Disparities in mortality rates within a country indicate social inequalities in population health across different regions. Initiatives aimed at reducing mortality have shown to effectively decrease preventable deaths and extend the lives of individuals with cardiovascular diseases; therefore, it is relevant to compare regions based on years of potential life lost (YPLL) due to premature preventable mortality.

The aim of the study was to compare YPLL for individuals who died from avoidable and unavoidable causes of cardiovascular diseases in Russian regions with different levels of available specialized medical care.

The results align with the hypothesis that regions with limited access to specialized medical care show higher rates of YPLL due to preventable cardiovascular disease deaths regardless of the morbidity, i.e., regional differences in mortality rates are highly related to social inequalities. To the greatest extent, premature preventable mortality from cardiovascular diseases is influenced by the availability of cardiology professionals.

The majority of cardiovascular deaths were avoidable. On the eve of the COVID-19 pandemic, YPLL were more than 27 years per 1,000 population among men and more than 9 years among women, accounting for 69.2% and 69.8% of total preventable YPLL for men and women, respectively.

Background. Senior citizens’ health, healthy aging, and active longevity have become at the top of the agenda while life expectancy is increasing. These issues are among the priorities for Moscow, as a metropolis with high levels of life expectancy in elderly age groups. Preventive healthcare is crucial to ensuring a good level of health and post-retirement activity among the older population.

Objective. To evaluate the preventive activity of seniors, i.e., undergoing periodical medical examination, in Moscow compared to the Russian Federation as a whole.

Materials and methods. The authors used the microdata sets from the study of the population’s health status conducted by the Federal State Statistics Service of the Russian Federation (ROSSTAT) using the representative sampling method in 2023.

Results. The commitment of elderly people to make regular health check-ups also depends on the behavioral risk factors. Respondents without a smoking habit, including non-smokers, former smokers, and those who have never smoked, take the most care of their own health: 60.3% and 63.8% of them underwent periodical medical examinations in Russia and Moscow, respectively.

Discussion. The elderly population shows insufficient activity in undergoing free periodical medical examinations. People aged 60-74 years are most committed to this type of preventive measure. Women take more care of their own health. The level of respondents’ responsibility for their own health increases with the level of respondents’ education.

During the coronavirus pandemic, there was a noticeable increase in mortality and a decline in life expectancy. Precise estimates of mortality depend, among other things, on the reliability of data on population size and the number of deaths. The goal was to identify changes in the level and trends of mortality of the Moscow population during the pandemic associated with changes in the estimate of the number and age composition of the Moscow population based on the results of the census. Between 2019 and 2021, life expectancy decreased by 0.8 years for men and 0.45 years for women compared to current estimates. Additionally, the age distribution shifted; there was a greater increase in mortality among men aged 30–60 and women aged 45–59. While the contribution of children remained relatively unchanged, the estimates of young adults (aged 15–29) and the elderly (aged 60–74) have decreased. As expected, higher mortality levels were mainly related to the coronavirus infection. However, excess mortality, especially in men, was associated with substance abuse. It was revealed that an extremely high contribution to the decline in life expectancy was related to the diseases of the nervous system. The estimates were comparable to the indicators of coronavirus infection in men and exceeded those in women.

Background. Body composition assessment plays an important role in characterizing physical development, monitoring health status, diagnosing nutritional disorders, and assessing disease risks.

Objective. To develop the criteria for assessing nutritional status in Moscow children and adolescents using bioimpedance analysis data.

Materials and methods. The research used data from a non-clinical, cross-sectional, observational study on the body composition of children and adolescents aged 5–17 in Moscow health centers from 2010 to 2019 by the method of bioimpedance analysis. A total of 115,200 persons were assessed, including 61,430 boys and 53,770 girls. Bioimpedance measurements were taken using bioimpedance analyzers according to a standard four-electrode assessment scheme in the supine position with disposable bioadhesive ECG-electrodes placed on the patient’s wrists and ankles. The relative fat mass (RFM) was assessed using the percentage of fat mass (%FM) and the fat mass index (FMI). The criteria for assessing RFM were the cut-offs of %FM and FMI calculated based on the centiles of BMI thresholds according to the IOTF ageand sex-specific criteria. Polynomial smoothing was then applied. In the same way, the criteria for assessing the relative fat-free mass (RFFM) were derived based on the cut-offs of the fat-free mass index (FFMI).

