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Law concept of socially significant diseases. On approval of the list of socially significant diseases and the list of diseases that pose a danger to others

Socially significant diseases are caused primarily by socio-economic conditions, cause harm to society and require social protection person.

The social health of an individual is related to his/her living environment. By interacting with living space, a person is included in its structure, spatial arrangement, which, in turn, shapes a person’s social health. Since a person is constantly in the living space, stereotypical patterns of behavior arise and are identified, increasing the risk of this type of disease. Despite the fact that with age, both the structural and content of the living space changes, behavior patterns, the level of awareness on various aspects of life, and the characteristics of the living environment often determine the activity of the subject, regardless of mental and social development.

The state of health of the population is a clear and objective evidence of the level of civilization of the state. It is of great socio-economic importance - as a criterion of a person’s ability to adapt to conditions environment. Changed pattern of growth general level morbidity is in a close causal relationship with shifts in demographic processes, which in economically developed countries are characterized by a trend towards decreasing birth rates, relative stabilization of general and child mortality levels and high average life expectancy.

Of particular importance in clinical medicine have acquired problems of spreading among the population of the country coronary disease heart (including myocardial infarction), hypertension and vascular lesions of the brain, which on average account for more than 80% of all deaths from cardiovascular diseases. The incidence of vascular disorders of the brain (cerebrovascular diseases, including stroke) due to arterial hypertension is 5776 cases per 100 thousand population, and mortality from vascular disorders of the brain (cerebrovascular diseases, including stroke) due to arterial hypertension is 325 cases per 100 thousand population. Factors that increase the risk of their occurrence ( nervous tension, insufficient physical activity, poor nutrition, alcohol and tobacco abuse), indicate the social conditioning of the causes of these diseases.

One of the most pressing problems of clinical and social medicine is malignant neoplasms. Mortality from them in most economically developed countries (USA, Japan, Germany, etc.) has increased 2-3 times over the past 70 years. Every year, about 5 million people die from cancer around the world. The proportion of patients with visual localizations of malignant neoplasms detected at stages I and II of the disease in the total number of patients with visual localizations of the tumor is 67.6 percent, the proportion of those who died from malignant neoplasms within a year from the date of diagnosis among patients registered for the first time in the previous year - 31.6 percent, mortality from malignant neoplasms per 100 thousand population is 233.1 cases for men, 170.3 cases for women.

In economically developed countries, especially dangerous epidemic diseases have been eliminated, and the incidence of childhood infections has decreased. At the same time, the fight against tuberculosis, influenza, viral hepatitis, AIDS and others viral diseases remains very actual problem. It is these diseases that are associated high level morbidity of the population and causing enormous damage to the health of citizens and the economy of the state.

Tuberculosis incidence in correctional institutions Federal service execution of punishments is currently 1515 cases per 100 thousand people, mortality is 153.4 cases per 100 thousand people, the proportion of cases of cessation of bacterial excretion is 73.5 percent, mortality from tuberculosis is 22.6 cases per 100 thousand population.

The number of newly registered cases of HIV infection reached 37.7 thousand cases, in correctional institutions of the Federal Penitentiary Service - 2 thousand cases, the share of HIV-infected pregnant women included in the program for the prevention of HIV infection in newborns was 75 percent.

The incidence of syphilis is 72 cases per 100 thousand population, in correctional institutions of the Federal Penitentiary Service - 176.6 cases per 100 thousand people, the incidence of syphilis in children is 21.2 cases, gonorrhea - 23.4 cases per 100 thousand children. . At the same time, the share of specialized medical institutions monitoring the variability of sexually transmitted infections in the total number of dermatovenerological institutions is 15 percent. The total number of adolescent specialized centers for the prevention and treatment of sexually transmitted infections does not exceed 12 in the country as a whole.

The incidence of acute viral hepatitis B and C is currently 8.6 and 4.5 cases per 100 thousand population, respectively, chronic viral hepatitis B and C - 51.4 cases per 100 thousand population.

An important problem of our time is the increase in the number of neuropsychiatric disorders, which in a number of countries is called the number one problem. In the USA, Germany and other economically developed countries, on average at least 10% of the population suffers from various neuropsychiatric disorders. Among them, the first place is occupied by alcoholism and drug addiction. Proportion of patients covered by team forms of care psychiatric care, in the total number of observed patients is 5 percent, the proportion of patients in need of inpatient psychiatric care in the total number of observed patients is 16 percent. At the same time, the average duration of treatment of a patient in a psychiatric hospital is 75.6 days, and the proportion of repeated hospitalizations during the year in psychiatric hospital- 20 per cent.

The rate of complications in diabetes mellitus is currently 35 percent. Limb amputations were performed in 1 percent of patients. In total, for the first time during the year, 38.6 thousand people were recognized as disabled due to diabetes.

Also one of the most pressing issues modern life society is the problem of combating injuries.

