Abstract: Social diseases and their danger to society. On approval of the list of socially significant diseases and the list of diseases that pose a danger to others Social factors of socially significant diseases

Socially significant diseases are diseases caused by the low quality of life of the population (low wages, pensions, deterioration of living conditions, work, rest, condition environment, quality and structure of nutrition, etc.), a decrease in sanitary and hygienic culture, and a person’s lifestyle.

Routes of infection and transmission

Sex is the norm of our life. THE SEXUAL TRACT IS ONE OF THE MOST COMMON METHODS OF TRANSMISSION OF BEHAVIORAL DISEASES. During unprotected sexual intercourse, sperm or vaginal secretions enter the body from infected person to a sexual partner. THE MOST DANGEROUS VIRUS THAT CAN BE SEXUALLY TRANSMITTED IS HIV. HEPATITIS B VIRUS, SYPHILIS, STDs, AND RARELY HEPATITIS C VIRUS CAN ALSO BE TRANSMITTED.

Parenteral route(through blood) - when infected blood enters the bloodstream healthy person through damaged skin and mucous membranes when sharing or reusing unsterile needles, syringes and other injection equipment.

The vertical route is from an infected mother to the child during pregnancy (through the placenta), during childbirth (if the newborn’s skin is damaged), during breastfeeding (with mother’s milk).

In 90% of cases, tuberculosis infection occurs by airborne droplets when coughing, sneezing, communicating.

Contact and household path transmission occurs either through direct contact (direct) or through contaminated environmental objects (indirect contact). As a result of direct contact, pathogens of tuberculosis, herpes, and scabies are transmitted. Through indirect contact through contaminated objects, linen, toys, and dishes, tuberculosis is transmitted.

Prevention measures

· Abstinence from sexual contacts with unfamiliar partners, observing the rules of personal hygiene.

· 2 Avoid contact with other people’s blood, secretions (saliva, semen, vaginal discharge) another man.

· Say no to drugs, unprotected sex and casual sex. Answer “yes” to mutual fidelity, condoms, personal hygiene.

· An important area of ​​specific prevention of tuberculosis is vaccination. Therefore, even in the maternity hospital, everyone healthy kids On the 3rd-4th day of life, they are vaccinated against tuberculosis, which is the main preventive measure for children in the first year of life. Subsequently, revaccination is repeated at 7 and 14 years of age. Adults over 15 years of age must undergo a fluorographic examination at least once every two years.

Algorithm of volunteer actions

· In the event of a domestic emergency (contact with human blood with a violation of the integrity skin or mucous membranes) - contact the AIDS center within 24 hours from the moment of contact for the purpose of examining the source possible infection and prescribing specific prevention of infection to the victim.

· Observe the rules of personal hygiene, use a mask (if you suspect tuberculosis), do not forget the following simple rules, such as thorough hand washing after contact with a sick person, before preparing food, before eating, after visiting the toilet.

· If in a personal conversation you are entrusted with information of an intimate nature, for example, about questionable sexual contact, you should explain that you should not delay contacting a medical institution. To avoid uncertainty and not be lost in doubts about your status regarding sexually transmitted diseases, you need to contact a specialist.

HIV INFECTION- infection caused by the human immunodeficiency virus. This is an infectious disease characterized by a specific lesion immune system, leading to its slow and steady destruction until the formation of acquired immunodeficiency syndrome (AIDS), accompanied by the development of opportunistic infections and secondary malignant neoplasms leading to death.

ROUTES OF TRANSMISSION OF INFECTION- sexual, blood contact, vertical. Other modes of transmission of infection have not been established to date.

PREVENTION: use of a condom during sexual intercourse If a domestic emergency occurs (contact with human blood with violation of the integrity of the skin or mucous membranes), contact the AIDS center within 24 hours from the moment of contact in order to examine the source of possible infection and prescribe specific infection prevention for the victim.

Viral hepatitis

Term viral hepatitis combines a group of infectious diseases manifested by damage to the liver and other organs and systems. The most studied and epidemiologically dangerous are viral hepatitis A, B, C. Hepatitis D, E, G are more rare in Russia.

HEPATITIS A is the most common and benign of all viral hepatitis. A person becomes infected with the hepatitis A virus by consuming food, water, or through household means (hands, dishes, and other household items infected with the virus). The incidence of hepatitis A registered in the Republic of Tatarstan is quite small, but many researchers believe that up to 90% of the population suffers from this hepatitis.

HEPATITIS B is the most epidemically dangerous. The virus is easily transmitted sexually, from mother to fetus, and any contact with microquantities of blood from a patient or a carrier of the virus is also dangerous.

In everyday life, a special role is played by the sharing of toothbrushes, washcloths, towels, toothpicks, razors, manicure and sewing supplies.

The greatest danger is posed by chronically ill or asymptomatic carriers of the virus. As a result of chronic viral hepatitis B (on average after 10-15 years), liver cirrhosis or primary liver cancer develops.

HEPATITIS C in acute form It proceeds easily, the patient does not consult a doctor, however, the process becomes chronic in 60-80% of cases. As a result of chronic hepatitis C, cirrhosis or primary liver cancer rapidly develops.

