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ENVIRONMENTAL HEALTH ISSUES

Demographic process and regional peculiarities of natural movement of population in 1998 change

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Birth rate, death rate and population growth coefficients (per 1,000 people)

The demographic situation in Ukraine, which has acquired the features of an acute demographic crisis in recent years, became increasingly complicated in 1998. That was evidenced by the fact that a population of 50.5 million people in early 1998 had decreased to 50.1 million people by early 1999, as well as by the growing depopulation.

The population is decreasing annually because the number of deceased has exceeded that of newborns, by 39,000 in 1991, 100,000 in 1992 and 299,700 in 1995, including 166,800 in urban settlements and 133,900 in rural areas. Thus, 55% of the natural decrease of population occurred in urban settlements in 1998.

In 1998 the tendency towards a decrease of the total population continued. The urban population decreased by 254,100 people, while the rural population decreased by almost 400,000, approximately the same level as in recent years.

A decrease of the total population was observed in all regions. The most essential decrease of the total population occurred in such highly urbanized regions of Ukraine as Donetsk (56,500), Dniepropetrovsk (30,400), Kharkiv (26,500), the Autonomous Republic of the Crimea and the city of Sevastopol (28,600). The number of people in these regions mainly decreased at the expanse of urban population. These five regions make up 44.3% (174,000 people) of the total population decrease in 1998. The group of regions with a decrease of population also includes the regions of Odesa (19,200), Zaporizhzhia (18,700), Chernigiv (15,600), Vinnytsia (15,600) and Sumy (15,300).

These nine regions and the Autonomous Republic of the Crimea as a whole make up about 66% of the population decrease in Ukraine. The lowest population decrease in 1998 was observed in the regions of Zakarpattia (800 people), Rivne (1,900), Ivano-Frankivsk (3,000) and Chernivtsi (3,100 people); the natural increase was positive in the first two regions (1,500 and 4,000 people, respectively).

The decreasing population figures are a result of a further natural decrease of the population and negative indices of migration (both in urban settlements and rural areas). But the migration indices in rural areas is 6.4 times as low as in urban settlements.

Regional peculiarities of the demographic situation are formed as a result of interstate relations, the ethnic background of people in a certain region, the basic gene pool, moral and religious conditions, etc.
Since the influence of these conditions has its distinctions in a concrete region, the state of the demographic process there gives a mosaic picture of reproduction of the population both in quantitative and qualitative respects.

A natural decrease of population has been recorded in all the regions of Ukraine except for Zakarpattia and Rivne regions. The decrease was highest in the regions of Chernigiv (10.8 people per 1,000), Sumy (9.2), Lugansk (8.9), Donetsk (8.7), Poltava (8.5), Kirovograd (8.3) and Cherkasy (8.2), and lowest in the regions of Ivano-Frankivsk (0.6), Chernivtsi (0.8) and Volyn (1.4).

The socio-economic crisis in Ukraine is the cause of the crisis situation in terms of population figures. Birth rates are still falling sharply. In 1998 the number of newborns (419,200) decreased by 23,400 as compared to 1997, and by 138,300 as compared to 1993. The birth rate coefficient in 1998 was 8.3 per 1,000 people. That is one of the lowest levels in Europe and in the world.

This index is even lower in the south-eastern (7.3%)and north-eastern (7.6%) regions of Ukraine. Only the western region is still characterized by a more or less considerable birth rate (11.7 in 1997, 11.3 in 1998). A relatively high birth rate level is observed in rural areas of Rivne (14.5%), Volyn (13.5%), Chernivtsi (12.9%), and Zakarpattia (12.8%) regions.

The total birth rate index has decreased to a level which evidences a lack of population reproduction. The average number of children born by one woman was 1.1 in 1998 (1.0 in cities, 1.6 in villages).

A sharp deterioration of the situation of population mortality was observed in Ukraine in the 1990s, especially in the first years of the decade. The annual number of deaths increased by 163,000: from 630,000 in 1990 to 793,000 in 1995. As of 1996 one can observe a very slow decrease of the mortality coefficient, the total one from 15.2% to 14.3%, the standardized from 14.0% to 12.9%.

One can also observe a significant difference in various regions as to mortality coefficient. The highest levels were registered in the north-eastern (17.1%) and central (15.9%) regions, the lowest ones in the western region (12.1%).

The decreasing birth rates and rising mortality rates result in a deepening depopulation crisis. In 1998 the natural increase remained negative; the loss was 6.0% in Ukraine. The worst situation was observed in the north-eastern (- 9.5%) and south-eastern (-8.0%) regions.

Infant mortality in 1998 decreased to 12.8 per 1,000 babies born alive. It was the first decrease of the death rate of babies in the 1990s. As compared to 1997 infant mortality has decreased by 8.8%. A decrease of infant mortality was observed in all the regions of Ukraine; the rates of decrease were highest in the north-eastern (by 12%) and central (by 6%) regions.

