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The population of Russia is dying out
According to the Interdepartmental Commission on Environmental Safety (Russia's Security Council), which considered the issue of worsening the demographic situation, it was reported: “... the population of the Russian Federation in 1995 decreased by 0.2% (380 thousand) and amounted to 148 million. human. The number of deaths exceeded the number of births 1.6 times.
Fertility is declining. The number of births has decreased compared to last year by 44.7 thousand people. ”
The main reasons for the catastrophic situation in Russia were: "... the decline in industrial and agricultural production, social stratification, unhealthy lifestyles, high levels of alcohol consumption, high stress levels, as well as adverse economic changes ..." - this is a statement of the Security Council Commission.
Is it not the familiar harmony of causes? We discuss these reasons with you throughout the lecture course on valeology and find confirmation in the opinion of the competent state body.
And what do these important indicators for the regions look like we agreed to talk about in more detail in connection with the topic of our lecture. So, about the population of Russia, presented in table. 12.
Table 12. The population of the Russian Federation
According to the State Statistics Committee of the Russian Federation, the population is counted here, taking into account the millions of migrants who were forced to leave the republics of the former USSR. Therefore, the “surge” in population growth dynamics since 1980, which is striking when considering the population size, depends on the huge influx of Russian-speaking population, the main reason for which is the socio-political situation.
And what does the population of Russia look like depending on the age and gender composition? At a lecture on the problem of longevity, we examined with you the modern stratification of the population, and this issue is of considerable interest in connection with the ambiguous demographic situation. Is the population of Russia aging and at what pace? In the table. 13 presents data for 1995 by age (selectively, with an interval of 10 years).
Table 13. Population by age and gender (optional)
As can be seen from the table. 13, a tendency toward a decrease in the working capacity of the population with age is indicated. This process is especially noticeable after a 50-54-year milestone both among citizens and residents of rural areas. The number of women is increasing, i.e. there is a situation about which we spoke at lectures on the problems of longevity.
This table shows that the ratio of men and women in older working age looks 8.2: 21.7 in Russia; 5.6: 15.0 among the townspeople; and 2.6: 6.7 among rural residents.
Let us consider what are the data on natural population growth in the regions under consideration. Where, in which city is it born more than it dies, and what is the indicator - positive population growth or negative in a particular city?
In the table. 14 shows the indicators of the natural movement of the population of Russia and individual industrial cities.
Table 14. Vital population movement in 1995 (per 1,000 people).
The presented data clearly show the negative nature of the natural population growth in all regions of Russia. Large cities such as Moscow (-8.9), St. Petersburg (-8.9), as well as the regions adjacent to these cities, have a rather high negative rate of natural growth, which indicates a population decline, i.e. . the number of deaths significantly exceeds the number of births.
Interestingly, in Russia as a whole in 1980, the number of births per 1000 people was 15.9, and the number of deaths was 4.9, in 1991 - 12.1 and 11.4, respectively, and the natural increase was 0.7, and already in 1994, these figures were 9.6 and 15.6, and the natural increase was 6.0.
Are there any regions where natural growth has a positive trend? There is. V. basically, these are residents of the North Caucasus region. For example, in the Republic of Dagestan, by 21.9 births and 7.5 deaths, the natural increase was 14.4. And even higher are the indicators in the republic of Ingushetia, which is bordering on Chechnya (an extreme situation that excites the whole of Russia): the number of births is 23.8, the deaths are 6.4, but the natural population growth in 1994 was 17.4.
The indications of infant mortality by years in the regions of Russia, presented in the following table 15, are also interesting.
We already know about the causes of death of children of the first year of life from previous lectures. Let me remind you that the most significant reasons are: congenital anomalies, respiratory diseases, infectious and parasitic diseases. The most negative reason is the condition that occurs in the prenatal period, which accounts for 88.0 deaths in 1993 to 78.5 in 1995 per 100 thousand children born. The highest infant mortality (see table. 12) in the Sakhalin (22.7), Tyumen (21.3) and Tula (20.1) regions. In Moscow - 15.5, St. Petersburg - 15.8, and the best indicator in the Yaroslavl region - 12.0. And these indicators are much lower than the average for Russia, in dynamics in large cities it is decreasing.
Table 15 Infant mortality rates (per 1,000 births)
Once we talked about child mortality in selected sample regions, I will present you with indicators of maternal mortality, i.e. indicators of the number of dead women from complications of pregnancy, childbirth and the postpartum period per 100 thousand live births (selectively).
As can be seen from the table. 16, maternal mortality in various regions from 23.3 (Murmansk region) in 1995 to 85.1 (Sakhalin region). In the cities of Moscow and St. Petersburg, these figures of 43.4 and 32.5 (1995) can be considered average compared with the data for Russia as a whole - 53.3 (1995), but the tendency to a noticeable decrease in maternal mortality in cities not marked.
Table 16 .. Maternal mortality rates
The causes of maternal mortality are: abortion outside the hospital (468 people in 1985, 148 in 1995), complications of pregnancy and childbirth, bleeding during pregnancy and childbirth, toxicosis of pregnant women and others.
In order not to bore you with statistical indicators of the state of health, I will give you another important indicator, which is calculated according to a specific methodology, which was mentioned earlier. This is the expected life expectancy (see table 17).
Life expectancy (expected) in Russia at birth 1992-1994 on average, 57.6 years are expected for men and 71.2 years for women (1994). In Moscow and St. Petersburg, the average life expectancy for men is 57.4 and women - 71.5 years (average age 64.4; 1994) and 58.1 and 71.2 (average age 64.5).
