I.S. Tsybulskaya, V.B. Tsybulskiy, Leonov S.A., Nizamova E.R.
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow 

Abstract. The article is devoted to one of the most urgent problems in Russia nowadays – life and health of rural population and quality of rural medical care.

The aim of the study was to determine peculiarities of morbidity, disability and mortality among urban and rural children through statistical analysis and sociological survey; to identify bottlenecks and to define ways to improve life support for the rural dwellers as well as rural health care delivery.

The study revealed higher morbidity among urban children and higher disability and mortality from suisides among rural children.

Most severe, systemic, degenerate and hereditary diseases prevail among rural children. During social crisis health disorders are more pronounced among rural children compared to urban children showing higher sensitivity and lower ontogenetic adaptation among rural children.

The situation is further complicated by high alcohol consumption among the rural population of active reproductive age (including women) and low quality of pediatric health care that is manifested in late diagnostics of disabling diseases.

The recent years have witnessed a relative improvement in health indicators among urban children and a certain decline in health indicators among rural children. The situation can be accounted for by insufficient measures aimed at improving living conditions of the rural population, inadequate financing of the rural healthcare and, to some extent, by certain measures implemented within the rural healthcare system due to economic interests.

Conclusions. The study results show that measures aimed at improving living conditions of the rural population are insufficient and call for the government, society and citizens to take efforts to reverse the situation.

Keywords: children population; morbidity among urban and rural children; disability among urban and rural children; suiside mortality in children; ontogenetic adaptation; age-specific and gender alcohol consumption; quality of diagnostics.

