Results of a study of socio-environmental risk factors affecting the development of diseases among students

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Justification

In recent years, state programs in the Russian Federation and the world as a whole are aimed at the prevention of the development of diseases both in adults and children. Preservation and strengthening of the health of the population of childhood is one of the main indicators of social and epidemiological well-being of the nation. The ambiguous socio-economic situation and the growth of morbidity indicate the search for effective ways to identify and weaken risk factors, with the aim of further development of a complex of highly effective preventive programs to form the foundations of health-saving behavior of the working-age population of the country [1, 2, 3].

In the Comprehensive Safety Strategy for Children until 2030, approved by the President of the Russian Federation, Vladimir Putin, it is noted that the provision of comprehensive safety for life in Russia by the authorities is the basis of this strategy. Health-preserving behavior is aimed at preventing the occurrence of diseases and is characterized by the exclusion or reduction of socially significant risk factors. According to research, students have a low level of awareness about risk factors, diseases, and their consequences, which can lead to the development of a range of functional disorders [4, 5, 6].

The life of a modern person requires flexibility in using mechanisms of adaptation to society, while students experience increased difficulties in this, which is a serious medical and social problem. Studying at a university is associated with constant psychoemotional stress, a sedentary lifestyle, and a violation of the regime of nutrition, work, and rest, which places them in a special social group of increased risk [7, 8].

To improve the effectiveness of measures to strengthen public health and prolong working life, it is necessary to systematically study the lifestyle of students as the future economic and reproductive potential of the country. The study of social-related risk factors among students is necessary on an ongoing basis to develop preventive measures for maintaining and improving health. The obtained data on social and environmental risk factors for the development of chronic non-communicable diseases should be taken into account when implementing corporate medical and preventive measures and developing individual programs for promoting a healthy lifestyle [9, 10].

The purpose of the study is to examine the socio-environmental risk factors that influence the development of diseases among students.

Material and methods

In the Udmurt Republic, on the basis of the FGBOU VO "Izhevsk State Medical Academy" of the Ministry of Health of the Russian Federation, a study of risk factors for the development of morbidity in students was conducted using a questionnaire. 351 students of the 5th and 6th courses of the medical, pediatric, and dental faculties were surveyed (the absolute number of students in the 5th and 6th courses), most of them were girls – 76.1% (267), and young men – 23.9% (84) aged 21 to 30 years. The developed questionnaire "On the study of socio-environmental risk factors for the development of morbidity among students of higher educational institutions" included 5 sections (general information, sanitary and living conditions, healthy lifestyle, dietary conditions, and non-hygienic habits) and consisted of 42 questions. The socio-hygienic survey was conducted using a questionnaire.In this work, the following research methods were used: a survey in the form of a questionnaire, study and generalization, and analysis of the results obtained. The representativeness of the sample was determined using the L. Zaks formula (L.F. Molchanova et al., 2004).
n = N / NΔ² + 1.
where n is the number of the sample population,
N is the size of the population, and
Δ is the maximum allowable error.
The total number of students in the 5th and 6th years of the medical, pediatric, and dental faculties at the Izhevsk State Medical Academy is 351.

If the maximum allowable error is 5% or 0,05
351/351*0,0025 + 1 =186.9.
The errors of the relative values are calculated using the formula:
, where p is the indicator expressed in %,
q = 100 is p, with p expressed in % (percent)
n is the number of observations.

Results

 Student youth is a special social group that is united by specific conditions of study and lifestyle. They usually lead a complex social life that includes many potentially dangerous socio-environmental risk factors. The quality of sanitary and living conditions of students is one of the factors that affect their well-being, performance, and overall health.

