Study of Regional Possible Prevented Health Losses as a Result of Controland Supervisory Activities to Rospotrebnadzor Based on a Cascade Model

Introduction: Exposure to adverse environmental factors has been proven to induce additional cases of disease and death in the population. In the absence of effective measures taken to improve environmental quality, the levels of these factors rise, thus causing a potential increase in related human health outcomes. The concept of "prevented" morbidity and mortality cases is used to describe contribution of such measures to improving health of the population. Objective: Theoretical computational study of regional possible prevented health losses as a result of control and supervisory activities of Rospotrebnadzor. Materials and methods: Using the methods of neural network modelling, factor analysis, multiple linear regression theoretically presented the previously developed cascade model in a triple system of links: ‘control and supervisory activities (CSA) of Rospotrebnadzor – habitat quality indicators – public health’. As an additional response from population health (in addition to morbidity and mortality), life expectancy is used. Specific planned and unscheduled actions of Rospotrebnadzor, including imposed liability measures, in relation to business entities that are sources of environmental pollution are considered as affecting the quality of the living environment. Results: There is a pronounced territorial differentiation in prevented cases of disease, so the largest number of prevented cases of disease for the entire population (from 4574 to 19047 per 100,000 population) is observed in the regions: Republic of Dagestan, Kaliningrad region, Saratov region, Sevastopol, Murmansk region, Altai Republic, Belgorod region, Karachay-Cherkess Republic. The smallest number of prevented morbidity cases (from 1976 to 2528 per 100,000 population) due to control and surveillance in the following regions: Sverdlovsk region, Altai region, Krasnoyarsk region, Tambov region, Republic of Tyva, Republic of Karelia, Ryazan region, R. North Ossetia – Alanya. The largest number of prevented deaths for the entire population (from 55.6 to 101.7 per 100,000 population) is observed in the regions: Sevastopol, Kaliningrad region, Republic of Dagestan, Saratov region, Tula region, Belgorod region, Krasnodar region, Chechen Republic. Some of these regions were also among the leaders in prevented morbidity. The smallest number of prevented cases (from 17.8 to 26.6 per 100,000 population) due to control and surveillance activities in the regions: Sverdlovsk region, Chelyabinsk region, Krasnoyarsk region, Transbaikal region, Altai region, Tyumen region, Murmansk region, North Ossetia – Alania, Nizhny Novgorod region. He largest number of prevented losses in life expectancy (from 1.61 to 3.73 years) is observed in the regions: Republic of Dagestan, Kaliningrad region, Sevastopol, Saratov region, Belgorod region, Bryansk region, Lipetsk region, Karachay-Cherkess. Many of these regions are also among the leaders in prevented morbidity and mortality. The smallest prevented losses of life expectancy are observed in the regions of the Central, Ural and Siberian federal districts. High values of prevented losses of life expectancy are observed in the Southern and North Caucasus federal districts. Conclusions: Thus, a theoretical computational study of regional possible prevented health losses as a result of control and supervisory activities of Rospotrebnadzor has been carried out; the losses are structured and differentiated by the constituent entities of the Russian Federation, by age groups of the population, causes of morbidity and mortality, and indicators of the quality of the living environment. The next stage of work may be the identification of priority activities and control and supervisory activities.