Findings. Diagnostic tables were designed to determine the RFM and RFFM in Moscow children and adolescents. The prevalence of normal weight obesity was assessed.

Conclusion. The study results can be used in clinical, preventive, or sports medicine to diagnose and correct nutritional status disorders as well as to monitor physical development.

Objective. To develop the criteria for assessing nutritional status in Moscow adults using bioimpedance analysis data.

Materials and methods. The research used data from a non-clinical, cross-sectional, observational study on the body composition of Moscow adults aged 18-96 in Moscow health centers between 2010 and 2019 by the method of bioimpedance analysis. A total of 340,814 persons were assessed, including 96,780 men and 244,034 women. Bioimpedance measurements were taken using bioimpedance analyzers according to a standard four-electrode assessment scheme in the supine position of patients with disposable bioadhesive ECG-electrodes. The relative fat mass (RFM) was assessed using the percentage of fat mass (%FM) and the fat mass index (FMI). The criteria for assessing RFM were the cut-offs of %FM and FMI calculated based on the centiles of BMI thresholds according to the IOTF ageand sex-specific criteria. Polynomial smoothing was then applied. In the same way, the criteria for assessing the relative fat-free mass (RFFM) were derived based on the cut-offs of the fat-free mass index (FFMI).

Results. Diagnostic tables were designed to determine the RFM and RFFM in Moscow adults. The prevalence of normal weight obesity was assessed.

Conclusion. In conjunction with the previously developed criteria for assessing the nutritional status of Moscow children and adolescents, the study results can be used in clinical, preventive, or sports medicine to diagnose and correct nutritional status disorders as well as to monitor physical development.

Background. Avoidable mortality serves as an integral indicator of healthcare system performance. The living conditions of Muscovites and the developments in Moscow healthcare have determined the highest life expectancy rates for the population of Moscow. However, the availability and quality of medical care as well as the prevalence of behavioral risk factors vary within the metropolis. Therefore, it is of great practical value to consider an uneven spatial distribution of avoidable mortality in order to implement corrective management actions.

Objective. To analyze the avoidable mortality of the population of Moscow by administrative okrugs and municipalities in 2023.

Materials and methods. The calculations were based on the list of avoidable causes of death from the "European Community Atlas of ‘Avoidable Death’" (the edition of 1997) for the age range 0-65 years. Data on mid-year population and number of deaths by municipality in 2023 were taken from the Moscow regional database "Death Registration" (RFS EMIAS) and then used to analyze an uneven spatial distribution of avoidable mortality.

Conclusions. There is a large reserve for reducing mortality not only by improving living conditions and strengthening adherence of the population to a healthy lifestyle, but also by improving availability and quality of medical care.

Background. Oncological diseases significantly contribute to the overall female mortality, so it is crucial to evaluate the reserves for reducing mortality from neoplasms in Moscow. Avoidable mortality includes the cases that could have been avoided with timely diagnostics, adequate treatment, and preventive measures.

Objective. To identify the main causes of death from neoplasms among the Moscow female population, which could be avoided by organizing medical care and introducing new technologies, methods, and educational programs.

Materials and methods. The authors used the official data of the Federal State Statistics Service of the Russian Federation (ROSSTAT) on deaths by causes of death according to several nosological entities and the ICD-10 chapter for neoplasms, all of which were defined as the initial causes of death in women in general and in certain age female groups in particular.

Results. Despite the overall decrease in cancer mortality, malignant neoplasms remain the second leading cause of death. Currently, a steady trend of reducing avoidable mortality has been observed in Moscow. In 2022, malignant neoplasms mostly contributed to the avoidable cancer mortality in the Moscow female population (0-85 years): breast (C50) – 16.7%; colon (C18) – 11.3%; pancreas (C25) – 9.0%; stomach (C16) – 7.5%; trachea, bronchus and lung (C33-C34) – 7.1%; rectum (C20) – 4.9%.