The problem of protecting and improving the environment, the pollution of which has a negative impact on human health and can cause genetic damage to the body, has acquired particular social significance.

There is a general aging of the population, i.e. increase in society specific gravity persons 60 years of age and older (in the above countries - up to 20%). The problem of demographic aging of the population affects the entire society and has become particularly relevant at the end of the 20th and beginning of the 21st centuries.

Wanted significant effort the entire human community to maintain the proper level of life of elderly and old people in conditions of socio-economic upheavals and a deteriorating environmental situation.

The rapid increase in the relative size of the elderly population in most countries of the world makes it untenable traditional attitude to the problem of aging. Active aging is necessary not only for the person himself, but is also useful for society as a whole, since it allows for more complete use of the production experience of older generations and contributes to a more favorable moral and ethical climate for each individual nation and humanity.

The degree of their participation in the industrial and socially useful life of the country depends on the preservation of their personal health by older people. This circumstance makes it especially topical issues widespread introduction of preventive and health measures at earlier stages of aging. There is an urgent need to develop new forms and methods of medical and social services to the population.

Thus, socially significant diseases include those that a) arise and develop as a result of unsatisfactory social and living conditions of people (tuberculosis, alcoholism, drug addiction, vitamin deficiencies, malnutrition diseases, some occupational diseases, gastrointestinal infectious diseases, etc.), b) are widespread and are the main cause of mortality of the population (cardiovascular and oncological diseases, injuries, infectious diseases, etc.), c) pose a danger to others (sexually transmitted diseases, acute mental disorders and etc.).

: methodological manual for students of the Faculty of Physical Education / A.V. Shelegina, I.L. Levina; State Educational Institution of Higher Professional Education "Kuzbass State Pedagogical Academy", Department of Technical and Physical Education and Physical Education - Novokuznetsk, 2011 -114p.

Toolkit “Fundamentals of preventing the spread of socially significant diseases among adolescents” intended for students of the Faculty of Physical Education studying the discipline of specialization “Fundamentals of health work in educational institution"The manual contains theoretical material necessary for a future specialist, professional activity which is aimed at organizing preventive work in an educational institution

Introduction

According to the Ministry of Health, the epidemiological situation in Russia is becoming increasingly tense. Economic and social instability in society entails an inexorable increase in the number of diseases that are called socially significant. Diseases of this group pose a significant threat to public health, causing enormous damage to society associated with the loss of temporary and permanent ability to work, the need for huge costs for prevention, treatment and rehabilitation, premature mortality, and crime.

Statistics show that socially significant diseases have become widespread among adolescents. Young people are the most vulnerable group of the population, which is quickly involved in the epidemic process. The reasons for the increase in socially significant diseases among adolescents are considered to be social maladaptation, low level of hygienic knowledge, environmental conditions and early onset of sexual activity. [Korchagina G.A. et al., 2004; Ramazanov R.S., 2005; Suslin S.A., Galkin R.A., 2006].

Solving the problem of the spread of socially significant diseases among adolescents is associated with the organization of primary prevention in educational institutions. The essence of preventive work is to expand the understanding of teenage schoolchildren in this area, the formation of health-saving behavior strategies in risk situations associated with the possibility of infection and the onset of the development of the disease.

The methodological manual “Basics of preventing the spread of socially significant diseases in adolescents” is intended for training specialists in organizing preventive work in an educational institution. The manual contains detailed theoretical material about socially significant diseases, their characteristics, methods of prevention, etc. Electronic version The manual contains a visual and illustrative block. In addition, developed for methodological manual workbook, will help to structure knowledge and check the quality of assimilation of theoretical material.

Socially significant diseases

The concept of “socially significant diseases”. Society and socially significant diseases. Human responsibility in the spread of socially significant diseases . Classification and main characteristics of diseases.

What is meant by socially significant diseases? An elementary analysis of the phrase “socially significant” shows that diseases of this group have great importance for society, pose a threat to a large number of people. Turning to literary sources allows us to assert that the concept of socially significant diseases includes a number of diseases that pose the greatest threat to the well-being of the country's population. The main features included in the concept socially significant disease This:

· the widespread nature of the disease, that is, a high percentage of the spread of the disease among the population, including the presence of a significant percentage of “hidden” patients in society,

· high rates of annual growth in the number of patients; diseases of this group tend to spread quite quickly,

· restriction of the patient’s full functioning in society in the presence of such a disease,

· danger of disease for others,

· infectious and non-infectious nature.

In addition, diseases belonging to this category not only destroy the health and body of a person, but also carry with them negative social consequences: loss of family, friends, work, means of subsistence, etc. A characteristic feature of such diseases is that they mostly claim the lives of young people and people of working age. Important feature socially significant diseases is that if you know how not to get sick and follow certain rules, then the disease can be prevented or stopped by early stage diseases.