References

1. Abrosimova M.Yu. Health and statistic features of mortality in the young people of Republic of Tatarstan. Kazanskiy meditsinskiy zhurnal 2005; 86 (1): 69-71p. (In Russia).
2. Kienya A.I., Zaika E.M., Mel'nik V.A., Mel'nik S.N. Anthropometric characteristics of rural schoolchildren of 8-13 ages. Gigiena i sanitariya 2001; (2): 61-62. (In Russia).
3. Araslanova S.A. Health and social aspects of socially significant diseases in the rural areas. Cand.Sci.Med. [thesis]. Moscow. 2006. 24 p. (In Russia).
4. Babaev Yu.A., Gerasimova G.F., Alekseeva M.S. Health of rural children and measures for its promotion. Sovremennye naukoemkie tekhnologii 2004; (4): 33-36. (In Russia).
5. Bogoyarkova T.V. Health protection of rural citizens: federal and regional aspects. Analiticheskiy vestnik 2008; (18): 30-54. (In Russia).
6. Bohan N.A., Artem'ev I.A., Mandel' A.I. Clinical and epidemiological analysis of an impact of selective living standards indicators on prevalence of alcohol and drug abuse. Psihicheskoe zdorov'e 2010; (1): 9-13. (In Russia).
7. Rural health care has its future. [Internet] 17.12.2009 [cited 2014 Jan 29]. Available from: http://www.d22d.ru/load/6-1-0-36. (In Russia).
8. Dar'in A.V. Improvement of planning and organization of health care in rural municipal settings. Cand.Sci.Med. [thesis]. Moscow. 2010. 31 p. (In Russia).
9. Health Ministry: National clinical examination of children 2002. Naselenie i obshchestvo 2003, November 17-30; (135-136). [Internet] [cited 2014 Jan 29]. Available from: http://demoscope.ru/weekly/2003/0135/analit01.php. (In Russia).
10. Territorial doctor. National project. [Internet] [cited 2014 Jan 29]. Available from: http://www.rg.ru/2011/12/05/vrachi.html (In Russia).
11. Kiselev A.S., Shestakov M.G., Mikhaylov M.Yu. Dependence of Russian population health on dynamics of living standards. Starodubov V.I and Mikhaylova Yu.V., editors. Moscow: Federal Research Institute for Health Organization and Informatics of the MoH of the RF; 2006. 210 p. (In Russia).
12. Conceptual views on child’s health. Shestakova V.N., editor. Smolensk. 2003. 592 p. (In Russia).
13. Concept of health care development in the Russian Federation up to 2020. [Internet] [cited 2014 Jan 29]. Available from: http://www.federalbook.ru/files/FSZ/soderghanie/Tom%2012/1-9.pdf (In Russia).
14. Mendelevich B.D. On the mental disorders in children. Kazanskiy meditsinskiy zhurnaë 2009; 90 (4): 609-611. (In Russia).
15. Mikhalyuk S.F. To make that the lights in the village did not go out . Meditsinskaya gazeta. 2004. ¹6. 28 January. [Internet] 2004 [cited 2014 Jan 29] (6). Available from: http://medgazeta.rusmedserv.com/2004/6/article_906.html (In Russia).
16. Nemtsov A.V. Lethal effect of alcohol abuse in Russia. Priroda 2003; (12): 11-15. (In Russia).
17. Nuzhnyy V.P. Alcohol consumption: current tendencies, social and health consequences. [Internet] 2000 [cited 2014 Jan 29]. Available from: http://www.pravoslavie.ru/sobytia/narckonf/alcotendecies.htm (In Russia).
18. “On the federal target program “Social development of rural regions until 2013”, Regulation of the Government of the RF of December 3, 2002 ¹ 858 (with revision and additions). [Internet] 2002 [cited 2014 Jan 29]. Available from: http://base.garant.ru/2159191/ (In Russia).
19. “On approving the statistical tools for organization of statistical monitoring for activity of social protection and population employment institutions by Russian Ministry of Labor”, Regulation of Goskomstat of September 19, 2000 ¹ 80 (ed. Regulation of October 11, 2006 N 59) [Internet] 2000 [cited 2014 Jan 29]. Available from: http://www.referent.ru/1/164722?l0 (In Russia).
20. Innovation potential of the city - to the wellbeing of the rural children. [Internet] [cited 2014 Jan 29]. Available from: http://rud.exdat.com/docs/index-751253.html (In Russia).
21. “On the project of Federal Target program “Social development of rural regions up to 2010”, Regulation of the Government of the RF of January 22, 2001 ¹ 76-r [Internet] [cited 2014 Jan 29]. Available from: http://base.consultant.ru/cons/cgi/online.cgi?req=doc;base=EXP;n=231653;dst=0 (In Russia).
22. “On approving the Concept of the Federal Target Program “Sustainable development of rural areas for 2014-2017 and for the period up to 2020”, Regulation of the Government of the RF of November 08, 2012 ¹ 2071-ð. [Internet] [cited 2014 Jan 29]. Available from: http://docs.cntd.ru/document/902379034 (In Russia).
23. “On results of work of the Ministry in 2012 and targets for 2013”, expanded meeting of the College of Health Ministry of Russia, [Internet] 2012 [cited 2014 Jan 29]. Available from: http://forsmi.ru/node/80141 (In Russia).
