rfhealthЗдравоохранение Российской ФедерацииHealth care of the Russian Federation0044-197X2412-0723Federal Scientific Center of Hygiene named after F.F. Erisman10.47470/0044-197X-2026-70-2-93-100knsmfzrfhealth-2219Research ArticleОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯHEALTH CARE ORGANIZATIONМетоды комплексной оценки общественного здоровья в связи с факторами среды обитания на основе использования интегральных показателей. Описательный обзор (сообщение 2)Methods for complex evaluation of the population health in relation to environmental factors based on use of integral indices. Descriptive review (Report 2)https://orcid.org/0000-0002-4755-8306ГлухихМаксим ВладиславовичGlukhikhMaxim V.

Канд. мед. наук, ст. науч. сотр., зав. лабораторией методов комплексного санитарно-гигиенического анализа и экспертиз отдела системных методов санитарно-гигиенического анализа и мониторинга ФБУН «ФНЦ медико-профилактических технологий управления рисками здоровью населения» Роспотребнадзора, 614045, Пермь, Россия

e-mail: gluhih@fcrisk.ru

PhD (Medicine), senior research, Head, Laboratory of methods complex sanitary and hygienic analysis and expertise, Department of sanitary and hygienic analysis and monitoring systemic methods, Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Perm, 614045, Russian Federation

e-mail: gluhih@fcrisk.ru

gluhih@fcrisk.ruhttps://orcid.org/0000-0003-0135-7258ОнищенкоГеннадий ГригорьевичOnishchenkoGennadiy G.

Доктор мед. наук, профессор, академик РАН, зам. президента ФГБУ «Российская академия образования», 119121, Москва, Россия

e-mail: journal@fcrisk.ru

DSc (Medicine), Professor, Academician of the Russian Academy of Sciences, Deputy President of the Russian Academy of Education, Moscow, 119121, Russian Federation

e-mail: journal@fcrisk.ru

journal@fcrisk.ruhttps://orcid.org/0009-0000-5549-8609КлейнСофья ДмитриевнаKleinSofia D.

Магистр Международного Бизнеса, Национальный исследовательский университет «Высшая школа экономики», 119602, Москва, Россия

e-mail: klein.sophia@yandex.ru

Master of International Business, National Research University “Higher School of Economics”, Moscow, 119602, Russian Federation

e-mail: klein.sophia@yandex.ru

klein.sophia@yandex.ruhttps://orcid.org/0000-0001-6316-7850УхабовВиктор МаксимовичUkhabovViktor M.

Доктор мед. наук, профессор каф. общей гигиены и профильных гигиенических дисциплин, ФГБОУ ВО «Пермский ГМУ им. академика Е.А. Вагнера» Минздрава России, 614990, Пермь, Россия

e-mail: uhabovvm@yandex.ru

DSc (Medicine), Professor Department of common hygiene and specialized hygienic disciplines, Perm State Medical University named after academician E.A. Wagner, Perm, 614990, Russian Federation

e-mail: uhabovvm@yandex.ru

uhabovvm@yandex.ruФБУН «Федеральный научный центр медико-профилактических технологий управления рисками здоровью населения» Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человекаFederal Scientific Center for Medical and Preventive Health Risk Management TechnologiesФГБУ «Российская академия образования»Russian Academy of EducationФГАОУ ВО «Национальный исследовательский университет "Высшая школа экономики"»National Research University “Higher School of Economics”ФГБОУ ВО «Пермский государственный медицинский университет имени академика Е.А. Вагнера»Perm State Medical University named after Academician E.A. Wagner20263004202670293100Copyright © Глухих М.В., Онищенко Г.Г., Клейн С.Д., Ухабов В.М., 20262026Глухих М.В., Онищенко Г.Г., Клейн С.Д., Ухабов В.М.Glukhikh M.V., Onishchenko G.G., Klein S.D., Ukhabov V.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rfhealth.ru/jour/article/view/2219

Представлена вторая часть серии описательных обзоров методологического инструментария для комплексной оценки общественного здоровья, касающаяся индексных показателей и показателей обременения/качества здоровья населения. Содержание рукописи сфокусировано на инструментах оценки потерь здоровья и многомерной оценке детерминант здоровья в продолжение разбора метрик достигнутого уровня здоровья.

