrovascular disease); rheumatism.

DISEASES OF THE CIRCULATION SYSTEM: morbidity The proportion of diseases of the circulatory system in the total structure of morbidity with temporary disability (TSD) is increasing: they account for 9% of all cases of morbidity with TS in 2002 in Russian Federation(according to the State report on the state of health of the population). The hospitalization rate decreased by 1.6%, but the proportion of deaths in hospital (hospital mortality) from all diseases of the circulatory system increased by 4.4% compared to 2001. In the Krasnoyarsk Territory over the past 5 years, the increase in general morbidity was 25.3%, primary morbidity - 37.8%, mainly due to diseases characterized by high blood pressure.

DISEASES OF THE CIRCULATION SYSTEM: Incidence The increase in the overall incidence of coronary artery disease over 5 years amounted to 31.6%, the primary incidence in 2003 decreased. The incidence of cerebrovascular diseases continues to grow: over 5 years, the increase in the overall incidence was 26.3%, primary - 35.4%. The incidence of myocardial infarction, which has been recorded in the region over the past 5-10 years, is at the level of 1.2-1.3 per 1000 population and is significantly underestimated.

DISEASES OF THE CIRCULATION SYSTEM: morbidity Structure of appeals of the adult population for diseases of the circulatory system: the leading role belongs to diseases characterized by high blood pressure (28.9%); coronary heart disease accounts for 26.6%; 25.1% of patients with CVD seek treatment for cerebrovascular diseases.

DISEASES OF THE CIRCULATION SYSTEM: Mortality Diseases of the circulatory system (CVD) have been the leading cause of death in the population since the late 1980s, causing enormous economic and social damage. In 2002, in the Russian Federation, according to the State Report on the State of Health of the Population, more than half (56%) of the causes of death in the structure of deaths were due to diseases of the circulatory system. Among them, 84.5% are coronary heart disease (47.2%) and cerebrovascular diseases (37.3%).

DISEASES OF THE CIRCULATION SYSTEM: mortality The share of mortality from CSD in working age is 23.7%. Mortality from CSD among residents countryside higher than in urban areas - by 26.1% (2002). At working age, this difference is 22.3% (2002). According to 2002 data, the difference in mortality rates from CVD at working age between rural and urban men is 13.4%; rural women die from CVD 27.6% more often than urban women.

DISEASES OF THE CIRCULATION SYSTEM: mortality In the structure of total mortality of the population of the Krasnoyarsk Territory, the proportion of mortality from CSD is 47.1% (2003) 4% of cerebrovascular diseases (CVD) - 36.8-37.5%. In the structure of the CVB, an increase in the proportion of strokes is noted. The death rate from stroke is more than 4 times higher than the death rate from myocardial infarction.

DISEASES OF THE CIRCULATION SYSTEM CONCLUSIONS Over the past 5 years, the increase in mortality from CSD has continued, however, in 2003 there has been a trend towards its decrease. There is a supermortality of men of working age, both in the city and in the countryside, and the predominance of the death rate of rural women compared to urban ones. In the structure of mortality from CSD, stroke is the leader, according to official statistics, exceeding the mortality rate from myocardial infarction by 4 times. The morbidity rates for seeking medical attention in the CSD class in the Krasnoyarsk Territory are increasing annually, primarily in the class of diseases characterized by high blood pressure and in the CVD class due to ongoing work on the prevention of hypertension.

Risk factors in the development of CVD Risk factors (RFs) are behavioral, biological, genetic, ecological, social, environmental and occupational factors that are potentially hazardous to health and increase the likelihood of developing diseases, their progression and adverse outcome

Risk factors in the development of CSD are controllable, uncontrollable, primary or external (smoking, wrong sex, age, nutrition, physical inactivity, hereditary psycho-emotional stress, predisposition, alcohol abuse and drug use); secondary, or internal (diabetes, high blood pressure, high blood cholesterol, allergies, immunodeficiencies).

Risk factors in the development of CVD The prevention strategy is based on the elimination or mitigation of the influence of controllable factors, which WHO includes: Lifestyle factors (smoking, unhealthy diet, overweight body, physical inactivity, alcohol abuse and drug use); biological factors (high blood pressure, elevated blood cholesterol levels, the presence of diabetes); psychosocial factors (stress, fatigue at work, social insecurity, etc.).

Risk factors in the development of CVD Risk factors for the development of diseases of the circulatory system are also: others 2. noise; 3. living conditions; 4. electromagnetic fields; 5. composition of drinking water: nitrates, chlorides, nitrites, water hardness; 6. biogeochemical features of the area: lack or excess of calcium, magnesium, vanadium, cadmium, zinc, lithium, chromium, manganese, cobalt, barium, copper, strontium, iron in the environment; 7. environmental pollution with pesticides and pesticides; 8. natural and climatic conditions: the speed of weather change, humidity, barometric pressure, insolation level, wind strength and direction.

