Introduction: Social determinants are fundamental causes of causes that shape the social gradient of health and delineate the limits of effectiveness of purely clinical interventions. The toolkit of big data and machine learning enables precise, reproducible evaluation of their contributions and helps identify meaningful policy priorities aimed at narrowing gaps in life expectancy.

Objective: To quantitatively assess and rank contributions of social, economic, demographic, and environmental determinants to the variation of the Public Health Index (PHI) across Russian regions and identify factors critical for decision-making.

Materials and Methods: A panel dataset was compiled for the regions of the Russian Federation for 2010–2024. Indicator normalization and transliteration of categorical variables were performed. A predictive model for the Public Health Index was developed using gradient boosting on decision trees. Interpretation of the results, including detailed analysis of the contribution of individual determinants, was carried out using a Shapley value-based technique.

Results: We established that mortality indicators (the total number of deaths and mortality from external causes), the poverty level, and the housing affordability index contributed the most to the variations in the Public Health Index. School meal coverage, environmental protection expenditures, and crime indicators demonstrated additional, yet significant effects. The parameters traditionally used as markers of socioeconomic well-being (per capita income and unemployment rate) demonstrated statistical redundancy when the poverty variable was included in the model. A pronounced interregional gradient was identified, indicating a substantial influence of territorial specificity.

Conclusions: A comprehensive analysis of socioeconomic, demographic, and infrastructural indicators using machine learning methods provides a robust foundation for forecasting and interpreting regional differences. Public health management strategies should be adapted to the specific features of each constituent entity.

Introduction: The incidence of congenital anomalies is associated with a combination of exogenous and endogenous factors influencing development.

Objective: To identify the areas at risk of congenital anomalies in children associated with air pollution using spatial analysis.

Materials and Methods: To characterize ambient air pollution in 23 regions of the Asian part of Russia, we used data collected by the Federal Service for Hydrometeorology and Environmental Monitoring (Roshydromet) for the years 2017–2023 on air quality indices (AQI) and exceedances of the maximum acceptable benzo(a)pyrene level. Incidence rates of congenital anomalies in children aged 0–14 years were retrieved from statistical bulletins of the Russian Ministry of Health, and the size of the exposed population was used. This multi-stage study was conducted using methods of descriptive statistics, as well as correlation, regression and cluster analysis.

Results: We found statistically significant correlations between ambient benzo(a)pyrene levels, AQI, and the incidence of congenital malformations of the nervous system in children. The cluster with the high incidence rates of congenital nervous system malformations included six regions noted for high and very high levels of ambient air pollution (AQI ranging from 10 to 18), extremely high airborne concentrations of benzo(a)pyrene (32 to 74-fold excess of MAC), and high proportions of exposed population (38–77 %), namely the Irkutsk Region, the Republic of Tyva, Krasnoyarsk Krai, Kemerovo Region, Transbaikal Territory, and the Republic of Buryatia.

Conclusions: The multi-stage analysis identified areas at risk of congenital malformations in children in the Asian part of Russia. Based on the results of correlation and cluster analyses, measures aimed at improving environmental conditions are essential in six regions with high and very high air pollution and airborne benzo(a)pyrene levels as they will contribute to reducing the incidence of congenital anomalies and neurodevelopmental defects in offspring.

Introduction: Melanoma is currently a public health challenge as it is one of the most aggressive skin tumors demonstrating increasing incidence and prevalence over recent decades.

Objective: To analyze age and sex-specific incidence rates of melanoma of the skin in the elderly population of the Samara Region.

Materials and Methods: We used annual federal statistical reporting data from Form No. 7, Incidence of malignant neoplasms, of the Samara Regional Clinical Oncology Dispensary for 2014–2023 and applied epidemiological, statistical, analytical, and graphical methods. We calculated mean and standardized rates of melanoma incidence per 100,000 population by sex, age, and territory (the region as a whole, cities, and rural areas); the R² coefficient of determination, and the Fisher exact test using Microsoft Excel.

Results: From 2014 to 2023, the incidence of melanoma increased by 29.8 % in the region, by 24.5 % in cities, and by 58.6 % in rural areas (R² = 0.488; Fisher exact test 7.63, p < 0.05). Sex-specific rates established in the region and cities were higher among male seniors. In rural areas, the malignancy was more incident in women. Yet, the rates of increase of melanoma incidence in urban women were significantly higher than in urban men, and those in rural men exceeded the rates in rural women. The incidence rate of melanoma increases with age, especially starting from the age of 65–69 years, and reaches maximum values in the population aged 80 years or older.

Conclusion: High incidence of melanoma in older adults and its observed growth over time determine the urgent necessity of preventive measures for this age group, especially those living in rural areas of the Samara Region. 

Introduction: Identification of genetic factors of blood pressure regulation is important for predicting intrinsic capacity (IC) in the elderly residents of the European North of Russia.

Objective: To investigate the associations between single nucleotide variants (SNVs) of the genes involved in blood pressure regulation with functional IC indicators in people aged 60–74 years living in the European North of Russia.

