Смертность от повреждений с неопределенными намерениями как показатель качества статистики смертности от внешних причин
More than half of all deaths in Russia in 2011-2014 were subjected to pathologic or forensic autopsy, as a result of which the cause of death was not identified for 3.8 percent of the cases. More than 147,000 unproductive autopsies which left the cause of death unknown were carried out. Such a large number of cases cannot be explained by the state of the cadavers at the moment of the autopsy. Another 161,000 deaths (4.1% of autopsies) were classified as events of undetermined intent. This paper attempts to find a rational explanation for such a high proportion of uncertain autopsy conclusions concerning the cause of death. The methods applied include an analysis at the macro-level (regions), with the help of factor analysis and clustering techniques, and multinomial logistic regression at the micro-level, using anonymous individual records. The study is based entirely on Russian state statistics data. There are large interregional differences in the practices of determining the cause of death based on autopsy. Practices of diagnosing external causes also vary greatly by region. In regions where the proportion of unspecified causes is higher, the share of events of undetermined intent is also higher. These differences are not connected with the peculiarities of mortality in each region. The analysis suggests that the large number of cases in which the cause of death remains unknown after an autopsy is due to the lack of incentives to clarify the cause of death after the issuance of the preliminary medical death certificate. Moreover, the existing system of relations between forensic bureaus and law-enforcement agencies makes no provision for apprising forensics experts of the final conclusions concerning the external causes of death. From 2011 to 2014 the number of forensic autopsies of persons who had died from disease increased by 20 percent, but there are doubts that the information obtained as a result of the autopsies is effectively used by the health care system.
Informing about safety along with the creation of safe living and movement conditions is an important task for preserving the independence of the elderly. The article describes the experience of the UK in limiting risk factors that can lead to various injuries of older people and even their death. The success and effectiveness of measures, which ensure safe living of elderly people, can be assessed through such indicators as age-standardized mortality rate from external causes and life expectancy at age 65. According to these indicators Russia significantly behind the UK, and given the global trend of an ageing population, we should use the experience of UK in our country.
The article presents an analysis of the demographic losses from the main causes of death in Russia, in the Republic of Bashkortostan and in OECD countries. Based on analysis of the numbers of deaths and potential years of life lost (PYLL), there was shown the position of external factors in the structure of total mortality in these regions. Although the number of deaths from external causes in both sexes before age 70 was on the 2nd place in 1992-2012 and in all ages one became on the 3rd place since 2006, in terms of PYLL premature loss from these causes had become the biggest threat to public health at least since 1990. There were specified peculiarities of calculation of the PYLL according to the methodology of the Organisation for Economic Cooperation and Development (OECD). The basic conditions of the reduction of mortality from external causes are considered: the formation of vital behaviors among the population, creating a safe environment, an increase in expenditure on health care. Because almost all of the external causes of death are preventable, preventive measures play a major role in the limiting of risk factors, so Russian health system approach should be aimed not only on treatment but first of all on prevention. In addition, there were shown the analytical capabilities of the Haddon Matrix in the classification of the main factors of risk of death from external causes on the example of the suicide.
Several approaches to the concept of fatherhood present in Western sociological tradition are analyzed and compared: biological determinism, social constructivism and biosocial theory. The problematics of fatherhood and men’s parental practices is marginalized in modern Russian social research devoted to family and this fact makes the traditional inequality in family relations, when the father’s role is considered secondary compared to that of mother, even stronger. However, in Western critical men’s studies several stages can be outlined: the development of “sex roles” paradigm (biological determinism), the emergence of the hegemonic masculinity concept, inter-disciplinary stage (biosocial theory). According to the approach of biological determinism, the role of a father is that of the patriarch, he continues the family line and serves as a model for his ascendants. Social constructivism looks into man’s functions in the family from the point of view of masculine pressure and establishing hegemony over a woman and children. Biosocial theory aims to unite the biological determinacy of fatherhood with social, cultural and personal context. It is shown that these approaches are directly connected with the level of the society development, marriage and family perceptions, the level of egality of gender order.
We address the external effects on public sector efficiency measures acquired using Data Envelopment Analysis. We use the health care system in Russian regions in 2011 to evaluate modern approaches to accounting for external effects. We propose a promising method of correcting DEA efficiency measures. Despite the multiple advantages DEA offers, the usage of this approach carries with it a number of methodological difficulties. Accounting for multiple factors of efficiency calls for more complex methods, among which the most promising are DMU clustering and calculating local production possibility frontiers. Using regression models for estimate correction requires further study due to possible systematic errors during estimation. A mixture of data correction and DMU clustering together with multi-stage DEA seems most promising at the moment. Analyzing several stages of transforming society’s resources into social welfare will allow for picking out the weak points in a state agency’s work.