Ways to solve the problem of the prevalence of CSD. Strategy for the prevention of cardiovascular diseases: Strengthening the preventive focus in activities. health services (primary prevention). Education of the population for a healthy lifestyle. Monitoring of the epidemiological situation in relation to diseases of the circulatory system among the population. Scientific research.

Ways to solve the problem of the prevalence of CSD Since January 1, 2005, the Law of the Krasnoyarsk Territory on the REGIONAL TARGET PROGRAM "PREVENTION OF THE DISTRIBUTION AND COMBAT OF SOCIAL DISEASES" FOR YEARS came into force, according to which, in terms of measures for the prevention and treatment of hypertension, it is supposed: blood pressure for the diagnosis and selection of treatment in persons with arterial hypertension; creation of a system of dynamic control over the epidemiological situation associated with arterial hypertension; provision of permanent seminars and "schools for the prevention of arterial hypertension and atherosclerosis" in medical institutions of the region; organization of a system for training medical workers in methods early diagnosis, treatment and prevention of arterial hypertension and other cardiovascular diseases; creation of a permanent system of sanitary education of the population on the prevention of arterial hypertension and risk factors for cardiovascular diseases.

Malignant neoplasms: prevalence Since the middle of the 20th century, malignant neoplasms have acquired the character of mass destruction of the population of all industrial countries, according to WHO experts, due to the following main reasons: an increase in life expectancy, an increase in tobacco consumption, a decrease in mortality from infectious diseases.

MALIGNANT NEOPLASMS: prevalence About 6 million people fall ill with cancer every year in the world Over the past 5 years, more than 400 thousand people fall ill in Russia every year, of which more than 3 thousand children. patients, which is 1.5% of the total population of the country for 1/3 of patients with a first-ever diagnosed cancer, the fact of permanent disability is documented. In 2002, in the Russian Federation, the proportion of deaths from cancer was 13.4% of all deaths (third place in the structure of causes of death)

MALIGNANT NEOPLASMS: prevalence The most important reasons steady increase in morbidity and mortality from malignant neoplasms in the Krasnoyarsk Territory: pollution of the external environment with carcinogens smoking unbalanced diet insufficient level of sanitary and educational work on the prevention of cancer and propaganda healthy lifestyle low oncological alertness of primary care specialists

MALIGNANT NEOPLASMS: incidence The primary incidence of cancer is low - in 2003 it amounted to 317.2 per 100 thousand of the population, however, its constant growth is observed (by 14.1% compared to 1993). localization malignant neoplasms: in Russia in the Krasnoyarsk Territory (2002) (2003) trachea, bronchi and lungs 13.3% 14.9% of the stomach 10.2% 10.7% of the breast 10.2% 10.4%

MALIGNANT NEOPLASMS: Incidence Primary incidence of cancer (per 100,000, 2003) Russia Krasnoyarsk Territory men 321.5 280.4 women 309.8 273.9 Structure of primary cancer incidence (average for Russia, 2002) men women 1st place trachea, bronchi, lungs (23.3%) mammary gland (19.4%) 2nd place stomach (12.3%) skin (13.1%) 3rd place skin (8.9%) stomach (8, 3%) 4th place prostate gland (6.1%) body of the uterus, colon (6.7% each)

MALIGNANT NEOPLASMS: mortality Structure of causes of death from cancer men women 1st place cancer of the respiratory organs cancer of the stomach 2nd place cancer of the stomach cancer of the mammary gland 3rd place cancer of the esophagus cancer of the cervix Mortality of men from cancer is much higher than that of women. At the age of years, the mortality rate for men is at times, for women it is higher than that of persons of the same sex under the age of 30 years. One-year mortality (deaths within the first year of diagnosis) is 33.9%

MALIGNANT NEOPLASMS: mortality One-year mortality rate Russia (2002) Krasnoyarsk Territory (2003) 33.9% 31.5% One-year mortality rate in some areas of the Krasnoyarsk Territory (2003) B-Uluysky district - 72, 4% Idrinsky district - 58.4% N-Ingashsky district - 58.6% Taseevsky district - 50.0% Novoselovsky district - 66.0% Partizansky district - 68.2% Kozulsky district - 56.0%

MALIGNANT NEOPLASMS: conclusions The medical and social significance of cancer is determined by: high proportion in the structure of mortality of the population high mortality (including one-year mortality) high economic losses due to premature death and disability long and expensive treatment

MALIGNANT NEOPLASMS: prevention Measures aimed at improving the effectiveness of activities to reduce neglect and mortality from malignant neoplasms: to implement in all territories the decision of the board of the city of Krasnoyarsk Territory on measures to prevent and reduce premature mortality, which indicates the need to increase the level of training in oncology doctors of the general medical network; to introduce in the region for the unification and standardization of data on patients with malignant neoplasms in accordance with international standards, the system of the State Cancer Registry (according to the order of the Ministry of Health of the Russian Federation 135 of the year); identify cancer risk groups in polyclinics of cities and regions of the region; make greater use of the media in health education; it is necessary to allocate full-time positions in oncology in all districts and staff them.