Conclusion. The analysis of the structure of cancer mortality in the Moscow female population showed that malignant neoplasms of reproductive system contributed the most. Thus, it is critical to analyze the reserves based on avoidable deaths from neoplasms among women in Moscow and then to develop targeted measures for improving the health of citizens and reducing the mortality rate in Moscow.

Background. Maternal mortality is a key indicator characterizing the status of the healthcare system and the social well-being of the population. Most of the countries, especially developing countries, still face the problem of maternal mortality. Maternal age at birth is one of the main factors affecting maternal mortality. The studies show that women under 20 and over 35 are at high risk of pregnancy and delivery complications. During the past decades, the changes in social, economic, and cultural settings have resulted in an increase of the average maternal age in many countries, including Russia.

Objective. To analyze maternal mortality in the context of the aging maternal age structure using the case of Moscow.

Material and methods. The research used the official data from the Federal State Statistics Service of the Russian Federation (Rosstat).

Results. The study investigated the correlation between changes in the age structure of women at birth and maternal mortality dynamics. The majority of maternal deaths is observed in women aged 30–40, especially in the 30-34 age group. The study confirmed the global trend towards an increasing age of first-time mothers. The aging of maternal age structure presents challenges for healthcare. The study results could be used to develop effective measures for reducing maternal mortality in the context of the aging maternal age structure.

Background. Moscow managed to overcome the challenges of the COVID-19 pandemic by increasing the efforts of the healthcare system and maintaining the birth rate. As a result, the population growth in Moscow remained steady. Like any metropolis, Moscow faces the issue of an aging population, largely due to increased life expectancy, which presents significant challenges for sustainable societal development.

Objective. To evaluate the size, composition, and structure of the Moscow population before and after the COVID-19 pandemic.

Materials and methods. The authors used the official population data from the Federal State Statistics Service of the Russian Federation (ROSSTAT) and demographic information from the Moscow and Moscow Oblast offices of ROSSTAT (MOSSTAT), focusing on age and gender distributions across municipal areas. The results were visually represented using cartographic tools from the Integrated Data Warehouse of the Information and Analytical System for Comprehensive Development Monitoring in Moscow.

Results. In 2021, Moscow's population experienced a decline primarily due to the significant negative effects of the COVID-19 pandemic. However, the number of residents began to increase again afterward. The Moscow population reduced only in 2021 due to the tremendous, negative impact of the COVID-19 pandemic, then the growth in the number of residents recovered. The analysis of the Moscow population pyramid demonstrated a substantial shift towards the older generations. On average, the population of Moscow is two years older than that of the Russian Federation as a whole.

Discussion. The demographic landscape of Moscow underwent substantial changes during the pandemic due to complex dynamics in demographic processes. High rates of morbidity and mortality from COVID-19 led to a temporary decrease in the Moscow population and altered natural population movement indicators.

Conclusion. Studying the impact of the COVID-19 pandemic on the population size and structure helps to forecast long-term consequences for health and the demographic situation in Moscow. This understanding is essential for developing the relevant improvement programs.

Background. Obesity and associated diseases could substantially affect life expectancy by increasing the risks of premature mortality.

Objective. To evaluate the changes in the age and sex distribution of adult mortality from obesity-associated causes in Moscow from 2011 to 2020 in comparison to the average national indicators.

Materials and methods. The analysis focused on standardized death rates among the adult population, categorized by sex and age groups (aged 20–54, aged 55–59, aged 60 and older).

Results. In Moscow, mortality from atherosclerotic cardiovascular disease significantly reduced, especially in persons aged 20–54. The reduction in mortality rate from cerebral infarction was higher in Moscow, especially in individuals aged 55 and older, across both sexes. Conversely, the incidence of ischemic heart disease mortality in Moscow has risen. The study showed an increase in mortality from endocrine diseases, including type 2 diabetes, which may be partly explained by the revised guidelines for coding primary causes of death. In addition, the dynamic in Moscow was more favorable. The mortality rates from malignant neoplasms in Moscow were 8% lower than in Russia, and mortality trends were rather favorable, both in Moscow and Russia. However, mortality rates and trends vary significantly depending on the type of malignancy.

