The social determinants of public health during the COVID-19 pandemic: an integrated assessment of Kaliningrad region data (municipal level)

Abstract

The issues of ensuring equality in the field of health and improving the level of public health have become more important than ever before at the present time. The reason for everything is the appearance and rapid spread of coronavirus infection (COVID-19). The scale of the epidemic, which covers countries and regions on all continents without exception, indicates its pandemic nature. In these conditions, as before, a key role in solving the issues raised is assigned to research on the social determinants of public health and their assessment. Research in this direction is carried out taking into account the multifactorial nature of social conditions on the basis of a component-by-component analysis of determinants and integral criteria. The article presents the results of the analysis of the incidence of COVID-19 in the first year (2020) of the pandemic on the scale of municipal urban districts of the Kaliningrad region. The ranking of the territory of urban districts by the level of morbidity was carried out. In general, municipalities with an average (10–15 cases per 1000 people) and a high (15–22 cases per 1000 people) incidence rate prevail among urban districts. The incidence rate of COVID-19 is compared with the composite indicator. The composite indicator (CI) acts as an integral criterion for assessing the favorability of social conditions for public health. The composite indicator is formed by additive “convolution” of eight parameters. The convolution procedure is carried out taking into account the assignment of the weight of individual indicators for non-numeric, inaccurate and incomplete information. The results of the spatial analysis of the composite indicator indicate the relative geographical diversity of assessments of social conditions at the level of urban districts. It is noted that the social environment in 15 out of 22 municipalities is characterized by unfavorable and the most unfavorable conditions for public health. At the municipal level, high values of the morbidity rate are usually associated with low values of the composite indicator. The results of spatial correlation analysis confirmed the existence of a negative relationship between the CP value and the incidence rate. The correlation coefficient is—0.46. Research on the social determinants of public health should be included in the list of priorities in the implementation of public health policy at the municipal level.