INJURIES Injuries - a set of newly emerging injuries in certain groups of the population or contingents of people who are in the same environment, working and living conditions. Trauma (Greek: Trauma) is a sudden simultaneous impact of various external factors (mechanical, thermal, chemical, radiation effects, etc.) on the human body, leading to a violation of the structure, anatomical integrity and physiological functions of the body.

INJURIES Classification of injuries and poisonings Transport - combines injuries that occur in people working or using vehicles. Depending on the type of transport, road and rail injuries, injuries in air and water transport are distinguished. It is proposed to single out the injuries of pipeline transport.

INJURIES Classification of injuries and poisonings Production - a set of injuries that people experience in the course of their professional duties. Depending on the type of production activity, industrial and agricultural injuries are distinguished. Street - combines an extensive group of injuries that occur in people on the street; mainly it mechanical damage associated with a fall from a standing position, falling of various objects from a height, conflict situations. Sometimes there may be damage by physical factors - electrical injury when power lines are broken, burns and other damage.

INJURIES Classification of injuries and poisonings Household - injuries that are very diverse in origin and occur during housework, apartment renovation, use of faulty household appliances, domestic conflicts and other situations. Athletic - observed in people involved in sports, during training or sports. Military - a set of injuries in persons in military service. There are military injuries in peacetime, i.e. injuries that occur during the training and training sessions of military personnel, and wartime military injuries - injuries during combat operations.

INJURY: medical and social significance In terms of morbidity with temporary disability, injuries rank second after respiratory diseases. According to the State report on the state of public health in the Russian Federation, during 2002, 12.8 million injuries and other accidents were registered. Compared to 2001, there was an increase in the number of injuries in adults by 11% and in children by 2.4%. Injuries take the second place among the causes of death of the population as a whole and the first place among the causes of death of the able-bodied population.

The structure of mortality from injuries, poisoning and accidents 18.7% are accidental poisoning and exposure to toxic substances, of which 12.4% is alcohol poisoning; 17.2% accounted for intentional self-harm (suicide), 12.6% - for damage resulting from an attack (murder), 12.2% - for road accidents, 5.3% - for drowning.

Domestic injuries In the structure of fatal injuries among all types of non-occupational injuries, domestic injuries account for 45-48%. Mortality from domestic injuries in men is 2.7 times higher than in women. The most common household injuries with a fatal outcome are observed in men of working age, especially from 30 to 50 years old, and in women over the age of 60 years. 4 main groups of domestic injuries: when performing work, when moving, in violation of the rules of public order, under other circumstances.

Domestic injuries The mechanism of domestic injuries can be represented in 7 variants: falling on a plane, falling from a height, hitting a falling blunt object, hitting a blunt object, exposure to piercing and cutting objects and chemicals, a person falling between objects, accompanied by compression, the actions of animals.

Domestic injuries Five groups of domestic injuries (depending on severity): without temporary disability, with temporary disability, not requiring hospitalization, with temporary disability, requiring inpatient treatment, causing disability, accompanied by death.

Transport injuries: medical and social significance Damage from road accidents in some countries reaches 2-10% of their GDP. About 40% of those who die in Russia from injuries die as a result of road accidents. A third of all those who die at the age of 10 die in road accidents. Approximately 30% of victims die prehospital stage, 25% of the victims require inpatient treatment.

Main reasons high level DTT alcohol intoxication drivers, insufficient efficiency of the current system of traffic supervision, compliance with the rules traffic. Measures aimed at improving road safety; improving the road network; speed limits; seat belts and airbags; prevention and detection of drunk driving; technical inspections; tightening of legislative acts; work with drivers (driving is a privilege, not a right, and this privilege can be withdrawn when the right to use creates a threat to other people).

Child injury Child injury remains one of the main causes of death of children, their severe disability. The structure of child injuries: domestic (39.3%) street (34.8%) school (15.9%) sports (5.6%) transport (1.2%) Age differences in the causes of child injuries: 5-6 months - everything that they can hold in their hands is pulled into the mouth; 1 year - falling from beds, sofas, chairs; 1-3 years - falling from a height (windowsills, stairs) and burns, foreign bodies in the nose; 4-10 years - burns, falls into pits, hatches, from scaffolding, fights and accidents;

Industrial injuries work injury is an injury sustained by a worker and caused by sudden exposure to a hazardous production factor in the performance of their production duties or the task of the work manager.

Industrial injuries: the main causes Technical causes that can be described as reasons that do not depend on the level of labor organization at the enterprise, namely: imperfection of technological processes; design flaws in equipment, fixtures, tools; insufficient mechanization of heavy work; imperfection of fences, safety devices, means of signaling and interlocks; strength defects in materials, etc.