IN general case the symptoms of viral hepatitis are similar: heaviness and pain in the right hypochondrium, darkening of the urine, a slight increase in body temperature, yellowing of the sclera and skin. Weakness, drowsiness, nausea, vomiting, diarrhea, and joint pain may occur. If you notice these symptoms, you should immediately contact a specialist.

The mechanisms and routes of transmission of HIV infection, hepatitis B and C are almost the same.

Preventive measures are:

For hepatitis A and E: consume only good-quality food and water, observe personal hygiene rules. When consuming non-alcoholic and low-alcohol drinks, semi-finished and finished food products, you should use only products from proven and well-known manufacturers. A specific vaccine has been developed against the hepatitis A virus.

A specific vaccine has been developed for hepatitis B, which also protects against the hepatitis D virus. In case of “emergency situations”, emergency prevention of infection is carried out with a combination of a vaccine and a specific immunoglobulin, which can significantly reduce the risk of infection.

No specific preventive measures have been developed for hepatitis C, G, E.

TUBERCULOSIS is an infectious disease with the formation of specific inflammatory changes and a tendency towards a chronic course.

The main source of the spread of tuberculosis is a person who releases bacteria, dispersing tuberculosis bacilli when coughing, sneezing, or laughing. Infection occurs upon penetration tubercle bacilli into the lungs both directly from an aerosol of saliva and sputum, and with dust and food. For all methods of infection, the duration of contact with the source of infection and the severity of the infection are important.

The first symptoms of tuberculosis are nonspecific: a slight increase in body temperature, sweating at night, deterioration of sleep and appetite, increased fatigue, tearfulness, irritability, deterioration of health, night sweats, cough, usually dry, less often with the release of mucopurulent sputum. When the lung collapses, hemoptysis or pulmonary hemorrhage may occur. Tuberculosis may have a flu mask, chronic bronchitis, prolonged pneumonia or other diseases.

PREVENTION. Measures aimed at increasing the body’s resistance and a rational hygienic regime are important. For the purpose of specific prevention, vaccinations are used.

SYPHILIS is a chronic systemic venereal disease affecting the skin, mucous membranes, internal organs, bones, nervous system with successive changes in the stages of the disease.

Syphilis is transmitted mainly through sexual contact (even in the absence of visible pathological foci on the patient’s skin and mucous membranes); syphilis can be transmitted through blood, in everyday life when using a shared toothbrush, razor, manicure accessories, dishes, towels, underwear and other things in contact with mucous membranes shells or skin of the patient with objects. It is possible for the baby to become infected with mother's milk.

Incubation period the primary stage of syphilis from 8 to 190 days.

The first manifestation of syphilis is usually a hard chancre-inflammatory infiltrate of tissue, in the center of which a painless ulceration appears. This formation persists in the patient from 1-2 weeks to a month. Primary manifestations of syphilis can occur both on the genitals, on the fingers, and in the oropharynx. Patients may experience malaise, weakness, dizziness, and fever.

In the next stage of the disease, generalized lesions of the skin and mucous membranes occur, often in the form of a pale spotty rash or in the form of multiple small hemorrhages in the skin and mucous membranes. Characterized by inflammation lymph nodes. Mild malaise, sub-febrile temperature (about 37 ° C or slightly higher), weakness, cough, runny nose, and conjunctivitis may occur. Often the disease looks like catarrh of the upper respiratory tract (that is, the common cold).

In the third stage, deep damage to the nervous system and internal organs gradually develops.

PREVENTION. Strict adherence to the rules of personal hygiene helps to avoid the everyday route of infection. Protected sexual intercourse prevents infection of the genitals, but does not exclude the transmission of syphilis. The use of local antiseptics does not guarantee against infection.

SCABIES is a contagious skin disease caused by the scabies mite.

The disease is localized in organized groups, united by common bedrooms, or in asocial strata of society.

Infection with scabies almost always occurs through prolonged direct skin-to-skin contact, and sexual transmission predominates. Children often become infected when they sleep in the same bed with sick parents. In crowded groups, other direct skin-to-skin contacts are also realized (contact sports, children fussing, frequent and strong handshakes, etc.). Via household items(household items, bedding, etc.) infection is less likely. Infection can also occur from animals with scabies; in this case, the rash is localized mainly in those areas that came into contact with the sick animal.

The characteristic signs of scabies are intense itching, which intensifies at night in the warmth of the bed. At the site of the mite's penetration, a bubble with transparent contents appears, from which an itch tract leads (a thin strip on the skin of a grayish color up to 1 cm long), a bubble is visible at the end of the itch tract. The rash is located on the flexor surfaces of the upper and lower limbs, in the interdigital folds of the hands, on the body, especially in the area of ​​the belt, abdomen and along the anterior edge of the axillary depressions. Scabies can be located on the palms, soles, and face.

PREVENTION scabies is carried out by early diagnosis disease and active identification of patients and persons in contact with the patient. During the treatment process and after its completion, current and final disinfection is carried out at home.