The situation with the spread of diseases of this group has become so acute that it is causing concern at the government level Russian Federation. Epidemiological observations served as the basis for compiling a list of socially significant diseases. In accordance with Article No. 41 of the Fundamentals of Legislation of the Russian Federation on the protection of the health of citizens, the Government of the Russian Federation approved a list of diseases classified as socially significant. (Resolution No. 715 of December 1, 2004 “On approval of the list of socially significant diseases and the list of diseases that pose a danger to others”). This list includes: disease caused by the human immunodeficiency virus (HIV), tuberculosis, hepatitis, sexually transmitted infections, diabetes, malignant neoplasms, mental disorders and behavioral disorders, diseases characterized by increased blood pressure.

According to statistics, society shifts responsibility for health onto the shoulders of the state, medicine, schools, and anyone else but itself. On the healthcare side, certain preventive actions, but their volume and effectiveness directly depend on the desire of the population to live in a society that is healthy in body and soul. Very often, people do not realize the magnitude of their health reserves and waste it, forgetting that it is easy to lose, but difficult to restore, and sometimes, in the case of socially significant diseases, impossible. At the same time, every person has the power to protect themselves and their loved ones. To do this, it is necessary to have basic hygienic knowledge regarding the prevention of socially significant diseases. In addition, due to the specific nature of diseases, a person interested in his own well-being must understand that his health largely depends on the health of his environment. Therefore, one of the most important activities federal program to combat socially significant diseases is to increase the level of knowledge about the existing epidemiological situation, disseminate hygienic knowledge about the prevention of these diseases. “A society that has a significant amount of information about these diseases, about preventive measures and effective ways treatment, can be of great help in the fight against socially significant diseases"

All this will contribute to a decrease in social significance, i.e. achieving a state of affairs regarding a disease in which the existence of a certain disease in the country ceases to have socially significant consequences.

Today, the incidence rate is so high that, in the opinion of many epidemiologists, sociologists, hygienists, etc., in order to reduce the social significance of diseases of this group, in addition to all of the above, it is necessary to ensure:

· full functioning of an individual in society in the presence of a disease (in particular, diabetes in Japan is a common but socially insignificant disease, since drug provision and education for diabetic patients is organized in such a way that the average life expectancy of a diabetic patient in Japan is higher than that of an ordinary person),

· reducing the number of “hidden” patients and guaranteeing the absence of a significant number of similar patients in society (by improving the quality of diagnosis in the first years, the number of officially registered patients will certainly increase, however, in the end, the social significance of the disease will be reduced due to a decrease in the number of fatal and seriously traumatic outcomes of treatment of the disease, due to the start of treatment at an early stage, for example, cancer patients).

So, socially significant diseases are a group of diseases that pose a threat modern society. Today, the situation with the spread of socially significant diseases is very serious, requiring the consolidation of many structures, not only government, medical, but also pedagogical. The education system has great potential in organizing primary prevention, the essence of which is to expand hygienic knowledge among young people, the formation of health-saving behavior strategies in situations associated with the risk of infection or the onset of disease development.

Let's consider brief description socially significant diseases included in the list approved by the Government of the Russian Federation.

Disease caused by human immunodeficiency virus (HIV). HIV infection, which has received the status of the “plague” of the twentieth and now the twenty-first century, is the most significant threat to human society. According to statistics, over the past 24 years, HIV has caused the death of over 25 million people, becoming one of the socially significant diseases dangerous to society. HIV is spreading at a high rate and is characterized by incredible variability - today science knows more than 40 thousand variants of its genome. This circumstance complicates the research of scientists in the field of search effective drugs against this infection. IN this moment There are no drugs in the world that can completely cure an HIV patient. All drugs known to date are aimed only at supporting the resources of the human body infected with the virus. Until now, scientists studying the phenomenon of HIV cannot establish how this disease penetrated into the human population. According to one of the most plausible hypotheses, the immune deficiency virus was obtained from monkeys, but scientists do not give an exact answer to the logical question of exactly how this happened. Only one thing is known for certain - the birthplace of HIV is in the countries of Central and Western Africa. HIV infection is a long-term infectious disease of viral etiology, characterized by a long latent period, damage to the cellular component immune system, leading to a condition known as acquired immunodeficiency syndrome (AIDS). During AIDS, secondary infectious and oncological diseases develop, usually leading to death. The disease was first registered in 1981; in 1983, the causative agent was discovered - the human immunodeficiency virus. During its existence, the disease has spread to all continents of the globe and has become a pandemic. According to the Federal Scientific and Methodological Center for the Prevention and Control of AIDS, the number of HIV-infected people in Russia may actually reach 1 million people (which corresponds to 1% of the country's adult population).