Industrial injuries: the main causes Organizational reasons that entirely depend on the level of labor organization at the enterprise: shortcomings in the maintenance of the territory, passages, passages; violation of the rules for the operation of equipment, Vehicle, tool; shortcomings in the organization of jobs; violations of technological regulations; violation of the rules and norms of transportation, warehousing and storage of materials and products; violation of the norms and rules of preventive maintenance of equipment, vehicles and tools; deficiencies in worker training safe methods labor; shortcomings in the organization of group work; weak technical supervision of hazardous work; use of machines, mechanisms and tools for other purposes; lack or non-use of personal protective equipment, etc.

Occupational injuries: main causes Sanitary and hygienic reasons: increased (above MPC) content in the air of working areas harmful substances; insufficient or irrational lighting; increased levels of noise, vibration; unfavorable meteorological conditions, the presence of various radiations above the permissible values; violation of personal hygiene rules, etc.

Injuries: the main directions of prevention state health policy; improvement of health legislation, the system of organizing medical care in the country, including primary health care assistance, strengthening preventive work on safety at home and at work, monitoring key indicators; improvement of the socio-economic situation in the regions; increasing the level of health financing.

TUBERCULOSIS: features of morbidity in modern conditions for the first time in 10 years in Russia, there has been a trend towards improving the epidemiological situation (according to the State report on the state of public health in the Russian Federation). The incidence rate of tuberculosis among the population decreased in 50 administrative territories. For the first time in the last 13 years, the incidence rate of children has decreased. age group of the year

TUBERCULOSIS Dynamics of primary morbidity and mortality from tuberculosis in the Krasnoyarsk Territory for the years.

Reasons for the low effectiveness of treatment of newly diagnosed patients An increase in the number of drug-resistant forms of tuberculosis, dishonest attitude to the treatment of patients (40% were discharged for violation of the regime), high percent advanced forms of tuberculosis requiring long-term treatment, the lack of bacteriological laboratories in most regions of the region.

The main directions of activities aimed at reducing the prevalence of tuberculosis infection Development of adequate programs to combat tuberculosis at the regional level with appropriate funding. Improving the system of centralized management of anti-tuberculosis activities at the level of head anti-tuberculosis institutions. Improving dispensary observation of registered patients with tuberculosis. Improving the system of active detection of TB patients with a focus on risk groups. Increasing the effectiveness of the treatment of patients with tuberculosis using intensive care. Security necessary quantity and a range of anti-tuberculosis drugs. Definition best practices dispensary observation of patients with tuberculosis and improvement of the regulatory framework of the Ministry of Health of Russia to improve anti-tuberculosis care to the population.

SEXUALLY TRANSMITTED INFECTIONS: prevalence In 2002, about 1000 STI patients were registered, which is 651.4 cases per 100,000 population. The incidence of STIs among adolescents is high - in 2002, 45,000 patients under the age of 17 years were registered. In the Krasnoyarsk Territory over the past 5 years, with the stabilization of the epidemiological situation as a whole, in some territories there has been an increase in the incidence. The frequency of congenital syphilis and latent forms that require mass examination is increasing.

SYPHILIS The incidence of syphilis (2003) The average for Russia is 118.8 per 100,000 population. In the Krasnoyarsk Territory - 106.0 per 100 thousand population; there was an increase and the highest incidence of syphilis in the following regions (indicator per 100 thousand population): B_Uluysky - 299.4 Ilansky - 165.3 Uyarsky - 162.1 Kansky - 158.1 Tyukhtetsky - 157.2 Uzhursky - 148.1 Kezhemsky - 143.1 Norilsk - 201.0 TAO - 307.5 EAO - 283.0

The main trends in the incidence of syphilis The increase in the incidence of syphilis in children (on average in Russia in 2002, the figure was 7.2 per 100,000 population), which is associated with an increase in the number of cases of congenital syphilis. In the Russian Federation, there is a tendency towards an increase in the proportion of pregnant women among women with syphilis (from 8.8% in 2001 to 12.3% in 2002). Increase in the number of patients with neurosyphilis. A persistent upward trend in secondary recurrent syphilis.

Causes of the spread of the incidence of syphilis Untimely and incomplete investigation of foci of infection Examination of contacts at a later date As a result, the formation of new cases of diseases Ways to detect syphilis The largest number patients with syphilis were detected "among contacts" 25.7% At the appointment with obstetrician-gynecologists 12.3% In hospitals 9%, At preventive examinations 19.7% In anonymous examination rooms 9.49.8% or about 10% on average of the total number of patients

The problem of the spread of HIV infection In 2002, the number of registered cases HIV-infected reached (the incidence rate was 182.8 per 100 thousand population). The real number of HIV-infected people, according to the estimates of the Federal AIDS Center, is 3-7 times higher. The growth of injecting drug use contributes to the spread of HIV infection (among adolescents, the incidence of drug addiction is 70% higher than that of the general population). The problem of HIV infection is relevant not only for categories of the population that are traditionally considered risk groups.