Active spread of the disease occurs in crowded places of people from different social groups, where a person least expects to become infected with head lice ( public transport, metro, hiking, mass celebrations, work contacts with people from disadvantaged social groups). The main symptoms of head lice include:

Constant itching, accompanied by scratching and bloody crusts;

Insomnia and irritability;

Visual detection of lice or nits on the pubis, head or clothing

With head lice, clusters of lice and nits are observed in the occipital and temporal parts of the head; with body lice, lice are found in the folds and seams of clothing and linen, rarely on the skin of the body; with pediculosis pubis, lice are found in the hair lower area abdomen and pubis, sometimes in the mustache and beard, eyelashes and eyebrows

There is no specific prevention of head lice. Preventive measures lice boil down to identifying and complete cure patients in the early stages of the disease, as well as mandatory treatment all sexual partners of a patient with pediculosis pubis, including examination for sexually transmitted diseases. An important role is played by thorough disinfection of the patient’s bedding and clothing, places common use and upholstered furniture, as well as strict adherence to personal hygiene rules.

Socially significant diseases

"...Socially significant diseases are diseases caused primarily by socio-economic conditions, causing damage to society and requiring social protection of a person..."

Source:

Order of Rosstat dated November 22, 2010 N 409

"On approval of the Practical Instructional and Methodological Manual on Health Statistics"

Official terminology.

Akademik.ru.

2012.

See what “Socially significant diseases” are in other dictionaries: Perm (city)

Perm Official terminology

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In the very general view socially significant diseases are diseases the occurrence and (or) spread of which largely depends on socio-economic conditions (list socially significant diseases see table 1). For example, outbreaks of tuberculosis are facilitated by crowded populations, unfavourable conditions accommodation, poor and poor nutrition, etc. Lack of minimum required hygiene knowledge and properly developed skills can lead to outbreaks of hepatitis A, sexually transmitted infections, etc. The main feature and at the same time the key problem of socially significant diseases is the ability to spread widely (mass). Patients suffering from diseases of this group, as noted in the Concept of the Federal Target Program "Prevention and Control of Socially Significant Diseases (2007-2011)" (approved by Order of the Government of the Russian Federation dated December 11, 2006 No. 1706-r), need medical care increases as their condition worsens and complications arise. Treatment of such patients requires the involvement additional funds and strengthening the material and technical base of health care institutions.

Table 1

List of socially significant diseases (approved by Decree of the Government of the Russian Federation of December 1, 2004 N 715)

In the absence of adequate government measures (organizational, technical, financial, medical-prophylactic, therapeutic, etc.), the level of morbidity, disability and mortality from certain diseases increases, the life expectancy of the population decreases, huge amounts of money are spent on stabilizing the morbidity situation and eliminating negative social and macroeconomic consequences. It is no coincidence that in Part 2 of Art. 43 of the Law "On the fundamentals of protecting the health of citizens in Russian Federation“It is said that the list of socially significant diseases and the list of diseases that pose a danger to others is approved by the Government of the Russian Federation based on the high level of primary disability and mortality of the population, and the reduction in life expectancy of the sick.

The social significance of diseases can be reduced with targeted and effective influence on the main factors that cause and maintain these diseases. In this situation, it would be logical to create legal mechanisms that guarantee the necessary medical and drug provision for patients with certain socially significant diseases. It is assumed that an additional mechanism to the main one (we are talking about the provision of medical care on a general basis) will allow citizens who want and care about their health (benefits for patients) to maintain their ability to work and an acceptable level of quality of life.

At the same time, socially significant diseases in a number of ways can hardly be compared with diseases that pose a danger to others.

In Art. 41 of the Law “Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens” states that citizens suffering from socially significant diseases are provided with medical and social assistance and are provided with dispensary observation in relevant medical institutions free of charge or on preferential terms. Types and volume of medical and social assistance provided to citizens suffering from socially significant diseases are established by the federal executive body that carries out legal regulation in the field of healthcare.

Measures social support in the provision of medical and social assistance and drug provision for citizens suffering from socially significant diseases are established by state authorities of the constituent entities of the Russian Federation.

Financial support for measures to provide medical and social assistance to citizens suffering from socially significant diseases (with the exception of assistance provided by federal specialized medical institutions, the list of which is approved by the Government of the Russian Federation), in accordance with these Fundamentals of Legislation, is an expenditure obligation of the constituent entities of the Russian Federation.

Diseases that pose a danger to others

Spread of plague, cholera, anthrax V modern conditions can lead to illness and even death of thousands of people in the shortest possible time, jeopardize the security of the region and the state, and cause irreparable damage to the economy. In this situation it is necessary to take emergency measures to localize and prevent the spread of a particular disease that is becoming an epidemic, to treat a large contingent of patients. Disability of the population and the demographic crisis are receding into the background.

table 2

List of diseases that pose a danger to others (approved by Decree of the Government of the Russian Federation of December 1, 2004 N 715)

Disease code according to ICD-10	Name of diseases
	disease caused by human immunodeficiency virus (HIV)
	viral fevers transmitted by arthropods and viral hemorrhagic fevers
	helminthiasis
At 16; At 18.0; At 18.1	Hepatitis B
B 17.1; At 18.2	hepatitis C
	diphtheria
	infections that are predominantly sexually transmitted
	pediculosis, acariasis and other infestations
	glanders and melioidosis
	anthrax
	tuberculosis

Under normal conditions (outside an outbreak or epidemic), the prevalence of diseases that pose a danger to others is usually low, in contrast to diseases classified as socially significant, and depends much less on the ethnic, national, cultural and other characteristics of the region.

