51829 UKRANIAN TpareAiJl, JlKO·" MO)l(Ha yHIIIKHyTIII: nOAOnaHHJI B YKpaeiHi Kplll3111 3AOPOB'JI nlOAIIIHIII AOCBiA EBpOnlll 3AOPOB'~ nlOAlJIHlJI TA AEMOrpA(J)I~ TpareAiR, RKO"i MO>KHa yHIIIKHyTIII: nOAOnaHHH B YKpa"'Hi Kplll3111 3AOPOB'H nlOAIIIHIII AOCBiA EBpOnlll YnpasniHHR P03Sl-1TKY nlO,QI-1HI-1 PerioH sponl-1 Ta Cepe,QHbo"l' A3i'f CSiTOSI-1H 6aHK nepeniK Ta6nMqb Ta6nv1l-1>1 1. Koecj:Jiwi8HT cMepTHOCTi AopocnV1x (I71MoBipHicTb BMepTV1 YBiWi 15 - 60 pOKiB Ha 1000 HaCeneHH>1). . ...... 14 Ta6nV1W>1 2. nOBiKOBa TpV1BanicTb >KV1TT>1 BYKpaiHi Ta BoKpeMV1x 8Bponel71cbKV1x KpalHax, 2005 piK .. ...... 17 Ta6nV1W>1 3. nV1ToMa Bara 10 ronoBHV1x npV1YV1H YnOBiKoBil71 cTaHAapTV130BaHil71 cMepTHocTi BYKpalHi 18 oKpeMV1x Aep>KaBaX 8BponV1 ... ....... ... 21 Ta6nV1W>1 4. nV1TOMa Bara 10 ronOBHV1X npV1YV1H YT>KCI BYKpalHi 18 oKpeMV1x Aep>KaBaX 8BpOnV1 (% BiA 3arany) ... 22 Ta6nV1W>1 5. nV1TOMa Bara ronOBHV1X cj:JaKTOpiB PV13V1KY YT>KCI BYKpa·iHi i oKpeMV1x 8Bponel71cbKV1x KpaYHax, 2002 piK (% BiA 3arany).. . ..... 31 Ta6nV1W>1 6. BiACOTOK perympHV1x ll\OAeHHV1X KYPWiB BiKOM 15+, YKpalHa Ta oKpeMi Aep>KaBV1 8BponV1 ..... 33 Ta6nV1W>1 7. CnO>KV1BaHH>1 YV1CTOro anKoromo, YKpalHa Ta oKpeMi Aep>KaBV1 8BponV1, OCTaHH>1 Ha>1BHa piYHa iHcj:JopMawi>1 , niTpiB Ha AYwy HaCeneHH>1 Ha piK .. . ........ ........ .......... ..... . ....... 35 Ta6nV1W>1 8. CepeAH8 CnO>KV1BaHH>1 Kpyn'>1HOI npoAYKwil, cj:JPYKTiB i OBOYiB, YKpalHa Ta 8C, 2003 piK .... 36 Ta6nV1W>1 9. 3aranbHa nepeAyaCHa cMepTHlcTb Ta nepellyaCHa cMepTHicTb, >1KY MO>KHa nOnepel1V1TV1, i3 p036V1BKOIO no TPbOXronOBHV1X cj:JaKTopax PV13V1KY, YKpa·iHa, 2004 piK .. ........... ..... .... . ....... ............ 40 Ta6nV1W>1 10. 3aranbHa cMepTHicTb Ta cMepTHicTb, >1KO·j MO>KHa 6yno YHV1KHYTV1 3aBI1>1KV1 niKYBaHHIO, YKpa·IHa, 2004 piK .. 41 Ta6nV1W>1 11 . 3aranbHa noniTV1Ka ll\0110 TIOTIOHY ... ....... .. ............... 43 Ta6nV1W>1 12 30HV1, Ae nanV1TV1 3a6opoHeHo .. ... 45 Ta6nV1W>1 13. noniTV1Ka YranY3i 3ano6iraHHIO anKoroni3MY·· ... 46 Ta6nV1W>1 14. PeKnaMa cnV1pTHV1x HanOIB .. .. 47 Ta6nV1W>1 15. 06Me>KeHH>1 Ha npOAa>K 3a yaCOM i MicweM .. ..... 48 Ta6nV1W>1 16. YyaCTb YnporpaMax B003 .. ... 50 Ta6nV1W>1 17 AoMiHicTPaTV1BHi CTPYKTYPV1, ll\O Bil1nOBiAalOTb 3a 311il71cHeHH>1 noniTV1KV1 YranY3i XapYYBaHH>1 ........ 51 Ta6nV1W51 18. Ecj:JeKTV1BHi 3axOAV1 npocj:JinaKTV1K\I1 Ta KOHTponlO HI3 BYKpaiHi. ........ 54 Ta6nV1L1>1 19. Orn>111 pecj:JopMYBaHH51 CV1CTeMV1 OXOPOHV1 3110POB'>1 yKpal Hax LjeHTpanbHo"i 8BponV1 .. ...... .. ... 58 Ta6nV1L1>1 20. PecypcV1 OXOPOH\I1 3AOPOB'>1 18 YXH8 BV1KOp\l1CTaHH>1 BYKpalHi Ta 8C , 2004 piK .. .... ... 62 nepeniK AiarpaM ,QiarpaMa 1. nporHo3 YV1CenbHocTi HaCeneHH>1 YKpaiHV1 3a iCHYIOYV1XTeHAeHL\il71, 2006 - 2050 POK\I1 ....... 12 ,QiarpaMa 2. ,QV1HaMiKa 30BHiwHbOI eMirpawii, 1990 - 2007 pOKV1 .. ... . 13 ,QiarpaMa 3. nOKa3HV1KV1 npV1pOIlHoro np\l1poCTy HaCeneHH>1 YKpaIHV1 .. ....... 13 ,QiarpaMa 4. ,QV1T>1ya cMepTHicTb Ta HeOHaTanbHa cMepTHicTb Ha 1000 HOBOHap0.Q>KeHV1X, YKpalHa Ta Ae>1Ki KpaiHV1, 2005 piK ... ..14 ,QiarpaMa 5. OYiKYBaHa TpV1BanicTb >KV1TI>1 np\l1 HapO.Q>KeHHi BYKpaYHi Ta OKpeM\I1X KpaiHax, YonoBiK\I1, 1970 - 2006 POKV1 .. ............ ... ... ..... .. .... ... .... ......... .......... ...... 15 ,QiarpaMa 6. OYiKYBaHa TpV1BanicTb >K\I1TT>1 npV1 HapO.Q>KeHHi BYKpalHi Ta oKpeMV1x KpalHax, >KiHKV1 , 1970 - 2006 POK\I1 .... 16 ,QiarpaMa 7. OYiKYBaHa Tp\l1BanicTb >KV1TT>1 3110POBOi nlOl1V1H\I1 , pOKiB, YKpaiHa, 2002 piK .... .......... ......... ........ .... 17 ,QiarpaMa 8. OYiKYBaHa TpV1BanicTb >KV1TT>1 3AOPOBOI nlOl1V1HV1 BYKpaiHi Ta oKpeMV1 x KpaiHax 8BponV1, pOKiB, 2002 piK .... 17 ,Qiarpa Ma 9. nporHo3 nV1ToMo·i BarV1 yonoBiKiB i >KiHOK npawe3AaTHOro BiKY Y3aranbHi~ YV1CenbHocTi HaceneHH51, 2002 - 2052 POK\I1 .. ...... ... .. ... ..... 18 4 DiarpaMa 10. CMepTHicTb i3 AeTani3aui81O no npIiIYIiIHaX, YKpalHa, 2002 piK ... ... ............ . ..... 20 DiarpaMa 11. fonosHi npliIYIiIHIiI cMepTHocTi i3 AeTani3aui81O no BiKOBIiIX rpynax, YKpaiHa y nopiBHS1HHi i3 8C (8C = 100), YonoBiKliI, 2005 piK ........... . . ...... . ... 21 DiarpaMa 12. fonoBHi npliIYIiIHIiI cMepTHocTi i3 AeTani3aui81O no SiKOSIiIX rpynax, YKpalHa y nopiBHS1HHi i3 8C (8C = 100), >KiHKIiI, 2005 piK .. ..... 21 DiarpaMa 13. DKCI i3 p0361i1BKOIO no npliIYIiIHax, YKpa'lHa, 2002 piK ..... . .... .. .... . ..... 22 DiarpaMa 14. CKC AnS1 3axBoplOBaHb cepueBo-cYAIiIHHo'i CItlCTeMliI , YKpaiHa 18 oKpeMi Aep>KaBIiI 8Bponlil, 1990 - 2005 POKIiI .. .. 23 DiarpaMa 15. CKC AnS1 iWeMiYHOi XBopo61i1 cepuS1, YKpalHa Ta oKpeMi Aep>KasliI 8Bponlil, 1990 - 2005 POKIiI .... 23 DiarpaMa 16. CKC AnS1 iHcynbTY, YKpalHa Ta oKpeMi Aep>KaBIiI 8sponlil, 1990 - 2005 POKIiI DiarpaMa 17. CKC AnS1 nClilxiYHIiIX i nOBeAiHKoBIiIX p03naAis, yonoBiKliI, YKpaiHa 18 oKpeMi Aep>KaBIiI sponlil, 1990 - 2005 pOKIiI .. ........ ...........·· . ........ 24 DiarpaMa 18. CKC AnS1 nClilxiYHIiIX i nOBeAiHKoBIiIX p03na,qiB, >KiHKIiI, YKpalHa Ta oKpeMi Aep>KaBIiI 8Bponlil, 1990 - 2005 pOKIiI .... ...... 24 DiarpaMa 19. CKC AnS1 paKY, YKpa'iHa Ta oKpeMi Aep>KaBIiI 8Bponlil, 1990 - 2005 POKIiI ....... 25 DiarpaMa 20. CKC AnS1 paKy Tpaxe'l, 6pOHXiB i nereHiB, YOnOSiKliI, YKpalHa Ta oKpeMi Aep>KaBIiI 8sponlil, 1990 - 2005 pOKIiI .. ........ .......... 25 DiarpaMa 21. CKC AnS1 paKy MOnOYHOi 3an031i1, >KiHKIiI , YKpa'IHa Ta oKpeMi Aep>KaBIiI 8Bponlil, 1990 - 2005 pOKIiI.. ..25 DiarpaMa 22. CKC AnS1 30BHiwHix npliIYIiIH, YonoBiKIiI, YKpa'iHa Ta oKpeMi Aep>KaBIiI 8Bponlil, 1990 - 2005 pOKIiI ........ 26 DiarpaMa 23. CKC AnS1 30BHiwHix npIiIYIiIH, >KiHKIiI, YKpaYHa Ta oKpeMi Aep>KaBIiI 8Bponlil, 1990 - 2005 POKIiI .. .26 DiarpaMa 24 . Oco61i1, UjO nocTpa>KAanlil BiA HeUjacHlilx BlilnaAKiB Ha Blilpo6HIiIUTSi, YKpalHa Ta oKpeMi Aep>KaBIiI 8sponlil, 1990 - 2006 pOKIiI.. . . . . . . .. . . . . . ................ .... .. 27 DiarpaMa 25. CMepTHicTb BiA HeUjaCHItlXBlilnaAKiB Ha Blilpo6HIiIUTBi, YKpalHa 18 oKpeMi Aep>KasliI 8Bponlil, 1990 - 2006 POKIiI ....... 27 DiarpaMa 26. CKC AnS1 Ty6epKynb03Y, YKpa'IHa 18 oKpeMi Aep>KaBIiI 8 Bponlil , 1990 - 2005 pOKIiI .. .. . .. 28 DiarpaMa 27. CKC AnS1 Bin/CHID (3a AaHIiIMIiI CIilCTeMIiI OnepaTliIBHOI cTaTIiICTItlKIiI), YKpa'iHa Ta oKpeMi Aep>KaBIiI 8Bponlil, 1990 - 2005 POKIiI .......... .... ........ ...... . ......... .. ......... . ...... 28 DiarpaMa 28. nlilToMa Bara Bcix npliIYIiIH, nOB'S13aHIiIX i3 TIOTIOHonaniHHS1M, BCKC, YKpalHa 18 oKpeMi Aep>KaBIiI 8Bponlil. YonoBiKIiI, 1990 - 2005 POKIiI ........ . ... .... .. . ..... .... ·........ 33 DiarpaMa 29. nlilTOMa Bara Bcix npltlYIiIH, nOB'S13aHlilx i3 TIOTIOHonaniHHS1M, BCKC, YKpa'iHa Ta OKpeMi Aep>KaBIiI 8Bponlil, >KiHKIiI, 1990 - 2005 pOKIiI.. ...33 DiarpaMa 30. naniHHS1 Ta cepeAH8 UjOAeHHe CnO>KIiIBaHHS1 TIOTIOHY i3 p036Ii1BKOIO no BiKOBIiIX rpynax, YKpaiHa, 2002 piK ..... · · . . . ....· 33 DiarpaMa 31 . nlilToMa Bara Bcix npliIYIiIH CKC , nOB'S13aHlilx i3 anKoroni3MoM, YKpaiHa Ta OKpeMi Aep>KaBIiI 8Bponlil, YonoBiKliI, 1990 - 2005 POKIiI ......... ... .............. . ... .... ............ .. ..... 34 DiarpaMa 32. nlilToMa Bara Bcix npliIYIiIH CKC, nOB'S13aHlilx i3 anKoroni3MoM, YKpalHa Ta oKpeMi Aep>KaBIiI 8Bponlil , >KiHKIiI, 1990 - 2005 POKIiI ................... .. . . ....... ...... .. . .... .... . ...... 34 DiarpaMa 33. CepeAH8 CnO>KIiIBaHHS1 Kanopil1 Ha AYWy HaceneHHS1 Ha AeHb (KKan), YKpalHa Ta oKpeMi Aep>KaBIiI 8Bponlil, 2003 piK .. ...... ............ ... ... 36 DmpaMa 34. YlilcenbHicTb HOBIiIX naui8HTiB y 3aKna,qax niKysaHHS1 BiA HapKoMaHi'l, YKpalHa 18 oKpeMi Aep>KaBliI8Bponlil , Ha 100000 HaceneHHS1. 1990 - 2006 POKIiI .................. . ...... 37 DiarpaMa 35. Ha,qnlilwKoBi BIiIKIiIAIiI AioKCIiIAY, YKpaiHa Ta oKpeMi Aep>KaSIiI8 Bponlil, 1990 - 2000 POKIiI ... ....... 37 DiarpaMa 36. CMepTHicTb, S1KOI MO>KHa 6yno yHIiIKHym, YKpaiHa, 2004 piK ................ .. .40 DiarpaMa 37. PiBHi cMepTHocTi, S1Ky MO>KHa nonepeAIiITIiI, oco61i1 BiKOM 25 - 64 POKItl, YKpaIHa .. .... 42 DiarpaMa 38. Dep>KaBHi BIiIAaTKIiI Ha OXOPOHY3AOPOB'S1, AIiIHaMiKa Ta cTpyKTypa, YKpaiHa ('Yo BBn) ...... 60 DiarpaMa 39. Dep>KaBHi BIiIAaTKIiI Ha OXOPOHY 3AOPOS'S1 BYKpaYHi Ta oKpeMlilx Aep>KaBaX ('Yo BBn) ...... 60 DiarpaMa 40. YacTKa rpoMaAS1H, S1Ki OTPIilMYIOTb MeAIiIYHYAonOMory, Konlil BOHa 'iM nOTpi6Ha ..... 63 t:\iarpaMa 41. TpliIBanicTb OYiKYBaHHS1 pe3ynbTaTiB na60paTopHlilx AOcniA>KeHb .. ..63 DiarpaMa 42. >1KicTb yMOS y niKapHi niA yac nepe6ysaHHS1 npOTS1roM OAHi8'i Hoyi .. ..... 