Tuberculosis- an infectious disease that develops when tuberculosis bacteria enter the body. In this case, the main organ that is affected by the disease is the lungs. In some cases, there may be tuberculosis of the brain and its membranes, tuberculosis of the bones, joints, kidneys, genitals, eyes, intestines and other organs. 75% of tuberculosis patients are people aged 20-40 years, that is, the most working and childbearing age. Today it has been proven that the vast majority of cases of tuberculosis can be cured. If the detection and treatment of tuberculosis is properly organized, which must be carried out under control and not interrupted, then patients will recover. More than 100 years ago, it was proven that tuberculosis is an infectious (contagious) disease caused by Koch's bacillus. Not only humans suffer from tuberculosis, but also animals and birds. In a living organism, tuberculosis bacilli find suitable nutritional and temperature conditions for themselves and can multiply quickly. People suffering from tuberculosis of various ages and gender. This disease affects not only the lungs, but also other organs: bones, eyes, skin, lymphatic, genitourinary and nervous systems, etc.

Infections that are predominantly sexually transmitted. Sexually transmitted diseases include: gonorrhea, syphilis, genital herpes, genital warts (genital warts), bacterial vaginosis etc. In addition, viral hepatitis can be transmitted sexually, which kills a large number of people every year. Today, the incidence of STIs is steadily increasing. Recently, doctors have been recording combinations different forms diseases caused simultaneously by several pathogens. Therefore for more effective treatment the patient must be examined for the presence of all types of STI pathogens. The social significance of sexually transmitted diseases lies in the fact that if not treated sufficiently, they can lead to infertility, sexual dysfunction in men and inflammation of the internal genital organs in women. Despite the fact that there is no 100% prevention of sexually transmitted diseases, following the rules of personal hygiene and reasonable behavior in sexual life will help to avoid an unpleasant encounter with STIs.

Hepatitis(from Greek hepatos - liver) - this common name inflammatory diseases liver. Hepatitis can be caused by some medicinal substances, toxins, infectious or systemic diseases. However, viral hepatitis is a significant problem for medical science and practical healthcare, which is becoming increasingly acute epidemiologically.

Its widespread prevalence throughout the world has included hepatitis in the list of the most dangerous socially significant diseases. This epidemiological situation is explained by the ease of spread of viral hepatitis. Even the smallest amount of infected blood entering the human body can lead to hepatitis infection.

With absence timely treatment hepatitis disease progresses and becomes chronic stage, more difficult to treat. According to research, approximately 20 million people in the world fall ill with viral hepatitis every year, and if left untreated, about 10% of them become chronically ill. Hepatitis A and hepatitis E occur mainly due to poor personal hygiene, while infection with viruses B, C, D, G occurs through contact with infected blood. Due to their widespread prevalence and destructive effects on the human body, hepatitis viruses pose the greatest threat to health. B and S.

Malignant neoplasms. Oncology(onco- + Greek logos doctrine, science) - a field of medicine and biology that studies the causes, mechanisms of development and clinical manifestations of tumors. Oncology studies methods of diagnosis, treatment and prevention of tumors. Tumor call excessive pathological growths of tissues consisting of qualitatively changed cells of the body that have lost their differentiation. Of the terms accepted in medicine denoting tumor process, the most frequently used are the following: tumor - tumores, neoplasms - neoplasma, blastoma - blastomata - the latter most fully reflects the essence of the process. Blastoma comes from the Greek verb blastonein - to grow. Based on the nature and growth rate, tumors are divided into benign and malignant. Most malignant neoplasms are cancerous tumors. Doctors note that the name of the disease “cancer” comes from the Latin word “cancer”, since the shape of the tumor resembles a crab in its outline. Today's doctors are seriously concerned that the incidence of cancer throughout the world is steadily increasing. This situation is primarily due to the deterioration of the environment and people’s lifestyle. Today, doctors call the most common types of cancer lung cancer, stomach cancer and breast cancer. The social significance of malignant neoplasms lies in the fact that the diagnosis of cancer often sounds like a death sentence for people. The lack of information about this disease and outdated ideas about treatment methods create a myth in society about the incurability of cancer. However, society must have reliable information about the disease and remember that cancer is a curable disease. According to doctors, on initial stages cancer is curable in most cases, and therefore society must realize the extreme importance early diagnosis. The danger of cancer is that long time it is asymptomatic. Many people turn to specialists for help only when they begin to experience physical illness, and this only happens when late stages diseases. It should be remembered that making a diagnosis too late significantly reduces the effectiveness of treatment. According to doctors, the main causes of cancer can be divided into external and internal. TO external factors include physical, chemical and biological factors. Internal reasons cancer are associated with a hereditary predisposition to the disease. This applies in particular to breast cancer in women.

Diabetes- disease endocrine system, caused by an absolute or relative deficiency in the body of the pancreatic hormone - insulin and manifested deep violations carbohydrate, fat and protein metabolism. Diabetes mellitus is one of the most common diseases. Its prevalence among the population is currently 6%. Every 10-15 years, the total number of patients doubles.