In Art. 42 of the Law “Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens” states that citizens suffering from diseases that pose a danger to others are provided with medical and social care in institutions of the state healthcare system intended for this purpose within the framework of the Program of State Guarantees for the provision of free medical care to citizens of the Russian Federation . For certain categories of citizens suffering from diseases that pose a danger to others, their place of work is retained for the period of their temporary disability, social support measures are established, determined by government authorities of the constituent entities of the Russian Federation. Financial support for measures to provide medical and social assistance to citizens suffering from diseases that pose a danger to others (with the exception of assistance provided by federal specialized medical organizations, the list of which is approved by the Government of the Russian Federation), in accordance with these Fundamentals, is an expenditure obligation of the constituent entities of the Russian Federation. Social support measures in the provision of medical and social assistance to citizens suffering from diseases that pose a danger to others are established by state authorities of the constituent entities of the Russian Federation.

In the domestic literature there is such a concept as “particularly dangerous infections”. These are infections that can occur among the population in the form of individual diseases, epidemics and even pandemics, often accompanied by natural disasters, wars, mass famine, etc. They are characterized by natural focality, rapid spread and severe course. These most often include plague, tularemia, yellow fever, cholera, generalized forms of anthrax. List and measures to prevent the spread of especially dangerous infections were first clearly established in the International Health Regulations adopted by the 22nd World Health Assembly (WHO) in 1969. Subsequently, changes were made to the Rules. At the national level, corresponding acts were adopted in pursuance of the Rules.

According to Art. 3 of the Federal Constitutional Law of May 30, 2001 No. 3-FKZ “On a State of Emergency”, the circumstances of introducing a state of emergency include, in particular, emergency environmental situations, including epidemics and epizootics resulting from accidents, hazardous natural phenomena, catastrophes, natural disasters and other disasters that have resulted (may result) in human casualties, damage to human health and the environment, significant material losses and disruption of the living conditions of the population and requiring large-scale rescue and other urgent work. A state of emergency throughout Russia or in its individual localities is introduced by decree of the President of the Russian Federation. This is a special legal regime for the activities of state authorities, local governments, organizations, regardless of organizational and legal forms and forms of ownership, their officials, public associations, allowing statutory restrictions on the rights and freedoms of Russian citizens, foreign citizens, stateless persons, the rights of organizations and public associations.

Federal Law No. 52-FZ of March 30, 1999 “On the sanitary and epidemiological welfare of the population” introduces the following concepts:

• - infectious diseases that pose a danger to others,
• -- human infectious diseases characterized by severe disease, high levels of mortality and disability, and rapid spread among the population (epidemic);
• -- restrictive measures (quarantine) -- administrative, medical, sanitary, veterinary and other measures aimed at preventing the spread of infectious diseases and providing for a special regime for economic and other activities, restricting the movement of the population, Vehicle, cargo, goods and animals. Restrictive measures (quarantine) are introduced at checkpoints across the state border of the Russian Federation, on the territory of the Federation, its constituent entities, in organizations and at facilities of economic and other activities in the event of a threat of the emergence and spread of infectious diseases.

In accordance with Art. 6 of the Federal Law of March 30, 1999 No. 52-FZ “On the sanitary and epidemiological welfare of the population”, the introduction and abolition of restrictive measures (quarantine) on the territory of a constituent entity of the Russian Federation is the authority of the constituent entities of the Russian Federation in the field of ensuring the sanitary and epidemiological welfare of the population.

Diseases are a pathology that is characterized by a fairly high prevalence among the population and serious treatment costs. However, it can lead to a significant deterioration in the condition of patients and limit their physical capabilities.

About the list of socially significant diseases

It was approved by Decree of the Government of the Russian Federation No. 715 dated December 1, 2004 as amended by Decree of the Government of the Russian Federation No. 710 dated July 13, 2012. Data normative document a list of socially significant diseases is regulated. Among them:

1. Sexually transmitted infections.
2. Tuberculosis.
3. Viral hepatitis B and C.
4. Malignant neoplasms.
5. Diseases characterized by increased level blood pressure.
6. Behavioral disorders and mental disorders.

All these diseases bring a huge number of problems, both social and financial. Successful fight against them is one of the factors of health and development of society.

Sexually transmitted infections

Such diseases pose a serious danger to the entire society, as they affect the young and middle-aged population. That is, that part of it that forms the main budget of the state. It is for this reason that healthcare institutions, sanitary services, as well as many government and non-government organizations actively prevent socially significant diseases of this type. Most effective forms such work are as follows:

• social advertising on billboards, as well as in media mass media;
• distribution of leaflets and booklets among the population;
• promotions with free distribution of means of protection against sexually transmitted infections (condoms);
• systematic educational work to convey to the population information about such diseases and means of protection against them (directly in educational institutions, as well as in the workplace);
• Conducting screening examinations of people at the age most susceptible to infection.

Among the most common diseases of this type are syphilis and gonorrhea. HIV, due to its danger, is included in a separate column of the list.

Tuberculosis

This socially significant disease is one of the most dangerous. It is special because its causative agent, Mycobactérium tuberculosis, is extremely widespread, especially among the population of large cities.