An analysis of students' living conditions showed that they were satisfied with the quality of their living environment by 8-10 points (on a 10-point scale) – 71.8±2.4 per 100 respondents (252 students), and with the environmental situation – 43.0±2.6 (151 students). The study revealed that the majority of students are satisfied with the conditions and availability of various rooms (Table 1). However, there are rooms that students are not satisfied with or are missing: the adjacent territory – 3.4 ± 0.1 per 100 respondents; hall – 12.6± 1.8; kitchen – 6.8± 0.2; bathroom – 6.5± 0.3; leisure – 16.0±2.0; shower – 7.4± 0.2; place for sports exercises – 36.7±2.6 and household – 9.9±0.1 per 100 respondents.

Leisure time plays a special role in every student's daily life. In the course of the sociological research, the respondents noted the following hobbies that occupy them: creative evenings – 13.7±1.8 (per 100 respondents); various competitions – 8.8±0.2; sports competitions – 8.3±0.2; Olympiads – 11.7±1.7; scientific conferences – 42.2±2.6; meetings with participants in a special military operation – 4.3±0.3 However, less than half of the respondents (44.4±2.6 per 100 respondents) showed no interest in any leisure activities. Further, the respondents noted various activities that they lacked throughout the entire period of study: sports – 16.2±2.0, educational – 14.2±1.9, patriotic – 1.7± 0.2, musical – 16.2±2.0, creative – 19.9±2.1. Less than half of the respondents (47.9±2.7) are satisfied with the number of available activities.

Recently, in our country and in the world as a whole, there has been an increasing focus on promoting a healthy lifestyle among students. This is due to the growing prevalence of diseases, particularly chronic non-communicable diseases, among future professionals during their training, which can lead to a decrease in their work performance. A healthy lifestyle represents a generalized model of students' daily activities. It fosters a sense of responsibility and commitment to maintaining their own health.

The study revealed that 7.7±0.2 respondents (out of 100) performed morning exercises daily, 15.7±1.9 performed them three to four times a week, 36.8±2.6 performed them rarely, and 39.9±2.6 did not perform them at all. One-third of the respondents did not engage in physical culture at all, and half of the respondents did not engage in amateur sports (Table 2).

The study identified the sports that students are most interested in. The top five include: gym – 29.9±2.4 (per 100 respondents), fitness – 24.8±2.3, walking or running – 24.5±2.3, yoga – 14.5±1.9, and swimming – 10.8±1.7. During the analysis of the reasons that prevented people from leading a healthy lifestyle, it was found that slightly more than half of the respondents (51.2±2.7 per 100 respondents) did not want to lead a healthy lifestyle, and nothing prevented them from doing so. The respondents noted the activities they engaged in outside of school hours (Table 3). More than half of the respondents noted the following activities: preparing for the next day's classes, socializing with friends, sleeping, going for walks, and using social media on their phones, tablets, or computers (66.1±2.5 per 100 respondents).

For students, the issue of proper nutrition is particularly acute. This is due to the excessive workload of the curriculum, lack of sleep, and irregular daily routines. Properly organized and nutritious meals can significantly contribute to the health and well-being of students.

The study revealed that most of the students had a snack once between main meals – 41.6±2.6 per 100 respondents (146 students). However, they did not participate in or were not interested in nutrition marathons, conferences, and webinars – 69.5±2.5 (244 students). Only 1.1±0.2 respondents fasted on certain days. 15.4±1.9 of the respondents consumed hot and nutritious food once a day. 15.4±1.9 (54 students) did not have the opportunity to eat hot food during their lunch break due to the lack of or short break between classes, insufficient funds, or the absence of a need for a lunch break.

As a result of the study, the food products most consumed by students were identified (Table 4). The majority of students noted: fresh fruits – less than half of the respondents consumed several times a week; biscuits, cakes, pies, sweet pies and muffins – a third of the respondents consumed several times a week; jam and honey – a third of the respondents consumed rarely; a quarter of the respondents rarely consumed chewing gum with sugar; a quarter of the respondents consumed sweets and lollipops several times a week; lemonade, cola and other sugary drinks – a third of the respondents rarely consumed; milk with sugar – more than half of the respondents never consumed; tea with sugar – less than half of the respondents never consumed; coffee with sugar – a third of the respondents had never consumed powdered bread; burgers – less than half of the respondents rarely consumed; rolls – more than half of the respondents rarely consumed;half of the respondents rarely ate French fries; more than half of the respondents rarely ate ice cream; more than half of the respondents never ate yeast-free products.