Mental and behavioral disorders.More than 450 million people in the world suffer from mental or neurological disorders. About a quarter of the population, both in developed and in developing countries suffer from certain mental disorders different periods life.

There are currently 120 million people in the world with depression and 37 million with Alzheimer's disease. About 50 million suffer from epilepsy and 24 million from schizophrenia. However, according to WHO, 41 percent of states do not have a developed policy regarding mental illness, 25 percent of countries do not have legislation on this issue. Two-thirds of governments allocate no more than one percent of their health budget to psychiatry.

Diseases characterized by high blood pressure. According to the World Health Organization, cardiovascular diseases are the leading cause of death worldwide, accounting for more than half of all cases. According to recent statistical research conducted by WHO in 34 countries, Russia today ranks first in mortality from complications of hypertension. The danger of hypertension is that it often goes unnoticed by a person. People often attribute the symptoms of hypertension to simple fatigue, without finding any reason to see a doctor. However, frequent headaches, dizziness, tinnitus, decreased performance, swelling of the limbs, and increased blood pressure may be symptoms of latent hypertension.

All of the listed socially significant diseases have risk and protective factors. Knowledge of these factors can play a big role in the implementation of prevention . Risk factors are associated with an increased likelihood of developing, greater severity, or longer duration of severe health disorders. Protective factors are conditions that increase people's resilience to risk factors and disorders; they are defined as factors that modify, improve, or change a person's response to certain environmental risk factors that predispose to impaired adaptive capacity.

Socially significant diseases (CVDs) are diseases whose occurrence and spread depend on the socio-economic conditions of society. The article discusses their danger, provides a list with codes according to ICD-10, and also describes the basics of providing medical care for some socially significant diseases

Persons with socially significant diseases (CVDs) are observed and receive the necessary medical care in appropriate medical institutions. The list of diseases that pose a danger to society has been approved at the level of the Government of the Russian Federation.

Since 2005, providing such patients with medicines has been the task mainly of regional authorities. Patients are provided with the necessary medical and social assistance and dispensary observation on free or preferential terms.

Why are such diseases dangerous and what can be done at the state level to reduce their prevalence? The answers to these questions are in this article.

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The main thing in the article

Current list of socially significant diseases

Socially dangerous diseases are currently considered:

viral hepatitis B and C;
STD;
tuberculosis;
diabetes;
malignant tumors;
mental and behavioral disorders;
pathologies associated with high blood pressure.

List with disease codes according to ICD-10 classification

The main symptom and at the same time the key problem of social diseases is their widespread nature. In such patients, the need for medical care increases as the pathology progresses, deterioration general condition and the development of complications. Their treatment requires the involvement of additional material resources and improvement of the material and technical equipment of clinics.

If there are no adequate measures to support such patients, the level of morbidity, disability and mortality of the population increases, the life expectancy of citizens decreases, great amount funds to stabilize the situation and eliminate Negative consequences for society and economy.

Main risk factors for CVD:

neglect of personal hygiene rules;
heredity (this is especially true cancerous tumors and diabetes mellitus);
excess weight;
sedentary lifestyle;
poor nutrition;
bad habits (smoking, alcohol abuse, etc.);
high blood pressure;
emotional instability, stress.

Social significance is reduced if the main factors that provoke them are targeted and effectively influenced. Therefore, legal mechanisms must be created to guarantee that persons with socially dangerous diseases receive the necessary medications. This will allow them to maintain their ability to work and normal level quality of life.

Classification: differences between CVD and other groups

Comparison criterion	CVD	Diseases that pose a danger to others
Public danger	Average	High
Prevalence in society	Medium and high	Low
Influence of ethnic, national, cultural, socio-economic and other factors	High	Low
Competence	Subjects of the Russian Federation and municipalities	Russian Federation, constituent entities of the Russian Federation
Nature of the events	Planned	Planned, emergency
Rules of law (legislation)	Predominantly social security law	Rules of public law
Limitations of individual rights	By general rule No; individual restrictions may be introduced	Restrictions on individual rights are introduced to the extent necessary in order to protect the foundations of the constitutional system, morality, health, rights and legitimate interests of other persons, to ensure the defense of the country and the security of the state.

Danger of diseases

Socially dangerous diseases are due to the following reasons:

high prevalence rate among the population, including the presence of a large number of “hidden” patients;
high rates of increase in morbidity, high speed spread of diseases of this group;
danger of infecting others (for hepatitis, HIV and STDs);
infectious and non-infectious nature of pathologies;
reduction in the quality of life of patients, restriction of their full social life.

Medical care for CVD

Below we discuss the features of diagnosis and treatment of some socially significant diseases (the list is given above), including from the standpoint of government guarantees.

Anti-tuberculosis care includes the following activities:

medical;
sanitary and hygienic;
social;
anti-epidemic.

Taken together, it is aimed at diagnosis, examination, treatment, clinical observation and rehabilitation in an inpatient or outpatient setting. The provision of medical care to patients with tuberculosis is guaranteed by the state, but requires the informed voluntary consent of the patient.