Despite the fact that tuberculosis has been known since the times of the Egyptian pharaohs, it is truly effective means to combat them still does not exist. Modern medicine uses techniques for the simultaneous use of large quantities special antibiotics, which have serious side effects. Patients with pulmonary tuberculosis are treated from several months to 2-3 years.

These socially significant diseases are combated using a whole complex preventive measures. Among them:

1. Sanitary education work among the population.
2. Conducting screening studies as part of clinical examination (fluorography).
3. Forced treatment patients avoiding TB care.
4. Providing food packages to reduce the number of relapses in patients who have already had tuberculosis.
5. Limiting the list of professions available to persons suffering from a socially significant disease of this type.

Thanks to these activities in developed and developing countries, it is gradually possible to limit the increase in the incidence of tuberculosis.

Viral hepatitis B and C

There are several options for the spread of these diseases. Among them:

• during blood transfusion;
• through a syringe;
• from mother to child during pregnancy;
• during sexual intercourse.

Viral hepatitis C is especially dangerous, since in 70-80% of cases it turns into chronic form. Without proper treatment pathological process can lead to the development of liver cirrhosis, an effective means of combating which currently does not exist.

Malignant neoplasms

These types of pathologies represent one of the most dangerous types of socially significant diseases. The program for the development of global health care in the 21st century assigns a special role to the fight against them. This is largely due to the serious danger of malignant neoplasms, as well as the growing incidence of pathology of this form.

Currently, there are a huge number of programs and funds that provide assistance to patients with cancer. In order to timely detect such a pathology, every resident of the Russian Federation must undergo preventive examinations as part of a medical examination in a timely manner. If such diseases are detected in the early stages of their development, patients have a good chance of recovery.

As for prevention, in the case of this group of pathologies, we are talking about:

• sanitary educational work among the population about factors contributing to the development of malignant neoplasms;
• working with the population to develop their commitment to healthy image life;
• activities to create conditions in the workplace that are not conducive to the formation oncological diseases.

Taking into account the fact that malignant neoplasms develop when the activity of one’s own cells is disrupted human body, then it is unlikely that it will be possible to prevent the formation of such a pathology in the coming decades. Currently, scientists are betting on the development of effective medicines, capable of combating the tumor process, providing a person with a complete recovery.

HIV

Along with malignant neoplasms this pathology is one of the most serious. The fight against it represents for society special meaning due to the fact that it mainly affects young and middle-aged people. The causative agent of the disease is the human immunodeficiency virus. It can be transmitted as follows:

• sexually;
• when injecting with used needles;
• during blood transfusion;
• from mother to child during pregnancy and childbirth.

A few decades ago, this disease was transmitted mainly by injection. Today, the main route of spread of the human immunodeficiency virus is sexual. The likelihood of infection is highest during anal intercourse, since it is more traumatic.

The danger of a socially significant disease of this type forced the World Health Organization to develop effective measures to prevent its spread. Of these, the following are implemented on the territory of the Russian Federation:

1. Promotions in which free condoms are distributed to the population (most often the organizer is the Red Cross).
2. Providing drug addicts with syringes free of charge.
3. Conducting educational events in educational institutions.
4. Implementation of systematic work to prevent HIV infection in health care institutions. We are talking about measures before use donated blood(transfusion is carried out only after testing for major infectious diseases, including HIV).
5. Conducting screening studies.
6. Performing free anonymous HIV diagnostics.
7. Organization of direct and hotlines, anonymous telephone counseling on routes of infection and organization of HIV treatment.

Despite the measures taken, today this socially significant infectious disease is spreading more and more widely. At the same time, over time, the age of newly diagnosed patients becomes increasingly higher. This may be largely due to more active preventive work with youth.

This socially significant disease is most common in developed countries of the world. Gradually, the number of patients with this diagnosis is increasing in the Russian Federation. A constant increase in blood glucose levels can gradually destroy the vascular wall. Those that have small calibers suffer especially hard. As a result, vision and kidney function may be impaired, leading to increased blood pressure levels. As the disease progresses, the patient begins to lose sensitivity in the skin of the hands and feet. Subsequently, microcirculation of the lower extremities can be disrupted to such an extent that “diabetic foot” syndrome develops. It leads to gangrenous changes and the need to remove the affected tissue.

As a result, patients with diabetes mellitus, especially those evading therapeutic measures, after 10-12 years from the manifestation of the disease, they often become disabled. As a result, such pathology fits perfectly into the concept of a socially significant disease.

Diseases characterized by high blood pressure

Today, both in Russia and in the world as a whole, the main cause of mortality is pathology of cardio-vascular system. Most important factor leading to the development of serious diseases of this profile is a constantly increased arterial pressure. This pathology contributes to the development of the following dangerous diseases:

• myocardial infarction;
• acute disorder cerebral circulation;
• cardiomyopathy;
• cardiac ischemia;
• arrhythmias various types and others.

Currently, the prevention and treatment of socially significant diseases of this type is the cornerstone in the activities of outpatient healthcare institutions.

Behavioral and mental disorders

The incidence of this pathology is also constantly increasing. Probably the reason for this is the increase in diagnostic capabilities, as well as the ever-increasing demands on the person himself from the public. A huge amount of money is spent annually on the treatment of such diseases. A feature of the pathology is the partial or complete loss of a person from public life in the presence of such a socially significant disease, which means additional costs for relatives and/or the state.