Health-preserving behavior plays an important role in maintaining one's health, especially for young people. Poor hygiene habits are significant social factors in the development of chronic non-communicable diseases.

As a result of the study, it was revealed that 90.6±1.6 out of 100 respondents (318 people) do not smoke cigarettes. However, 20.2±2.1 respondents noted that they smoke electronic pipes. Most of the respondents (39.3±2.6) only consume alcoholic beverages on holidays, in amounts of 200-300 ml. A third of the respondents reported that they consume alcohol to relax after studying and to socialize.

Discussion

 A modern student of higher education institutions is influenced by a variety of socio-determined factors. These include: motivation among students, relations with the teaching staff, approaches in modern education, quality and living conditions, financial security, the presence of a competitive environment, personality traits, and others. However, one of the key factors of influence is the state of health and morbidity, where according to previously conducted studies, that 65.0% or more of students have a history of chronic non-communicable diseases. This may be due to a complex of socio-economic, environmental, demographic, personal-psychological and other factors. It is noted that 50.0% and more students have bad habits (smoking, including e-cigarettes and alcohol consumption). About 30.0% of students of higher education institutions regularly engage in physical culture and sports [11].

According to a previous study conducted at the Far Eastern Federal University and the Pacific State Medical University, the quality of living conditions is directly related to academic performance among medical students (r= –0.034 (0.017), p<0.05; r= –0.045 (0.019), p<0.05) and humanities students (r= –0.032 (0.015), p<0.05; r= –0.042 (0.016)). High financial security was associated with better academic performance (r=0.035 (0.013), p<0.05; r=0.036 (0.015), p<0.05). The influence of the quality and conditions of study and accommodation among medical university students (in the range of 3-6 and 6-10 points), the correlation level was r=0,059 (0,012), 0,066 (0,016), p<0.01, respectively; for students of humanities (in the range of 3-6 and 6-10 points), the correlation level was r=0.044 (0.015), r=0.076 (0.021), p<0.01, respectively [12].The study found that only 71.8±2.4 out of 100 respondents were satisfied with the conditions and quality of their housing, while 43.0±2.6 were satisfied with the environmental conditions. A third of the respondents (36.7±2.6) reported a lack of space for physical exercise, which made it difficult for them to engage in physical activity during their free time. Leisure activities during non-school hours play an important role in the daily lives of students, providing them with opportunities for mental and physical relaxation. However, 44.4±2.7 out of 100 respondents showed no interest in any leisure activities at all.

In the course of the study conducted at the Nizhny Novgorod State Pedagogical University, it was noted. Over the course of three months, the daily routine and amount of physical activity received by first- and third-year students were observed. As a result, it was revealed that students from the Faculty of Physical Education, Sports, and Life Safety have a significantly higher level of physical activity than students from the Faculty of Linguistics and Humanities, due to their different daily routines and curricula [13]. In the course of the study conducted at the Izhevsk State Medical Academy, it was revealed that a third of the respondents did not engage in physical culture at all, half of the respondents did not engage in amateur sports, including due to a lack of places. At the same time, slightly more than half of the respondents (51.2±2.7 per 100 respondents) did not have a desire for health-preserving behavior.

A student's academic performance depends on the following factors: the organization of the educational process; the students' attitude towards it; and the amount, structure, and content of their free time. Free time is defined as the time spent on social activities, physical and mental development, personal growth, and educational and cultural pursuits [14]. A study conducted at Mordovian State University revealed that students rarely used their free time for sports, reading, or visiting theaters, museums, or cinemas. In addition, 44.0% of respondents preferred to spend their free time with friends, while 32.0% wanted to spend their free time with their family [15]. In a study conducted among medical academy students, it was found that more than half of the respondents spent their free time preparing for the next day's classes, socializing with friends, sleeping, going for walks, and using social media on their phones.

