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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">zdme</journal-id><journal-title-group><journal-title xml:lang="ru">Здоровье мегаполиса</journal-title><trans-title-group xml:lang="en"><trans-title>City Healthcare</trans-title></trans-title-group></journal-title-group><issn pub-type="epub">2713-2617</issn><publisher><publisher-name>ГБУ «НИИОЗММ ДЗМ»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47619/2713-2617.zm.2022.v.3i3;67-76</article-id><article-id custom-type="elpub" pub-id-type="custom">zdme-43</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Медико-социальные аспекты безопасности здоровья в формировании общественного здравоохранения</article-title><trans-title-group xml:lang="en"><trans-title>Medical and social aspects of health security in the formation of public health</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9856-8643</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ойноткинова</surname><given-names>О. Ш.</given-names></name><name name-style="western" xml:lang="en"><surname>Oynotkinova</surname><given-names>O. Sh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ойноткинова Ольга Шонкоровна – д. м. н., профессор кафедры терапии факультета фундаментальной медицины</p><p>Scopus Author ID: 33156677</p><p>115088, г. Москва, ул. Шарикоподшипниковская, д. 9;</p><p>119192, г. Москва, Ломоносовский пр., д. 27, корп. 1</p><p>117997, Россия, г. Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>Olga Sh. Oynotkinova MD, PhD, Professor, Department of Therapy, Faculty of Fundamental Medicine</p><p>115088, 9 Sharikopodshipnikovskaya st., Moscow;</p><p>117192, 31–5 Lomonosovsky avenue, Moscow;</p><p>117997, 1 Ostrovityanova st., Moscow</p></bio><email xlink:type="simple">olga-oynotkinova@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7825-5597</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ларина</surname><given-names>В. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Larina</surname><given-names>V. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ларина Вера Николаевна ‒ д. м. н., профессор кафедры поликлинической терапии лечебного факультета</p><p>117997, г. Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>Vera N. Larina ‒ MD, PhD, Professor, Department of Polyclinic Therapy of the Faculty of Medicine</p><p>117997, 1 Ostrovityanova st., Moscow</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГБУ «Научно-исследовательский институт организации здравоохранения и медицинского менеджмента Департамента здравоохранения города Москвы»;&#13;
Факультет фундаментальной медицины МГУ им. М. В. Ломоносова;&#13;
ФГАОУ ВПО «Национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России</institution></aff><aff xml:lang="en"><institution>State Budgetary Institution “Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department”;&#13;
Faculty of Fundamental Medicine, Lomonosov Moscow State University;&#13;
FGB HPE “National Research Medical University named after N. I. Pirogov” of the Ministry of Health of Russia</institution></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГАОУ ВПО «Национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России</institution></aff><aff xml:lang="en"><institution>FGB HPE “National Research Medical University named after N. I. Pirogov” of the Ministry of Health of Russia</institution></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>23</day><month>10</month><year>2022</year></pub-date><volume>3</volume><issue>3</issue><fpage>67</fpage><lpage>76</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Ойноткинова О.Ш., Ларина В.Н., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Ойноткинова О.Ш., Ларина В.Н.</copyright-holder><copyright-holder xml:lang="en">Oynotkinova O.S., Larina V.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.city-healthcare.com/jour/article/view/43">https://www.city-healthcare.com/jour/article/view/43</self-uri><abstract><p>Введение. Мониторинг состояния здоровья населения в целом, оценка и анализ ведущих детерминант здоровья, включающих генетические, поведенческие, антропогенные, биофизиологические факторы, представляют одну из глобальных функций общественного здравоохранения, ориентированного на охрану здоровья и предоставление медицинских услуг. На сегодняшний день нарушения здоровья прежде всего связаны с образом жизни и всегда являются совокупностью индивидуальных персонифицированных данных о состоянии здоровья. Нездоровое питание и низкая физическая активность являются факторами риска развития целого ряда хронических неинфекционных заболеваний, и прежде всего сердечно-сосудистых, метаболических, в частности сахарного диабета 2 типа, и некоторых видов рака. Эти факторы риска приводят к ранней инвалидизации, снижению качества и продолжительности жизни людей, потере трудоспособности, влияют на бюджет здравоохранения и экономику. Так, если на программы профилактики заболеваний в среднем затрачивается лишь 3 % от бюджета здравоохранения, то на лечение ожирения – около 7 % бюджета в странах Европейского союза, что оборачивается 2,8 % мирового ВВП. В этой связи проведение ранних профилактических мероприятий характеризуется благоприятными и положительными результатами.