64 5 5 . O'!iKYBaHa Tpl1BanicTb )KI1TTR B YKpaii-li e Ha6araro MeHWOIO, Hi)K B iHWI1X Kpaii-la x eBPOnl1, npl1 '!OMY Hatil6inbwe BIIlHocHe cKopo'!eHHR Tpl1BanOCTi )KI1TTR cnocrepiraeTbcR cepe)J, rpoMa)J,RH npa~e3- )J,aTHoro BiKY, OC06nl1BO cepe)J, '!onoBiKiB . .00 KiHLj51 80-x pOKiB TeH,QeHLjil Ha TepeHi Tpv1BanOCTi >KIt1TT51 Y CXi,QHit'i1 8Bponi 6ynlt1 nplt16nlt13HO O,QHaKOBIt1MIt1, ane nOTiM 3'51Blt1nIt1C51 p036i>KHOCTi: B YKpalHi Ta Pocil OT>K nO'-lana CKopO'-lYBaTIt1C51, B TOVi '-lac 51K y KOnlt1WHix cOLjianicTIt1'-1HIt1 X KpalHax - YecbKiVi Pecny6ni Lji, YropLl\It1Hi , CnOBeHil Ta nonbLl\i - BOHa nO'-lana CYTTCBO 3pOCTaTIt1 . Cboro,QHi npoLjec CKOpO'-leHH51 OT>K B YKpalHi, 3,QaCTbC51, 3HaXO,QIt1TbC51 y CTarHaLjiL 6. Y nopiBHRHHi i3 iHWI1MI1 eBponetilcbKI1MI1 Kpaii-laMI1, YKpaii-l~i He TinbKI1 nOMl1palOTb Y 6inbw MO nO)J,oMY Bi~i, ane til npO)KVlBalOTb MeHwe pOKiB Y nOBHicTIO 3)J,OPOBOMY cTaHi. "ixHiVi CTaH 3,QOPOB '51 BIt1 ,QacTbc51 ripWIt1M 3a HopManbHIt1Vi CTaH npoT51rOM MaVi>Ke 13% Tplt1BanOCTi >KIt1TT51 , B TOVi '-lac y nonbLl\i Ljet'i1 nOKa3HIt1K CKna,Qac 8%, CnoseHii Ta YecbKiVi Pecny6niLji - 9% . .00 piBH51 YKpa'IHIt1 Ha6nlt1>KaCTbC51 nlt1we YropLl\It1Ha - 11 %. Tpl1BanicTb lKMTTIi npl1 HapolllKeHHi BYKpa'iHi Ta llellKI1X Kpa'iHax CBpOnl1, 'lonoBiKM, 1970 - 2006 POKM 77 82 +-------------------------------~~ 75 80 73 71 78 69 67 76 65 63 61 59 57 70 1970 1975 1980 1985 1990 1995 2000 2005 1970 1975 1980 1985 1990 1995 2000 2005 '-IonoBiK~ >KiHK~ ~ '-IecbKa Pecny6niKa ~ YrOpll1~Ha -40- nOnbll1a - - Poci~ _ CnoBeHi~ - - YKpa'iHa -+- C 7. P0361JKHOCTi Y TpVlBanOCTi )KVlTTR )KiHOK i '!onoBiKiB TaKO)K BVI)J,aIOTbCR Ha6araro 6inbWVlMVI , Hi)K Y Kpaii-lax i3 BVlCOKVlM piBHeM )J,OXO)J,iB Ta Kpaii-lax eG. Cepe,QH51 pi3HIt1Lj51 y Tplt1BanOCTi >KIt1TT51 >KiHOK i '-IOnOSiKiB B YKpaiHi 3Ha'-lHO 3pocna - i3 ,QeB'51TIt1 pOKiB B 1989 pOLji .00 MaVi>Ke 12 pOKiB B 2005 pOLji , B TOVi '-lac 51K pi3HIt1Lj51 Y Tplt1BanOCTi >KIt1TT51 >KiHOK i '-IonoBiKis B 8C 3MeHWlt1naC51 Ha O,QIt1H piK .00 6,2 pOKY B 2005 pOLji . O'-liKYBaHa Tplt1BanicTb >KIt1TT51 B YKpalHi Ha 8,2 pOKY KopOTwa 3a cepe,QHiVi nOKa3HIt1K 8C ,Qn51 >KiHOK, i Ha 14 pOKiB KopoTwa y '-IonoBiKiB . OItHa TpeTUHa YKpaiH~is nOMupac nepelt'laCHO, Y SiLl; tlO 65 pOKis. LIeu nOKa3HUK Ha6araTo nepesu~yc piSeH& , RKUU cnocTepiraCT&CR y csponeucbKux KpaiHax. 8. BVlCOKi KoecjJi~ieHTt1CMepTHOCTi nORCHlOlOTbCR nepeBa)KHO cMepTHicTIO cepe)J, '!onoBiKiB npa ~e3)J,aTHoro BiKY. CMepTHicTb cepe,n '-IonoBiKiB npaLje3,QaTHoro BiKY ,QOpiBHIOC nOKa3HIt1KaM Kpa'iH 3 HIt13bKIt1MIt1 ,QOXO,QaMIt1 . II1MOBipHicTb ,QO>KIt1TIt1 .00 noxlt1noro BiKY B YKpalHi C HIt13bKOlO Y nopiBH51HHi i3 LjeHTpanbHOCBponeVicbKIt1MIt1 KpalHaMIt1, OC06nlt1BO cepe,Q '-IonoBiKiB. CMepTHicTb cepe,Q '-IonoBiKiB npaLje3,QaTHoro BiKY C nO,Qi6HOlO .00 clt1TyaLji'i y Kpa'iHax, ,Qe BHn Ha ,Qywy HaceneHH51 CTaHOBIt1Tb n'51TY '-IacTIt1Hy Bi,QnOBi,QHoro nOKa3HIt1Ka B YKpa·iHi. CMepTHicTb cepell '1onoBiKiB npalte31laTHOrO BiKY Ta BHn; YKpa'iHa Ta HM3Ka BM6paHMX Kpa'iH - PiBeHb CMepTHOCTi cepeA Kpa'iHH '1onoBiKiB npaue3AaTHoro BiKY 5eHiH 1250 349 Toro 770 371 IBiHeS1 1130 380 lai"ri 1070 329 laHa 1240 350 YKpa"iHa 6110 384 8 '< ,POT KV1 t1i Or Jl>lD 9. IOnOaHt1Mt1 npW-It1HaMt1 cMepTHocTi a YKpaiHi, oco6nt1ao cepelJ YOnOaiKia npaLje3IJaTHOm aiKY, C HeiHcjJeKLjii1Hi 3axaoplOaaHHR (H13) i xpoHiYHi 3axaoplOaaHHR. Y 2005 pOL1i iWeMiYHa xBopo6a cepL1$1 6yna nplt1YIt1HOIO MaLl1>Ke 40% 3aranbHOi cMepTHocTi, u.j0 nplt16nlt13HO y,qBiYi nepeBIt1u.jY8 piBeHb , $1KIt1L11 cnocTepil3BC$1 y YecbKiLl1 Pecny6niL1i Ta YlOpu.jIt1Hi (20 - 25%), Ta y YOTlt1plt1 pa31t1 piBeHb CnOBeHil. PIt131t1K 3arlt16eni Bi,q 3axBoplOBaHb CepL1eBo-cy,qIt1HHOI CIt1CTeMIt1 (3CCC) i paKY B YKpa'iHi BIt1,qa8TbC$1 Ha6a13TO 6inbWIt1M, Hi>K y cepe,qHboMY no 8G. 10. KpiM TOm, Ll10 CTOCYCTbCR iHcjJeKLjii1Ht1X 3axBoplOaaHb, TO YKpaiHa a YCbOMY caponei1cbKoMY peli oHi 8003 Mac Hai1at1Ll1t1i1 KoecpiLjicHT CMepTHOCTi, 3a HelO II1,qYTb Poci$1 Ta CXi,QH08BponeVicbKi KpaiHIt1. B YKpa'iHi Ha Bln/CHI,[\ i Ty6epKynb03 nplt1na,qa8 90% 3aranbHoi cMepTHocTi Bi,q iHcpeKL1iLl1HIt1X 3aXBO plOBaHb. 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P03f10,n n S !vfEPTHOLf JA X8::lPIOB"I-tOCl f A IHBAnlIlHOCT I Ta6nKI\lI 3. nKTOMa Bara 10 ronoBHKx npM'IKH y nOBiKoBiM cTaHAapTM30BaHiM cMepTHocTi BYKpa"iHi Ta oKpeMKx Aep>KaBaX EBponK ,[\eCATb ronOBH~X npl1'iIiH cMepTHocTi IWeMiYHa xBopo6a cepuS1 23,85 22,38 20,99 27,58 14,68 38,42 XBopo6a COCYAis M03KY 2 14,14 12,61 11,59 20,17 10,39 14,57 (iHcynbT) 3 xom 1,64 2,16 1,57 1,30 3,05 2,90 4 CaMoTpasMysaHHS1 2,08 2,90 2,26 2,89 3,94 2,80 5 OTpyeHHS1 0,41 0,09 0,55 3,19 0,26 2,72 6 IHWi HeHaBMI1CHi TpaBMI1 1,69 0.82 1,14 3,39 1,22 2,66 PaK Tpaxe'i, 6pOHXis, 7 5,63 6,37 6,51 2, 34 5,34 2,33 nereHis 8 Bln/CHIt:\ 0,00 0,01 0,05 0,76 0,06 2,19 9 Ul1P03 neyiHKI1 1,96 5,37 1,71 1,65 4,73 1,82 10 PaK wnyHKY 1,41 1,59 1,96 1,75 2,09 1,55 Dwepeno . 803'; XYHKvl WHO Gio al Burden 01 Disease (GBD), 2002 21. HaH6inbwi p036iJKHOCTi Y nOKa3HHKax CMepTHOCTi MiJK YKpaiHOIO Ta CC cnocTepiralOTbCR B lliana30Hi npaL(e3llaTHOrO BiKY (,L/t1B. ,L/iarpaMt1 11 fa 12) nicnS1 t:\OCS1rHeHHS1 Ha~Billu..joi TOYKili KpiliBa pi3KO cnat:\ae Y rpyna x 6inbW noxillnoro BiKY · We cBit:\YiIITb npo BiliCOKiII~ p iBeHb nepet:\yacHoi cMepTHocTi Ta npo Benil1KY KinbKiCTb aHat:\MipHiIIX» cMepTe~. B yci x BiKOBiI1 X rpynax cMepTHicTb 8it:\3a xBoplOBaHb cepweBo-cyt:\iI1HHOi CiliCTeMiI1 BiI1t:\aeTbcS1 nocTi~HO BiI1u..jOIO Bit:\ cepet:\Hboro nOKa3HiI1Ka 8C, y4 - 6 pa3is 6inbwolO cepet:\ 'lonoBiKiB SiKOM 15 - 74 POKili Ta npil16nill3HO y 4 pa3i11 6inbwolO cepet:\ YKpalHcbKili X >+KiHKK, 2005 piK 600 .-----------------------------. 500 500 400 t-~------~~~~---\ t- 400 t- J: ~ 300 +---~--_n~--------~----~~ '" ~ .~ :e- Q) 300 t 0 ~ ~ 200 1-----+ ---------------~----__j 200 100 +----.----~--~------~~~ 100 0-14 15-29 30-44 45-59 60-74 ,i + 0-14 15-29 30-44 45-59 60-74 0 0 -'------------- - -- - - ---------' BiKOBa rpyna (poKiBj BiKOBa rpyna (poKiB) --+-- Cepl.\eBO-CY,QVlHHa CVlCTeMa --+-- Cepl.\eBO-CY,QVlHHa Cl>1CTeMa PaK PaK - . - 30BHiwHi npVlYVlHl>1 ---.- 30BHiwHi npl>1Yl>1Hl>1 ,O.>Kepeno 6a.X1 n 1-I.~X 5DC, 2008 pii\ 21 TpArE):lI'iI . ~ ,( I"ll 'vI O>KHA Vf-'VI II B Y'KCI) - qe nOK03HUK oeq,il4umy 300POS'R, RKUU y30 HOCTi. B 2002 POLli HeiHcjJeKLliHHi 3aXBO lonbHIOE KinbK;cmb POK;S }KUmmR, SmpO'leHUX sHocn;ooK plOBaHHR cKna~anH 68% i3 20 MnH. po- cMepm; mo 30XSOpIOSOHb. KiB JKHTTR 3 ypaXYBaHHRM iHBani~HOCTi (,£lI1B. ,£lia,paMY 13). 3axBopfOBaHH~ He TinbK\!l CKOpO'-lyfOTb LjIl1Kn >KII1TT~, ane iii HeraTII1BHO Bnnll1BafOTb Ha ilioro ~KicTb, Tpll1BanicTb ~Koro y TaKII1X BlI1na,QKax MO>KHa BII1Mip~TII1 3a ,QonOMorofO nOKa3HII1Ka «Tpll1 BanicTb >KII1TT~ 3 ypaxyBaHH~M iHBani,QHOCTi - pOKiB» (T>KCI) . Hacni,llKII1 Bi,Q H13 , 30BHiwHix npll1'-lIl1H, iH cpeKLjiiliHII1X, MaTepIl1HCbKII1 X, n ep ll1HaTanbHII1X Ta aniMeHTapHII1X npll1'-lIl1H ,Qn~ T>KCI E: npll16nll13HO TaKII1MII1 CaMII1MII1, ~K ,Qn ~ CMepTHOCTi. 23. npW-IHHOIO MaHJKe nono ,[tiarpaMa 13, T>KCI i3 p036ltBKOIO no nplt'lItHaX, YKpa'iHa, 2002 piK BHHH 3aranbHoro nOKa3HH Ka T>KCI ~eCRTb ronOBHHX npW-IHH (,£lI1B , Ta6nl1LjlO 4). Iwe Mi'-lHa xBopo 6a cep Lj~ B YKpa'IHi BII1,QaE:TbC~ ronOBHOfO npll1'-lll1 3aXBoplOBaHHH 68% HOfO He TinbKII1 CMepTHOCTi , ane iii iHBani,QHOCTi, YKpa'iHa MaE: HailiMeH WIl1i1i T~rap T>KCI Bi,Q MOHonOn~pHII1X ,llenpeCII1BHII1 X p03na,QiB (5,2%), B Toili '-lac ~K B iHWII1X Kpa'lHax Ljeili nOKa3HII1K KOnIl1Ba8TbC51 Bi,ll 7 ,llO 11 %. 3 iH woro 60KY, ~Kll10 HaCen8HH51 YrOpll1I11HII1, nonbll1i , CnoB8Hi'l Ta YeCb Ko'i Pecny6niKII1 BTpa'-la8 Benll1KY KinbKicTb pOKiB >KII1TT51 Y 3,QOPOBOMY CTaHi '-lepe 3 pi3Hi BII1,Q1I1 paKY, TO B YKpalHi Ha CTaH 3,QOPOB'~ Hace neHH~ CYTT8BO Bnnll1BafOTb Bin/CHID (3 ,6%), OTpy8HH~ (3 ,0%), HaClI1nbCTBO (2,5%) Ta HenOBHOLjiHH8 Xa p'-lyB aHH51 (2,8%) , Ta6nlt1.l1l 4. nltTOMa Bara 10 rOnOBHItX nplt'lItH y T>KCI BYKpa"iHi Ta OKpeMItX AeplKaBax EBponlt (% BiA 3arany) JleclITb ronOBHHX npH'tIlH T>KCI IWeMiYHa xBop o6a cepLlfl 8,26 7,75 7.27 10,91 4,73 12,65 Xsopo6a CYAIi1H M03KY 2 5,50 4,98 4,58 7,25 4.49 6,02 (iHcynbT) MOHonon flpHi AenpecVlB- 3 8.68 7,03 8,91 4.30 11 ,34 5,18 Hi p03n8):lVl 4 IHwi HeHaBMl>1CHi TpaBMIi1 4.10 1,96 4.40 5.62 3,09 4,81 5 Bin/C HID 0,16 0 ,12 0,10 1,50 0,08 3,62 6 CaMoTpaBMysaHHfl 2,52 3,04 2,55 3,55 4.08 3,28 7 OTPY8HHfl 0,53 0, 13 0,59 3,33 0,30 3,02 8 Yp0j:l>KeHi aHoManfi 1,26 2,04 1.93 2,09 2,00 2,94 HenOBHoLliHHe xapyy- 9 0,69 1.16 0,84 2,16 0,71 2,82 BaHHfl 10 Hacli1nbcTBo 0,39 1,11 0,55 4.07 0.38 2,48 D"fICiO flO' )dX'IHM1 WHO GkI\JJ' BLwJe:, of Disease (C,8DL 2002 22 P()3,Q 10? PO,,110D n :::'vI[PTIIC ::;T " 3 A XB'JPI(lPAI J ) Cl l TA IHRAnlDi IOCT HeiHcpeK~ii1Hi 3axBoplOBaHHfI 24, CMepTHicTb Bill 3axBOplOBaHb cep~eBO-CYIlUHHOi" CUCTeMU (3CCC) C OIlHiclO ;3 rOnOBHUX npU'IUH CKOpO'leHHfI OT)#( B YKpaiHi. 