The exceptions are the following:

the consent of the patient or his representatives is not required to establish dispensary observation;
patients with open forms of pulmonary tuberculosis, violating the sanitary and epidemiological regime and avoiding examination and treatment, are hospitalized in specialized medical institutions By the tribunal's decision.

Mental disorders and behavioral disorders.

A disease caused by the human immunodeficiency virus (HIV).

Diabetes.

Malignant neoplasms.

Tuberculosis.

Hepatitis.

Infections that are predominantly sexually transmitted.

Diseases caused by high blood pressure.

The concept of “socially significant diseases”.

An elementary analysis of the phrase “socially significant” shows that diseases of this group are of great importance for society and pose a threat to a large number of people. The concept of socially significant diseases includes a number of diseases that pose the greatest threat to the well-being of the country's population. The main features included in the concept of a socially significant disease are:

· high rates of annual growth in the number of patients; diseases of this group tend to spread quite quickly,

· restriction of the patient’s full functioning in society in the presence of such a disease,

· danger of disease for others,

· infectious and non-infectious nature.

In addition, diseases belonging to this category not only destroy the health and body of a person, but also carry with them negative social consequences: loss of family, friends, work, livelihood, etc. A characteristic feature of such diseases is that they take away in the bulk of the lives of young people and people of working age. An important feature of socially significant diseases is that if you know how not to get sick and follow certain rules, then the disease can be prevented or stopped at an early stage of the disease.

The situation with the spread of diseases of this group has become so acute that it is causing concern at the level of the government of the Russian Federation. Epidemiological observations served as the basis for compiling list of socially significant diseases. In accordance with Article No. 41 of the Fundamentals of Legislation of the Russian Federation on the protection of the health of citizens, the Government of the Russian Federation approved a list of diseases classified as socially significant. (Resolution No. 715 of December 1, 2004 “On approval of the list of socially significant diseases and the list of diseases that pose a danger to others”). This list includes: disease caused by the human immunodeficiency virus (HIV), tuberculosis, hepatitis, sexually transmitted infections, diabetes mellitus, malignant neoplasms, mental and behavioral disorders, diseases characterized by high blood pressure.

Order of the Ministry of Health and Social Development dated October 7, 2011 No. 1154n approved the distribution of subsidies provided in 2011 from the federal budget to the budgets of constituent entities of the Russian Federation for co-financing of activities regional programs, implemented at the expense of the budget of a constituent entity of the Russian Federation, within the framework of the federal target program “Prevention and Combating Socially Significant Diseases (2007-2012)”, in order to financially support the costs of improving the provision of specialized medical care:

For diabetes mellitus;

For diseases of tuberculosis;

For oncological diseases;

In cases of sexually transmitted infections;

In cases of mental disorders;

For diseases of arterial hypertension;

In case of HIV infection;

For diseases of viral hepatitis.

The inclusion of a certain nosology in the list of socially significant diseases depends on a number of national, cultural and economic factors. For example, in Japan, diabetes is a common, but not socially significant disease. Medicine provision and education of patients are organized in such a way that their average life expectancy is no lower than that of a person who does not have diabetes. Tuberculosis – serious problem for Russia, many countries in Africa and Asia, and in countries North America the prevalence of the disease is low.

The current share of complications in diabetes mellitus is 35%. 1% of patients underwent limb amputation. In total, for the first time during the year, 38.6 thousand people were recognized as disabled due to diabetes.

The incidence of vascular disorders of the brain (cerebrovascular diseases, including stroke) due to arterial hypertension is 5776 cases per 100,000 thousand population, mortality is 325 cases per 100 thousand population.

The number of newly registered cases of HIV infection reached 37.7 thousand, in correctional institutions of the Federal Penitentiary Service - 2 thousand cases. The proportion of HIV-infected pregnant women included in the program for the prevention of HIV infections in newborns was 75%.

The incidence of acute viral hepatitis B and C reached 8.6 and 4.5 cases per 100 thousand population, respectively, chronic viral hepatitis B and C - 51.4 cases per 100 thousand population.

Socially significant diseases, and especially diseases that pose a danger to others, affect public interests. Here there is a possible conflict between private interests, the implementation of the will of individuals (to be treated or not) and the interests of society. Finally, state interests are interests whose bearer is the state. The representatives of these interests are the competent state and other authorized bodies.

· full functioning of an individual in society in the presence of a disease.

So, socially significant diseases are a group of diseases that pose a threat to modern society. Today, the situation with the spread of socially significant diseases is very serious, requiring the consolidation of many structures, not only government, medical, pedagogical, but also volunteer ones. Volunteering has great potential in organizing primary prevention, the essence of which is to expand hygienic knowledge among young people, the formation of health-saving behavior strategies in situations associated with the risk of infection or the onset of the development of a disease.

