Gruzieva Tetiana S, Hrechyshkina Nataliia V, Diachuk Mykhаilo D, Dufynets Vasyl A
Bogomolets National Medical University, Kyiv, Ukraine.
State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department, Kyiv, Ukraine.
Wiad Lek. 2020;73(5):937-942.
The aim: identifying the characteristics and trends of inequalities in the health of the population to substantiate the educational content of the curriculum for the training of Master in Public Health.
Materials and methods: Bibliographic, sociological, medical-statistical and information-analytical methods were used in the study. Ukraine's healthcare institutions were the scientific base of the study. The data on the average life expectancy, morbidity, mortality, satisfaction of medical needs of different groups of the population for revealing the social gradient are analyzed. Documents on strategies to reduce health inequalities have been examined.
Results: Health inequalities between WHO countries have been identified, including a difference in the average life expectancy at birth of 17.1 years in premature mortality due to differences in the levels of economic development of countries. The inequality in the prevalence of diseases and the difference in the satisfaction of specific medical needs among the first and tenth decile population of Ukraine were determined. The prevalence of diseases of the genitourinary system in the population older than 60 years with low rates by 27.3% was higher than the figure among financially insured persons. The incidence of ocular pathology among adults with different income levels varied 1.8 times. The provisions of the WHO strategic documents on reducing health inequalities and its protection and on developing the public health system are analyzed. We justify the necessity of expanding the coverage of the problems of reducing disparities in health and health care in the course of training of the Master in Public Health. A modern curriculum "Social Medicine, Public Health" has been developed with the inclusion of inequalities in public health and appropriate educational and methodological support.
Conclusion: The strategic goal of reducing inequalities in public health and its care requires integrating these issues into a modern master's in public health program. The curriculum developed covers various aspects of health inequalities and health care, including the identification and assessment of disparities, the clarification of causes, the identification of counter-measures. Created educational and methodological support allows acquiring theoretical knowledge and practical skills that form the necessary competencies of professionals in the context of overcoming inequalities in health.
确定人群健康不平等的特征和趋势,以充实公共卫生硕士培训课程的教育内容。
材料与方法:本研究采用了文献法、社会学方法、医学统计学方法和信息分析方法。乌克兰的医疗机构是该研究的科学基础。分析了不同人群组的平均预期寿命、发病率、死亡率、医疗需求满意度等数据,以揭示社会梯度。审查了关于减少健康不平等策略的文件。
结果:已确定世卫组织各成员国之间的健康不平等情况,包括由于各国经济发展水平差异导致出生时平均预期寿命相差17.1岁,以及过早死亡率方面的差异。确定了乌克兰第一和第十分位数人群在疾病患病率和特定医疗需求满意度方面的不平等情况。60岁以上人群中生殖泌尿系统疾病的患病率比有医保人群高27.3%。不同收入水平的成年人眼部疾病发病率相差1.8倍。分析了世卫组织关于减少健康不平等及其保护以及发展公共卫生系统的战略文件的规定。我们论证了在公共卫生硕士培训过程中扩大减少健康和医疗保健差距问题覆盖面的必要性。已制定了现代课程“社会医学、公共卫生”,纳入了公共卫生不平等问题及适当的教育和方法支持。
结论:减少公共卫生及其保健方面不平等的战略目标要求将这些问题纳入现代公共卫生硕士课程。所制定的课程涵盖了健康不平等和医疗保健的各个方面,包括差异的识别和评估、原因的阐明、应对措施的确定。所创建的教育和方法支持使学员能够获得理论知识和实践技能,从而在克服健康不平等的背景下形成专业人员所需的能力。