Understanding the Issues

By the forces of one government regulation, and medical workers budgetary organizations it is impossible to cope with these diseases. Isolating them into a separate list, as well as active educational work are aimed at developing public understanding of the danger of this pathology both for each person individually and for society as a whole. As a result, they are able to take on a certain role in preventing the occurrence of such ailments and providing partial assistance to those suffering from them. public organizations(both governmental and non-governmental), which brings closer the solution to the problems associated with these diseases.

Further tactics

Currently, socially significant diseases are a worldwide problem. As a result, the World Health Organization has already developed a plan for the coming years to combat each type of such pathology. These programs have already shown their effectiveness. Not all of them have made it possible to turn the situation around in the direction of reducing morbidity, however, thanks to their implementation, the level of disability is gradually decreasing and the active life expectancy of patients with socially significant pathologies is increasing.

About the activities of the funds

In order to help patients with certain diseases of public importance, special funds are created. Their sponsors are often wealthy individuals or organizations. Thanks to their funds, every year a large number of patients undergo specialized treatment using the best domestic and foreign techniques.

To create interest in this type of patronage, the government of most countries in the world, including the Russian Federation, applies preferential tax schemes to the “donors” of such funds.

Socio-economic reforms in the country at the end of the 20th century. They devalued generally accepted human values ​​- kindness, morality, mercy. This could not but cause an increase in aggression, hatred, and bitterness in society, which caused an increase in the number reactive psychoses, depression, severe neuroses and psychosomatic disorders, alcoholism, drug addiction and STIs. These diseases, along with circulatory system diseases (CVD), malignant neoplasms, tuberculosis, human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS), have become the leading causes of deteriorating public health. As a result, a vicious circle is formed, the main connecting links of which are sociopathy: diseases that have a pronounced dependence on social factors of the human environment. These diseases and conditions are indicators of her distress. lead to a decrease in the economic potential of the country and are a real threat to national security.

To break this vicious circle, it is necessary to eliminate the causes of these diseases.

BSK(see also section 2.5) is a major public health hazard and public health problem, a leading cause of disability and mortality in adults. These diseases occupy 1st place in the structure of causes of death in most economically developed countries of the world and in the Russian Federation.

Every year in Russia, 18-19 million people suffer from cardiovascular diseases are registered. 1.2-1.5 million people die from them every year, among them 200 thousand people of working age. BSC accounts for about 56% of all deaths, 47% of disability cases, 9% of temporary disability.

The main reasons shaping high level mortality from CSD: coronary heart disease (CHD) and cerebrovascular diseases.

The incidence of CSD has its own age and gender characteristics. The morbidity rate according to the negotiability data in women is 1.5 times higher than in men. With increasing age, the prevalence of such diseases increases rapidly. In recent years, a rejuvenation of this pathology has been observed. In structure

The prevalence of CHD is 23%. giving up first place hypertension - 36%.

Doctors from the American Heart Association call arterial hypertension(AG) "a silent and mysterious killer." The danger of this disease is that many patients are asymptomatic and feel healthy. There is the concept of the “law of halves”: 1/2 of all people with hypertension do not know about their disease; only 1/2 of those who know about it treat it; Only 1/2 of them treat it effectively.

CVD causes significant economic damage to the state due to morbidity. disability and mortality. According to expert estimates, the economic damage from hypertension, ischemic heart disease and cerebrovascular diseases alone annually amounts to about 35 billion rubles.

Due to the exceptional social and economic importance vascular diseases The Russian Ministry of Health is implementing a set of measures aimed at improving medical care for such patients:

Creation effective system prevention of hypertension in risk groups;

Development and implementation of modern methods of early diagnosis, treatment and rehabilitation of patients with complications as part of the implementation of the subprogram “ Arterial hypertension» federal target program “Prevention and control of socially significant diseases (2007-2011)”;

Networking vascular departments and regional vascular centers;

Introduction of new effective technologies diagnosis and treatment of stroke, other cerebrovascular disorders, coronary artery disease;

Multidisciplinary early rehabilitation of patients who have suffered a stroke, angioplasty and stenting, minimally invasive neurosurgical methods for the treatment of hemorrhagic stroke, aneurysms.

Malignant neoplasms occupy 2nd place in the structure of causes of disability and mortality in the Russian Federation.

According to international statistics, about 7 million cases of malignant neoplasms and more than 5 million deaths from them are registered annually in the world.

In Russia, more than 500 thousand people get sick with cancer every year, of which more than 3 thousand are children. In patients with newly registered malignant neoplasms, about 40% of diseases are detected in stages III-IV. At the end of 2011, about 2.9 million patients were registered with the oncology service, i.e. 2% of the country's population. Of these, rural residents accounted for 19.8%.

In 2011, 292.4 thousand people died from neoplasms in Russia - 15% of all deaths. Over the past 20 years, the number of deaths from malignant neoplasms has been constantly growing, and not only in older age groups, but also among children.

The level and structure of mortality from malignant neoplasms are closely related to gender and age. The mortality rate of men is 2 times higher than that of women. The higher mortality rate is due to the higher prevalence of cancer of internal organs in men: esophagus (2 times), stomach, trachea, lungs (7 times).