The problem of HIV infection is relevant not only for categories of the population that are traditionally considered risk groups. 63% will not use condoms; 29% will not report their infection to their sexual partners; 57% will not reduce the number of their sexual partners; 59% will not give up intravenous drugs. At the same time, 56% of respondents have sex with people who do not use drugs, and 35% share a syringe.

Features of the incidence of HIV infection in the Krasnoyarsk Territory The Territory is one of the twenty regions of Russia that are not safe for HIV infection, and ranks fourth in terms of incidence in the Siberian region. High incidence rates (per 100,000 population) were formed in the territory of the Norilsk industrial district - 950.2 in Lesosibirsk - 309.1, Krasnoyarsk - 224.5, Podtesovo settlement - 662.4. Among HIV-infected people, 86.0% of newly identified infected people are of summer age, 36% do not have a permanent job, 20% of those infected are in prison, 10% are students of secondary and higher educational institutions Intravenous drug use remains the main cause of infection, but the proportion of people infected through sexual contacts- 38.0% in 2003 against 24.0% in 2002.

Measures to reduce the spread of HIV infection The regional target program "Prevention of the spread and fight against diseases of a social nature" for 2005-2007 provides for: - Conducting awareness-raising activities to prevent further spread of HIV infection among the population - "Your choice is your success" ; – examination of epidemically significant risk contingents of the population in diagnostic laboratories of health care institutions of the region; – purchase of test systems, disposable blood sampling systems and medical instruments to confirm the results of primary tests for HIV infection in the regional state health institution "Regional Center for the Prevention and Control of AIDS and Infectious Diseases"; - Prevention of the spread of HIV infection during pregnancy, childbirth and newborns in healthcare institutions of the region (in addition to the free medical care provided for by the Program of State Guarantees for the provision of free medical care to the population of the Krasnoyarsk Territory); - purchase of kits medicines in order to prevent occupational infection in healthcare institutions of the region (in addition to the Program of state guarantees for the provision of free medical care to the population of the Krasnoyarsk Territory).

Measures to reduce the incidence of STIs in the population Increasing the speed and efficiency of recovery (effective diagnosis and treatment). Reducing the likelihood of spreading the infection (use of protection). Change sexual behavior(education, promotion of less dangerous behaviors).

Conclusions on reducing the incidence of socially significant diseases in the population Improving the social well-being of the country, the entire population, individual citizens. Economic stability of the state, improvement of the material well-being of citizens. Strengthening the material and technical base of health care and strengthening its social and preventive direction. Sanitary and educational work, raising the cultural level of the population, promoting a healthy lifestyle. Reducing the number of stress factors.

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PREVENTION.

Prevention - a set of measures aimed at ensuring a high level of people's health, their creative longevity, eliminating the causes of diseases, incl. improvement of working conditions, life and recreation of the population, environmental protection.

Prevention levels: primary, 2nd, 3-ton. The main tasks of gig education of the population: I. introduction of the mass of honey and gig knowledge; 2. instilling health skills in the population. 3. education in people of a sense of responsibility for personal and public health. 4. attraction of the population to active participation in the gig education of the population. 5. Promoting a healthy lifestyle as a factor in the health of the population. The main goals of gig education of the population: I. raising the level of dignity of the culture of the population. 2. Preservation and strengthening of health, increase in working capacity, longevity, upbringing of a healthy family. P doing work up to gig nurturing takes part: the staff of medical institutions is a direct official duty.

Primary prevention: Primary P. is a system of social, medical, hygienic, and educational measures aimed at preventing diseases by eliminating the causes and conditions for their occurrence and development, as well as at increasing the body's resistance to the effects of adverse factors in the natural, industrial, and domestic environment. Unlike secondary P., aimed at early detection diseases, prevention of relapses, progression of the disease process and its possible complications, the goal of primary P. is to maintain health, prevent exposure harmful factors natural and social environment that can cause pathological changes in the body. Secondary: maintaining health healthy, effective secondary P. of non-communicable diseases also includes measures of primary P. This provision once again indicates the unity of preventive activities in the field of health protection, and in this regard, despite the difference in the initial goals, primary and secondary P. can be considered as two stages of a single preventive process designed to ensure a high level of public and individual health, as well as the implementation of the main economic function of health care - the preservation and enhancement of the labor resources of society based on the prevention of morbidity and disability. This staging is quite clearly expressed in terms of the goals and focus of each of the mentioned forms of preventive activity in relation to the preservation of labor resources: primary P.'s measures are designed to prevent morbidity, secondary P. is aimed at preventing disability and the development of severe forms of the disease, in which the ability to work is either lost or is significantly limited. Tertiary prevention: prevention of recurrence of the disease, reduction of MTD, increase in life expectancy, prevention of disease aggravation.