3CCC BKnlOyalOTb IXC i iHcynbT, CMepTHicTb Bil=\ 3aXBOplO BaHb CepueBO-CYI=\VlHHOI CVlCTeMVI nOyana 3pOCTaTVI B YKpalHi B TOtIl CaMVltIl yaC , KOnVi nOyana CKOpO YYBaTVICb OT>I< , B YKpalHi cTpiMKe 3pOCTaHH51 MaCWTa6iB HI3 cnocTepiranOC51 y 1990 - 1995 pOKax, nOYVlHalOYVI i3 1995 pOKy i 1=\0 TenepiwHbOrO yacy npouec 36inbUJeHH51 HI3 ynoBinbHVlBC51 (,aI1B, ,aia ,paMY 14), CTaHI=\apTVl30BaHVltIl Koec:piui8HT cMepTHocTi (CKC) B YKpalHi 6inbw Hi>K y 2,5 pa3V1 nepeBVI Ll\Y8 cepel=\Hitll nOKa3HVlK ec, oco6nVlBo y BiKOBitll rpyni 30 - 44 POKVI: CKC I=\n51 YKpaiHcbKVlX YonoBiKiB npVl6nVl3Ho y 6 pa3iB 6inbwVltIl, Hi>K B ec, a I=\n51 >KiHOK -l=\eCb y 4,5 pa3V1, AiarpaMa 14. eKe AIlA 3axBopHlBaHb cepueBo-cVAIIHHo"i CIICTeMII, YKpa'iHa Ta oKpeMi AeplKaBII EBponll, 1990 - 2005 POKII 1000 ' -+-- YeCbKa Pecny6niKa 900 II: J: ----0--- YropU1"1Ha J: Q) " Q) u en 800 J: - - nonbU1a 0 0 700 0 0 ~ 600 --+-- Poci~ '" J: () ~ () 500 " ~- - N-- CnoBeHi~ 400 300 - YKpa'iHa 200 0 N C'l ..,. - 8C 600 350 a: J: II: 300' ~ 500 J: J: OJ " Q) u en " Q) u 250 J: 400 en J: 0 0 0 0 0 0 200 g 300 ' 0 ~ en 150 J: () 200 '" J: () ~ () ~ 100 () 100 0 I 0 I N ..,. Ke 40% 3aranbHOI cMepTHocTi. Ue npV16nV13Ho YABi'-!i 6inbwe piBH~ , ~KV1~ cno cTepiraBc~ B YecbKi~ Pecny6niLji, nonbLl1i Ta YrOpLl1V1Hi, Ta 6inbwe Hi>K Y 2,5 pa3V1, Hi>K Y CnOBeHiL Y nepio,Q 1990 - 2005 pOKiB nOBiKoBV1~ cTaHAapTV130BaHV1~ KoecpiLji8HT cMepTHocTi (CKC) Bi,Q iweMi'-!Ho'l xBop06V1 cepLj~ (IXC) B YKpa'iHi ,Qy>Ke WBV1,QKO 3pocTaB, HaTOMicTb Y 6inbwOCTi 8BponeG1cbKV1x Kpa'iH BiH 3anV1waBC~ Bi,QHOCHO cTa6inbHV1M (,[1/118, ,[IiarpaMY 15), 26, CMepTHicTb Bill iHcynbTY lleU40 CKopOTHnaCR, ane 3anHwaeTbCR Ha BHCOKHX piBHRX (,[1/118 ,[IiarpaMY 16). Y nepioA 1990 - 2005 pOKiB B YKpaiHi cMepTHicTb Bi,Q nopyweHH~ M03KOBoro KpOBO 06iry (iHcynbTY) 3poCTana, a B iHWV1X KpalHax pi3KO CKopo'-!YBanac~ . 3MeHweHH~ BV1na,QKiB iHcynbTY B CnoBeHi'1 06YMOBnfOBanO cKopo'-!eHH~ cMepTHocTi cepe,Q >KiHOK, a B YroPLl1V1Hi - nepeBa>KHO CKOPO '-!eHH~M cMepTHocTi cepe,Q HaceneHH~ npaLje3,QaTHoro BiKY, nO'-!V1HalO'-!V1 3 1995 POKY, CMepTHicTb Bi,Q iHcynbTY BYKpalHi no'-!ana CKopO'-!yBaTV1c~ , ane CborOAHi BOHa Bce Ll1e y 2 - 3 pa3V1 BV1 Ll1a , Hi>K B iHWV1X ,Qep>KaBaX CXi,QHOI 8BponV1 , 27, B 1990 - 1996 pOKax CMepTHicTb Bill nCHxiLfHHX p03naIJiB B YKpaiili pi3KO 3pocna i ,Qoc~rna piBH~ 14 cMepTe~ Ha 100 000 '-!onoBiKiB i 4 cMepTi Ha 100000 >KiHOK (,[1/118 ,[IiarpaM/il 17 i 18), nOTiM ,QO 1999 pOKY Lji nOKa3HV1KV1 CKopOTV1nV1C~, a B nO,QanbWOMY 3HOBY no'-!anV1 3pOCTaTV1 AHanori'-!Ha ,QV1 HaMiKa cnoCTepiranac~ i B YroPLl1V1Hi, CnOBeHil Ta nonbLl1i Y YeCbKi~ Pecny6niLji BV1na,QKV1 nCV1xi'-!HV1X p03na,QiB OCTaHHiMV1 pOKaMV1 TaKO>K no'-!anV1 36inbWYBaTV1Cb, Ui TeH,QeHLjii CTOCyIOTbC~ nepeBa>KHO oci6 nOXV1noro BiKY, oc06nV1BO '-!onoBiKiB, l\iarpaMa 17. eKe All!! nCI1Xi'lHI1X i nOBeAiHKOBI1X l\iarpaMa 18. eKe All!! nCI1Xi'lHI1X i nOBeAiHKOBI1X p031laAiB, '101l0BiKI1, YKpa"iHa Ta oKpeMi p031laAiB, lKiHKI1, YKpa"iHa Ta oKpeMi AeplKaBI1 EBponl1, AeplKaBI1 EBponl1, 1990 - 2005 POKI1 1990 - 2005 POKI1 YKpa'iHa -+- Poci~ ~ eC 30 ~------------------------------, 12 ~--------------------------------- 0; 25 +-------~~~------------------_1 i 10 ' C-------\--=~ "<----'\ ----=----- - g 6 +--V-'---\- -/ o '0 o <1l 10 +-~~~--i!~~~----~~~~~~~ J: U :.:: u 5 --!---&"""'---- - - - - - - - - -- - - - - -- - - - - - - -- o 01 N 01 ... 01 01 o o N o ... o o 01 N 01 ... 01 01 o o N o ... o 01 01 01 01 01 o o o 01 01 01 01 01 o o o N N N N N N U*,eCleno Ga3a )l8HMX 5.QC, 2U08 Pi' 28, Y MHHynoMy lleCRTHpiLfLfi, KonH Bill6YBanHcR eKoHoMiLfHi Ta cOLlianbHi TpaHccpopMaLlft~ nCHxiLfHi p03nallH cnpHLfHHRnH cKopoLfeHHR OT>K. 30KpeMa, TicHV1~ B3a8M03 B'~30K cnocTepira 8TbC~ Mi>K COLjianbHO-eKoHoMi'-!HV1MV1 YMoBaMV1 Ta MacwTa6aMV1 nowV1peHocTi ,QenpecV1BHoro cTaHY, Y '-!acV1 cTpiMKV1X COLjianbHO-eKoHoMi'-!HV1X 3MiH 3He,QoneHi nlO,QV1 nocTi~HO OLjiHlOlOTb CB08 CTaHOBV1Ll1e ~K HeraTV1BHe, nO'-!YBaIOTbc~ 6e3noMi'-!HV1MV1 Ta BTpa'-!alOTb KOHTponb HaA c0601O. TaKi CTaHV1 CTalOTb MaCOBV1MV1 TOAi, KonV1 cycninbCTBO WBV1AKO non~pV13y8Tbc~, a COLjianbHa 3narO,Qa, AOBipa , B3a8MHicTb Ta COLjianbHa ni,QTpV1MKa pi3KO 3MeHwylOTbc~ (Kopp et. AI , 2007), 29, PaK B YKpaiili Bill3HaLfaeTbcR Hall3BHLfaHHo BHCOKOIO neTanbHicTIO, oco6nHBo y MonOllwHX BiKOBHX rpynax. B 2005 pOLji CKC An~ paKy y BiKOBi~ rpyni 0 - 64 POKV1 B YKpa'iHi CKna,QaB 104 no MepnV1x Ha 100 000 HaceneHH~, y nonbLl1i - 101, Y YecbKi~ Pecny6niLji - 93 , a B 8C - 79. Ha~BV1Ll1V1~ piBeHb 6YB 3ape8cTpoBaHV1~ B YropLl1V1Hi 135 nOMepnV1x Ha 100 000 HaceneHH~ (,[1/118 ,[IiarpaMY 19) 24 P031J Jl 2 r~ G 2 110Llin CM EPTH() (:TI , 3A XBOPIO BA HOCT TA HB,IIJ11,[(HOC II Ha Bi,llMiHY Bi,ll CMepTHOCTi Cepe,ll MOnO,llWV1X BiKOBV1X rpyn YKpaiHV1, Y BiKOBill1 rpyni 65 pOKiB i 6inbwe cMepTHicTb Bi,ll paKY Hall1HV1>++++I< B YKpalHi BV1,l1aTbCH HacTinbKV1 KOPOTKOIO, u.\0 KinbKicTb oci6 nOXV1noro BiKY, HKi Hapa>+Ke J10 62 ' A8HI1X 5 J , 2008 piK 30, B YKpaiHi Bitl paKy nOMHpac BtlBi'li 6inbwe '1onoBiKiB, HiM MiHOK. Cepe,ll pi3HV1X BV1,l1iB paKY Haill6inbWV1111 THrap cnpV1YV1HH paK nereHiB Y YonoBiKiB (,aVt8, ,aia,paMY 20) Ta paK MOnOYHOi 3an03V1 Y >++< B yciill 8BpOni, Y nepio,ll 1990 - 2005 POKV1 CMepTHicTb Bi,ll paKY MonOYHOI 3an03V1 B YKpa'iHi Y nopiBHHHHi i3 6inbwicTIO iHWV1X BponeillcbKV1X KpaiH 3anV1wanaCH HV13bKOIO, ane npV1 WbOMY 3a OCTaHHi 15 pOKiB BOHa 3HaYHO 3pocna, rlKu.\O B iHWV1X KpaiHax CMepTHicTb, CnpV1YV1HeHa paKOM MOnOYHOi 3an03V1, CKO pOYYTbCS1, TO Cepe,ll YKpaIHCbKV1X >+Kaa8 6inbwe 1 MinbC10Ha moaeC1 , a60 2,25% HaceneHH51, npll1YOMY Lje 3a xsoplOsaHH51 npOaOS>KY8 cTa6inbHo nOWlI1plOSaTII1Cb . LUopiYHO S YKpaiHi SII151Sn51IOTbC51 100000 HOSII1X XSOpll1x. L\e 3axsoplOsaHH51 i3 «xsop06111 nlOaeC1 nOXlI1nolO SiKY» nepeTBOpll1nOC51 Y xsop06y, 51Ka spa >Ka8 nlOaeC1 Y nepwiC1 nonoslI1Hi 'IXHbOIO >KII1TT5'I. 3aranOM, aia6eTlI1KlI1 MalOTb Y 3 - 4 pa3111 6inbwlI1C1 PIl1 3l11K nepeayaCHO SMepTII1 sia cepLjeso-cyall1HHolO 3axsoplOsaHH51, Hi>K pewTa HaceneHH51. KpiM TO 10 , Aia6eT 8 oaHi81O i3 Sa>KJlIl1SII1X npll1YII1H cninOTII1 cepea nlOaeVi npaLje3aaTHOIO SiKY, all1CCPYHKLjil HII1POK, aMnYTaLji'l Hir i HaaMipHOI nepll1HaTanbHOi CMepTHOCTi (B003, 2002 piK). 30BHiwHi npH'IHHH 32. /1,Pyra Haii6inbw Ba)l(nHBa npH'IHHa cMepTHocTi -I..le 30BHiwHi cpaKTopH. Do Kona 30SHiwHix npll1YII1H Hane>KaTb slI1naaKosi TpaSMII1, caMory6cTBo Ta s6l11scTBa . npll1KnaaaMII1 30SHiwHix npll1YII1H MO>KYTb TaKO>K 6YTlI1 OTPY8HH5'I, HeLl1aCHi SlI1naAKII1 Ha soai , naaiHH5'I a60 nO>Ke>Ki . MiCLj51 aii TaKII1 X 30 SHiwHi x npll1YII1H - Lje aOporll1, p060ye MicLje a60 aOMisKa. Y nopiSH51HHi i3 cepeaHiM nOKa3HlI1KOM no 8C , YKpa'IHCbKi YOnOSiKII1 MalOTb 6inbw Hi>K Y 4 pa3111 slI1Ll1l11C1 pll13l11K 3arll16eni sia aii 30SHiwHix npll1YII1H (J/118. J/ia,paMY 24). Y >KiHOK TaKII1C1 pll13l11K 8 npll16nll13HO sasiYi 6inbWII1M, Hi>K YcepeaHbOMY no 8C (J/118 J/ia,paMY 25). 5inbw 3a sce HaAnll1WKOSa cMepTHicTb cnocTepira8TbC51 Y SiKosiC1 rpyni 45 - 59 pOKis, ae KoecpiLji8HT cMepTHocTi y 6 pa3is nepeSII1Ll1Y8 cepeaHiC1 nOKa3HlI1K 8C an51 YOnOSiKis i npll16nll13HO y 4,5 pa3is )J,Jl51 >KiHOK . B YKpaiHi SII1Knll1KaHa 30SHiwHiMlI1 npll1YII1HaMII1 cMepTHicTb cepea xnonYII1Kis Ta aiSYaT SiKOM ao 15 pOKis npll16nll13HO y 4 pa3111 nepeSII1Ll1Y8 KoecpiLji8HT CMepTHOCTi sia 30SHiwHix npll1 YII1H cepea 'IX oAHoniToK i3 8C. 33. Haii6inbw Ba)l(nHBOIO 30BHiwHbOIO npH'IHHOIO cMepTHocTi cepe,q '1onoBiKiB i )l(iHOK C BH nallKoBi OTPYCHHR. BlI1naaKosi OTpy8HH5'I cepea YKpalHcbKII1X YOnOSiKis , oc06nll1so npaLje3aaTHoIO SiKY, 8 nOWlI1peHII1M 51SII1Ll1eM. L\51 npo6neMa SlI1aa8TbC51 oco6nll1so rOCTpolO i WSlI1aKO nOWlI1p108TbC51 y cinbCbKiC1 MiCLjeSOCTi. Do 2001 pOKy CMepTHicTb sia SlI1naaKOSII1X OTPY8Hb cepea YKpalHcbKII1X yono SiKis He nepeslI1Ll1ysana piseHb CMepTHOCTi sia caMory6cTsa. B 2005 pOLji KoecpiLji8HT cMepTHocTi sia SlI1naaKOSoro OTPY8HH51 an51 YOnOSiKis i >KiHOK YKpaiHII1 6ys apyrll1M HaC1slt1Ll1I11M nicn51 Pocil. PiseHb SII1 naaKOSOIO OTPY8HH51 an5'l >KiHOK Ha 56% nepeSII1Ll1Y8 HacTynHII1C1 3a 3HaYeHH5'lM aHanoriYHII1C1 nOKa3HlI1K S YropLl1I11Hi. LUo CTOCY8TbC51 YKpa'lHcbKlI1 x YOnOSiKis, TO TyT CMepTHicTb SlI1aa8TbC51 6inbw Hi>K yasiYi SII1Ll101O sia HaC16nll1>KYo'l KpaiHII1, T06TO nonbLl1i . 34. nicnR nepio,qy CKOpO'leHHR cMepTHocTi y 1996 - 1998 pOKax, nO'lHHalO'IH 3 1999 POKY, BOHa 3HOBY nO'lana 3pOCTaTH (J/118. J/ia,paMI1 22 i 23). 10nOSHlI1MlI1 npll1YII1HaMII1 3pOCTaHH5'I piSH51 CMepTHOCTi sia 30SHiwHix npll1YII1H SYKpaiHi SOyeSlI1ab 8 noripweHH51 eKOHOMiYHOI cII1TyaLji'l, nOClI1neHH51 nCII1XOnOriYHOro cTpecy, nocna6neHH51 OXOPOHII1 npaLji Ha siaMiHy sia MII1Hynll1x pOKis i nosepHeHH51 ao 3SlI1YOK cnO>KII1SaHH51 Cnll1pTHOIO, 51Ki iCHysanll1 ao aHTlt1anKOlOnbHo'l KaMnaHii 1985 - 1986 pOKis . ltiarpaMa 22. eKe Aflll 30BHiwHix npH'IHH, '10flOBiKH, ltiarpaMa 23. eKe Aflll 30BHiwHix npH'IHH, lKiHKH, YKpa"i YKpa"iHa ra OKpeMi AeplKaBH EBponH, 1990 - 2005 POKH Ha ra OKpeMi AeplKaBH EBponH, 1990 - 2005 POKH --¢-- YeCbKa Pecny6niKa -0-- YrOpL11IAHa ~ CnoseHi!l ......... nOnbL11a - YKpa"Ha -+- Poci!l ~ ec 110 .,....