In the structure of primary morbidity among men, the 1st place is occupied by malignant neoplasms of the trachea, bronchi, and lungs, the 2nd place is occupied by cancer prostate gland, 3rd - stomach cancer. In the structure of primary morbidity among women, 1st place belongs to breast cancer, 2nd place to cervical and uterine cancer. 3rd - stomach cancer.

Economic losses from malignant neoplasms amount to over 100 billion rubles per year.

Attaching great importance to the fight against malignant neoplasms, the Russian Ministry of Health has developed a national oncology program that includes:

Carrying out measures for the primary prevention of cancer diseases based on medical examination of the working population according to a unified examination standard for early detection persons from high-risk groups;

Increasing the oncological alertness of “primary contact” doctors and dispensary observation of identified cancer patients;

Introduction of telemedicine with the exchange of information between regional and interdistrict oncology clinics and oncology offices of health care institutions of the general medical network;

Development of domestic production of diagnostic and therapeutic equipment, antitumor drugs, equipping regional oncology dispensaries with modern medical equipment.

Tuberculosis occupies a special place among social diseases. Currently, about 1/3 of our planet's population is infected Mycobacterium tuberculosis.

In Russia in 2010, more than 250 thousand tuberculosis patients were registered with the TB service. Since the early 1990s. Primary morbidity and mortality from tuberculosis have increased. Primary morbidity increased 2.1 times and amounted to 73 per 100 thousand population in 2011, mortality - 15.3 per 100 thousand population in 2010, increased 1.6 times (Fig. 2.15). Patients of working age accounted for 75% of the deaths.

Among all forms of active tuberculosis, respiratory tuberculosis predominates (96%), among extrapulmonary forms - tuberculosis genitourinary organs(1.5%). Tuberculosis in advanced form is detected in 30% of patients. Men suffer from tuberculosis 2-3 times more often than women. The situation with tuberculosis is especially unfavorable in penitentiary institutions, where the incidence is 1302 per 100 thousand persons under investigation and convicts, which is 17 times higher than the national average.

STI- large group diseases: syphilis, gonorrhea, trichomoniasis, chlamydia, urogenital herpes. Like most sociopathies, these diseases “bloom” during periods of social and economic instability in society. Given the growing incidence of sexually transmitted diseases in adults, the increase in the incidence of sexually transmitted diseases in children and adolescents is extremely alarming.

In the structure of STIs in 2011, the 1st ranking place belongs to trichomoniasis (159.2 thousand people), 2nd - to gonococcal infection (54.5 thousand people), 3rd - to syphilis (53.8 thousand people).

From the early to mid 1990s. There was a sharp increase in the incidence of STIs, primarily syphilis (Fig. 2.16). In 1993-2010 the incidence of syphilis in children increased 11 times, congenital syphilis - 20 times. In recent years, the situation with venereal diseases somewhat stabilized. But the primary incidence of syphilis is still 7 times higher than it was before the 1990s.

STIs should be regarded as “behavioural diseases”. Features that distinguish patients with STIs from total number minors, allow us to draw up their medical and social portrait: living in single-parent families with a history of alcoholism, psychopathological character traits, which are aggravated against the background of neglect, alcohol abuse and lead to criminogenic behavior, accompanied by promiscuous relationships. Mental illness and sexual deviations are common causes of STIs among minors.

Despite the apparent ease of STIs, they lead to future severe consequences: infertility, intrauterine infection of the fetus, persistent reproductive health disorders. Thus, STIs in minors are a risk “ social disability"in adulthood.

HIV infection and AIDS. According to UN experts, at the beginning of the 21st century. There were about 35 million people living with HIV in the world, including more than 1.2 million children. Every day, an average of 8,000 new cases of HIV infection are registered around the world, mainly among people young. The spread of HIV infection has become most catastrophic in African countries.

By the end of 2011, only 422.3 thousand HIV-infected people were registered in Russia, of which 1012 were children. However, experts believe that the true number of HIV-infected patients is many times higher. People most often affected by HIV are drug users, commercial sex workers and prisoners. Among drug users, the prevalence of HIV infection in various regions of the Russian Federation is 8-64%. among commercial sex workers - 6%, among prisoners - 5%.

HIV infection often affects the young population: 75% of registered cases of HIV infection are detected in young people aged 15-30 years. Over the past 5 years, the proportion of women among HIV-infected patients has doubled. In 2010, 10,473 children were born to HIV-infected mothers, and 46 of them died in the first days of life. The largest number of children born to HIV-infected mothers was registered in the Sverdlovsk, Samara, Irkutsk regions, Moscow and St. Petersburg. The incubation period of HIV infection is long and different people varies greatly. About half of those infected become ill within 10 years of infection.

To manage the epidemiological situation, since 1990 in Russia, 20-24 million people - 15-17% of the population - are tested for HIV annually. At the same time, about 50 thousand new cases of HIV infection are detected annually.

Mental disorders and behavioral disorders. According to WHO experts, mental disorders are widespread throughout the world, affecting 10-15% of the population of economically developed countries in Western Europe and North America, and 2.5-5% of the population of developing countries.