Цель. Проанализировать роль нездорового питания и низкой физической активности как ключевых факторов риска кардиоваскулярных и метаболических заболеваний, особенно в популяции больных с сахарным диабетом 2 типа.Материалы и методы. Характеристика представленных исследований, включенных в статью, охватывает международный опыт и анализ проведенного пилотного исследования на популяционной выборке больных с сахарным диабетом 2 типа. Для оценки экономических затрат, связанных с нездоровым питанием и низкой физической активностью, применяли общий подход, основанный на анализе отдельных заболеваний, в частности сахарного диабета 2 типа, с использованием популяционных атрибутивных фракций, метода регрессии.Результаты. На основании полученных данных следует, что у пациентов с нездоровым питанием и низкой физической активностью, отягощенных избыточной массой тела или ожирением, высок пятилетний риск развития новых случаев сахарного диабета 2 типа и кардиоваскулярных осложнений. Это включает раннюю инвалидизацию и экономические затраты на оказание медицинской помощи. Данное исследование ориентировано на то, чтобы на примере ряда европейских стран и на собственных результатах оценить тот экономический ущерб, который связан с нездоровым питанием и низкой физической активностью среди населения независимо от региона проживания и мегаполиса.</p></abstract><trans-abstract xml:lang="en"><p>Introduction. Monitoring of the health status of the population as a whole, assessment and analysis of the leading determinants of health, including genetic, behavioral, anthropogenic, biophysiological factors, represent one of the global functions of public health, focused on health protection and provision of medical services. To date, health disorders are primarily related to lifestyle and are always a collection of individual personalized health data. Unhealthy diet and low physical activity are risk factors for the development of a number of chronic non-communicable diseases, primarily cardiovascular, metabolic, in particular type 2 diabetes mellitus and some types of cancer. These risk factors lead to early disability, a decrease in the quality and life expectancy of people, disability, as well as the health budget and the economy. So, if on average only 3 % of the health budget is spent on disease prevention programs, then about 7 % of the budget in the EU countries is spent on the treatment of obesity and turns into 2.8 % of world GDP. In this regard, the implementation of early preventive measures is characterized by favorable and positive results.Purpose. Analyzes the role of unhealthy diet and low physical activity as key risk factors for cardiovascular and metabolic diseases, especially in the population of patients with type 2 diabetes mellitus.Methods and materials. The characteristics of the presented studies included in the article cover international experience and analysis of the pilot study conducted on a population sample of patients with type 2 diabetes mellitus. To assess the economic costs associated with unhealthy diet and low physical activity, a general approach was used based on the analysis of individual diseases, in particular, type 2 diabetes mellitus, using population attributive fractions, regression method.Results. Based on the data obtained, it follows that patients with an unhealthy diet and low physical activity, burdened with overweight or obesity, have a high five-year risk of developing new cases of type 2 diabetes and cardiovascular complications. This includes early disability and the economic costs of providing medical care. Using the example of a number of European countries and its own results, this study is focused on assessing the economic damage that is associated with unhealthy diet and low physical activity among the population, regardless of the region of residence and the metropolis.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>общественное здравоохранение</kwd><kwd>сахарный диабет 2 типа</kwd><kwd>сердечно-сосудистые заболевания</kwd><kwd>ишемическая болезнь сердца</kwd><kwd>нездоровое питание</kwd><kwd>низкая физическая активность</kwd></kwd-group><kwd-group xml:lang="en"><kwd>public health</kwd><kwd>type 2 diabetes</kwd><kwd>cardiovascular disease</kwd><kwd>coronary artery disease</kwd><kwd>unhealthy diet</kwd><kwd>physical inactivity</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">World Health Organization (WHO) (2012a) Regional Office for Europe. 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