---- - - - - - - -- - - - - - -- - - - - - - - - - - ----, I ::: ,-------~~---------------~ 100 +------~~---------·----------~ 0: c:; Q) i 90 -------f----~----------~~~~~ u Q) co 350 ~--~~----~~-- ~----------~ c:; I ~ 80 ------~------~--~~------------1 a co a 300 j--- --/-- - - -- - - - - - - -- - - - - -- - - - - - - I a ~ 70 +",..",="f-------------------------~ a a a 250 ~-~----~----~~~~----~--~ ~ 60 +-~'-----"-t_=;__"O;;;;::----------__----___1 ~~~~~~~~~~~:?::~::~ co I ~ 200 +-~--------------------------~ : 50 I u ~ 40 ~~~~ U30 -r-- 100 · · .· · , , · . , , · · · .,.-,- 20 50 a N ' 0'> 0'> 0'> 0'> a a a 0'> 0'> a a a a a a 0'> 0'> a a a ~ ~ ~ ~ ~ N N N N N N 26 PJ 3 n r 2 P 3110QIII C IA[PIHOC-I I. :MX fldPIOi'KV1BaHH51 anKoroneM Y 8C CKnalJ,aB nonOBV1HY nOKa3HV1Ka YKpa·IHV1 . L\51 cV1TyaLji51 n0S1CHI08TbCS1 nepeBa>KHO cMepTHicTIO cepelJ, YonoBiKiB, B Toill yac 5lK cepea >KiHOK KoecpiLji8HT cMepTHocTi 6YB yeTBepTV1M nicn51 ECTOHi'l, HiMeYYV1HV1 Ta CnoBeHil. OTPY 8HH51 , cMepTb BilJ, 3nOB>KV1BaHH51 anKoroneM MO>Ke BiIJ,6YTV1Cb Y BV1naIJ,KY, 5lKll\0 31J,0POBV1i11 IJ,OpOcnV1i11 yonoBiK CepelJ,Hbo'i' BarV1 MeHwe Hi>K 3a OIJ,HY rolJ,V1HY CnO>KV1Ba8 niBniTpa YV1 6inbwe MiLjHOro HanolO (40 rpalJ,yciB), 6e3 B>KV1BaHH51 'i'>Ki (Marquez 2005). 36. Y nepiotl nicnR nporonoweHHR He3aneJKHOCTi i tlO 1997 pOKY BHnatlKH caMorv6cTBa Ta caMOTpaBMYBaHHR B YKpaiHi CYTTCBO nOWHpHnHCR. Y 1997 pOLji piBeHb caMory6cTB CKnaaaB 29 Ha 100000 HaceneHHS1, ll\0 6inbw Hi>K ylJ,BiYi BV1ll\e 3a cepelJ,Hiill nOKa3HV1K no 8C. nicn51 1998 pOKY cV1TyaLjiS1 noyana noninWYBaTV1C51, i B 2005 pOLji Ljeill nOKa3HV1K 6YB 20,8 Ha 100 000 HaCeneHH51. 8 2005 pOLji CKC IJ,nS1 caMory6cTBa B YKpa'i'Hi 6YB HV1>KYV1M, Hi>K Y CnoBeHi'i' Ta YrOpll\V1Hi Y 70-x pOKa x Yropll\V1Ha Mana HaillBV1ll\V1i11 piBeHb caMory6cTBa B YCbOMY 8BponeillcbKOMY perioHi 8003, ane i3 CepelJ,V1HV1 80-pOKiB BiH CKOPOTV1BC51 6inbwe , Hi>K Ha TpeTV1Hy. PiBeHb caMory6cTBa y CnoseHi'i' TaKO>K CKOpOYY8TbC51 . 37 . Y 2005 POLli 6,4% cMepTHocTi, CnpH'IHHeHoi" 30BHiwH;MH cpaKTopaMH, npHnatlano Ha B6HB CTBa Ta p036iHHi HanallH. CKC TyT CKnaaas 9 Ha 100 000 HaCeneHH51 . L\eill nOKa3HV1K y 8 pa3iB nepeSV1ll\y8 cepelJ,Hiill aHanoriYHV1i11 nOKa3HV1K 8C i SV1lJ,a8TbCS1 Ha6araTo 6inbwV1M, Hi>K s iHWV1X 8BpO neillcbKV1x Kpa'i'Hax, oxonneHV1X LjV1M aOCnilJ,>KeHH51M . 3HaYHa KinbKicTb 3nOYV1HiB BYV1H518TbC51 YonoBiKa MV1 Ta >KiHKaMV1 y cTaHi cn'51HiHH51 . Y 6inbwocTi SV1nalJ,Kis nilJ, yac 3lJ,iillcHeHH51 B6V1SCTBa >KepTBV1 TaKO>K 3HaXOambC51 y cTaHi cn '51HiHH51 (Marquez 2005). 38 . 8 1999 POll; YKpaiHa Mana HaHHHJK'IHH nOKa3HHK CMepTHOCT; y 1l0POJKHbO-TpaHcnopTHHX npHrOllax, ane tlBOMa pOKaMH nOTOMY LleH nOKa3HHK CTaB HaHBHU4HM. CMepTHicTb y DTn noya na CKOpOYYBaTV1CS1 y 1992 pOLji, ane y 1999 pOLji Ljeill IlOKa3HV1K 3HOSy nOyaB 36inbwYBaTV1cb. Yepe3 YOTV1pV1 POKV1 BiH ylJ,BiYi nepeBV1ll\V1B cepelJ,Hiill piseHb 8C. Y 2005 pOLji cMepTHicTb y DTn CKnana 20 3arV16nV1 x Ha 100 000 HaCeneHH51 (npoTV1 13 Ha 100 000 B 1999 pOLji), BHaCnilJ,OK yoro yaCTKa DTn y 30BHiwHix npV1YV1HaX cMepTHocTi CKnana 14%. TaKV1i11 piseHb cMepTHocTi y DTn BV1lJ,a8TbC51 6inbw IJ,V1BHV1M, S1Kll\O BpaxyBaTV1, ll\0, y nOpiBH51HHi i3 3axilJ,HOlO 8sponolO , s YKpalHi KinbKicTb aSToM06inis Ha IJ,ywy HaCeneHH51 6yna MeHWOIO (Marquez 2005). KpiM TOro, B YKpalHi IJ,n51 060x CTaTeill cnOCTe pira8TbC51 HaillsV1ll\V1i11 S YCbOMY 8sponeillcbKoMY perioHi piseHb cMepTHocTi BilJ, noaiill HeSV13HayeHoro xapaKTepy, ll\0, MO>KnV1BO , CBiIJ,YV1Tb npo HeHane>KHY KaTerOpV13aLjilO 30SHiwHi x npV1YV1H CMepTHOCTi Ta npo npV1xoBYBaHH51 IJ,e51KV1 X cneLjV1cpiYHV1X npV1YV1H. AiarpaMa 24. OC06H, 1110 nocTpalK,QanH AiarpaMa 25, CMepTHicTb Bi,Q Hel1laCHHX BHna,QKiB Bi,Q Hel1laCHHX BHna,QKiB Ha BHp06HHIITBi, YKpa'iHa Ha BHp06HIIIITBi, YKpa'iHa Ta oKpeMi ,QeplKaBIl EBponll, 1990 - 2006 POKH Ta oKpeMi ,QeplKaBH EBponH, 1990 - 2006 POKH ~ YeCbKa Pecny6niKa -0-- YrOPlUtAHa -*- CnOBeHi" ----.- nonblUa - YKpa'iHa -+-- Poci" ......c- ec 0; 2505 . , - - - - - - - - - - - - - - - - - - - , 6 .-------------~~ J: J: Q) c:; Q) u 2005 +------------;;--~~'=="~=::....:c-~----i ~ 5 .~~~~~=_----------~ '" J: o Q) c:; o o ~ 4 ~~---~~--------------I o 1505 -h,- - - - - - - - - - - - - - - ----------1 J: o o g 3 +v-~~-----~~~~~----------I o o o N ' 0> en o o o o 0> 0> en 0> 0> o o o o en en en en en o o o o 0> 0> 0> 0> 0> o o o o N N N N N N N N .Q.>r~ereno. ~3<1 n- HMX 3.o.B. 20 plK 27 TPAi E[\I >1 ~ KO I MO>KH,\ Yl-' l o KIiYTll\ ODOfi AH H>1 B VK I AIH I " PV1 3V1 3DOP08' rJ rfOQHHV1 DoC' ..n tspon V1 39. PiBeHb cMepTHocTi Ha BHpo6HHUTBi BHRaCTbCR BHCOKHM (I/i1B.l/iarpaMY 25). npoTe KinbKicTb 3ape8cTpoBaHV1x BV1p06HV1YV1X TpaBM Ha 100000 HaCeneHH51 B YKpa·IHi y nOpiBH51HHi 3 iHWV1MV1 Kpa·IHa MV1 8 nOCV1Tb HV13bKOIO, 1110 MO>Ke CBi):1YII1TV1 npo HenOBHY 3BiTHicTb a60 npo Te , 1110 6inbwicTb TpaBM 8 cpaTanbHV1MV1 (I/i1B.l/iarpaMY 24). 40. B 2002 POLli piBeHb npocjJeciHHoi" 3axBoplOBaHocTi B YKpaiHi CKnaRaB 21,6 Ha 100 000 npa LlIOIO'IHX, To6TO MaHJKe BRBi'li 6inbwe, HiJK y 2001 POLlio .00 Kona HaMinbw nOWV1peHV1x 3aXBO plOsaHb Hane>KaTb xsop06111 ):1V1XanbHoY CV1CTeMV1 Ta oc06nV1Bo nHeBMoKoHi03 (30,6%) i xpoHiYHV1~ 6POH XiT (19,1%). IHcjJeKLliHHi 3axBoplOBaHHR 41. nonpH Te, U40 TRrap iHcjJeKLliHHHX 3axBoplOBaHb CKnaRac nHwe 6inR 6% 3aranbHoi" cMepT HOCTi, YKpaiHa Mac HaHBHU4HH KoecjJiLlicHT CMepTHOCTi BiR iHcjJeKLliHHHX 3aXBoplOBaHb B yCbO My CBponeHCbKOMY periOHi B003. UJBV1):1Ke nOWlI1peHH51 cV1cpinicy Ta ):1V1cpTepi·1 Ha noyaTKY 90-x pOKis 6yno npV1nV1HeHe HanpV1KiHLji ):1eC51TV1piYY51. PiBeHb 3axBopIOBaHocTi Ha Kip npOT51rOM MII1HynV1x TpbOX):1eC51TV1piY 6YB pi3HII1M, ane CV1CTeMa OXOPOHV1 3):10POS'$1 YKpaYHV1 He 6yna CnpOMO>KHOIO ni):1TpV1 MYBaTV1 WV1pOKe nOKpV1TT51 nepwolO ):103010 l11enneHH$1 Bi):1 KOPY Ta 3a6e3neYV1TV1 OTpV1MaHH51 HaceneH H51M ):1pyroY ):103V1 l11enneHH51. 42. B YKpaiHi Ha BlfllCHltl i Ty6epKynbo3 npHnaRac 90% 3aranbHoi" cMepTHocTi BiR iHcjJeK LliHHHX 3axBoplOBaHb. nV1ToMa Bara BIJl/CHI,q y 3aranbHiVl cMepTHocTi B YKpalHi CKna):1a8 2,19%, a T5 - 1,04% (I/i1B. BCTaBKY 3). Ujo CTOCY8TbC51 T>KCI, TO TyT Ha BIJl/CHI,q npV1na):1a8 3,62%, a Ha T5 - 1,48%. 3a nepio):1 1990 - 2005 POKII1 CKC ):1n51 T5 6inbw Hi>K nO):1Bo·IBC$1 i Ha nOyaTOK 2005 pOKy 6YB HaVlBV1ll1V1M CKC Cepe):18SpOneVlcbKV1x Kpa·IH (I/i1B.l/iarpaMY 26). CKC ):1n51 BIJl/CHI,q 3a TOll! caMV1V1 nepio):1 eKCnOHeHLjianbHO 3pic Ha Si):1MiHY Bi):1 8C, ):1e BiH cTpiMKO CKOPOTV1BC$1, Ta iHWV1X KpaYH CXi):1HOY 8sponV1, ):1e BiH 3anV1WaBC$1 Ha O):1HOMy piBHi (I/i1B.l/iarpaMY 27). ,QiarpaMa 26. CKC Ami Ty6epKYHb03Y, YKpaIHa Ta OKpeMi ,QiarpaMa 27, CKC Ami BII1/ CHI,Q (3a AaHMMM CMCTeMM AeplKaBM EBponM, 1990 - 2005 POKM onepaTMBHo'j CTaTMCTMKM), YKpaIHa Ta OKpeMi IleplKaBM EBponM, 1990 - 2005 POKM ~ YeCbKa Pecny6JliKa -0--- YropLUI1Ha --*- CJlOBeHi~ 25 . - - - 8 7 +_- - - - - - - - - - - -1-1 20 t------------,l~~'=',L_C_---'-__t '" I go 6 +--------------~--t I I OJ OJ c:; c:; o o o ~15 I +-- ! 5 I ~ 4 +I----r~-------+---_l o ~10 +_~~-----------__; ~ 3 --~----~-----_+---t ~ () '" I :.:: () 5 h~=::_:_---=.;:,·~:;;-------_____i ~ () 2 1 .r- - - - 1oc- - -+- --l o N o N o N o N CJ) CJ) CJ) CJ) o o o o " o o CJ) 2? CJ) (j) Kepeno 6333 .!lJHV1X 6DC, 2008 plK BemosKo 3. BIn/CHI,ll ; T6 S YKpaiiii BIn-iHq,eKl.lill S YKpoiiii nOlUuplOEmbeR oyJKe empiMKo.,llo 1994 pOKY YKpaiiia 6yno OOHiEIO 3 oepJKas ;3 HU3bKUM piSHeM nOlUupeHoemi Bffl-iHq,eKwi; ane, nO'4UHOIO'4U 31995 POKY, KinbKiemb KniHi'4HO oiOZHoe mosaHUX sunooKis CHI,lly nO'4ano IUSUOKO 3poemamu. RKIl40 y 1998 pOl.4i piseHb 30XSOPIOsoHocm; HO CHI,lls YKpo;iii 6ys HOUSUIl4UM y CniSopYJKHoemi He3ane)#(Hux ,llepJKos (CH,llJ, one Bee ll4e HUJK'4UM, HiJK Y 28 ~OJJlIn 2 P03r100lf C EPTHO C fl, 3 A XBO P IOBAHOC T I TA IHBAr "IlHOCTI fC, mo CbOZOOHi y fsponi YKpoiHO Eeniu,eHmpOM BIn-iHq,eKu,Ii' (XO'lO, nposoo, cumyou,iR e YKpoiHi sce U4e KIIOCUq,iKYEmbCR RK «KoHu,eHmpOeOHO)), 0 He RK «30Z0nbHOI) enioeMiR (B003 YKpaiHa, 2008 piK). Y nepioo MiJK 1987 i 2007 pOKaMu s YKpoiHi oq,iu,iriHi 6yno 30peEcmpoeaHo 122 374 HOClTe BIn-iHq,eKu,I;~ SKllIO'Ia IOIIU 22 424 xsopux HO CHill ma 12490 30zu6nux s;o CHilly. B YKpaiHi HeMO JKOOHOZO pezioHY, oe He 6yno xOlla 6 OOHOZO HoaR BIn-iHq,eKLJ,Ii: Y U,bOMY nnaHi YKpoiHa Si03HOilOEmbCR WUPOKUMU eiOM;HHocmRMU: Hari6inbw nowupeHOIO BIn-iHq,eKqiR E y nieoeHHO-CX;OHOMY pelioHi. Y2005 - 2006 POKOX KinbKicmb HOSUX BIn-n03umusHux xeopux 3pOcnO HO 16,8%,0 Y2006 - 2007 pOKOX - HO 10%. Y 2007 pou,i U4ooeHHo BIn iHq,eKu,ilO SURenRnu y 6inbwe HiJK 48 oci6, a CHIIl- y 6inbwe HiJK 12 zpoMaoRH. Bio CHilly U4ooeHHo SMU ponu 6 oci6. YOiOZpOMi HUJK'Ie HosooumbcR oUHaMiKo 3pocmoHHR KinbKocmi CHill n03umUSHUX xsopux ; cMepmHocmi s;o CHilly y nepioo 1991 - 2007 poKis. 