Vol 30, No 7 (2023)

Excess mortality is a measure of the increase in the number of deaths in a population during a certain time period compared to the expected values. This phenomenon can be triggered by a variety of natural or man-made disasters. Throughout the global COVID-19 pandemic, all countries experienced a rise in mortality rates, although not all deaths were directly caused by the coronavirus infection. Estimation of excess mortality during a pandemic, particularly stratified by the leading causes of death, is an important public health issue. The outcomes of these calculations, however, can vary significantly depending on the methodological approaches employed to estimate excess mortality.

The aim of this study was to provide a systematic review of the analytical methods used by the international research community to quantify excess mortality during the COVID-19 pandemic. Full-text publications in both Russian and English, published between 2020 and 2022, that focused on assessing excess mortality during the COVID-19 were reviewed. The search for English-language publications was conducted in the MEDLINE database (www.pubmed.gov), while Russian-language publications were sourced from the scientific electronic library database eLIBRARY.RU (www.elibrary.ru). Out of the 725 publications initially identified, we included 83 original studies in this review. Among the various statistical methods employed to estimate excess mortality, the most utilized approaches were Poisson regression with correction for overdispersion and a range of adaptive models based on autoregression and integrated moving average. The selection of a specific model depended on factors such as the duration of the existing time series, its characteristics, and the forecasting interval.

This review may serve as a resource for Russian-speaking researchers and analysts seeking guidance on selecting an appropriate analytical approach when examining excess deaths during the COVID-19 pandemic in Russia.

This article is a review of the key international documents within the conceptual framework of the “Decade of Healthy Aging 2020–2030” by the World Health Organization (WHO). The aim was to identify potential areas of research in gerontosocial policy in Russia. The methodology employed in this study involved a comprehensive examination of the WHO’s strategic directions for the “Decade of Healthy Aging 2020–2030,” as well as relevant global documents from both the WHO and the United Nations. Additionally, federal sources on population aging policy implemented in the past five years were also considered. In total, 16 texts containing the term “Healthy Aging (Longevity)” in their title or full text, along with 2 texts specifically focused on “Healthy Aging (Longevity) policy,” were sourced from the electronic scientific database eLIBRARY.RU.

The evolution of conceptual approaches to population aging policy within the global community is examined in the context of the World Health Organization (WHO) and the United Nations (UN) global documents. This analysis encompasses changing attitudes, opinions, and behaviors towards age and aging, as well as empower older individuals in local communities. Additionally, we explored the importance of personalized comprehensive and primary healthcare that caters to the specific needs of older people, as well as ensuring their access to long-term care. Furthermore, this study identifies the points of contact and synergy between scientific activities focused on the Decade of Aging, UN goals, and other gerontological policy documents. By doing so, we attempted to establish a comprehensive understanding of the conceptual and practical approaches to Healthy Aging policy within both Russian and international research communities.

The WHO concept of Healthy Aging has highlighted the need for a paradigm shift in the way we approach the medical and social services provided to the elderly. This shift calls for a personalized and coordinated care model, as well as a greater emphasis on the development of long-term care solutions. Research has consistently shown that the integration of medical, psychological, social, environmental, and economic support, is important in establishing a solid foundation for comprehensive information exchange. This integration is essential in ensuring the provision of effective services that can effectively support the elderly throughout their Healthy Aging process.

BACKGROUND: Regional differentiation adds complexity to the issue of high mortality among the working-age population. The identified regional patterns of mortality causes are typically not confined to specific areas, but rather influenced by spatial factors.

AIM: To study temporal trends in spatial patterns of mortality of the working-age population mortality from the main causes of death in the Republic of Bashkortostan. In addition, we identified territorial factors associated with the mortality patterns and trends.

METHODS: Mortality data on 6 main causes of death from 54 municipal districts, 20 urban districts and urban settlements were collected for the period from 2002 through 2020. The analysis included estimation of the Moran's index and the spatial panel data modeling.

RESULTS: Spatial mortality patterns were evident for mortality from diseases of the circulatory system, infectious and parasitic diseases, and external causes. The impact of crime levels in a specific region (male: p=0.046; female: p=0.019) negatively affected mortality rates from circulatory diseases among working-age men and women. Additionally, for men, the volume of gross municipal product (GMP) had an additional effect (p=0.046). Factors that contribute to a decrease in mortality from external causes among able-bodied men and women included the growth of GMP (male: p=0.010; female: p=0.003 — for women), an increase in the number of doctors per 10,000 people in the population (male: p=0.001; female: p=0.037), and the availability of nursing staff (male: p=0.026; female: p=0.005). Furthermore, crime rates had a significant impact on mortality from external causes for men (p=0.028), while the availability of hospital beds played a crucial role for women (p=0.030).

CONCLUSION: The study provides the evidence on the presence of spatial autocorrelation in the context of causes of death, as well as common and differing factors influencing male and female mortality in Bashkortostan. The findings provide a solid foundation for further analysis of spatially determined factors contributing to mortality among working-age population.

BACKGROUND: Associations between genetic stability of human somatic cells and solar activity across latitudes have been studied. A human buccal epithelium micronucleus test was selected as a method for evaluating genetic homeostasis.

AIM: To assess effects of solar activity on the genetic stability of human somatic cells using the micronucleus test in buccal epithelium in relation to the geographical location of subjects.

METHODS: Men aged 18 to 21 years with no harmful habits and taking no medication comprised the sample. Studies were conducted simultaneously in four cities of the Russian Federation: Sevastopol, Voronezh, Tomsk, and Khanty-Mansiysk. The effect of three types of solar flares, whose classification is based on changes in the amplitude of the thermal X-ray burst, was studied. Material for the cytogenetic study was collected on days 3, 7, and 10 after the solar flare. The human buccal epithelium micronucleus test was selected as a method to evaluate genetic homeostasis. At least 1,000 cells were examined on each preparation, among which the number of cells with micronuclei, perinuclear vacuoles, notches, “broken egg” and “tongue” type protrusions, karyorexis, karyolisis, and karyopyknosis was determined. In total, 495 thousand buccal epithelial cells were analyzed. Statistical processing of the data was performed using “Stadia” and “Statistica” software packages. Effecs of solar andlatitude on genetic homeostasis of somatic cells was performed using multivariate analysis of variance and two-factor analysis of variance with fixed effects.

RESULTS: Solar activity affected the stability of the human genetic apparatus by increasing the influence of the city pollution and its geographical location on the number of cells with nucleus abnormalities. We also observed a combined effect of solar flare and season on the number of cells with nucleus aberrations. More nuclear anomalies were registered in the winter. We did not detect any difference in the number of cells with nucleus anomalies on the 3^rd, the 7^th, the 10^th, and the 17^th days after the flare suggesting no associations between solar activity and the number of cells with nuclear abnormalities.

CONCLUSION: The highest number of cells with nucleus abnormalities is observed in Sevastopol reflecting with the greatest level of anthropogenic pollution of this city compared to the other locations. Solar activity increases the influence of the city pollution and its geographical location on the number of cells with nucleus abnormalities. The results obtained can be used in conducting a micronucleus test of human buccal epithelium and in planning measures to assess the genotoxicity of the environment.