Цель исследования — описание принципов построения, методологических особенностей, областей применения, преимуществ и ограничений интегральных показателей, сфокусированных на оценке бремени болезней (DALY, QALY) и многомерных композитных индексах.

Анализ научной литературы выполнялся методом «снежного кома» по ключевым словам в реферативных базах данных Scopus, Web of Science, PubMed. Приоритет отдавался основополагающим в концептуальном отношении документам, описывающим методику построения показателей. Дополнительно изучались обзоры и доклады международных организаций (ВОЗ, ОЭСР, ООН).

Установлено, что показатель «годы жизни, скорректированные на нетрудоспособность» является «золотым стандартом» для мониторинга неравенства в состоянии здоровья населения с выделением наиболее значимых факторов риска. Показатель «годы жизни с поправкой на качество», основанный на субъективных оценках полезности состояний здоровья, позволяет сравнивать эффективность разнородных медицинских технологий в рамках фармакоэкономического анализа. Композитные индексы, например, Индекс человеческого развития и Индекс здоровья Англии, обеспечивают комплексную межсекторальную оценку путём интеграции социальных, экономических и экологических детерминант в единый показатель.

Ограничения исследования

Ограничения исследования. Выполненный обзор является нарративным (описательным), без строгой систематизации стратегии поиска по типам исследований, датам публикаций и источникам.

Заключение

Заключение. Выбор конкретного инструмента должен определяться поставленными задачами, доступностью и качеством исходных данных, а также требуемым уровнем детализации для обоснования управленческих решений, в том числе в сфере санитарно-эпидемиологического благополучия населения.

Участие авторов

Участие авторов:Глухих М.В., Ухабов В.М. — редактирование, написание текста, утверждение окончательного варианта статьи; Онищенко Г.Г. — концепция и дизайн исследования, редактирование, утверждение окончательного варианта статьи; Клейн С.Д. — сбор и обработка материала, статистическая обработка данных, написание текста. Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных  конфликтов интересов в связи с публикацией данной статьи.

Поступила

Поступила: 13.02.2026 / Принята к печати: 19.02.2026 / Опубликована: 30.04.2026

This paper presents the second part of descriptive reviews on methodological tools for the comprehensive assessment of public health, focusing on index-based indicators and measures of population health burden and health-related quality of life. The manuscript is centered on instruments for assessing health losses and the multidimensional evaluation of health determinants, continuing the analysis of metrics of achieved health status.

The purpose of the study is to describe the principles of construction, methodological features, fields of application, advantages, and limitations of integral indicators focused on the assessment of disease burden (DALY, QALY) and multidimensional composite indices.

The analysis of the scientific literature was conducted using the method of «snowball» based on scientific articles indexed in bibliographic databases including Scopus, Web of Science, PubMed. Priority was given to conceptually foundational documents describing the methodology for indicator development. In addition, reviews and reports from international organizations (WHO, OECD, UN) were analyzed.

DALY (Disability-Adjusted Life Years) was shown to be «gold standard» for monitoring inequalities and gaps in population health status, with identification of the most significant risk factors. QALY (Quality-Adjusted Life Years), based on subjective health state utility assessments, enables comparison of the effectiveness of heterogeneous medical technologies within pharmacoeconomic evaluations. Composite indices, such as the Human Development Index and the English Health Index provide a comprehensive cross-sectoral and interagency assessment by integrating social, economic, and environmental determinants into a single metric.

Research limitations

Research limitations. The review is narrative (descriptive), without strict systematization search strategy by study type, publication date, or source.

Conclusion

Conclusion. The choice of a specific assessment tool should be determined by the research objectives, the availability and quality of input data, and the required level of detail for supporting decision-making, including in the field of sanitary and epidemiological well-being.

Contribution of the authors: Glukhikh M.V., Ukhabov V.М. — editing, writing the text, approval of the final version of the article; Onishchenko G.G. — study concept and design, editing, approval of the final version of the article; Klein S.D. — editing, writing the text, approval of the final version of the article, collection and processing material, writing the text. All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Funding

Funding. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: February 12, 2026 / Accepted: February 19, 2026 / Published: April 30, 2026

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The authors declare that there are no conflicts of interest present.