3apeCCTpOBaHi xBopi Ha CHI,[I i CMepTHicTb BiA CHI,[Iy, YKpa'iHa, 1991 - 2007 POKM 4217 4723 4573 - - KillbKicTb HOB~X XBOp~X Ha CHI,Q 2743 1915 {?4£O 2507 1353 177~ 867 .__a_11a r 47~3C.a-8~3 4_-+-_ _ _+-_r--~ L~~~~~!3lI:::gB!~~~~~ = KillbKicTb HOB~X Jarl<161ll<1x Bil1 CHI,Q ..... a o N o 000 (') 0 ..,. - 0 '" o o CD 0 0 o o N N N N N N N .ll'Kepeno UI'-lGASS 200 1. 110 CbOZOOHi enioeMiR Bin S YKpoiH; 6yna nowupeHolO y sp03nusux npowopKOX HaceneHHR, nepeSaJKHO cepeo cnoJKusailis ;H'EKU,iliHUX HapKomuKis (ClH). PiseHb nowupeHocm; cepeo sozimHux JKiHOK y Micmox 6ys MeHwe 7%, 30 oecRmb pOKis IIepe3 cmomes; 3HOCUHU en/oeMiR suriwno 30 MeJKi zpyn SUCOKOZO pU3U Ky mo nowupunOCb Ha secb 30zan HaceneHHR. numOMO soza iHq,eKqiri, cnpUIIUHeHUX sHympiwHboseHHUM cnOJKUSOHHRM HopKomUKis, 3MeHwunOCR i3 84% Y 1997 pou,i ao 40% y 2007 pou,i, s moli IIac RK IIacmKO iHq,eKu,iU, U40 nepeoolOmbcR lemepoceKcyanbHuM wnRXOM, 3pocna i3 11,3% 00 38%. B 1998 pou,; YKpoiHO cKacysana SUMOZY 060S'R3Kosoi"nepeeipKu HO Bin i 3anposoouna npoKmuKY ao6pos;nbHolo 06CmeJKeH HR ma KOHcynbmomusHi nocnyzu e yciii KpoiH;, U40, riMosipHO, ; npu3eeno ao CKOpO'leHHR KinbKocmi 3a peECmposoHuX sunOaK;S BIn-iHq,eKu,ii'cepeo c/H (Cs;mosuli 60HK, 2006). B 2007 pou,; BIn·;Hq,iKoeOHi HoeOHOpOaJKeHi CKnanu 19% 3azanbHoi" K;nbKocmi sunooK;e Bin· iHq,;KYeOHHR. B 2006 pou,i HO Bin npoiiwnu nepeeipKY 95% yc;x sozimHux JKiHOK. TOKUii senuKuii s/o comOK nORcHIOEmbcR cYK}'nHicmlO oeRKux q,oKmopie: 30npOSOOJKeHHR OepJKOSHUX npozpOM npoq,inOK mUKU BIn-/Hq,eKu,/T cepeo HeMosnRm, 30~onbHO cmpomeziR a06posinbHUX KOHcynbmYSOHb 3 numOHb Bin ma nepesipKu Ha Bin nia '10C saz;mHocm;, ma nposeaeHHR aHmupemposipycHoi'npoq,inoKmuKu. 3a zanOM, onR 30n06izaHHR eepmUKanbHOMY BIn-;Hq,iKyeaHHIO nio 'lac ea~imHocmi mo nono~;s OHmupe mpoe;pycHY npocpinOKmUKY npoiiwoe 91% 13 2575 BIn-no3umueHux JKiHOK, RKi HapOaunu y 2006 pOl.{i. KinbKicmb oq,iu,iiiHO 3apeEcmposoHuX BIn-xsopux He slonoeioaE q,aKmuIIHuM Mocwmo6oM enioeM;'~ mOMY SSOJKOEmbCR, U40 q,aKmU'IHO K;nbKicmb BIn-;Hq,iKoeoHux nlOaeri s YKpaiHi E 3HOIIHO SUU401O. 30 ocmoHH;Mu niopoxYHKOMU, cmOHOM HO KiHeu,b 2007 pOKY, e YKpoiif; 6yno 440 000 BIn-;HcpiKOSOHUX nlO aeii. 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PiSHi TIOTIOHonaniHH51 cepeA >KiHOK YKpalHcbKoro cena 3a oCTaHHi 25 pOKis 3pocnVl 6inbwe, Hi>K y 17 pa3is (CINDI Ukraine 2001). Y nopisH51HHi i3 >KiH KaMVl CTapworo SiKY, MonoAi >KiHKVl nan51Tb AeAani 6inbwe (MiH3Apas, 2008 piK). 3pocTaHHIO piSHis TIOTIOHonaniHH51 cepeA YKpalHcbKVlX >KiHOK cnpVl51IOTb MOAa, arpecVlsHa peKnaMa, eMaHCVlnaL\i51 >KiHOK Ta HVl3bKi L\iHVl Ha TIOTIOHosi sVlp06Vl. OCTaHH8 AOcniA>KeHH51 CTasneHH51 AO csoro 3AOPOS'51 cepeA YYHis wKin nOKa3ano, l.L(0 AO cnp06 nanVlTVl SAasanVlC51 39% xnonyaKis i 18% AisYaT SiKOM 11 - 12 pOKis (UISS 2007)". CnOJKHBaHHR anKoronlO 53 . PiBeHb cMepTHocTi, nOB'R3aHoi" i3 anKoroni3MoM, B YKpaiili C BHCOKHM i ~e~ani 3pocTac. 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B YKpalHi Ha BiKOBY rpyny 25 - 64 POKV1 npV1na,qae neBOBa yaCTKa cMepTHocTi, >1Ky MO>KHa nonepe,qV1TV1: 80% cMepTHocTi cepe,q YonoBiKiB npaLje3,qaTHolO BiKY Ta npV16nV13Ho 30% cMepTHocTi cepe,q >KiHOK npaLje3,qaTHo 10 BiKY MO>KHa nonepe,qV1TV1 Ha nepBV1HHoMy piBHi CV1CTeMV1 OXOpOHV1 3,q0POB '>1 (/lJ.1B. /liarpaMY 37) BV1KnIOYHO niKYBanbHi 3axo,qV1 BV1,qaIOTbC>1 ecpeKTV1BHV1MV1 nepeBa>KHO ,qn>1 nlO,qelll Mono,qworo BiKY. npaLje3,qaTHe HaCeneHH>1 npo,qoB>Kye nepe,qyaCHO BMV1paTV1 yepe3 Hea,qeKBaTHi npocpinaKTV1KY Ta ni KyBaHH>1 (Nolte and McKee 2004). HanpV1Kna,q, 3a ,qaHV1MV1 DOC3 YKpaIHV1, 2008 piK, 25% >KiHOK BiKOM 15 - 49 pOKiB CTpa>K,qaIOTb Ha rinepTOHilO , npV1 LjbOMY 3a ,qonOMOIOIO niKiB ni,qBV1ll\eHV1111 KPOB'>1HV111l TV1CK KOHTponlOlOTb nV1we 3% i3 HV1X. Cepe,q YonoBiKiB BiKOM 15 - 49 pOKiB Ha rinepToHilO CTpa>K,qaIOTb 32%, npoTe MeHwe 1% KOHTponlOlOTb TV1CK 3a ,qonOMOIOIO niKiB. ,[UarpaMa 37. PiBHi cMepTHocTi, IlKy MOlKHa nonepeAHTH, OC06H BiKOM 25 - 64 POKH, YKpa'iHa 1000 900 j 0 1rpyna · II rpyna 916 .9 0: 819.8 J: ai 800 c:; III rpyna Q) g 700 J: 600.8 g 600 o o o 500 '" ~ 400 ... (J 288.7 268.2 J: 300 Ii Q) 222.8 :; 200 u 100 o +---~---L---.--~--~---,--- ~----L-~--~----~--r---~--~--.---~---L-- YOIlOBiKI'1 >KiHKI'1 YOIlOBiKI'1 >KiHKI'1 YOIlOBiKI'1 1989 1995 2006 .1l"w,:,n'l fl [,;lH::JBc EM ,1 IM!DI 20('7 Ol~ . LJinboBi 3aXO,QH ;3 npocpinaKTHKH Ta KOHTponlO cpaKTopiB PH3HKY 76. 5Y,Qb-RKa npH"IHHa cMepTi CKiHLleBHM pe3ynbTaToM CK17a,QHoro naHLllOry nO,QiH.lf MO>KHa IiPO aHani3YBaTV1 3a ,qonOMOIOIO KOHLjenLjil IIpocTOpy 3,q0POB'>1 (Lalonde 1974). 3ri,qHO 3 KOHLjenLjielO, CTaH 3,qOPOB'>1 (Ta CMepTHOCTi) 06YMOBnlOeTbC>1 YOTV1pMa YV1HHV1KaMV1: reHeTV1Ka, OTOYYlOye cepe,qOBV1ll\e, no Be,qiHKa Ta Me,qV1YHi nocnyrV1. HI3 He e pe3ynbTaTOM HenOBHOLjiHHOI CV1CTeMV1 OXOpOHV1 3,qOPOB'>1. 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Y LlbOMY Ta HaCTynHOMY p03,qini aBTOplll npOnOHYIOTb ,qBa Hanp>1MIIl, Ha >1KIIl X MalOTb nepeBa>KHO 30Cepe,qIllTIIlC>1 YKpa'iHcbKi MO>KHOBna,qLli: 1) BVl3HayeHH>1 Ta 3,qiillcHeHH>1 Kona nepwOyeprOBlIlx 3axo,qiB (ycepe,qIllHi CIIlCTeMIIl OXOpOHIIl 3,q0POB'>1 Ta n03a HelO) i3 niKBi,qaLli', nplllYVlH cMepTHocTi Ta 3axBoplOBaHocTi. 2) nepeopi8HTYBaHH>1 CIIlCTeMIIl OXOPOHIIl 3,qOPOB'>1 Y cnoci6, 5'1 Kill ill ,q03BOn>18 BlIlpiwYBaTIIl cKna,q- Hi np06neMIIl npOcpinaKTIIlKIIl Ta KOHTponlO H13. 77. OCHOSHi 3axO,qH i3 nO,qOnaHHR ronosHHx c/JaKTOpis PH3HKY MO)l(YTb ,qaTH nni,qHi pe3ynbTa TH ,QflR 3,qOPOS'R flIO,qeH npH HesenHKHX sHTpaTax. Y HaCTynHoMY p03,qini p03rn>1,qa8TbC5'1 HIIl3Ka ronoBHlIlx 3axo,qiB i piweHb Ha nOniTIIlYHOMY piBHi, 5'1Ki Cnp5'1MOBaHi Ha YCYHeHH5'1 ronOBHIIlX cpaKTOpiB plll311lKY ,qn>1 nonepe,q>KeHH5'1 HeBlIlnpaB,qaHo BIIlCOKO', 3axBOpIOBaHOCTi, iHBani,qHOCTi Ta nepe,qyaCHo'i CMepTHOCTi . Haronoc TYT P06I1lTbC>1 Ha 3axo,qax ,qn>1 HaCeneHH>1, Ll10 ,q03BOn>1IOTb ,qOnaTIIl ronoBHi cpaKTOplll plll311lKY - anKoroni3M, TIOTIOHOnaniHH5'1 , 6e3neKa ,qOpO>KHbOrO pyxy Ta ,qi8Ta XapYYBaHH5'1/cpi 311lYHa aKTIIlBHicTb. i=\e>1Ki 3axo,q1ll B>Ke 3,qiillcHIOIOTbC5'1 B YKpa"Hi, ane nOTpe6YIOTb y,qOCKoHaneHb , iHWi He 3,qiillcHIOIOTbC5'1 B YKpa'iHi, ane 8 ycniwHIIlMIIl B iHWIIlX Kpa'iHax L\eHTpanbHo'i Ta C Xi,qHO'i 8Bponlll. KOHTponb TIOTIOHonaniHHR 78. YKpaiHa si,qcTac si,q ueHTpanbHocsponeHcbKHx KpaiH, RKi MalOTb Koop,qHHauiHHi MexaHi3MH ,QflR snposa,q)l(eHHR HauioHanbHHx nnaHis ,qiH Y ranY3i KOHTponlO TIOTIOHY (,[IViB . Ta6f7V1L.j1O 11). 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CKOpOyeHH5'1 cMepTHocTi , nOB'5'13aHOi i3 TIOTIOHonaniHH>1M, nepe,q6aya8 CKOpOyeHH5'1 CnO>KIIlBaHH5'1 TIOTIOHY , 3an06iraHH5'1 CTIIlMy nlOBaHHIO ,qo cnmKIIlBaHH5'1 TIOTIOHY Ta BTOplllHHIIlMIIl cpa KTopaMIIl . 3axo,q1ll BIIlMaralOTb 3acTocYBaHH5'1 6araT06iYHOrO ni,qxo,qy ,qo YTBep,q>KeHH5'1 3,qopoBoro cnoc06y >KIIlTT>1 Ta 3MiHIIl nOBe,qiHKIIl yepe3 npo cBiTY, 3MiHY OTOYYIOYOro cepe,qoBIIlLl1a 3a ,qonoMorolO 3aKOHiB ill iHWIIlX HopMaTIIlBHlIlx aKTiB, a TaKO>K 3a6e3neyeHH>1 y clIlcTeMi OXOpOHVl 3,q0POB'5'1 anbTepHaTlIlBHIIl X MeTO,qiB niKYBaHH>1 . 3aranoM ecpeKTIIlBHi ni,qxo,qlll Ha nOniTIIlYHoMY i a,qMiHicTPaTIIlBHOMY piBH5'1 X ,qo BlIlpiweHH5'1 np06neMIIl CnO>KIIlBaHH5'1 TIOTIOHY BKnlOyalOTb : · npocBiTHVlL.jbKi 3axo,aVl, BKnlOyalOYIIl KaMnaHil npoTIIl TIOTIOHonaniHH51, iHcpopMaLliillHi WOKIIl Ta nonepe,q>KeHH5'1 npo wKi,qnlllBicTb TIOTIOHonaniHH5'1 Ha ynaKoBLli TIOTIOHOBIIlX BlIlp06iB; · 3axo,aVl i3 perYf7IOBaHHR OTO'-IylO'-IOro cepe,aoBVlL1.Ja , 5'1Ki 3a6opOH5'1IOTb peKnaMY TIOTIOHY Ta cnoHcopcTBO , npo,qa>K TIOTIOHOBIIlX BIIlp06iB ,qiT>1M Ta naniHH5'1 y rpoMa,qcbKlIl x MicLl5'1 X Ta p060 YIIlX npVlMiLl1eHH5'1 X; 43 · 3axo)J.J,1 i3 perymoBaHHR )J.OXO)J.iB, Y nepwy '-Iepry niABIt1u.jeHH~ nOAaTKiB Ha TIOTIOH 3 MeTOIO CKOpO'-leHH~ ViOIO CnO>+++< HaAaIOTbC~ cpiHaHCOBi CTIt1My nlt1: CnO'-laTKY '-Iepe3 HaLjioHanbHIt1Vi KOHKYpC An~ TIt1X, XTO 3Mo>++++++++++++++++++< 06KnaAIt1HOK >++< i3 2003 pOKY 3a60pOHeHO peKnaMYBaTIt1 TIOTIOHOBi 6peHAIt1 niA '-lac MaCOBIt1X 3aXOAiB , u.j0 cpiHaHcylOTbC~ cnOH COpaMIt1. ,Om nopiBH~HH~, 6YAb-~KY peKnaMY TIOTIOHY 3a60pOHIt1nlt1 Bci KpalHIt1 UeHTpanbHol eBpOnlt1, ~Ki 3raAylOTbc~ y UbOMY Aocni,Q>+++< 3a60poHeHa B YlOpu.jIt1Hi Ta CnoBeHil. 44 83. 3a6opoHa npo,qaJKY TIOTIOHOBMX BMpo6iB oco6aM, RKi He ,qOCRrflM 18-pi"lHOrO BiKY, Ta ii" CYBO pe ,qOTpMMaHHR MOJKYTb CKOpOTMTM TIOTIOHonaniHHR cepe,q ,qiTeM. 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HaneJKHMM "IMHOM 3anpoBa,qJKeHa nOBHa 3a6opoHa TIOTIOHonaniHHR Y Mic'-IRX rpoMa,q CbKoro KOpMcTYBaHHR Ta Ha p060Ti (npoTM ,qo3Bony nanMTM Y ,qeRKMX Mic'-IRX) MOJKe CKOpO TMTM CnOJKMBaHHR TIOTIOHY Ha 4- 10% (CBiTOBI!1V1 6aHK, 1999 piK). B 1998 powi YKpaiHa npl!1V1H5'1na 3aKOH npo perynlOBaHH5'1 BI!1p06HI!1LjTBa Ta 36YTY BI!1HHOIO Cnl!1pTY, KOHb5'1KY Ta CPPYKTOBI!1X cnl!1pTiB, 8JlKoronbHI!1X HanOIB i TIOTIOHOBI!1X Bl!1p06iB . O,QHI!1M i3 Ba>KJlI!1BI!1 X MOMeHTiB LjbOIO 3aKOHY 8 BI!1MOra Bi,QBO,QI!1TI!1 cneLjianbHi MiCLj5'1 ,Qn5'1 naJliHH5'1 B Me,QI!1YHI!1 X 3aKna,Qax, OCBiTHix YCTaHOBax, ,Qep>KaBHI!1X 6Y,QI!1HKaX, TeaTpax, KiHOTeaTpax i TpaHCnOpTHI!1X 3ac06ax. 