Integral assessment of social determinants of public health of the Kaliningrad Region population in the context of the COVID-19 pandemic (municipal level)
Authors: Ogurtsov Aleksandr , Dmitriev Vasiliy 
Published: November 2023

Assessment of the impact of coronavirus infection (COVID-19) on the world community, its spread in different countries and regions is far from complete, which is confirmed by the scale of the study of the causes and factors of morbidity in different countries. The article is devoted to the issues of integral assessment and analysis of spatial features of inequality of social determinants of public health. The aim of the study was to identify the influence of social conditions on the spatial features of the spread of the coronavirus pandemic on the basis of an integral assessment of the impact on the incidence of social factors on the example of municipalities of the Kaliningrad Region. The authors collected data on individual municipalities on the incidence of COVID-19 and social factors for 2021. The list of social factors included: 1—the level of registered unemployment; 2—coverage of children with preschool education from the number of children of the appropriate age; 3—the number of conditional (minimum) set of food; 4—the proportion of families in need of improved housing conditions; 5—the proportion of citizens in the total population who enjoy social support for housing and communal services; 6—the number of registered crimes per 1 000 people; 7—openness and accessibility of information on the provision of medical services in outpatient settings; 8—the comfort of the conditions for providing medical services and the availability of receiving them on an outpatient basis. As an integral criterion for assessing the impact of social determinants on morbidity, a composite indicator characterizing the level of morbidity of the population (CI) is considered. Modeling of additive convolution of criteria based on the principles of ASPID methodology is used as the main method. This makes it possible to take into account non-numerical, inaccurate and incomplete information about criteria and their priority in evaluation studies. Cartographic models based on geographic information systems (GIS) are used to perform spatial analysis, visualize the level of morbidity and assess the impact of social determinants on morbidity. The study revealed spatial trends in the development of COVID-19 in the region and noted an increase in the incidence of the population. For most municipalities, the incidence rates exceed 60 cases per 1 000 people. Against the background of an increase in the level of morbidity, a feature of its spatial distribution was the leveling of the nature of morbidity within the region, accompanied by smoothing in the space of social inequalities. The analysis and assessment of the influence of various social factors on the spatial variability of coronavirus infection confirmed the conclusions previously made by the authors that the weight of the social determinants affecting COVID-19 changes over time and in space. The main factors contributing to inequality in public health in 2021, along with housing conditions, were the state of crime and employment of the population. The results of the correlation analysis confirm the presence of a negative correlation between the composite indicator (KP) and the incidence of COVID-19. In general, in 2021, the correlation relationships previously identified remain moderate in strength (0.30 < p < 0.49). As the results of the study have shown, the use of the ASPID method can provide important information to public authorities at all levels for decision-making and the development of necessary measures in emergency situations of an epidemic nature and health management in the regions.