Materials and Methods: We examined 611 residents of the Arkhangelsk Region, 36.8 % of whom were men, and assessed their socio-demographic status, the presence of arterial hypertension, parameters of the locomotor, sensory, and cognitive, and psychological IC domains, and genotypes of six SNVs in the genes AGT (rs699, rs4762), AGTR1 (rs5186), ACE (rs4646994), NOS3 (rs2070744), and EDN1 (rs5370). Statistical analysis was performed using linear, logistic, and quantile regressions with adjustments for age and sex.

Results: The C allele of the AGTR1 gene (rs5186) was associated with greater handgrip strength (+1.9 kg/m²; p = 0.045) and lower odds of hearing impairment (p = 0.040). Heterozygotes AC of the AGTR1 gene (rs5186) had two times lower odds of hearing impairment compared to AA homozygotes (p = 0.020). The C allele of the AGT gene (rs4762) was associated with 4.2-fold lower odds of visual acuity reduction (p = 0.030), whereas the TT genotype was associated with a 3.9-fold higher odds (p = 0.037). The CC genotype of the NOS3 gene (rs2070744) was associated with higher depression symptom scores (p = 0.030) whereas the G allele of the EDN1 gene (rs5370) – with lower scores (p = 0.039).

Conclusions: We identified several genetic biomarkers of reduced functional IC parameters in elderly residents of the European North of Russia, namely the T allele of the AGT gene (rs4762) (visual acuity) and the C allele of the NOS3 gene (rs2070744) (depression symptoms). The sustained functional IC parameters were associated with the C allele of the AGTR1 gene (rs5186) (hearing acuity, handgrip strength), and the G allele of the EDN1 gene (rs5370) (depression symptoms).

Introduction: Medical students experience greater physical and psycho-emotional stress during their academic years compared to students of other professions. To develop prevention programs, it is necessary to study the factors that affect students’ health and the quality of life.

Objective: To compare the quality of life of medical university students between the years of study and identify its health and demographic predictors.

Materials and Methods: Using the SF-36 questionnaire to assess the quality of life, we conducted a survey of 1,884 first, third, and fifth-year university students specializing in general practice. Collected data were analyzed using SPSS version 22, and a multiple regression analysis was performed to identify quality of life predictors.

Results: Medical students had high physical but low psychological quality of life scores. The median scores of physical functioning reached 95 points, while the role functioning and vitality scores dropped to 33.0 and 45.0 points, respectively. We established sex-specific differences in the quality of life indicators. Median physical and mental component summary scores in boys were 80.0 and 61.0 points, while in girls they were 72.0 and 49.0 points, respectively (p = 0.001). We observed an increase in the physical component score among fifth-year students and the lowest psychological component scores among the third-years. The main predictors of the quality of life were stress, physical activity, housing conditions, and financial situation, the maximum contribution of which to the variance of the physical and psychological components reached 25.1 % and 38.8 %, respectively.

Conclusion: The quality of life indicators established in medical university students and the associated health and demographic factors should be taken into account when developing disease prevention and health promotion programs for students.

Background: The reduction of stunting is a global public health priority under target of the United Nations Sustainable Development Goals and a major public health challenge in Indonesia, with a national prevalence of 21.6 % in 2022, and 13.9 % in North Sumatra.

Objective: To examine basic sanitation and personal hygiene as risk factors associated with stunting among toddlers in coastal areas of North Sumatra.

Materials and Methods: This cross-sectional quantitative study was conducted in Paluh Sibaji Village, Deli Serdang Regency, and involved 141 mothers of toddlers selected by simple random sampling from a total population of 375. Data collection involved validated questionnaires, observation sheets, and inspections of basic sanitation and personal hygiene, with a focus on clean water availability (quantity, quality, continuity, and affordability). Stunting was determined using anthropometric measurements by the WHO Z-score standards.

Results: The prevalence of stunting was 16.3 %. The analysis of stunting risk factors showed a significant relationship between clean water continuity (OR 3.365, 95 % CI: 1.154–9.816, p = 0.026), latrine ownership (OR 4.272, 95 % CI: 1.240–14.720, p = 0.021), ownership of wastewater disposal facilities (OR 7.301, 95 % CI: 2.233–23.872, p = 0.001), the practice of washing hands by cleaning between the fingers with soap and running water (OR 5.772, 95 % CI: 1.830–18.205, p = 0.003) and stunting.

Conclusion: Poor hygiene practices, inadequate access to drinking water, and inadequate ownership of toilets, wastewater disposal facilities, and waste management can increase the risk of stunting among toddlers in Paluh Sibaji Village. The absence of wastewater disposal facilities emerged as the strongest risk factor, thus highlighting the importance of improving sanitation systems as part of integrated communitybased stunting prevention strategies. 

Introduction: The leading role of environmental factors and occupational hazards in the development of respiratory cancers determines the relevance of studying regional characteristics of carcinogenesis in the population of an industrial city.