In 2010, 1,637.7 thousand people were registered in Russia with mental disorders and behavioral disorders, including diseases associated with the use of psychoactive substances. Every year, more than 70 thousand people are taken under dispensary observation. Mental disorders are the reason for the exemption of more than 30% of young men from conscription.

Mental disorders play important role in disability of the population. especially children. Among the diseases that cause disability in adults, mental disorders account for 4%; in children their share increases to 19%.

The highest primary incidence of mental disorders, especially borderline conditions, is observed in adolescents. During this period of life, a person experiences the action of two natural, but ambiguous processes: intensive socialization of the individual and active physiological restructuring of the body. They often reach the strength and severity of a sociopsychobiological crisis, giving rise to significant problems in the adolescent’s health. Serious problem adolescence- insufficient social adaptation. It manifests itself in a high frequency of behavioral disorders: from increased conflict and lack of discipline to behavior, the obligatory and defining component of which is the commission of illegal actions (delinquency).

Biological, psychological and social factors contribute to mental illness. Special studies show that schizophrenia and Alzheimer's disease are associated with genetic disorders, depression - with changes chemical composition brain, mental retardation- with iodine deficiency. Stressful situations, poor upbringing, cruelty in everyday life and in society lead to increased risk mental illness. Extreme poverty, wars, and forced displacement lead to the emergence or worsening of mental illness.

Depressive disorders and schizophrenia are the cause of 60% of suicides. In 2011 alone, 30.6 thousand suicides were registered in Russia.

Violation of the mental health of children and adolescents worsens their quality of life and threatens the development of severe mental and psychosomatic disorders in the future.

pathologies, leads to antisocial behavior of young people - drug addiction, alcoholism. prostitution, crime.

An important place among mental disorders and behavioral disorders include alcoholism, drug addiction and substance abuse.

Alcoholism(see also section 2.5). According to WHO, there are currently more than 150 million people suffering from alcohol dependence in the world, and about 400 million people abuse alcohol.

In Russia in 2011, under dispensary observation for psychotic disorders associated with alcohol use ( alcoholic psychoses), and alcohol dependence syndrome were 1.9 million people, or 1.4% of the country's population. The number of patients seeking treatment for alcoholism for the first time was 1.4 million people, or 1% of the population.

Against the background of the prevalence of drunkenness and alcoholism among the population as a whole, an increase in alcoholism in women, children and adolescents is observed. The number of children registered for the first time due to alcohol abuse in 1990-2010. increased by 1.7 times, among teenagers - by 1.5 times.

According to experts, about 10-15% of the working population in the country abuse alcohol. It is the leading cause of preventable deaths from accidents and injuries.

Alcoholism is the reason serious problems health-related, including accidents and injuries, cardiovascular diseases, liver diseases, alcoholic psychoses. Problems associated with alcohol abuse affect not only alcoholics themselves, but also their families and people around them. society. They can be combined into three groups.

The first group is the problems of an alcoholic:

♦ consequences of acute alcohol intoxication (decreased self-control, aggressiveness, violation of law and order, accidents, etc.);

♦ alcohol poisoning (in 2010 alone, 19.1 thousand people died from accidental alcohol poisoning);

♦ consequences of long-term alcohol consumption (health problems, decreased mental abilities, premature death).

The second group is the problems of the family of an alcoholic: O deterioration of relationships in the family;

♦ pedagogical neglect of children:

♦ decrease in material well-being.

The third group is problems of society: Violation of public order;

♦ increase in crime;

♦ increase in the number of diseases with temporary loss of ability to work (TLD):

♦ increase in disability;

♦ increase in mortality among the working population;

♦ economic damage.

Special studies show that the economic damage from alcoholism in different countries varies from 0.5 to 2.7% of the gross national product.

Drug and substance abuse(see also section 2.5). Today, drug addiction in Russia ranks 3rd in the ranking social problems facing society, after crime and low level income of citizens. In 2011, 320 thousand people were under dispensary observation due to drug addiction. Compared to 1992, this figure has increased more than 10 times. At the same time, the level of primary incidence of drug addiction in minors is 2.5 times higher than in adults. Total under supervision drug treatment clinics There are more than 90 thousand teenagers. The proportion of drug addicted women is growing.

In 1999-2010 the number of women with drug addiction increased by 35% and amounted to more than 75 thousand. However, data from special studies indicate that these figures are much higher. There are about 2 million drug addicts in Russia, half of them are children and teenagers.

Drug addiction mainly affects young people. The average age of first drug use is constantly decreasing. Today we already meet 7-8 year old drug addicts.

Drug addiction is an intractable disease that leads to the premature death of the patient. The average life expectancy of drug addicts is no more than 21 years, and after the start of regular drug use - about 4 years. Half of drug addicts die at the age of 17-18 from an overdose.

Unlike alcoholism, drug addiction leads to more severe consequences for the patient himself, his family and society. Patients under the influence of drugs do not control their behavior, which often leads to suicide and the commission of illegal actions. The morbid craving for drugs contributes to the criminalization of society. The use of shared needles and syringes when injecting drugs entails the spread of HIV infection and hepatitis. Drug addicts rarely seek treatment themselves medical care, which leads to their low detection.

Drug use is a global social and medical problem that requires the involvement of all government institutions and society to solve it.