Research has shown that most students do not eat regularly, often snacking on the go and not drinking enough water with their meals. However, students are interested in having a healthy and nutritious diet at their universities. This could help improve their overall health and daily routine. The current student diet is not healthy or vitamin-rich, which requires monitoring the variety, quantity, and quality of their meals [16]. A study at the Izhevsk State Medical Academy revealed that the majority had a snack once between main meals – 41.6±2.6 per 100 respondents, did not participate in or were interested in marathons, conferences and webinars on proper nutrition – 69.5±2.5, starved on certain days – 1.1±0.2 respondents, once 15.4±1.9 of the respondents consumed hot and full–fledged food per day, while more than half of the respondents never consumed yeast–free products.

A study conducted at the Voronezh State Medical University revealed that alcohol consumption is the most common harmful habit among medical students. A smaller number of students smoke. Drug use was almost non-existent. However, it was noted that senior students smoke and drink alcohol more frequently than junior students. The reasons included the desire to improve mood, relieve stress, or appear more mature [17]. During the study at the Izhevsk State Academy, it was noted that 20.2±2.1 out of 100 students smoke electronic pipes. A third of the students reported drinking alcohol only on holidays, in amounts of 200-300 ml. The reason for drinking for a third of the students was to relax after school and to socialize.

Conclusion

Today's youth is characterized by a fairly high susceptibility to socially-determined risk factors, which can lead to the emergence of chronic non-communicable diseases. As a result of the study, it was noted that only two-thirds of the respondents were satisfied with their housing conditions, and less than half of the respondents were satisfied with the environmental situation in the region. One-third of the respondents noted the lack of places for physical culture and sports. At the same time, less than half of the respondents showed no interest in any leisure activities at all. Every second student noted that they do not see any point in health-saving behavior at all, while they will begin to conduct independent medical activities within a year. In their free time from studying, most students are not ready to spend it in a beneficial way for their own health, they are ready to spend this time for communicating with friends, sleeping and being in social networks in the phone, tablet or computer.As noted by many studies, the incidence of obesity tends to increase. However, two-thirds of the respondents did not participate in or were not interested in marathons, conferences, or webinars on proper nutrition, and more than half of the respondents had never consumed yeast-free products, mostly due to their high cost. One in five respondents smoked electronic heating tubes, and one in three consumed alcoholic beverages on holidays, typically in amounts of 200-300 ml, primarily for relaxation after school and socializing.

The study showed that in the training of specialist doctors in higher medical educational institutions, along with teaching professional skills and abilities, it is necessary to form a stable dominant and motivation for the formation of healthy lifestyle behavioral attitudes among the population. Therefore, it is necessary to supplement educational programs with competencies for the formation of health-preserving behavior among both students and young people in general.

About the authors

Vladimir I. Starodubov

Central Research Institute of Healthcare Organization and Informatizationion

Email: starodubov@mednet.ru
ORCID iD: 0000-0002-3625-4278
SPIN-code: 7223-9834

MD, PhD, Professor, Academician of the RAS

Russian Federation, Moscow

Georgy I. Bezdetko

Central Research Institute of Healthcare Organization and Informatizationion; Izhevsk State Medical Academy

Author for correspondence.
Email: bezdetko.g@yandex.ru
ORCID iD: 0000-0001-6395-0538
SPIN-code: 8948-4389

MD, PhD, Senior Lecturer

Russian Federation, Moscow; Izhevsk

Valery S. Stupak

Central Research Institute of Healthcare Organization and Informatizationion

Email: stupak@mednet.ru
ORCID iD: 0000-0002-8722-1142
SPIN-code: 3720-1479

MD, PhD, Assistant Professor

Russian Federation, Moscow

References

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