The State of Public Health in Constituent Entities of the Russian Federation in Times of a Large-Scale Epidemiological Challenge: The Example of the COVID-19 Pandemic

ABSTRACT

Introduction: In 2020–2022, Russia, like the rest of the world, faced the COVID-19 pandemic. The necessity to overcome its challenges has led to the expansion of powers of the regions. To improve public policy, it is expedient to evaluate the effectiveness of measures taken by the regions for public health preservation. Such an evaluation is proposed to be carried out using the public health index, which requires the development of appropriate methodological approaches. Objective: To develop and test a methodological approach to analyzing the effectiveness of public policy measures in terms of preserving public health. Materials and methods: This work continues a series of studies on establishing the public health index in the Russian Federation, which has already developed an approach to calculating this indicator in view of medical and social resources of the population. The approach is based on the recommendations of the World Health Organization standard "The Urban Health Index". The evaluation of the effectiveness of public policy measures involves the implementation of several stages for calculating the public health index and the classification of Russian regions depending on the degree of its change for 2019-2022. When performing calculations, correlation analysis is used to identify indicators that do not contradict each other. Through the normalization of indicators, as well as the calculation of average geometric values, the calculation of the public health index is carried out. The data for calculating the public health index are taken from the website of Rosstat and the Ministry of Health of Russia. Results: We established deterioration of public health indicators in most regions. We believe that this finding is primarily related to the COVID-19 pandemic as a large–scale challenge. In 2022, the public health index for the Russian Federation has decreased by 13.15 % compared with 2019. The largest decline has been observed in the Saratov Region (69.14 %). At the same time, an increase in the public health index has been registered in several regions, e.g. by 6 % over the study period in the Tyumen Region. Conclusion: The analysis of the components of the public health index makes it possible to ascertain the cause of public health worsening in the region and to assess its determinants. Having classified the regions, it is important to identify the determinants of public health that can be influenced through public policy instruments. © 2023, Federal Center for Hygiene and Epidemiology. All rights reserved.