Individual and social prevention. Individual P. includes measures to prevent diseases, preserve and promote health, which are carried out by the person himself, and in practice comes down to compliance with the norms healthy lifestyle, to personal hygiene, hygiene of marriage and family relations hygiene of clothes, shoes, rational litany and drinking regimen, hygienic education of the younger generation (Baby , toddler age, preschool age, School age, Adolescence). rational regime work and rest, active physical culture (Glancing, Charging, Sports, Physical culture), etc.

Public law includes a system of social, economic, and legislative systems. educational, sanitary-technical, sanitary-hygienic, anti-epidemic and medical measures, systematically carried out by state institutions and public organizations in order to ensure the comprehensive development of the physical and spiritual forces of citizens, to eliminate factors harmful to the health of the population. Public health measures are aimed at ensuring a high level of public health, eradicating the causes of disease, creating optimal conditions for collective life, including working conditions, recreation, material support, housing and living conditions, and expanding the range of food and goods. consumer goods, as well as the development of health care, education and culture, physical education. The effectiveness of public health measures largely depends on the conscious attitude of citizens to protecting their own health and the health of others, on the active participation of the population in the implementation of preventive measures, and on how fully each citizen uses the opportunities provided by society to strengthen and maintain health.

The practical implementation of social P. requires legislative measures, constant and significant material costs, as well as joint action all levels of the state apparatus, medical institutions, enterprises of industry, construction, transport, agro-industrial complex, etc.

Objectives: 1. organizing and conducting evidence-based activities for vocational education (education, population, knowledge 2. analysis of cause-and-effect relationships m / y with the health of the population, its life expectancy and san culture, the level of medical care, the environmental situation. 3. implementing information support 4. organization, control and analysis of the activities of departments, medical prevention rooms of health care facilities 5. Ensuring con-health and rehabilitation activities on the issues of maintaining and strengthening the health of the population.

LIFESTYLE

Lifestyle - the leading generalized factor that determines the main trends in changes in health, is considered as a type of active human life. The structure of the lifestyle with its medical and social characteristics includes: 1) labor activity and working conditions; 2) household activities (type of dwelling, living space, living conditions, time spent on household activities, etc.); 3) recreational activities aimed at restoring physical strength and interaction with the environment; 4) socio-leadership activities in the family (care for children, elderly relatives); 5) family planning and relationships between family members; 6) formation of behavioral characteristics and socio-psychological status; 7) medical and social activity (attitude towards health, medicine, attitude towards a healthy lifestyle). Such concepts as the standard of living (the structure of income per person), quality of life (measurable parameters characterizing the degree of material security of a person), lifestyle (psychological factors) are associated with lifestyle. individual characteristics behavior), way of life (national-social order of life, way of life, culture).

P promotion of healthy lifestyles and gig education of the population

Organization of propaganda.

Healthy lifestyle promotion methods n gig of education of the population: combined, visual method of propaganda, method of oral propaganda (method of the heard word), method of printed propaganda (method of the visible word), pictorial method. Means of oral propaganda method(lecture, conversation, evening of questions and answers, radio). Means of the printed propaganda method: (book, brochure, memo, leaflet, slogan, dignity bulletin, magazine articles, satire window). Means of visual method: natural objects. planar means, volumetric means. Flat means of the visual method of propaganda: diagrams, tables, photos, slides, posters. To the voluminous means of the visual method of propaganda: model, dummy, model. Types of posters: propaganda (minimum text, maximum drawings), propaganda (vice versa) Means of the combined method of propag Key words: television, film, theatre, stage, exhibition. The work on promoting a healthy lifestyle and gigantic education of the population in a medical institution is carried out by head of the medical institution.

Goals:

The student must:

Know:

Definition, main tasks, types of prevention and indicators for evaluating its effectiveness;

Definition: risk factors, risk groups, screening, healthy lifestyle;

Epidemiological approaches to the identification of risk factors;

Classification of risk factors and basic methods for their assessment in the most important non-communicable diseases;

Basic principles, forms, methods and means of hygienic education and upbringing of the population;

The role of the doctor in the formation of a healthy lifestyle.

Be able to:

Substantiate the relevance of prevention at the present stage;

Determine risk factors in their practical activities during the internship;

Apply methods for determining and assessing risk factors when studying at specialized departments;

Choose methods and means of hygienic training and education, depending on the specific situation.

Prevention as one of priority areas public health protection. Issues of prevention in legislative documents.

The purpose of prevention; its tasks, levels (state, collective, family, individual) and types: social, socio-medical (medico-social), medical.

Prevention stages: primary, secondary. Criteria for evaluating the effectiveness of prevention.

