Economic and industrial characteristics of Russian regions influencing individual risk of death: results of a prospective ESSE-RF study

Introduction. The territorial characteristics of the population’s residence can influence individual health risks. For the Russian population, the influence of regional living conditions on the individual probability of behavioural risk factors and the development of a number of diseases is shown.

The purpose of the study is on the base on prospective observation data to assess the individual risks of death from the regional living conditions of the Russian population.

Materials and methods. Individual indicators were taken from the Russian study ESSE-RF 2013–2014, with subsequent prospective observation during 2015–2021. (sixteen thousand three hundred twenty nine people of 25–64 years from 10 regions of Russia). To assess regional living conditions, 4 regional indices were used: Socio-geographical, Demographic, Industrial, Economic. A proportional hazards model (Cox regression) was used to estimate associations, calculating odds ratios and 95% confidence intervals, adjusting for a wide range of individual sociodemographic, behavioural and clinical characteristics.

Results. In the full model, living in an economically developed region reduces the individual probability of death (0.55; 0.43–0.71). The contribution of the Economic Index, compared to individual traditional health risk factors, is quite high. The influence of the Economic Index is most pronounced in men and people aged of 55–64 years. In the group of people without higher education, living in an industrialized region increases the individual probability of death (1.36; 1.05–1.76).

Research limitations. To represent a Russian representative sample, 10 regions is sufficient, however, when considering regional characteristics, of course, more stable patterns of influence would be obtained if a larger number of regions were involved, with all the diversity of regional living conditions of the population.

Conclusion. The study made it possible to identify the dependence of the individual probability of death on the regional characteristics of the Russian population, which expands the fundamental understanding of the cause-and-effect dependencies of human health on environmental factors and makes it possible to take into account environmental factors in predicting the health of the population.

Compliance with ethical standards. The study was approved by local ethical committees: National Medical Research Center for Therapy and Preventive Medicine (Moscow), protocol No. 07-03/12 dated 07.03.2012. All patients signed an informed consent to participate in the study.

Contribution of the authors:
Maksimov S.A. — research concept and design, writing the text, compilation of the list of literature, statistical data processing;
Shalnova S.A. — research concept and design, editing;
Kutsenko V.A. — statistical data processing, editing;
Kapustina A.V. — collection and processing of material;
Balanova Yu.A. — collection and processing of material;
Muromtseva G.A. — collection and processing of material;
Evstifeeva S.E. — collection and processing of material;
Imaeva A.E. — collection and processing of material;
Karamnova N.S. — collection and processing of material;
Drapkina O.M. — collection and processing of material, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: January 25, 2024 /Accepted: March 19, 2024 / Published: February 28, 2025