Conclusions. A favorable trend was observed in mortality from obesity-associated diseases, such as acute cerebrovascular accident (cerebral infarction) and some malignant neoplasms (colorectal cancer and breast cancer in women). The negative trends in mortality from such chronic diseases as ischemic heart disease and type 2 diabetes were observed. Men aged 55–59 have been identified as a risk group for these negative trends. Therefore, it is necessary to expand the preventive measures targeting these at-risk groups.

Background. As a separate constituent entity of the Russian Federation, Moscow is characterized by significant heterogeneity of the population and its determinants of health, largely due to socioeconomic factors, the most important of which is the educational status of the population. Considering that the main contribution to the trends in life expectancy is made by the workingage population, the purpose of the study is to analyze the difference in the level of education of certain age groups in the districts and municipalities of Moscow. The data was obtained from the Population Census 2021. The highest educational qualification is observed in the Central and Western parts of Moscow, including the recently incorporated Novomoskovskiy Administrative Okrug (administrative district), while the residents of the Southern, Zelenogradskiy, and Troitskiy Administrative Okrugs have the lowest educational qualification. At the same time, there is a mixed education trend: on the one hand, the centripetal force in educational qualification is prevalent (the closer the center, the higher the educational qualification); on the other hand, dispersed settlement is being formed. As a result, the highest qualification levels are observed in remote areas of the capital, while the lowest are shifting to the center. From a social point of view, special attention should be paid to territories with the maximum share of both highly and poorly educated populations, especially considering the similar situation in the Central Administrative Okrug.

Background. The increasing life expectancy of the population of Russia and its regions is high on the agenda. Numerous studies have investigated population losses at the national level; however, such an approach hasn’t enabled to identify region-specific features.

Objective. To identify the commonality and specificity of health issues in the population of Moscow and Moscow Oblast in the 2000s.

Materials and methods. The research used data from the Federal State Statistics Service of the Russian Federation (Rosstat) on the mortality of the population of Moscow and Moscow Oblast from leading causes in the 2000s, including the 2019–2022 COVID-19 pandemic period.

Results. In the 2000s, steady positive trends in life expectancy due to all the leading causes of death were observed both in Moscow and Moscow Oblast. At the same time, divergent mortality trends in Moscow and Moscow Oblast were noted for only one cause, i.e., gastrointestinal diseases: the mortality rates decreased among the population of Moscow and increased among the population of Moscow Oblast. The increasing mortality from socially important causes of death (such as infectious diseases) among the female population along with the decreasing losses in the male population were a common problem for both Moscow and Moscow Oblast.

Introduction. The socio-demographic status of residents is a significant factor for differentiating territories by the public health level at the national, regional, and municipal levels. To develop and implement measures aimed at improving population health, it is advisable to consider the social and demographic structure of municipalities. This should be followed by typological classification and clustering according to the level of development and demographic potential as part of the execution of the state assignment of Moscow Healthcare Department (Reg. No. NIOKTR 123032100064-0).

Purpose. To conduct a review of socio-demographic indicators used in international practice for further formation of a socio-demographic profile of districts and municipalities of Moscow based on Census data.

Materials and methods. Content analysis was conducted on international and Russian scientific publications accessible through international databases such as Web of Science, Scopus, Google Scholar, ResearchGate, eLibrary, and CyberLeninka. The units of analysis were the queries “socio-demographic indicators” and “municipal” with “public health” as an adjustment.

Results. The most frequently used indicators were identified. In almost all the studies, income level and education were mentioned; employment status (including the unemployment rate) was studied slightly less frequently; age distribution of the population was ranked 4th, followed by social class and social cohesion; living conditions and behavioral factors were presented only in 2 of 13 studies.

Conclusions. Based on a review of international experience and Russian research, it seems appropriate to use the following indicators to form a socio-demographic profile of administrative districts and municipalities of Moscow based on Census data: population size, age, and sex composition (especially the ratio of children to the elderly), components of natural population change (birth rate, mortality), education, income and source of livelihood, employment status, living conditions, and other indicators.