Cascade Model for Assessing and Predicting Health Losses Prevented through Control and Supervisory Activities of Rospotrebnadzor

Abstract

Introduction: Solving problems related to reducing morbidity and mortality of the population and increasing life expectancy is one of the strategic goals of the development of the Russian Federation. Objective: To improve approaches to assessing losses to public health prevented through control and supervisory activities of the bodies and institutions of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor). Materials and methods: For the first time, a new cascade model has been proposed for assessing and predicting prevented health losses in the triple system “control and supervisory activities of Rospotrebnadzor – environmental quality indicators – population health.” Thirty-five new neural network models were obtained to describe the relationships between factors characterizing the activities of Rospotrebnadzor and indicators of the quality of environmental media. New approaches have been developed to estimate the decrease in the modified indicator of life expectancy, which describes healthy life expectancy, based on prevented disease and death cases. Results: The proposed approaches were tested using the example of the Russian Federation as a whole. The estimates showed that the proportion of prevented cases relative to actual levels for the entire population ranged from 0.8 % to 32.6 % depending on the disease category while the proportion of averted deaths ranged from 1.8 % to 13.4 %. In total, about 4.8 % of cases of total morbidity and 2.6 % of cases of all-cause mortality were prevented as a result of control and surveillance activities, while the prevented loss of modified life expectancy was about 1.14 years. Conclusions: The results of this work can be used in the future to assess economic losses associated with health damage and to evaluate the efficiency of control and supervisory activities. To establish priority types of the latter, additional numerical experiments are required, which may be the subject of further research.