Let's consider some of the most common and dangerous diseases from the above list, included in the 1st and 2nd groups.

2. Mental disorders and behavioral disorders.Mental disorders pose a serious threat to the social well-being of people. More than 450 million people worldwide suffer from mental or neurological disorders. About a quarter of the population, both in developed and developing countries, suffer from one or another mental disorder at various points in life.

There are currently 120 million people in the world with depression and 37 million with Alzheimer's disease. About 50 million suffer from epilepsy and 24 million from schizophrenia. However, according to WHO, 41 percent of countries do not have a developed policy regarding mental illness, and 25 percent of countries do not have legislation on this issue. Two-thirds of governments allocate no more than one percent of their health budget to psychiatry.

Today, the World Health Organization notes a growing trend in the number of mental illnesses in society. Some experts associate this phenomenon with the unstable socio-economic situation in the country. According to official data, in Russia today there are 6 million people with mental problems. According to medical statistics, since the 90s, Russia has been one of the five countries with the highest number of suicides. The current epidemiological situation has determined that mental disorders are included in the list of the most significant social diseases. The highest level of primary incidence of mental disorders, especially borderline pathology, is observed in adolescence. This is due to the fact that at this age each individual experiences the action of two natural, but ambiguous processes: intensive socialization of the individual and active physiological restructuring of the body. So, in particular, a serious problem adolescence is insufficient social adaptation, manifested primarily in a high frequency of behavioral violations - from increased conflict and lack of discipline to behavior, the obligatory and determining component of which is the commission of illegal actions.

To prevent the epidemiological situation from worsening, society needs to understand its seriousness. To do this, people must have reliable information about these diseases.

Depression(lat. deprimo “to crush”, “to suppress”) is a mental disorder, an illness that is characterized by a decrease in mood, loss of the ability to experience joy, and impaired performance.

Symptoms of depression are very extensive and vary depending on the severity of the disease. It's safe to say that depression is a disease of the whole body. The most common symptom of depression is low mood. Very often, a person suffering from this illness experiences sadness, a feeling of hopelessness, worry and fear, guilt and anxiety. He becomes irritable, withdraws into himself, minimizes or does not communicate at all with friends and family. A person stops enjoying previously enjoyable activities. His self-esteem decreases, he loses interest in life, in hobbies, in his favorite hobbies. Life becomes as if colorless and flat. From the physiological side of manifestation depressive state - feeling of constant fatigue. A person quickly gets tired even after doing things that he previously handled with ease. Often he experiences constant fatigue, i.e. as if you had not rested at all, and short-term rest does not give the desired effect, sexual desire decreases. Physical disorders such as headaches, problems with digestion and heart function, and other pain may also appear. A person prone to depression very often suffers from sleep disturbances. He cannot fall asleep for a long time in the evening or, on the contrary, he finally wakes up too early in the morning. Appetite decreases or, on the contrary, overeating occurs.

Neuroses- the most common type of painful conditions caused by exposure to traumatic factors; they are characterized obsessive states, hysterical manifestations, etc., a critical attitude towards them, preservation of the consciousness of the disease, the presence of somatic and autonomic disorders.

Neurosis(or whatever it is also called neurotic disorder) is the general name for a group of certain functional psychogenic reversible disorders. Neurosis has a direct tendency towards a protracted course. Today, neurosis is characterized by a decrease in mental and physical performance. Most often it manifests itself in the form of hysteria or variants of obsessive behavior and is an asthenic state of a person. Neurosis is directly related to the condition nervous system, and if a person has experienced any strong experiences, stress, or had some other impact on the nervous system, then the likelihood of nervousness increases. As practice shows, neurosis most often occurs due to severe stressful situations. It is stress that causes exhaustion of the nervous system, resulting in impaired heartbeat, as well as the work of the stomach and other organs.

The main causes of neuroses:

· Severe physical or mental stress, expressed in constant work, without the possibility of rest for a long time. The emergence of a permanent, i.e. chronic stress, as well as strong emotional distress associated with problems in his personal life. The combination of these factors gives a double effect in the development of neurosis.

· Severe exhaustion of the nervous system due to the inability to perform a certain task or solve a problem.

· Busy work schedule, without the opportunity to rest, or inability to rest.

· Innate tendency to get tired quickly, and then overwork.

· Alcohol or drug abuse.

· The presence of diseases accompanying nervousness that greatly deplete the body, and in particular the immune system.

Main symptoms of neurosis. Symptoms of neurosis are divided into mental and somatic. TO mental symptoms include:

· Emotional stress, often manifested in the form of problems arising for no apparent reason. obsessive thoughts and obsessive actions.

· Acute reaction and unpreparedness for stressful situations. If some people react to this with tearfulness or aggression, then with neurosis a person becomes fixated and withdrawn. Constant worries and anxiety for no apparent reason. Possible development of phobias.