Objective: To establish environmental risks and morphological features of the development of malignant tumors with an emphasis on bronchopulmonary histology in the population of the city of Novokuznetsk.

Materials and Methods: Individual carcinogenic risk was determined using data on average annual pollutant concentrations in Novokuznetsk for 2018–2022. We analyzed morbidity and mortality from malignant neoplasms of the lungs and bronchi among Kuzbass residents during that period and conducted morphological studies of autopsy specimens from the bronchopulmonary system of 50 Novokuznetsk miners, 12 of whom were diagnosed with stage 4 lung cancer.

Results: In 2018–2022, ambient benzo(a)pyrene and formaldehyde levels in Novokuznetsk exceeded their permissible limits. Elevated concentrations of harmful carcinogenic air contaminants posed alarming risks to public health. During those years, an increase in lung and bronchial cancer cases was observed among Kuzbass residents, primarily men. As of 2022, 74 % of individuals diagnosed with lung and bronchial cancer were considered conditionally resectable or inoperable at initial diagnosis. In Novokuznetsk, high morbidity and mortality rates were typical for individuals over 50 years of age, with the one-year fatality rate from lung and bronchial cancer reaching 46.1 %. High activity of fibroblastic cells with malignant potential was detected in the areas of pulmonary fibrosis in Novokuznetsk miners. This suggests that fibrosis associated with long-term exposure to coal dust may trigger tumor growth.

Conclusion: Our findings substantiate the need for a comprehensive set of measures aimed to manage carcinogenic risks posed by environmental and occupational factors.

Introduction: The complete elimination of infectious properties and alteration of the morphological composition of medical waste are achieved primarily through thermal treatment methods. However, there exists no assessment system that, given the advantages and drawbacks of each technology, allows for the selection of the optimal waste decontamination technique.

Objective: To provide hygienic characteristics of healthcare waste high- and low-temperature treatment technologies and to assess their impact on ambient air and human health in the affected area in order to substantiate a set of appropriate preventive measures.

Materials and Methods: Between 2017 and 2022, experimental testing of pyrolysis and low-temperature medical waste treatment plants was carried out in St. Petersburg. Using the “Ecolog” unified software for calculating ambient air pollution, we modeled emission dispersion patterns from the thermal treatment installations and determined maximum single and average daily ground-level concentrations of chemicals. Furthermore, a comprehensive assessment of chronic carcinogenic and non-carcinogenic health risks was conducted in accordance with Russian Guidelines R 2.1.10.3968–23.

Results: We assessed the impact of emissions from high- and low-temperature medical waste treatment facilities on ambient air quality and human health. Pyrolysis was found to emit 28 pollutants. The maximum carcinogenic risk from the high-temperature facility was associated with benzo[a]pyrene; the highest chronic non-carcinogenic risk levels from sulfur dioxide, particulate matter, nitrogen dioxide, and benzo[a]pyrene exceeded the permissible limits. Unacceptable levels of non-carcinogenic risk were established for the pyrolysis plant: 8.07 for the respiratory system; 6.89 for additional death cases; 2.43 for developmental processes; 1.18 for the hematopoietic system, and 1.12 for the immune system. The lowtemperature treatment technique was found to emit seven chemicals, predominantly of hazard class III, with maximum carcinogenic and non-carcinogenic risk values below the permissible limits.

Conclusion: The pyrolysis plant poses the highest non-carcinogenic health risks, thus necessitating comprehensive preventive measures aimed to mitigate them to acceptable levels.

Introduction: The high epidemic potential and the presence of natural foci of Yersinia pestis necessitate timely revision of specific plague preventive measures. Individual and group plague vaccination schedules are being developed for annually vaccinated populations based on the post-vaccination immunity status and its prediction for the next booster dose.

Objective: To determine probability ranges for predicting immune responses in order to assess the feasibility of applying a prediction-based approach to planning specific plague prevention measures.

Materials and Methods: We conducted a retrospective cohort analysis of immune responses to plague vaccination in 340 individuals using immunological monitoring data for 2016–2022. A customized expert assessment method for immune response types and the possibility of predicting them was applied based on a nonparametric analysis of Th-1 (IFN-γ, TNF-α) and Th-2 (IL-4)-associated cytokines and specific antibodies to the plague capsular antigen before and 12 months after vaccine administration using Statsmodels by Python and Microsoft Excel 2016.

Results: The ratios of individual and group types of immunoreactivity were determined in the examined subjects. We found low, normal, and high immune responses in 18 %, 71 %, and 11 % of cases, respectively. Over the four-year observation period, normal immune responses were repeatedly found in 71–86 % of the subjects, while low and high responses persisted in 7–18 % and 7–11 % of the subjects, respectively. We established a 1.7-fold increase in the proportion of individuals with a low type of immunoreactivity among the respondents revaccinated multiple times but a 6-fold increase in the proportion of individuals with high immune responses among those administered one or two doses.

Conclusion: The conducted analysis of the recurrence of immune response types allowed us to determine feasibility of predicting the immune response to the next revaccination in the group of population annually vaccinated against plague.