Introduction
The Russian Federation is the largest country in the world, yet it is still considered a developing nation. Russia managed to separate from the Soviet Union in the 1990s in hopes of a better future for the country and its citizens. In 1993, under the Russian Constitution, the right to free health care was guaranteed to every Russian citizen. Thus far, the healthcare system in Russia is subpar and even described with such words as “grim” and “bleak.” Health care facilities are lacking, resources are limited, and public health is not a priority to Russian Citizens. The mortality rate for young Russian men are astronomical, and alcoholism, tobacco usage, and HIV/AIDS are preventing Russians from living health and disease-free lives.
A current shift towards health promotion and prevention of not transmissible diseases is on the rise in Russia. The problems have been identified by health care officials, and now it is up to the government and health and wellness stakeholders to provide the necessary resources to Russian Citizens. It should be noted that there are chronic health concerns within the Russian Federation and an assessment of public health and its promotion within Russia (“Russian City Offers Health Pursuits for All Ages,” 2013). In addition, one needs to assess fundamental healthcare principles and how self-care is perceived in Russia (Tolpygina et al., 2018). It is also critical to understand how Russia’s healthcare system is impacted by investments and the local economy (Tokun, 2016). Therefore, several key factors lead to major Russian healthcare issues, such as chronic diseases, poor lifestyle habits, and lack of health promotion.
Impact on Vulnerable Population
The healthcare system of the Russian Federation is not developed enough to be able to provide fully covered care for its vulnerable population. It is stated that there is an issue of representation of children, which results in higher instances of complications (Bovina et al., 2018). Another study suggests that there is a wide range of problems in health provision for children, where socioeconomic factors play an essential role (Kononova, 2016). The primary causes of childhood disability are mental disorders, diseases of the nervous system, congenital malformations, and somatic diseases. The formation of disability as a result of a severe course of somatic pathology occurs mainly by the age of 10-12, and as a result of mental disorders – by the age of 14-15 (Kononova, 2016). The outcome of chronic disease into disability is most often associated with an insufficient level of preventive work with a healthy child, health-improving, and with children suffering from a chronic pathology– rehabilitation work. Not enough attention is paid to the rehabilitation treatment of children with an established disability, but with high rehabilitation potential.
The aging process of the population in Russia requires the state to pay more attention to its social protection. The formation of social and medical stability of the elderly, and its development, and management has become an objective necessity of the nation. The system of social and medical work with the elderly has already been established in the country. However, despite certain successes, it can be concluded that the previous forms and methods of social and medical work with elderly citizens are not always effective. It is necessary to solve social and medical problems by further improving the social and medical practice with the elderly, and this requires an analysis of the current state of the ego type of activity. The organization of social and medical work at the regional level is of great importance.
Low income is one of the main factors, and the rise in food prices leads to a deterioration in the diet of the elderly. The pensioner is experiencing difficulties in purchasing essential goods, and spending on social and cultural needs is decreasing. All of this hurts the health of older people. Loneliness for many older adults is an important problem, characterized by a low level of social contact, estrangement, and emotional detachment. The main reasons for loneliness in mature and old age are long-term illness, inability to adapt to constantly changing external conditions, death of loved ones, spouse, and relatives.
Women’s Health and Maternal Child Health
Women belong to the part of the population that most sensitively reacts to all changes in the social, economic, and social life of the country. They especially respond to changes related to the state of their health, reproductive behavior, and the quality of their children’s health. The state of health of a woman is a marker that shows the state of health of a society at a certain moment and determines it for the distant future. Of women and maternal health, Russian healthcare possesses certain risk factors. It is stated that preterm birth is one of the central issues in this regard, where induced and spontaneous abortions are identified as the main catalyzers (Usynina et al., 2016). However, the current measures of the Russian Federation’s healthcare system involve a three-level system, which includes intensive care during pregnancy, childbirth, and the postpartum period (Shuvalova et al., 2015). The overall morbidity picture becomes especially alarming when analyzing the health of the most reproductively active part of the female population, such as pregnant women. Their health status directly determines the health status of their children.
The history of modern women entering pregnancy is already burdened by various genital diseases. Over the past decade, the proportion of such women among pregnant women has increased significantly. The most common, severe illnesses, and complications of pregnancy are anemia, kidney disease, circulatory system, late gestation (Shuvalova et al., 2015). The issues of prenatal health deserve serious attention because the intrauterine or prenatal period takes up an insignificant period of time in the total life span of a person. However, it is during this period that human health and ill-health are formed, and not only at the organismic level, but also the health of subsequent generations is determined.
Disease Management of Communicable and Non-Communicable Diseases
The Russian healthcare system is not lagging behind regarding communicable diseases. However, there is a major issue in terms of non-communicable ones, where chronic issues are the most prominent. It is stated that, currently, almost 40% of all Russian citizens live with multi-morbidity due to chronic conditions (Kaneva et al., 2018). Insufficient resource provision of Russian healthcare is exacerbated by ineffective management. It manifests itself in the fact that the industry does not highlight priorities. There is a contradictory regulatory framework, the regulatory requirements themselves are often not provided with the necessary resources. Moreover, statistical data are conflicting or closed, an objective, systematic analysis of activities is not carried out, as a result, the right decisions are not made. Thus, the requirements of mandatory procedures are not coordinated with the methodological documents.