Risk factors, identification of risk factors. Classification of risk factors and their practical significance. Methods for assessing risk factors used at the individual, group and population levels.

Prevention strategies (population-based, strategy high risk), their use for solving problems of strengthening and maintaining health.

Screening: definition, purpose, types. Risk groups: definition, stages of formation.

The concept of medical and social aspects of prevention. The role of medical workers in the implementation of preventive measures.

Lifestyle: definition, category. The impact of lifestyle on health various groups population. The concept of medical activity, its parameters.

Healthy lifestyle (HLS): definition, mechanisms of its formation. Medical activity as a necessary element of a healthy lifestyle. The role of doctors in the formation of a healthy lifestyle.

Hygienic education and education of the population, goals, principles, methods, forms and means. Hygienic education and upbringing is an activity to preserve, strengthen and restore the health of the population. Evaluation of the effectiveness of this activity.

BLOCK 6. MAJOR NON-COMMUNICABLE AND INFECTIOUS DISEASES AS A MEDICAL AND SOCIAL PROBLEM:

Goals:

The student must:

Definition and main criteria of the medical and social significance of the problem;

Features of the organization of medical care for the most important infectious and non-communicable diseases,

Substantiate the relevance of the most important non-communicable and infectious diseases as a medical and social problem;

Apply knowledge of epidemiology, organization of medical care and prevention when studying at specialized departments

Socially significant diseases: definition, primary morbidity, prevalence, disability, mortality, economic damage, organization of specialized medical care, etc.

Diseases of the circulatory system as a medical and social problem in Russia and abroad. Level, dynamics, structure of primary and general morbidity, morbidity with temporary disability, disability, mortality. Age-sex and regional features.

Risk factors. Prevention strategy. The role of a healthy lifestyle in the prevention of cardiovascular diseases. Organization of medical care in cardiovascular diseases, kinds specialized care, structure and functions. Clinical examination of high-risk groups and patients with cardiovascular diseases.

Malignant neoplasms as a medical and social problem in Russia and foreign countries. Level, dynamics, structure of primary and general morbidity, morbidity with temporary disability, disability, mortality.

Age-gender, professional and regional features. Risk factors. Cancer registry. Prevention strategy. The role of a healthy lifestyle in the prevention of malignant neoplasms

Organization of medical care for oncological diseases, types of specialized care, structure and functions. Clinical examination of high-risk groups and patients oncological diseases. Hospices.

Respiratory diseases (RD) as a medical and social problem. Level, dynamics, structure of primary and general morbidity, morbidity with temporary disability, disability, mortality. Age-sex and regional features.

Risk factors. Prevention strategy. The role of a healthy lifestyle in the prevention of respiratory diseases. Organization of medical care, types of specialized care, structure and functions.

Tuberculosis as a medical and social problem. Level, dynamics, structure of primary and general morbidity, morbidity with temporary disability, disability, mortality. Age-sex and regional features.

Risk factors. Prevention strategy. System of measures to combat tuberculosis. The role of a healthy lifestyle in the prevention of tuberculosis.

Organization of medical care, types of specialized care, structure and functions.

Alcoholism, drug addiction, substance abuse, smoking as a medical and social problem. Distribution dynamics, age-sex and regional characteristics, medical and social consequences. Organization of the fight against alcoholism, drug addiction and substance abuse in the Russian Federation.

The role of a healthy lifestyle in the prevention of alcoholism, tobacco smoking, drug addiction and substance abuse.

traumatism as a medical and social problem. Types of injuries, their prevalence. Temporary disability, disability, mortality due to injuries and poisoning.

Factors contributing to injury. Injury prevention. The role of a healthy lifestyle in traumatism. Organization of trauma care.

Infectious diseases as a medical and social problem Prevalence of infectious pathology, regional peculiarities. HIV infection, sexually transmitted diseases (STDs).

Risk factors for the spread of infectious diseases.

Medical and social prevention of infectious diseases. federal program"Vaccinal Prevention".

Organization of medical care for patients with infectious diseases.

Diseases of the digestive system, as a medical and social problem. Prevalence, dynamics, age-sex and regional features. Risk factors, the role of a healthy lifestyle in the prevention of diseases of the digestive system. Organization of medical care.

Diseases of the musculoskeletal system as a medical and social problem. Prevalence, dynamics, age-sex characteristics. Risk factors, the role of a healthy lifestyle in the prevention of diseases of the musculoskeletal system. Organization of medical care.

BLOCK 7. BASICS OF MANAGEMENT, PLANNING, ECONOMY AND
HEALTH FINANCING

Goals:

The student must:

Know:

Basic methods of planning and sources of financing of public health measures;

The main problems of management, economics and financing of health care;

Be able to:

Apply the acquired knowledge when studying at specialized departments and during the internship.

Health Management: definition, principles, tasks, methods and structure of the management process.