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B YKpa'IHi nOniTI!1Ka onO,QaTKYBaHH5'1 TIOTIOHOBI!1X BI!1p06iB BI!1,Qa8TbC5'1 HeCTa6inbHolO, npl!1YOMy iCHYIOYI!1V1 aKLjI!13HI!1V1 36ip Ha TIOTIOHOBi BI!1p061!1 8 HeBenI!1KI!1M, a u.jOpiYHi TeMnl!1 Vloro 36inb WeHH5'18 Ha6araTO MeHWI!1MI!1, Hi>K TeMnl!1 iHcpn5'1Ljil. 45 86. EC/JeKTuBHuMU 3 TO'lKU 30PY BUTpaT MeXaHi3MaMU ~OnOMOrU nlO~flM y npUnUHeHHi naniH HfI BU~aIOTbCfI npOrpaMU npUnUHeHHfI TIOTIOHOnaniHHfI, HanpUKna~ TeneC/JOHHi niHii~onOMOrU y Bi~MOBi Bi~ naniHHfI. ,[IocniA>KeHH~ BnnvlBY TaKII1X TenecpOHHII1X niHiil1 B 8BpOni nOKa3anO, LL10 21 % 06CTe>KeHoro HaceneHH~ yTpll1MyBanll1c~ BiA TIOTK)HOnaniHH~ npoT~rOM OAHoro pOKY nicn~ P03MOBII1 no TaKiil1 TenecpOHHiil1 niHil- HaBiTb nicn~ OAHoro TenecpOHHoro A3BiHKa (Miquez and Becona 2008). B YKpaiHi TaKa TenecpOHHa niHi~ npaLjlO8 , ane niATp1l1My8TbC~ BOHa Heyp~AOBII1MII1 A>KepenaMII1. YeCbKa Pecny6niKa 3anpOBaAII1na TenecpOHHY niHilO AonOMorll1 y npll1nll1HeHHi naniHH~ B 2005 pOLji, npll1YOMY KOHcynbTaHTII1 TyT npaLjlOlOTb no p060YII1x AH~X i3 12:00 AO 20:00. LlIO iHiLjiaTII1BY niATpll1Manll1 MiHic TepCTBO OXOpOHII1 3AOPOB'~, B003, a BnpOBaA>KY8 II YecbKa KoaniLji~ npOTII1 TIOTIOHY YrOPLL1I11Ha 3a npOBaAlI1na TaKY TenecpoHHY niHilO B 2004 pOLji 3i 3HII1>KeHOIO BapTicTIO TenecpoHHoro A3BiHKa OAII1H A3BiHOK TyT onnaYyE::TbC~ 3a LjiHOIO MicLjeBII1X p03MOB. HOMep Lji8'1 TenecpOHHOi niHil APyKy8TbC~ Ha Bcix naYKaX Ljll1rapoK. KpiM TOro, B anTeKaX ycix KpaiH, OXOnneHII1X AOcniA>KeHH~M, npoAa8Tbc~ KypC aHTII1 HiKOTII1HOBO'1 pea6iniTaLjiil1Hoi Tepani'l, ane, y nopiBH~HHi i3 TaKII1MII1 AeWeBII1MII1 MeTOAaMII1, ~K TenecpOHHi niHi'l, BiH BII1Aa8TbC~ AOP0>KYOIO anbTepHaTII1BOIO, KOHTponb anKorOfllO 87. 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Cepe,q ycix oxonneHV1X ,qocni,q>KeHH51M KpaiH Haill>KopCTOKiwy noniTV1KY 1l10,q0 CnO>KV1BaHH51 anKoronfO npoBo,qV1Tb nOnbll1a, ,qe CnO>KV1BaTV1 cnV1pTHi HanOI 3a60pOH518TbC51 B ycix 3ra,qaHV1x BV1ll1e MicLj51X, i nV1we ,qn51 MicLjb ,q03Binn51 ,qi8 ,q06poBinbHa 3a60poHa , Y nonbll1i TaKO>K yaCTKOBO 3a60poHeHo B>KV1BaTV1 cnlt1pTHi Hanoi y peCTOpaHax i Ha Mi>KHapo,qHIt1X aBiapeillcax. 94, BCTaHoBneHHR 6inbworo MiHiManbHOro BiKY , i3 RKOro IJ03BOnReTbCR B>KI1BaTI1 anKoronbHi Hanoi, Cnpl1Rt: 3MeHweHHIO CnO>KI1BaHHR aJ]KoronlO, JlTn i nOB'R3aHI1X i3 anKoroneM npo6neM (Wagenaar and Toomey 2002) MeHwV1i1i BiK, i3 51Koro ,q03Bon518TbC51 B>KV1BaTV1 CrlV1PTHi Hanoi, 36inbWY8 iliMOBip HicTb nOB'513aHVlx i3 anKoroneM np06neM y Maill6YTHbOMY, KnfOyeM ,qo YTpV1MaHH51 HenOBHoniTHix Bi,q B>KV1BaHH51 anKoronfO 8 cyBope 3aCTOCYBaHH51 3a60pOHV1 y TaKV1i1i cnoci6 , 11106 HenOBHoniTHi CnO>KV1Ba yi cnV1pTHoro 3HanV1, 1110 CnO>KV1BaHH51 HV1MV1 anKoronfO npV13Be,qe ,qo peanbHV1x Hacni,qKiB, Ha ,qo,qaTOK ,qo 3aCTOCYBaHH51 CaHKLjiill ,qo TV1X 3aKna,qiB, 51Ki npo,qaBaTV1MYTb anKoronbHi Hanoi HenOBHoniTHiM. 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B YKpa'IHi BVl Mora LL\O.OO BVlKopVlCTaHHS1 peMeHiB 6e3neKV1 Hane>KHVlM '-IVlHOM He BVlKOHY8TbCS1, xO'-la peMeHi 6e3ne KVl MO>KYTb CKOPOTVlTVl TpaBMaTVl3M YLnn Ha 45 - 55% (B003 , 2004). DnS1 nornVl6neHHS1 06i3HaHocTi rpoMa.oS1H i3 nVlTaHHS1M 6e3ne'-lHOrO nepeBe3eHHS1 .oiTeill B aBToM06inS1x YrOpLL\VlHa npoBena KaMnaHilO "PeMeHi 6e3neKVl», a nOnbLL\a - " npVlcTe6HiTb peMeHeM CBOIO .oVlTVlHY! ». B 8C BVlKopVlcTaHHS1 peMe HiB 6e3neKVl e 060B'S13KOBVlM, i i3 BBe.oeHHS1M B.oilO 3aKoHY npo peMeHi 6e3neKVl BVlKopVlcTaHHS1 peMe HiB 6e3neKVl 3pocno i3 37% .00 95%, BTOiIl '-lac S1K '-Iepe3 KopoTKVlVl nepio.o KinbKicTb rocniTani30BaHVlx nOCTpa>K.QanVlX YDTn CKopoTVlnacS1 Ha 35%. 103. MOJ/epHi3aL/iR J/opir i nepeBe3eHb, a TaKO.>K BVlKopVlcTaHHR nOMiTHVlX IIOPO.>KHix 3HaKiB "ABapii1Ho-He6e3ne'-lHa J/inRHKa» J/03BonRIOTb CKOPOTV1TV1 KinbKicTb nOCTpa.>KlIanVlX Y JJ,Tn. Mo.oep Hi3aL\iS1 .oopir i nepeBe3eHb nepe.o6a'-lae CKOpO'-leHHS1 WBVl.oKOCTi pyxy, noninweHHS1 cTaHY Aopir i 3a6e3ne'-l8HHS1 anbTepHaTVlBHVlx BVl.oiB nepeBe3eHb. CKOpO'-leHHS1 WBVl.oKOCTi pyxy Ha cinbcbKVlx .ooporax Ha 10 KM/ro.o. MO>Ke CKOPOTVlTVl cMepTHicTb Y DTll Ha 6%, a CKOpO'-leHHS1 WBVlAKOCTi pyxy Ha aBToMariCTpanS1x npVl6nVl3Ho Ha 14 KM/ro.o. - Ha 21% (Racioppi 2004). nporpaMa TpaHcKop .oOHHVlX nepeBe3eHb - L\e iHiL\iaTVlBa 8C, cnpS1MoBaHa Ha ni.oBVlLL\eHHS1 6e3neKVl Ta ecpeKTVlBHoCTi nepeBe3eHb Y TpaHcnopTHiVi cVlcTeMi L\eHTpanbHo! 8BponVl. Ycnix Kpa!H 8C Y cnpaBi CKOpO'-leHHS1 '-IVlcenbHocTi nOCTpa>K.oanVlx YDTn e LL\e O.oHVlM ni.oTBepA>KeHHS1M TOro, LUO ronOBHe - L\e nOniTVl'-lHa BonS1 Ta KOMnneKcHi 3axo.oVl (AMP CWA, 2006 piK). DnS1 nonepe.o>KeHHS1 aBapiVi i BTpaT nlO.oeill Ha aBapiillHo-He6e3ne'-lHVlX .oinS1HKax nonbLUa 3anpoBa.oVlna nOMiTHi .oopo>KHi 3HaKVl. BHacni.ooK L\bOrO DTn Ha L\VlX .oinS1HKax CKopoTVlnVlcS1 Ha 35%, cMepTHicTb - Ha 23%, a TpaBMaTVl3M - Ha 28% (AMP CWA, 2006 piK). Xap'lysaHHR Ta cpi3H'IHa aKTHsHicTb 104. nporpaMa «31l0pOS'R HaL4ij"» (Ha 2002 - 2011 pOKH), RKy yxsanHs Ka6iHer MiHicrpis y 2002 pOL4i, nepeIl6a'laE: nowHpeHHR 31l0pOSOro cnoco6y JKHTTR RK OIlHH i3 ronOSHHX 3axollis 3MiL4 HeHHR 31l0POS'R HaceneHHR YKpaiHH. npore L4R nporpaMa 3lliifcHIOE:rbCR nosinbHo ra Henocni 1l0SHO. YKpa'IHa niATpVlMye rn06anbHi 3ycVlnnS1, .00 S1KVlX Y 2002 pOL\i 3aKnVlKana HaA3BVl'-laillHa ceciS1 ieHepanbHo! AcaM6ne! OOH B iHTepecax .oir8i1l. B 1998 pOL\i 6yna p03p06neHa nporpaMa ,,KeHHS1 3.oOPOBOro cnoc06y >KVlTTS1, p03BVlTKy .oYXOBHOC Ti Ta 3MiL\HeHHS1 MO panbHVlx npVlHL\VlniB y cycninbCTBi». KpiM TOro , YKpa'IHa 6epe Y'-lacTb y TaKVlX nporpaMax B003 (IIVlB. Ta6nVlL/1O 16), S1K ,,3.oOPOBi MicTa », " WKonVl 3MiL\HeHHS1 3.o0pOB'S1» i ,,3aranbHOHaL\ioHanbHa KOMnn8K CHa nporpaMa 60POTb6Vl i3 HeiHcp8KL\iVlHVlMVl 3axBopIOBaHHS1MVl » (3K5H3), ane piBeHb 1"1 Y'-lacTi BVl.oa 8TbCS1 HVl3bKVlM (Lekhan et. al. 2004). Y 2004 pOL\i 6yna npVlVlHS1Ta p03p06neHa B paMKax nporpaMVl YKpalHVl - 3K5H3 cTpaTeriS1 "KOHL\enL\iS1 HaL\ioHanbHol noniTVlKVl y ranY3i xap'-lyBaHHS1 ». L\S1 KOHL\enL\iS1 nep8.o6a'-lae 3an06iraHHS1 HeCTa'-li nO>KVlBHVlX MiKpoeneM8HTiB y xap'-lYBaHHi Ta YCYH8HHS1 .oecpiL\VlTY iIlo.oy. B paMKa nporpaMVl 3K5H3 TaKO>K Bi.ocTe>KYIOTbcS1 nOBe.oiHKoBi cpaKTopVl PVl3VlKY, LUO BnnVlBa IOTb Ha CepL\eBo-cy.oVlHHY cVlcTeMY, BKnlO'-IalO'-IVl Ha.oMipHY Bary Ta o>KVlpiHHS1, H83AopoBe xap'-lyBaHHS1 Ta 6paK cpi3Vl'-lHO! aKTVlBHoCTi. Ta6m1~!1 16. Y'IaCTb y nporpaMax 8003 3):10POBi MicTa TaK TaK TaK TaK TaK PeriOHI-1 Mepe>K 3):10pOB'fl TaK TaK TaK Hi Hi niKapHi 3):1 0POB'fl Hi TaK TaK Hi Hi WKOnl1 3AOPOB'fl TaK TaK TaK TaK TaK 3aranbHoHauioHanbHa KOMnneKCHa nporpaMa 60POTb61-1 13 HeiHcpeKui~HI1MI1 3aXBoplOBaHHflMI1 TaK TaK TaK TaK TaK (3K5H3) 8Bpone~CbKI-1Vi CPOPYM MeAI-1YHI-1X acouiauiVi i 8003 TaK TaK TaK TaK TaK 8Bpone~cbKI1~ CPOPYM HauioH anbHI1X acouiaui~ Hi Hi Hi Hi Hi Me):1CeCTep i aKywepiB Ta 8003 CDOPYM ,,8BpocpapM» TaK TaK TaK TaK Hi 50 PO 105 . ,Qnfl 3J:{iHcHeHHfI i MOHiTopHHry nporpaMH 3MiLlHeHHfI 3J:{OpOB'fI B YKpaiHi Heo6xiJ:{HO CTBOPHTH CJ:{HHHH KoopJ:{HHaLliHHHH opraH. npOCYBaHH~ 3AopOBoro cnoc06y >KV1TT~, nepeA6aye He nporpaMOIO «3.QOpOB'~ HaLji'i" (Ha 2002 - 2011 pOKV1), ~Ky YXBanV1B Ka6iHeT MiHicTpiB y 2002 pOLji, Ll\e Ma SV1t11TV1 Ha eTan npaKTV1YHOI peani3aLjil'. Dm p03p06KV1 Ta 3Aitl1CHeHH~ 3aXOAiB 3i CKOpOyeHH~ CnO>KV1BaHH~ TIOTIOHY Ta anKoronlO, 3a6e3neyeHH~ Hane>KHOrO Xap YyBaHH~ Ta cj:li3V1YHOI aKTV1BHOCTi i nOCV1neHH~ 6e3neKV1 AOpO>KHbOro pyxy YKpalHa nOTpe6y yTBopeHH~ cneLjianbHOI aAMiHicTpanlB Hoi CTpyKTypV1. LUo CTOCyTbC~ np06neMV1 xapYysaHH~, TO KepiBHi opraHV1 iHWV1X KpaiH HaSOA~Tb C~ y Ta6nV1Lji 17 . 5inbwiCTb Bponeil1cbKV1x KpalH 3.Qiil1CHIOIOTb .QoBrocTpoKOsi npOrpaMIt1 3MiLjHeHH~ 3 AOPOB'~ . KpiM TOro, Ae~Ki KpalHV1 YTBoplt1nlt1 cneLjiani30BaHi iHCTIt1TYLjil, Ll\0 6e3nocepeAHbo oniKY IOTbC~ yTsepA>KeHH~M 3AopoBoro cnoc06y >KV1TT~. OAHIt1M i3 nplt1KnaAiB 3yClt1nb , cnp~MoBaHV1x Ha p03p06KY i 3.Qitl1CHeHH~ KOMnneKCHV1X .QosrOCTpOKOSV1X npoipaM , Ll\0 BpaxoBylOTb B3aM03B'~30K Mi>K pi3HV1MV1 cj:laKTopaMV1 pV13V1Ky Ta BiKOBIt1MV1 rpynaMV1, cnyry ni.QxiA, Ll\0 3acTocoBYlOTb B YOTV1 pbOX KpalHax Ll\0.Q0 yTBep.Q>KeHH~ 3AoPOBOro paLjioHY XapYyBaHH~ Ta cj:li3V1YHOI aKTV1BHoCTi (,aV1B. BCT8BKY 5 HWKlfe). Ta611MIVI 17. AAMiHicTpanloHi CTPYKTypM, ~o oiAnooiAalOTb 3a 3AiMcHeHHII noniTMKM YrallY3i xap'IyoaHHII AAMiHicTjlaTI1BHa CTpVKTvpa, utO oiAnosiAac 3a BI1KOHaHHA Ha3Ba AOpaA'iOI CTPVKTYPI1 HauioHanbHa paAa 3 nHTaHb O)f(lIIpiHH5l, HaYKOSHC1 '-IecbKa MiHicTepcTso OXOPOHH 3AOPOS'5l, MiHicTepcTso KOMiTeT HauioHanbHoro iHCTHTYTY rpOMaAcbKoro Pecny6niKa cinbcbKoro rocnoAapCTBa 3AOPOS'5l MiHiCTepCTBO OXOPOHH 3110POS'5l , HallioHanbHa HaYKOSHC1 KOMiTeT HallioHanbHoro iHCTHTYTY xapyy Yropll.