Life expectancy at birth in 1992-1994 (in years)
As you already know, one of the factors that have a negative impact on health is the state of health. About 10% of risk factors are assigned to it, therefore, individual indicators on the provision of the population with medical personnel, attendance at medical institutions and the provision of the population with hospital beds will be able to give true information, having estimated from a certain point the concern for the health of the population of the government and administration of this city. Unfortunately, the quality of medical care, i.e. the final result of the treatment (excluding the average length of the patient’s stay in the hospital) cannot be given in the lecture due to the heavy workload of numbers and the inadequacy of numerous techniques.
Provision of the population (selectively) per 10 thousand people looks like this: in Russia the provision with doctors of all specialties was 38.6 in 1985, in 1994 - 39.6; the average medical staff is 97.0 and 94.4, respectively, and in selected cities of Moscow (1), St. Petersburg (2), Yaroslavl Oblast (3), Krasnoyarsk Territory (4) and Tyumen (5) and Kaliningrad Oblast (6) the following: (1) - 78.1 (1985) and 68.6 (1994) - the provision of doctors, 122.0 and 105.7 with secondary medical personnel. The remaining digits in the order of listing cities by numbers:
And on the provision of outpatient care to the population per 1 resident (including consultations with emergency doctors), these data are as follows (Table 18).
Table 18. Medical assistance to the population of cities
The analysis of the given indicators gives an idea that the number of doctors is greatest in Moscow - 68.6 according to 1994 data, as well as the average medical staff - 105.7 per 10 thousand of the population. In St. Petersburg, these figures are, respectively, 62.7 and 98.4, and the smallest number of doctors falls on the vast territory of the Tyumen region - 34.1, although the region is provided with average medical workers at the level of 2 capitals: Moscow and St. Petersburg (104 in 1994).
But the indicators of medical care are quite high just in the two largest cities, i.e. Moscow and St. Petersburg. In Moscow in 1985, the average number of visits was 15.2; in 1992 - 9.7; and in 1995, 9.8; in the northern capital - 15.4; 10.6; 11.0, which significantly exceeds the average for Russia. Moscow and St. Petersburg have mixed indicators regarding the provision of the population with beds.
If in Moscow in 1985 there were 137.8 beds per 10,000 population, and in 1995 - 124.0, then in St. Petersburg, respectively - 119.0 and 103.7 in all departments. According to the system of the Ministry of Health, the figures are slightly lower, but the trend continues. And the average data for Russia is 134.6 (1985) and 126.1 (1995). In other compared regions, this indicator approximately corresponds to the average for the Russian Federation.
But what is the occupancy of beds in hospitals and hospitals in connection with the diseases of the population of the cities in question?
These data are presented in table 19.
Table 19 shows two very important indicators: the average number of days that a bed was occupied per year and the average number of days a patient spent a bed. These data reflect the specifics of how quickly (of course, successfully) the patient was cured and left the hospital.
On average in Russia, the occupancy of a bed per year is slightly more than 300 days (from 1985 to 1995), and the average patient stay is slightly more than 17 days. Approximately the same indicators for the cities under consideration.
Table 19. The average occupancy of the bed and the average duration of the patient’s stay in hospital
In Moscow, the first indicator tends to decrease (1985 - 319 days a year, and in 1995 - 281 days), as well as the patient's stay in the hospital - 19.5 in 1985 and 17.4 in 1995.
In the Moscow region, unfortunately, the rate of stay in a hospital bed is one of the highest, in second place is the Sakhalin Region (19.3), then Tula (18.2). The same indicators for the Leningrad region. For St. Petersburg, these data also exceed the average for Russia. Without going into an analysis of the health care activities of these cities, we note a large influx of forced migrants into them, which, of course, have an impact on bed occupancy rates and the length of stay of patients. But about this problem a bit later ...
And the latest information, which, of course, will be of interest, is the number of abortions in the regions under consideration. Moreover, this information will be a continuation of the lecture topic - the social problems of abortion (see tab. 20).
Table 20. Abortion rates in Russia (absolute abortion rates)
It is difficult to compare the average values for cities, especially for the city of Moscow, where millions of forced migrants, refugees and visitors from near and far abroad, are currently staying, as mentioned above. Data in absolute numbers presented in table. 17 do not include statistics on mini-abortions during short gestation periods. These indicators are analyzed separately. There is another indicator - the frequency of abortions. Unfortunately, these data are not available by region, but in Russia as a whole they are as follows: in 1985 - 184.2, in 1993 - 250.1. The number of abortions per 100 born alive and dead was 200.4, i.e. in comparison with 1985, there was a noticeable increase in the number of abortions, but this indicator was the highest in all departments in 1993 and amounted to 250.1 abortions per year.
So, we examined the most informative indicators for assessing the state of health, life expectancy, estimated the demographic situation of our immense native Russia. We had the opportunity to consider and evaluate the provision of the population of cities with medical care, including the provision of doctors and nurses.
In addition, indicators such as natural population growth, infant mortality and maternal mortality, as well as bed occupancy per day and the average number of patients staying in the hospital, provide information on the analysis of the work of medical institutions and cities and the government and administration's health concerns their population.
Data on the number of abortions in the regions under consideration, and in particular in Moscow and St. Petersburg, is not without interest. The data of this indicator should interest listeners, as almost 95–97% of students of pedagogical universities and medical schools are women.
At present, as I mentioned several times during the lecture, an extraordinary situation has arisen in Russia on the problems of the so-called “migratory population”.
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