Despite the considerable decrease, the coefficient of infant mortality remains the highest in the southern region (14.0%) , its lowest level being observed in the central (11.1%) region. A considerable decrease of the death rate of newborn boys and a certain increase of the death rate of girls were observed in the south-eastern region (Table 6.1).
Sharply decreasing birth rates cause the health of newborns to be of special concern. It depends essentially on the health of the parents and complications in the course of pregnancy and during delivery. An unfavourable ecological situation favours the expansion of chronic diseases which reaches the reproductive period and creates a closed cycle: a sick mother (father) sick child sick teenager sick parents. The cycle term is 20-25 years, and with each such cycle the pathologic states of newborns become more severe.

Introduction of modern medical and organizational technologies in maternity and childhood protection services has, in spite of the unfavourable ecological situation and limited financing, resulted in a reassuring tendency in terms of neonatal (7.7 per 1,000 alive newborns in 1997 and 7.2 in 1998) and maternal mortality (30.9 and 29.5 per 100,000 of alive newborns, respectively).

The decrease of neonatal mortality took place against the background of a deterioration of the health of babies: while in 1995 only 211.8 of 1,000 newborns had birth defects, in 1998 this number reached 260.3. The acuteness of the prematurity problem is determined by the fact that the sickness rate of premature babies is 3.4 times and early neonatal mortality is 16.0 times as high as analogous indices for the mature.

Thus in all the areas of the central region the level of neonatal mortality and prematurity is the lowest (on average) in Ukraine, while in most regions of the southern and south-eastern regions the index of neonatal mortality remains high against a high level of prematurity.

In the south-eastern region, and in some areas of the western (Ivano-Frankivsk, Lviv, Ternopil) region the high level of neonatal mortality (lower prematurity than in Ukraine on average) is mainly determined by a high level of infant mortality from birth defects of development and states originating from the perinatal period.

The high levels of maternal and infant mortality are persisting in the regions hardest hit by the after-effects of the Chernobyl catastrophe. These are Kyiv, Zhitomyr and Chernigiv regions as well as the developed industrial complex (Zaporizhzhia, Kirovograd).

Constantly low levels of mortality were observed in the recent years only in Lugansk and Vinnytsia regions (Table 6.2).

An analysis of statistical data shows that there are regions in Ukraine where the demographic situation has acquired a special character. Among them:

    The south-eastern region (Dniepropetrovsk, Donetsk, Lugansk and Kharkiv regions) with the highest population decrease, especially in the urban population. This decrease has been determined mainly by mortality exceeding natality as well as by the negative balance of population migration.

    The capital region (Kyiv and district) with a considerable decrease of the urban population. The decrease of the urban population was observed side by side with that of the rural population.

    The central region (Vinnytsia, Zhitomyr, Kirovograd, Poltava, Sumy, Khmelnitskyi, Cherkasy and Chernigiv regions) is characterized by a steadily increasing depopulation.

    The southern region (AR of the Crimea, Mykolaiv, Odesa, Kherson regions) is also characterized by a decrease of population (both urban and rural).

    The western region (Volyn, Zakarpattia, Ivano-Frankivsk, Lviv, Rivne, Ternopil and Chernivtsi regions) is the most stable as to demographic development. It is still a region of natural reproduction.

The favourable age structure of the population is one of the factors causing a natural increase of the population in the western region. The youngest population and, therefore, the highest potential of demographic reproduction are characteristic of the region. Social and natural conditions for vital activities are the most important factors of reproduction. Living conditions for some people in certain regions of Ukraine have a negative effect on the quantitative indices of population reproduction. This mostly concerns the south-eastern region where considerable hyperurbanized areas with permanently high pollution of the atmospheric air, water, soil and food products affect public health, especially the health of children. A considerable spread of all diseases, especially those connected with the quality of the environment (malignant tumours, pregnancy pathologies, maternal anomalies, etc.) are characteristic of the region.

The same influence of unfavourable natural conditions is manifested in other highly urbanized regions of Ukraine. In the future such regions cannot be an essential source of population reproduction both because of the low natural increase, and because the physical state of the people has been weakened as a result of the natural and socio-economic conditions that have developed.

Considerable pollution by radioactive elements will also have a negative effect on population reproduction for a long period of time. Almost 2,350,000 people live in territories with different degrees of radioactive pollution. Various factors connected with this phenomenon determine the deterioration of reproduction indices. This mostly concerns areas of the central and capital regions, especially the Polissia parts of Kyiv and Zhitomyr regions, which have become areas of a demographic catastrophe.

The regional peculiarities of the demographic situation in Ukraine are caused by various reasons of social, economic and ecological character and this situation can be improved only with due regard to the fact that only the creation of favourable conditions for people's vital activities will ensure positive progress in the demographic processes in Ukraine.

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