(HHa cnY)f(6a rpOMaACbKoro 3AOPOS'5l i MeAHYHIIIX npallis' SaHH5l Ta 6e3neKH XapYOSH X npOAYKTi s HIilKis nOnbll.(a MiHicTepCTBO OXOPOHH 3AOPOS'5l, 1HKVlpiHH51, 51Ke y CSOIO '-Iepry CnpVl'-lVlH51C cMepTHicTb sHacJli,QoK rinepTOHi'l, ,Qia6eTY, cepueso-cy,QVlHHVlX 3axsoplOsaHb, ncVl xoco uiaJlbHVl X np06JleM i ,Qe51KVlX sVI,Qis paKy. 6i,Qnosi,QHo, ,QJl51 3an06iraHH51 Ha,QMipHiill sa3i Ta CTVlMYJlIO saHH51 sTpaTVI sarVi He06xi,QHO S>KVlSaTVI 3axo,QVI ,QJl51 P03SVlTKY KyJlbTypVl 3,Qoposoro xap'-lysaHH51 Ta cpi3V1'-1HOI aKTVlsHoCTi. · SKJlIO'-IaIOTb KaMnaHiI3,QoPOSOI KyJlbTypVl xa p'-lysaHH51, KaMnaHil cpi3V1'-1 npo cBiTHIIIWbKi 3aXO,[l1ll HViX TpeHysaHb, nonepe,Q>KeHH51 Ha ynaKosL1i xap'-losVix npo,QYKTis npo wKi,QJlVlSicTb HaTpilO, >KVlpis i L1YKPY; · 3axo,[l1ll i3 perY!7IOBaHHR Cepe,[lOBIIILlja, TaKi 51K p03p06Ka Ha MicuesoMY piSHi HaCTaHOS L11o,Qo npaSVlJlbHOI ,QiTVI xap'-lysaHH51 ; · nO,QaTKVI Ha npO,QyKTVI xap'-lysa HH51, L110 MicT51Tb wKi,QJlVlSi KOM nO,[laTKOBi perYf7RTOpHi 3aXO,[lIll, nOHeHTVI (UYKOP, >KVlpHe M'51CO Ta aJlKorOJlbHi Hanoi); · Me,[lIl1'IHi 3aXO,[l1ll ,QJl51 STpaTVI sarVl , KJliHiKVI STpaTVI sarVi. 107. nporpaMIII 3,[10POBOro XapYYBa HHR, RKi nponarY/oTb CnO)f(IIIBaHHR CPPYKTiB i OBOLfiB cepe,[l ,[li CKOpOYYBaTIII o)f(lIIpiHHR ,[liTeM, 3HIII)f(YBaTIII KPOB'RHIIIM TIIICK i 3MeHwYBaTIII plll3111K TeM , MO)f(YTb CYTTBO o)f(lIIpiHHR ,[Iopocnlllx (Angelopoulos et. al. 2009). YKpalHa He Mac >KO,QHOI nporpaMVI YTsep,Q>KeHH51 3,Qoposol KyJlbTypVl xap'-lysa HH51. 6 YropL11V1Hi S paMKax HauioHaJlbHOI nOJliTVlKVI xap'-lys aHH51 cepe,Q WKOJl51pis n'51Toro KJlacy ycici KpalHVI O,QHa TaKa nporpaMa 6yJla ycniwHo snposa,Q>KeHa 3 MeTOIO 03HailloMJleHH51Ix i3 npVlHUVlnaMVI 3,Qoposoro xap'-lysa HH51. O,QHVlM i3 WJl51xis 03HailloMJleHH51 Y'-lHis i3 eJleMeHTaMVI 3,Qoposoro xap'-lysaHH51 6yJlO peryJl51pHe p03nosCIO,Q>KeHH51 iHcpopMauiillHVlX 61OJleTe His (6003, 2006 piK). 108 . Cnp/l/RTIII yTBep,[/JKeHH/O 3,[10POBoro cnoco6y )f(IIITTR MO)f(YTb KaMnaHii cpi3111LfHOi ni,[lroTOBKIII. CJlO seHi51 snposa,QVlJla niJlOTHY nporpaMy ni,Q Ha3SOIO «5Y,QeMo 3,Qoposi I», 51Ka Mae Ha MeTi nponarysaHH51 3,Qoposoro cnoc06y >KVlTT51 Ta OC06V1CTOI si,Qno si,Q3JlbHOCTi 3a csoe 3,QOpOS'51. 6 paMKax uiel nporpaMVI 3acTocosyeTbc51 KOMnJleKCHVliII ni,Qxi,Q ,QO sVlpiweHH51 np06JleMVI cpi3V1'-1HOI aKTVlsHoCTi 13 xap'-lysaHH51 i3 SVlKopVlcTaHH51M 3ac06is Macosol iHCPOpMaUi', Ta MacosViX 3axo,Qis. Y nporpaMi 6epYTb Y'-lacTb 30 000 oci6 i3 70 rpoMa,Q, npVl L1bOMY 8 i3 KO>KHVlX 10 Y'-lacHVlKis 3a51SVlJlVl, L110 sHacJli,QoK 3,QiillcHeHH51 Uici npo rpaMVI SOHVI 3M iHVlJlVl cnoci6 csoro >KVlTT51. 109 . XapYOBa iHcpopMawiR Ha ynaKoBwi npO,[lYKTiB ,[I03BOnRCnO)f(/l/BaYaM cBi,[lOMOB/l/6/1/paTIII npO,[lyK Till xapLfYBaHHR 3ane)f(HO Bljj KanopiMHOCTi npO,[lYKTY , BMicTY )f(lIIpiB Y HbOMY i MOro xapyoBoi WiHHOCTi . 52 PO J Dlr ,~ U lf bOB I3/· XOI:\ 1;1 3 3AnO Elr AHHrt nFPEJ] 1ACH , 11 CM f P TH OC T I B paMKaX HeL110t:laBHbOrO npOeKTY 8C " P03M iL11eHH51 XapYOBOI iHcpOpMaui'l Ha ynaKoBui npOt:lYKTiB t:ln51 ! KOBUi npOt:lYKTiB XapYYBaHH51. 5yno BCTaHOBneHO , L110 mOt:lVl YVlTalOTb TaKY iHcpOpMauilO, P03YMilOTb ii, ane He 060B'513KOBO 3Ba>KaKHb Ha Her. KonVl KynYIOTb npO,QyKTVl XapYYBaHH51 (Cowburn and Stockley 2005, Grunert and Wills 2007) . 110 . HaCTaHOBt1 LLiOI/O paL/ioHY Xap'-lYBaHHR MO/KYTb 6YTt1 al/amOBaHi I/O KYf7bTYPHt1X Tpal/t1L/it1 Kpai'Ht1 i, Bil/nOBiI/HO , MO/KYTb KpaLLie Cnpt1t1MaTt1CR . HacTaHoBVl L110t:l0 pauioHY XapYYBaHH51 Hat:lalOTb iHcpopMa uilO nVlwe npo >KVlBVlnbHi peYOBVlHVl (>KVlPVl, UYKOP, cinb, KanbuiVi, 3ani30 T0L110), 51Ki CnO>KVlBaIOTbC51, B TOVi yac 51K HaCTaHOBVl L110t:l0 pauioHY XapYYBaHH51 3 ypaXYBaHH51M oc06nVlBOCTeVi npOt:lYKTiB XapYYBaHH51 BpaXOBYIOTb KynbTYPHi Tpa,QVlui'l, npouec nit:lrOTOBKVl, 06p06KVl Ta Ha51BHicTb npOt:lYKTY. TaKi HaCTaHOBVl YrOpL11VlHa Ta nOnbL11a 3apa3 p03po6n51IOTb 51K napTHepVl Y BVlKOHaHHi 8BponeVlcbKVlx peKOMeHt:lauiVi CTOCOBHO >KVlBVlnbHVlX MiKpoeneMeHTiB (EURRECA). 111. npOrpaMt1 BTpaTt1 Bart1 MO/KYTb CKOpO'-lYBaTt1 3axBopIOBaHicTb l/ia6eTOM Ta HaBiTb 3an06iraTt1 t10MY. Bi3VlTVl t:lO ,QiCTonoriB, 51Ki nponarYIOTb HVl3bKoKanopiVlHVlVi pauioH XapYYBaHH51, npVl3BOt:lmb t:l0 3MeHweHH51 nepBicHo'l BarVl npVlHaVlMHi Ha 5% npoT51roM O,QHoro POKY (Compe et. al. 2003). YyaCTb Y nporpaMax, Y 51KVlX peKOMeHt:lYIOTbC51 HVl3bKoKanopiViHi npOt:lYKTVl XapYYBaHH51 i3 BMicTOM BVlCOKO KOM6iHoBaHVlx ByrneBOt:lHiB, t:l03Bon51C 'IxHiM yyaCHVlKaM YTpVlMYBaTVl 3MeHweHY Bary HaBiTb npOT51roM t:lBOX HacTynHVlx pOKiB (Greene et. al. 2006). CKpHHiHr xsopo6 - npocpinaKTHKa Ha ,qpyroMy piSHi CHCTeMH OXOpOHH 3,qOpOS'R 112. npOcpinaKTHKa cpaKTopis pH3HKy Ha nepwoMY piSHi CHCTeMH OXOpOHH 3,qOpOS'R 30sciM He 060S'R3KOSO 3ano6irae 3axsoplOsaHOCTi. 3aXOt:lVl i3 KOHTponlO TIOTIOHY, nponarYBaHH51 KynbTypVl 3,QOPOBOro XapYYBaHH51 Ta aKTVlBi3aui51 cpi3VlYHO'I t:li51nbHOCTi 6e3nOCepet:lHbO nocna6nlOIOTb cpaKTOpVl pVl3VlKy i Y TaKVlVl cnoci6 3an06iralOTb xBop06aM, 51Ki TaKi cpaKTOpVl PVl3VlKY MO>KYTb CnpVlYVlHmVl. npo Te t:ln51 t:le51KVlX HI3 Ot:lHa nVlwe npocpinaKTVlKa Ha nepwoMy piBHi CVlCTeMVl OXOPOHVl 3t:l0POB'51 BVlt:laCTb C51 Het:lOCTaTHbOIO a60 yepe3 Te, L110 cpaKTOpVl PVl3VlKY He nit:lt:laIOTbC51 3MiHi (HanpVlKnat:l, Cnat:lKOBicTb, BiK a60 CTaTb), a60 yepe3 Te, L110 BOHVl Bit:lHOCHO 3aMano BnnVlBalOTb Ha 3axBoplOBaHicTb. Y TaKVlX cVlTyaui51x o,QHiclO i3 anbTepHaTVlB C npocpinaKTVlKa Ha t:lpyrOMY piBHi CVlCTeMVl OXOPOHVl 3t:l0POB'51: T06 TO t:liarHOCTYBaHH51 Ta niKYBaHH51 HI3 Ha nOyaTKOBOMY eTani 3aXBopIOBaHH51, t:l0 n051BVl YCKnat:lHeHb YVl CMepTi . npVl paHHbOMY ,QiarHOCTYBaHHi 3aXBopIOBaHH51 Hane>KHe Vioro niKYBaHH51 YVl KOHTponb MO>KYTb 3MeHWVlTVl V1MOBipHicTb CMepTi Ta T51rap 3aXBopIOBaHOCTi. BTopVlHHa npocpinaKTVlKa MO>Ke npOBOt:lVl TVlC51 Ha iHt:lVlBit:lyanbHOMY piBHi , KonVl, HarlpVlKnat:l, niKap t:liarHOCTYC rinepTOHilO Ha paHHbOMY eTani, Hat:laC KOHcynbTaui'l Ta niKYCI'I a60 npOBO,QVlTb 06CTe>KeHH51 Ha npet:lMeT paKy MOnOYHo'i 3an03Vl, a60 Ha piBHi HaceneHH51 3a t:lOnoMorolO uinbOBVlX nporpaM CKpVlHiHry. npOcpinaKTVlKa Ha t:lpyrOMY piBHi CVlCTeMVl OXOPOHVl 3t:l0POB'51 BVlt:laCTbC51 ecpeKTVlBHOIO y BVlnat:lKax paKy MonOYHo'l 3an03Vl Ta paKy WVlVlKVl MaTKVl, t:lia6eTY Ta rinepToHil. 113. 3 OmRI/Y Ha Bt1COKt1t1 piBeHb CMepTHOCTi (80%), CKpt1HiHr paKY M0f70'-lHOi' 3af703t1 i Wt1t1Kt1 MaT Kt1 , a TaKO/K 3MiL/HeHHR cTaHY 31/0POB'fj Ha piBHi nepBt1HHoi' Mel/t1KO-CaHirapHoi' 1/0nOMOrt1 MO/KYTb 6YTt1 Bef7bMI1 I/Ope'-lHI1MI1 B YKpaiHi. Lljo CTOCY8TbC51 paKy MOnOYHOI' 3an03Vl , TO V1oro CB08yaCHe t:lia rHoCTYBaHH51 Ta niKYBaHH51 MO>KYTb Bp51TYBaTVl >KVlTT51 14 YKpalHcbKVlM >KiHKaM Ha 100 000 HaCeneHH51. 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BCTaBKY 6), npH LlbOMY p03no,ain pe CypCiB 3,ainCHIOf:TbCfl3aneJKHO Bi,a CCBHpo6HH'4HX nOTYJKHOCTen» (Lekhan et. 31, 2004) , Clt1CTeMa OXOPOH1I1 3.o0pOB'51 YKp3IHlt1 CTpa>K,Qae Bi.o Ceptll03Hlt1 X np06neM y cc:pepax ec:peKTlt1BHOCTi, ynpaBniH H51, c:p iHaHcYBaHH51 T3 Ha.o3HH51 Me.olt1'-1Hlt1X nocnyr (CBiTOBlt1t1l 6aHK , 2006), ICHYIO'-I3 Clt1CTeM3 OXOpOHlt1 3.o0POB'51 Bi.o3HaY3eTbC51 6P3KOM CTlt1Mynis .00 ni.oBlt1UjeHH51 51KOCTi 06cnyroBys3HH51, P03.oYTOlO CTPYK TypOIO cTauioHapHlt1 X 3aKn3.oiB i Bi.ocYTHicTIO H3ne>KHOi npoc:peciViHol ni.orOTOBKlt1 Me.olt1YHlt1X npauiB 56 HVlKiB Ta OnnaTVllxHbOI' npal1i. CVlCTeMY nepBVlHHO·1 Me,QVlKO-CaHiTapHol' ,QonOMOrVl (nMCD) YKpa·IHa ycna,QKYBana nepeBa>KHO Bi,Q Pa,Q51HCbKorO COI03y. 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CnoBeHiR Pecj:JopMa CI!1CTeMI!1 OXOPOHV1 3AOPOS'fl Y CnoseHfl p03nOYa- nOAOBIKeHH51 Tpl!1SanOCTi IKI!1TT51, CKOpOyeHH51 Tpl!1SanOCTi naC51 nicnfl npl!1l11HflTTfl y 1992 po~i HOSOro 3aKoHY npo oxopo- rocniTani3a~ir, noninweHHfl nepSI!1HHo'l MeAV1Ko-caHiTapHo'i Hy 3AOPOB'51. Pecj:JopMV1 6ynV1 30Cepel1lKeHi Ha rapMoHi3a~fl i3 AonOMorV1 i3 HaronocoM Ha npocj:JinaKTV1ui Ta 3MiUHeHHi ec, noninweHHi MeTOAiB p03no,Qiny pecypciB ,Qnfl nOCl!1neHHfl 3,QOpOS'fl. cTV1MynlOsaHHfl AO Ha,QaHH51 ecj:JeKTI!1BHV1X MeAI!1YHI!1X nocnyr, y,QocKoHaneHHi iHcj:JopMauiIllHV1x CV1CTeM Ta P03BV1TKosi nepe- AOBO'I KniHiYHO'i npaKTI!1KV1. CDiH8HCYB8HHR 127. Mo6ini3auifl pecypcis. 3a perioHanbHHMH Ta esponeHcbKHMH cTaH,qapTaMH, ,qepJKasHi sH,qaTKH Ha OXOPOHY 3,qOPOS'fI S YKpaiHi y P03Mipi 3,7% BBn SH,qaIOTbCfI HH3bKHMH, npoTe SOHH e ,qeU40 SHU4HMH 3a si,qnosi,qHHH MiJKHapo,qHHH nOKa3HHK (CBiTOBlt1t11 6aHK, 2006) (Iit1B.lii8 ipaMy 39). 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CnOBeHiS1 Ha BTOPVlHHOMY Ta TpeTVlHHOMY piBHS1X CVlCT8MVl OXOpOHVl 3AOPOB'S1 onnayy MeAVlYHi nocnyrVl 3a KO>KHOro XBoporo, a Ha piBHi nepBVlHHoi MeAVlKo-caHiTapHO! AonOMorVl BiAnOBiAHO AO OTpVlMaHVlX niKapS1MVl rOHopapiB; Ha LjbOMY piBHi iCHYKlTb TaKO>K nnaTHi nocnyrVl . Ha.aaHHR Mefl,I1'-IHMX nocflyr 135. l1elJeHTpani3alJiR Ta vnpaBniHHR. CborollHiwHi nillxollH IlO nnaHYBaHHR nOTYJKHOCTeii Y cHcTeMi OXOpOHH 31l0POB'R YKpaiHH He BpaXOBYIOTb MeIlH'IHi nOTpe6H HaceneHHR a60 MicLleBi oco6nHBOCTi. 