COMPARATIVE ANALYSIS OF THE RELATIONSHIP BETWEEN CARDIOVASCULAR MORBIDITY IN THE ADULT POPULATION AND SOCIO-ECONOMIC INDICATORS IN THE REGIONS OF RUSSIA

Abstract

Significance. Cardiovascular diseases occupy one of the leading places in the structure of disease incidence in the adult population and are the leading cause of death. The purpose of the study is to analyze the relationship between all-cause disease incidence and cardiovascular morbidity in the adult population and socio-economic indicators in the Republic of Tatarstan and the Republic of Mari El, which differ in terms of living standards. Material and methods. The analysis included data from official federal and regional statistics on disease incidence and cardiovascular morbidity, as well as socio-economic indicators (gross regional product, employment/unemployment ratio, number of unemployed people, proportion of people with monetary incomes below the subsistence minimum, the Gini coefficient, R/P ratio) of the studied regions for 2000–2019. The trend dynamics is assessed by the coefficient of determination (R2). Statistical significance of time series differences was assessed by the Mann-Whitney U test, and the median was calculated with 95% CI. The relationship between the indicators was determined by the Spearman and Pearson correlation coefficient with a time lag of one year or more. Results. In the studied regions, the all-cause disease incidence in the adult population in 2000–2019 was higher than the national average with an upward trend in the Republic of Mari El (R2=0.452) and a downward trend in the Republic of Tatarstan (R2=0.455). The incidence of cardiovascular diseases in the adult population in the Republic of Tatarstan, while remaining relatively stable (R2=0.315), was higher than in the Republic of Mari El with a steady increase in the number of new cases (R2=0.729). During the analyzed period, the republics report a statistically significant increase in per-capita gross regional product and employment, due to decreased number of unemployed people and decreased proportion of people with monetary incomes below the subsistence minimum. All-cause disease incidence and cardiovascular morbidity in the adult population both in the Republic of Tatarstan and in the Republic of Mari El were in correlation with the gross regional product over a long-time interval - up to 13 years (r=0.63-0.92; p<0.05). However, the dependence vector in the regions was opposite. Correlations similar in the sign were also determined in relation to other considered socio-economic indicators that have different temporal effects on the morbidity under study. Conclusions. Regional socio-economic indicators have a statistically significant correlation with both overall incidence and cardiovascular morbidity in the adult population with the effect of cumulative and potentiated impact.