Health planning: definition, principles, tasks. Basic planning methods: analytical, normative, etc.

Health plans: territorial, current and prospective. Plans of medical institutions.

Program-targeted and functional-industry planning. Determining the needs of the population in outpatient and inpatient care.

Federal, regional and local health promotion and disease prevention programs

Health Economics: definition, tasks. Types of healthcare efficiency (medical, social, economic), their indicators.

Ways to improve the efficiency of health care.

Health financing. Sources of health financing. Financing of medical institutions. Estimate of the institution (main articles).

BLOCK 8.
HEALTH CARE IN FOREIGN COUNTRIES
WORLD HEALTH ORGANIZATION

Goals:

The student must:

Know:

Main characteristics and problems of foreign health care systems;

The role of WHO in international cooperation.

Be able to:

Give a comparative description of health care systems in the world;

Apply the acquired knowledge when studying at specialized departments.

Health systems. The main characteristics and problems of health care in foreign countries. Training of medical personnel in foreign countries.

International medical cooperation in research and decision practical problems public health and healthcare; training and retraining of medical personnel. International medical organizations, associations, societies.

World Health Organization (WHO), its structure, main activities. The place and importance of WHO in addressing various issues of international health. WHO international programs. Participation of Russia in the activities of WHO and other medical organizations.

5.1. List and thematic plan of lectures

List of lectures of the discipline

Thematic plan of lectures

5.2. List and thematic plan of practical classes

Lecture plan:

Chronic non-specific diseases

Dynamics of the manifestation of hereditary chronic diseases during the growth period of ontogeny (by classes

Dynamics of the manifestation of hereditary chronic diseases during the period of life, from 18 to 50 years (by class

Dynamics of growth rates of body length of family members S.

Dynamics of the absolute dimensions of the body length of the members of the family S.

The dynamics of the absolute values ​​of the body length of the children of mother R. from the first marriage with M and from the second marriage with R.

Definition

Definition

Definition

Terminology

Purpose of rehabilitation

Rehabilitation tasks

distant targets

primary goal

Stages of medical rehabilitation

Aspects of Rehabilitation Treatment

The principles of organization and implementation of rehabilitation are as follows

Main directions of rehabilitation

Family as a social organization

The rehabilitation potential of the family

Rehabilitation Programs

Necessary conditions for success

Rehabilitation center

Family Rehab

Life factors

Self-realization of personality

social communication

sustenance

recreation

Socialization

1. Prevention as one of the priority areas of public health protection. The health of the population is due to the complex influence of factors that determine the way of life of a h / ka and the state of its habitat - the atmosphere. air, soil water, the level of well-being of society, etc. Factors that are potentially dangerous to h / ka health and contribute to the occurrence of diseases are called risk factors (Socio-economic; Social-hygienic; Social-biological; hygienic; Medical-organizational). Revealing a fact. risk and profile of chronic diseases contributes to maintaining health and improving the quality of life of the population. Taking this into account, the most important task of state authorities is to develop a set of measures aimed at correcting and eliminating risk factors for their occurrence. Medical prof-ka-complex of prof-x measures, implemented through the system of s / o. State-covers large groups of the population; Collective - with groups of individuals with similar risk factors and Family. Primary a professional complex of medical and non-medical measures aimed at preventing the appearance of those or other diseases and deviations in the state of health. (reducing the influence of harmful environmental factors on org / m h / ka; forming. healthy lifestyle, prevention of occupational diseases, accidents, and deaths at working age, immunoprofessional testing. Secondary- a complex of medical, social, sanitary hygienic, psychologist and other measures aimed at early detection of obstructions, as well as preventing their exacerbations, complications and chronicity (target sanitary hygiene education of patients and members of their families with knowledge and skills related to a specific disease; conducting medical examinations to identify diseases in the early stages of development; conducting professional treatment courses). Tertiary (rehabilitation) - a complex of medical, psychologist, teacher, social measures aimed at restoring disturbed physiology, social functions of org / ma, quality of life and working capacity of patients and disabled people. This is achieved by developing a network of centers for restorative medicine and rehabilitation, as well as sanatorium-resort institutions.

V. Improving the health of the population. Modern problems of prevention.

2. Lifestyle. One of the most important components of primary prevention is the formation of a healthy lifestyle (HLS), which includes favorable living conditions for a person, the level of his culture and hygiene skills, which allow maintaining and strengthening health, maintaining an optimal quality of life. The most important areas for the formation of a healthy lifestyle are: - propaganda factors contributing to the preservation of health: personal hygiene, occupational hygiene, rest, nutrition, physical education, sexual hygiene, medical social activity, environmental hygiene, etc. - promotion of measures to prevent factors that adversely affect health: excessive consumption food with insufficient physical activity, alcohol abuse, drug use, tobacco smoking, observance of certain ethnic rituals and habits, etc. her4 tt t g nipper mpm