24. “On the current state and measure for improving health care to rural population” (Protocol ¹ 10 of May 22 , 2001). Resolution of the College of Health Ministry of Russia. [Internet ] 2001 [cited 2014 Jan 29]. Available from: http://rudoctor.net/medicine/bz-zw/med-gmdyw.htm (In Russia).
25. Rimashevskaya N.M. Risk of poverty in the present day Russia. Narodonaselenie 2010; (2): 4-9. (In Russia).
26. Rogozhnikov V.A., Starodubov V.I. Orlova G.G. Problems of health protection in rural population. V.I. Starodubov, editor. Moscow: GEOTAR-MED; 2004. 448 p. (In Russia).
27. Rozenfel'd L.G., Moskvicheva M.G. Health care activity in population living in rural regions. Problemy sotsial'noy gigieny, zdravookhraneniya i istorii meditsiny 2009; (2): 8-11. (In Russia).
28. Rozhnova T.M. Psychopathological disorders in children whose fathers are alcohol abuse patients (clinical and genealogical study). Cand.Sci.Med. [thesis]. Moscow. 1996. 21 p. (In Russia).
29. Rural health care in Russia in 2012. (Statistical information). MoH of the RF, Department for health care analysis, prediction and innovation development. Federal Research Institute for Health Organization and Informatics of the MoH of the RF. Moscow. 2013. 78 p. (In Russia).
30. Russian adolescents’ mortality from suicides. UN Children’s Fund (UNICEF). 2011. 131 p. (In Russia).
31. Maksimova T.M., Belov V.B., Lushkina N.P., Korol'kova T.A., Gaenko O.N., Barabanova, et al. Health status, living conditions and medical service for children in Russia. Moscow: Per Se; 2008. 367 p. (In Russia).
32. Starodubov V.I., Kalininskaya A.A., Dzugaev K.G., Stryuchkov V.V. Health care problems in rural regions. Moscow. 2012. 207 p. (In Russia).
33. Starodubov V.I., Tsybul'skaya I.S.,Sukhanova L.P. Maternal and child health protection as a priority challenge in the present day Russia. Sovremennye meditsinskie tekhnologii 2009; (2): 11-16. (In Russia).
34. Toropov D.I. Access to medical service for rural population as a factor of sustainable development of rural regions. Analiticheskiy vestnik 2009; (3): 7-13. (In Russia).
35. Uchakina R.V. Ecological and physiological grounds for hormonal status, physical and sexual development of children in the Far East region. Dr.Sci.Biol. [dissertation]. Khabarovsk. 2006. 271p. (In Russia).
36. The Feral Law ¹ 122-FZ of August 22, 2004 “On amendments to the legislations of the RF and invalidation of some legislative acts in connection with adoption of the federal laws: “On amendments and additions to the Federal Law “ On general principles of organization of legislative (representative) and executive bodies of the state power in the subjects of the Russian Federation” and “On general principles of organization and local self-government in the RF” (Adopted by the State Duma of the RF 2004, August 05, approved by the Federation Council of the RF 2004 August 08, signed by the President of the RF 2004 August 22. [Internet] 2004. Available from: URL:http://zakon122.narod.ru/zakon.html (In Russia).
37. Medvedev L.N., Kashkevich E.I., Demidova T.V., Chmil' I.B. Physical development of children of 7-17 years in Siberian region. Novye issledovaniya 2011; 1 (26): 77-82. (In Russia).
38. The form for federal statistical monitoring ¹11 “Data on patients with drug abuse disorders” (approved 2010 December 31) [Internet] [cited 2014 Jan 29]. Available from: http://www.com-papers.info/lib23/b23356z.htm (In Russia).
39. Tsybul'skaya I.S., Dmitrieva O.V., Sokolovskaya T.A. Alcohol abuse as an important factor of mental health disorders of population. In: Proceeding of IV All-Russian scientific and practical conference with international participation “Population health is a basis for prosperity of Russia”. Anapa. 2010. P. 295-296. (In Russia).
40. Tsybul'skaya I.S. Medical and social aspects of children health formation: Tver'. 2013. 288 p. (In Russia).
41. Shamaeva O.V. Complex assessment of children health status in relation to medical and social factors. Cand.Sci.Med. [thesis]. Samara. 2007. 25 p. (In Russia).
42. Sharapova O.V., Tsaregorodtsev A.D., Kobrinskiy B.A. National health examination: the main tendencies and children health status. Rossiyskiy vestnik perinatologii i pediatrii 2004; (1): 56–61. (In Russia).
43. Shchukina E.A. Optimization of inpatient care to children in rural areas. Cand.Sci.Med. [thesis]. Kemerovo. 2006. 25 p. (In Russia).

Write Comment

Please keep the topic of messages relevant to the subject of the article. Personal verbal attacks will be deleted. Please don't use comments to plug your web site. Such material will be removed. Just ensure to *Refresh* your browser for a new security code to be displayed prior to clicking on the 'Send' button. Keep in mind that the above process only applies if you simply entered the wrong security code.
Name:
E-mail
Comment:
Code:*