· Fatigue, chronic fatigue.

· High sensitivity To sudden changes temperature, as well as bright light and very loud sound.

· The appearance of complexes about one’s communication, low or too high self-esteem.

· Changeable mood depending on trifles. Severe irritability.

As a result of studying the chapter, the student should:

know

general characteristics the main socially significant ones are not infectious diseases(diabetes mellitus, hypertension, cancer, mental disorders);
general characteristics of the main socially significant infectious diseases (hepatitis, HIV infection, tuberculosis, sexually transmitted diseases);

be able to

Identify medical and social problems that arise in clients with socially significant non-communicable and infectious diseases;

own

The foundations of the culture of modern social thinking, methods of medical and social analysis of socially significant diseases.

General characteristics of socially significant diseases

The concept of “socially significant diseases” appeared in the 19th century. in an era of rapid industrial development. At that time, the high incidence of this form of pathology (primarily tuberculosis) was associated with difficult working conditions, unsatisfactory living conditions and the inaccessibility of qualified medical care.

As the course of the historical process has shown, social transformations aimed at improving working conditions and creating safety precautions, improving the quality of life of workers, and the development of medicine have led to a decrease in the incidence of certain types of diseases from this group. It should be noted that at that time different authors classified different diseases as socially significant diseases. Tuberculosis and sexually transmitted diseases were originally included in this group.

Sometimes socially significant diseases included vitamin deficiency (hypovitaminosis), neuroses, starvation and a number of occupational diseases.

In the 1980s the first reports appeared that in some countries of the world (USA, Spain, Brazil, Tanzania) previously unknown known form immunity disorders, clinically occurring in the form of a tumor disease. It turned out that the cause of the disease is the human immunodeficiency virus - HIV. This disease is called “acquired immune deficiency syndrome” - AIDS. It has been discovered that a large number of people are carriers of HIV, but they do not have clinical manifestations of the disease. This group of patients is called “HIV-infected”.

Quite quickly, HIV infection became an epidemic. This was facilitated exclusively social factors: almost 100% of patients are homosexual men and drug addicts (both men and women). At this time, homosexuality was excluded from ICD-10 (1995) as a disease.

By the beginning of the 1990s. In Russia, the situation with sexually transmitted diseases has sharply worsened. The multiple increase in the incidence of syphilis and gonorrhea was associated with the advent of effective antimicrobial drugs, with which these diseases could be treated at home.

A significant contribution to the spread of sexually transmitted diseases is made by insufficient awareness of the general population about the causes and epidemiology, clinical manifestations, principles of therapy, and most importantly, about prevention. Apparent ease of row elimination external signs the treatment of these diseases with the help of antibiotics is the basis for the “frivolous attitude” of a large number of citizens, mainly young people, towards them. Self-medication, which has become widespread, contributes to the transition of acute types of diseases into a chronic form, which is difficult to respond to subsequent therapy and often leads to infertility.

The increase in the incidence of tuberculosis is mainly explained by the deterioration of the sanitary and epidemiological situation in Russia at the end of the last century. The increase in the incidence of active forms (newly identified) is about 2%, and the increase in cases of respiratory tuberculosis for the first time is about 3%.

The increase in the incidence of major non-communicable diseases, such as hypertension, mental pathology, diabetes mellitus and tumor diseases, due to a number of reasons. Among them is the acceleration of the pace of life (most relevant for hypertension and mental illness).

Technical progress, use of new synthetic materials in industry, construction, and everyday life, the deterioration of environmental conditions for human life, as well as changes in the quality of nutrition, have contributed to an increase in the incidence of diabetes mellitus and cancer.

Age - important factor in the development of cancer. Many malignant tumors, including prostate, stomach and colon cancer, most often occur in people over 60 years of age. More than 60% of cancers are detected after 65 years of age. In general, the likelihood of developing such diseases after a person reaches the age of 25 doubles every five years. The rise in cancer appears to be the result of a combination of greater and longer exposure to carcinogens and a weakening of the body's immune system. Both of these factors are associated with an increase average duration life.

In order to concretize the work to solve medical and social problems of those suffering from socially significant diseases, the Decree of the Government of the Russian Federation of December 1, 2004 No. 715 approved a list of socially significant diseases and a list of diseases that pose a danger to others. It states that socially significant diseases include: tuberculosis; infections transmitted primarily through sexual contact; hepatitis B and C; disease caused by human immunodeficiency virus (HIV); malignant neoplasms; diabetes; mental and behavioral disorders; diseases characterized by high blood pressure.

Diseases that pose a danger to others include: disease caused by the human immunodeficiency virus (HIV); viral fevers transmitted by arthropods and viral hemorrhagic fevers; helminthiases; hepatitis B and C; diphtheria; infections transmitted primarily through sexual contact; leprosy; malaria; pediculosis and other infestations; glanders and melioidosis; anthrax; tuberculosis; cholera; plague.