3aranOM , iCHYKlYiC1 CVlCT8Mi 6paKY AVlHOro niAXOAY AO 3a6e3neY8HHS1 Hane>KHoi Kinb KOCTi M8AVlYHVlX npaLjiBHVlKiB. HOPMaTVlBVl, Ll..\OlX 3aCTOCOBY MiH3ApaB , MicTmb yiTKi BKa3iBKVl Ll..\OAO KinbKOCTi niKapiB, MeAceCT8p C1 iHWVlX npaLjiBHVlKiB. TaKi HopMaTVlBVl 6a3YKlTbCS1 Ha KinbKOCTi ni>KOK y niKapHS1 X C1 iHWVl X napaMeTpax noniKniHiK i aM6ynaTOpHVl X 3aKnaAiB. Ue npVl3BOAVlTb AO p03AYBaHHS1 WTaTiB i nVlWa MicLjeBVlX K8piBHVlKiB MO>KnVlBOCTi p03nOAinS1TVl pecypcVl 3 ypaXYBaHHS1M nonVlTy Ha MeAVlYHY AonOMory (CBiTOBVlC1 6aHK , 2008 piK) B TOC1 >Ke yac M8AVlYHVl X npaLjiBHVlKiB H8 BVlCTaya Ha piBHi npocpinaKTVlKVl i n8pBVlHHOI M8AVlKo-caHiTapHo'i AonOMorVl Ta y cinbcbKiC1 MicLj8BOCTi JliKapi , Ll..\0 HaAaKlTb nepBVlHHy M8AVlKO-CaHiTapHY AonOMory, CKnaAaKlTb nVlW8 npVl6nVl3Ho OAHY YBepTb yci x npaLjKlKlYVlX niKapiB, B TOC1 yac S1K niKapi 3aranbHoi npaKTVlKVl - MeHwe 2% Bci x niKapiB. 12 B 1995 pOLji 3aranbHa YVlC8nbHicTb MeAVlYHVl X npaLjiBHVlKiB B YKpalHi CYTTBO CKopoTVlnacS1, i B 2004 pOLji KinbKicTb niKapiB Ha AYWy Hacen8HHS1 CKnana npVl6nVl3Ho 300/100 000, Ll..\0 HVl>Kye cepeAHboro nOKa3HVlKa ec. Yepe3 HVl3bKy 3apnnaTHKl Ta BiACYTHicTb n8pcneKTVlB npocyBaHHS1 no cnY>K6i npVlTiK M8AC8CT8P no cTiC1HO 3MeHwYTbcS1. KpiM TOro, 3aMiHKlBaTVllx HiKVlM, oCK inbKVl BVlnycK M8AcecTep i3 HaByanbHVlX 3aKnaAiB CKOpOYYTbCS1. 136. CHcTeMa OXOpOHH 31l0POB'R e lleLleHTpani30BaHolO, ane nonpH cpiHaHcYBaHHR opraHaMH MicLleBoro caMoBpRIlYBaHHR MeIlH'IHHX 3aKnalliB, RKi 3HaxollRTbCR Y iXHiii BnacHocTi, HallMip He perynlOBaHHR i3 LleHTpy 3anHwae MicLleBHM opraHaM IlYJKe Mano rHY'IKOCTi B aIlMiHicTPY BaHHi nocnyr i MeIlH'IHHX 3aKnalliB. 3aKOHOAaByiC1 6a3i YKpalHVl npVlTaMaHHi p03nopoweHicTb i CKnaAHicTb, Ay6nKlBaHHS1 i P03MVlTicTb nOBHOBa>K8Hb. CTaTTS1 49 KOHCTVlTYLjil YKpalHVl nep8A6aya , Ll..\0 «,Oep>KaBa CTBOPKl YMOBVl AnS1 8cpeKTVlBHoro i AOCTynHoro AnS1 Bcix rpoMaAS1H MeAVlYHoro 06 cnyroBYBaHHS1». npoTe LjS1 caMa CTaT151 3a60pOHS1 CKOpOY8HHS1 M8pe>Ki MeAVlYHVlX 3aKnaAiB Ha 6YAb S1KOMY piBHi BnaAVl, BHacniAoK yoro iCHYKlya Mep8>Ka LjVlX 3aKnaAiB BVlAaTbCS1 HeecpeKTVlBHoKl i He 3aAOBOnbHS1E: nonVlT Ha MeAVlYHY AonoMory. Xoya 6inbwa yaCTVlHa Aep>KaBHVl X BVlAaTKiB Ha OXOPOHY 3AOPOB'S1 HaAaTbCS1 yepe3 MiCLj8Bi opraHVl BnaAVl, npaKTVlKa perynKlBaHHS1 3 60KY MiHicTepCTBa OXo POHVl 3AOPOB'S1 (M03) 03Haya , Ll..\0 Lji opraHVl He MO>KYTb nOBHOKl MipOKl KOHTponKlBaTVl p03nOAin KOWTiB. PecpopMVl 2001 i 2002 pOKiB, S1Ki ManVl Ha M8Ti 3MiHVlTVl nopS1AoK aCVlrHYBaHHS1 Aep>KaBHVl X KO wTiB, 6ynVl BTin8Hi nVlwe YaCTKOBO, i MicLjeBi BVlAaTKVl npOAOB>KYKlTb 3AiC1cHKlBaTVlCS1 3a HOpMaTVlBaMVl MaTepianbHo-T8XHiYHoro 3a6e3neyeHHS1, p03p06neHVlMVl M03. Ui HopMaTVlBVl BVl3HayaKlTb KinbKicTb niKapiB, MeAc8cT8P C1 iHworo nepcoHany 3an8>KHO BiA YVlCenbHocTi HaC8n8HHS1 , KinbKocTi ni>KOK C1 iHWVl X napaM8TpiB (CBiTOBVlC1 6aHK, 2008 piK). 137. tlocBill pecpopM Y LleHTpanbHiii f:Bponi CBill'lHTb, LL40 HaneJKHa opraHi3aLliR HallaHHR Me IlH'IHHX nocnyr nOTpe6ye lleLleHTpani3aLlii" Ta caMocTiiiHOCTi B ynpaBniHHi. B YrOpLl..\VlHi 6inb WiCTb M8AVlYHVlX 3aKnaAiB n8pBVlHHoro Ta BTOpVlHHoro piBHS1 CVlCTeMVl OXOPOHVl 3AOPOB'S1 6ynVl nepe AaHi i3 Aep>KaBHOI BnacHocTi y BnacHicTb opraHiB MicLjeBoro caMoBpS1AYBaHHS1. nOnbLl..\a nepeAana opraHaM MicLjeBOrO caMoBpS1AYBaHHS1 CPYHKLjil 6KlA>KeTYBaHHS1, nnaHYBaHHS1 , opraHi3aLjil Ta HarnS1AY 3a 3aKnaAaMVl nepBVlHHo'! MeAVlKO-CaHiTapHOI AonOMorVl i 3anVlWVlna 3a LjeHTpanbHoKl BnaAOKl AeS1Ki I\VlP ('~II1bHl1';i 3S'-' I )CI 7 r,e' 61 ynpaBniHCbKi nOBHOBa>KeHH>1 (KOHTpOnb >1KOCTi, BCTaHOBneHH>1 CTaH,qapTiB, KOOp,qIllHaLji>1 periOHanb HIIlX nnaHiB OXOpOHIll 3,qOPOB'>1, 3aKyniBenbHi npOLje,qyplll TOLl\O) , YeCbKa Pecny6niKa nepe,qana pa ViOHHi niKapHi i3 ,qep>KaBHO'1BnaCHOCTi y BnaCHiCTb opraHiB MicLjeBorO CaMOBp>1,qYBaHH>1, a nepBIIlHHy Me,qIllKo-caHiTapHY ,qonOMory Ta aM6ynaTopHi nocnyrlll - y nplllBaTHy BnacHicTb. 138. PayioHani3auifi HallMipHuX nOTVJKHOCTeH. CucTeMa OXOPOHU 3J10POB'fI YKpaiHu OpiCHTO BaHa Ha cTal..lioHapHe niKYBaHHfI, BHaCniJlOK '4oro Y niKapHflHoMY ceKTopi iCHYIOTb HaJlMipHi nOTYJKHOCTi. KinbKicTb ni>KOK y cTaLjioHapax Ha 100 000 HaCeneHH>1 Ha 33% nepeBIIlLl\YE: cepe,qHiVi nOKa3HIIlK 8C-10, a cepe,qH>1 TplllBanicTb nepe6YBaHH>1 y niKapH>1X YKpa"HIll CKna,qaE: 13,9 ,qH>1 , O,qIllH i3 Haill6inbwIIlx nOKa3HIIlKiB y perioHi (CBiTOBIllVi 6aHK, 2008 piK) (11/118. ra6n/l1l..{/O 20) . .om nopiBH>1HH>1 , y CnOBeHil cepe,qH>1 TplllBanicTb niKYBaHH>1 y niKapH>1X CKna,qaE: 8 ,qHiB, BYroPU1I1lHi - 8,7 ,qH>1, a y YecbKiVi Pecny6niLji - 11 ,5 ,qH>1 . Ta6mll.\11 20, PecYPcl1 OXOpOHI1 3~OpOB'1I Ta 'ixH& BI1KOpl1CTaHHII BYKpa'iHi Ta EC, 2004 piK YKpa'iHa lliKapeHb Ha 100 000 HaceneHHR 5,6 3,1 ni>KOK Y niKapHRx Ha 100 000 HaceneHHR 872,9 585,5 rOcniTani3aljiR Ha 100 HaceneHHR 21,1 18,0 CepeAHR Tpl-1sanicTb nepe6ysaHHR y niKapHi, ,QHis 13,9 9,3 KinbKicTb 3sepHeHb 3a aM6ynaTOpHoIO ,QonoMorolO Ha oco6y, Ha piK 10,5 6,8 niKapis Ha 100000 HaceneHHR 301,3 320,0 spcr ,) ' :(Xl AcJl~I" X 3LlB, 2008 f.:11\ 139. B YMOBax cjJiHaHCYBaHHfI niKapeHb 3aneJKHO BiJl niJKKOBOrO cjJOHJlY 3ycunnfl i3 pal..liOHa ni3al..lii", cnpfiMOBaHi Ha CKOpO'4eHHfI HaJlMipHUX nOTYJKHOCTeH, He npU3Benu JlO niJlBUYleHHfI ecjJeKTUBHOCTi B YKpaiHi. HaMaralOYIIlCb pecpopMYBaTIll ceKTOp niKapeHb , yp>1,q 30cepe,qIllBC>1 Ha CKOpOyeHHi KinbKOCTi ni>KOK y cTaL(ioHapax, >1Ka Ha nOyaTKY 90-x pOKiB 6yna HaillBIIlU1010 y 8Bponi, Ta Ha ynOp>1,qKYBaHHi Me,qIllYHIIlX nocnyr, HanpIllKna,q, wmXOM 3aMiHill niKYBaHH>1 y niKapH>1X iHWIIlMIll cpop MaMIll Me,qIllYHO', ,qonOMorlll , TaKIIlMIll >1K ,qeHHlllill cTaL(ioHap, ,qOMaWHiVi cTaL(ioHap Ta ,qeHHlllill xipypriY Hillill CTaL(iOHap. BTiM , Hacni,qKIIl TaKO', 3aMiHill ,qn>1 BIIlKopIllCTaHH>1 ni>KKOBOro CPOH,qy 6ynlll He3HaYHIIlMill llepeBa>KHO yepe3 He3aL(iKaBneHicTb niKapeHb y CKOpOyeHHi KinbKOCTi rocniTani30BaHIIlX, oCKinbKIll cpiHaHCYBaHH>1 Ha,qaBanOC>1 niKapH>1M 3ane>KHO Bi,q I'xHboro ni>KKOBOro CPOH,qy (Lekhan e1. al. 2004) CYTT8BOI e¢eKTIIlBHoCTi MO>KHa 6yno 6 .QOC>1rTIll 3a paxYHoK npocpinaKTIIlYHo'l Me,qIllLjIllHIll Ta 3acTocy BaHH>1 cyyaCHIIlX MeTo,qiB aM6ynaTopHoro niKYBaHH>1 140. 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Tplo1BaJ1icTb >KIo1TTSI 3 ypaxYBaHHSlM 3AopoBoro CTaHY J1IOAIo1HIo1, a60 Tplo1BaJ1icTb >KIo1TTSI 3AOPOBO'j J1IOAIo1HIo1 (T>K3fl) - cepe,qH51 eKBiBaneHTHa KinbKicTb pOKiB, 5lKi HOBOHapo,q>KeHV1~ MO>Ke npO>KV1TV1 y nOBHOMY 3,qOPOB'i, 5lKl1.j0 BiH "lV1 BOHa npOT51rOM CBoro >KV1TT51 YHV1KHe nOBiKOBOi CMepTHOCTi Ta 3aXBO 71 TPA.I EOI~ I'l'<.n l MO>KHA VHVoiI B YKP A,HI KPV' 3 V1 1 -1nOP O B'~1 non" Hill DOCEl1il 8BP Oml1 pIOBaHOCTi, nplllTaMaHHOI KOHKpeTHOMY pOKY >KIIlTT51 (8003 2002). T>K3n - Lje cYMapHIIlIII nOKa3HIIlK, 51KVoC1 BpaxoBye cMepTHicTb Ta 3axBoplOBaHicTb: ,Qn51 oTpIllMaHH51 3aranbHoro nOKa3HIIlKa, 51KIIlIII Bi,Q611l Bae cMepTHicTb Ta 3axBopIOBaHicTb HaceneHH51, KinbKicTb pOKiB, npO>KIIlTIIlX Y MeHw, Hi>K Bi,QMiHHOMY 3,QOPOB'-', 3Ba>KeHa Ha cKna,QHicTb cTaHY, Bi,QHiMaTbC51 Bi,Q nOBiKOBo-, TpVoBanoCTi >KIIlTT51 3axsopIOsaHicTb - nowVopeHicTb 3axBopIOBaHH51, XBop0611l, TpaBM i iHBani,QHocTi cepe,Q HaceneHH51 (Haup A., Kane T . 2004). Koecpi~icHT AIIITSI'"IO'j cMepTHocTi (KAC) - KinbKicTb ,QiTeC1, ll\0 nOMepnlll Y BiLji .00 1 pOKy Ha 1000 HOBO Hapo,Q>KeHIIlX Y KOHKpeTHoMY pOLji (Haup A., Kane T. 2004). TplllsanicTb )l(IIITTSI, cKoplllrosaHa Ha iHsaniAHicTb (T)KCI) -Lje nOKa3HlIlK ,QecpiLjIllTY 3,QOpOB'51, 51KIIlC1 Y3aranbHIOe KinbKicTb pOKiB >KVoTT51 , BTpayeHVoX BHacni,QoK cMepTi 13 3axBoplOBaHb. T>KCI 51Bn51e co 6010 CTaTIIlCTVoYHlIl1ii BVoMip KinbKOCTi Hepeani30BaHlIlx pOKiB >KIIlTT51 Y 3,QOPOBOMY cTaHi, BiH noe,QHye Hacni,QKVo 3aXBoplOBaHb, iHBani,QHocTi Ta cMepTHocTi ,Qn51 3,Q0POB'51 HaceneHH51 (8003, 2002 piK). T>KCI BVoKOplllcToByeTbc51 Y ,QBOX Ljin51x : ,Qn51 BIIl3HayeHH51 nOTOYHOro T51rap51, ll\0 BIIlHIIlKae yepe3 no raHVoC1 C13H 3,QOPOB'51, HanplllKna,Q yepe3 XBop0611l Ta TpaBMIIl, i ,Qn51 BIIl3HayeHH51 T51rap51, 51KOro MO>KHa yHIIlKHYTIIl Y MaC16YTHbOMY. 8 oCTaHHboMY BVona,QKY i3 eTionoriYHOi TOYKIIl 30PY 1II0ro MO>KHa Bi,QHecTIIl,Qo cpaKTopiB pVo3l1lKY a60 ,QO npW-IIIlH. CTaHAapTIII30saHillVi Koecpi~icHT cMepTHocTi (CKC) -Lje nOKa3HIIlK, ll\0 Bi,Q6l1lBae cMepTHicTb cepe,Q pi3HlIlX KaTeropiC1 HaceneHH51, ,Qe BnnlllB BiKY e nocTilllHIIlM (5araroMoBHIIlC1 ,QeMorpacpiYHIIlIII cnOBHIIlK, 1982 piK). TYT CKC 06YIIlCnlOeTbc51 i3 BIIlKopVocTaHH51M np51Moro MeTo,Qy, T06TO BiH nOKa3ye , 51KVoM Mir 6111 6YTlIl arperoBaHIIlIII nOKa3HVoK cMepTHocTi, 51K611l HaceneHH51 Mano TaKY caMY nOBiKOBY CTPYKTYPY, 51K i eBponelllCbKe HaceneHH51 _ 72