The costs of chronic illness can be reduced or moved later in life through prevention. Quantifying the risk factors that determine the development of chronic diseases is the key to understanding how to build prevention of pathology. The structure of prevention should include three main components, such as primary, secondary, and tertiary prevention. Primary prevention is carried out before the development of the disease, and secondary prevention is aimed at those who have the first symptoms or conditions that are former to the development of the disease. Tertiary prevention is aimed at those who already have the disease, where the goal is to reduce disability, the frequency of exacerbations, and complications. The means of preventing most chronic diseases range from interventions for individuals or families, initiatives for health workers, and organizational change.
The requirements of standards of medical care and procedures for its provision are often not provided with resources, and, accordingly, are not feasible. At the same time, numerous inspections of control and supervisory bodies are carried out for compliance with the requirements of procedures and standards, but the effectiveness of these inspections is questionable. Moreover, the restrictions themselves and the criteria for the checks are multiplying. Therefore, it is critical to follow the priority directions for actions to protect the health of the population of the Russian Federation by slowing the occurrence rate of chronic diseases. In the coming years, these should be the protection of the health of Russian men of working age, Russian children, and adolescents, as well as the elimination of differences in the health status of urban and rural residents.
The Theory and Practice of Health Promotion
The Russian healthcare system lacks strong structural integration for health promotion and in both theory and practice. The urgency of solving this problem continues to remain high due to the fact that, despite some positive trends, health indicators, and the state of health care, in general, are at an unsatisfactory level. The hard conditions for the social and economic development of the country displayed themselves, especially, in extremely high rates of morbidity and mortality. There are also low birth rates, the state of health of mothers and children, the quality of nutrition, especially of the unprotected segments of the population, and deepening social differentiation.
The special significance of health promotion programs lies in the fact that socially dependent and professionally determined health defects of the population have been progressing in the last decade. After diseases of the circulatory system, accidents, poisoning, and injuries became the second cause of death in the structure. For many years, the general tendencies in mortality of the population of Russia have been determined by the situation with the high mortality of people of working age. Every year, the overall proportion of neurotic and mental disorders in the structure of morbidity increases. One of the effective ways out of this situation is to increase the health potential of healthy people. Secondly, there is the return of health to patients, patients outside the stage of exacerbation, persons in a state of pre-illness, due to the system of methods of restorative medicine.
The key problem for all areas of health protection is the formation of a culture of health, increasing the prestige of health, self-awareness of the value of health as a factor of resilience, active longevity. The highest priority is to increase the level of psychophysical health, maintain optimal performance, quality of life of the population, and the individual’s achievement of a genetically determined life expectancy. This will ultimately provide the need for a healthier lifestyle and the cultural, social, and economic motive for maintaining and promoting health. It is important to take into account the current situation associated with the deterioration of the basic parameters of the population’s health, the low level of influence on it by the activities of medical institutions. The main and important priorities should be the availability of measures for the rapid assessment of the health status and health improvement of the population, regardless of social status. In addition, it is important to focus on a quantitative evaluation of the body’s reserve capabilities and their correction for the person to realize the health potential.
Behavioral and Lifestyle Factors That Affect Health and Illness
In terms of behavioral and lifestyle factors, there is tobacco smoking and alcohol drinking affect health. It is stated that the overall drinking of homemade alcoholic beverages in Russia significantly contributes to morbidity and risk (Radaev, 2016). In order for the Russian healthcare system to properly handle the issue, it requires the implementation of two key strategic directions. First of all, it is important to reduce the consumption of alcohol and tobacco among the population. The application of this direction should become the area of responsibility of the heads of regions and municipalities. To do this, it is necessary to urgently start developing and implementing national, regional, and municipal comprehensive interdepartmental programs to reduce the prevalence of alcohol and tobacco consumption, especially among young people.
Secondly, it is critically important to enhance free medical care and its availability. This is the area of responsibility of the Minister of Health of the Russian Federation and the regional health authorities. In this case, priorities are also important, because it may not be possible to develop everything at the same time due to the lack of resources. Employers as well ought to participate in the implementation of this approach.
Comparison with the US
There are a number of factors that make Russia vastly different from the US, such as politics, culture, wealth, history, and environmental factors. It is stated that corruption is a major issue in Russia, and it has a significant effect on the local healthcare system (Schulze et al., 2016). The lack of political representation of the public and the absence of health-promoting culture alongside the low median income of Russian households results in the fact that providing free state-run healthcare is paramount. Therefore, there is no market force to improve the healthcare system because it is highly regulated.
Conclusion
In conclusion, the healthcare system of the Russian Federation is not as developed as it should be due to low funding and poor infrastructure. One of the most vulnerable members of society suffers from preventable issues, whereas the majority of the population suffers from chronic diseases. Although there are some attempts to promote health, the current system is weak due to the system’s inherent inefficiency. In contrast with the US, Russian healthcare does not benefit from market forces and lacks sufficient funding.
References
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