15 years of social crisis in the largest Circumpolar region: hygienic implications.

The aim of the study was to determine the nature and size of the hygienical impact of social crisis on the public health of the population of a Circumpolar region. The study was carried out in the Sakha (Yakutia) Republic (area 3.1 million km2; population nearly 1 million). The analysis of health indicators was done using demographic and hygienical methods, and 15-year (1989-2005) statistical data from the Federal State Statistic Service division in the Sakha Republic. The study has yielded reliable data on public health trends of the population in the Sakha Republic. During a period of 15 years of social crisis, the population has declined by 13%, mainly due to the departure of 1/3 of the non-Aboriginal population, which clearly demonstrated the negative nature of social changes. The natural increase rate has been reduced to a 1/ 3. Marriage and family institutions were affected seriously, with twice more children born to single mothers and 2.6-fold more to fathers of a foreign origin. Incidence rates of alcoholic psychosis, chronic alcoholism and drug abuse increased 3.1- to 4.2-fold; and mortality associated with psycho-emotional stress (circulatory diseases, external causes of injury, digestive system diseases), 1.7- to 3.1-fold. Rates of mortality due to circulatory, respiratory and malignant neoplastic diseases were 1.6- to 2.7-fold lower than those in Russia in general. Such low mortality due to degenerative diseases was predetermined by the small percent of the elderly in the age structure (8.4%), which was 2.5-fold lower compared to Russia and developed countries. The public health status of the residents of Circumpolar areas was extremely sensitive to socioeconomic changes. The social crisis had a multifactorial effect on lifestyle, quality of life-supporting infrastructure, and particularly, on the medical care system, with highly negative hygienical implications.