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Vol. 39, Nº 71 (2021), 942-956
IEPDP-Facultad de Ciencias Jurídicas y Políticas - LUZ
Recibido el 14/09/2021 Aceptado el 19/11/2021
Disease prevention for the social and
economic well-being
DOI: https://doi.org/10.46398/cuestpol.3971.57
Vasyl Shevchuk *
Pavlo Ivanchov **
Igor Paryzkyi ***
Vitalii Maltsev ****
Vitaliy Oksin *****
Abstract
The objective of the article was to analyze the socio-economic
eectiveness of preventive measures of the main diseases of
people of dierent age groups in the reality of Ukraine. The
subject of the study is the characteristics of disease prevention for
various age groups. The following research methods are used in
the article: analysis and synthesis; systematization of theoretical
and empirical research results; analogy and summary. As a
result, the role of the prevention of major human diseases is claried to
ensure the socio-economic potential of countries, increase labour capital
and productivity and, in addition, contribute to the expansion of gross
domestic product. Prevention possibilities are characterized to reduce the
burden of disease. At a practical level, comprehensive means of disease
prevention are proposed for dierent age groups of the population. By way
of reference, the conditions and possibilities of reducing the fatal outcomes
of the main diseases inherent in the population of Ukraine, such as cancer
and cardiovascular diseases, among others, are determined.
Keywords: public health policy; disease prevention; life expectancy;
labour productivity; socioeconomic well-being.
* Doctor of Economics, Director General of the Center for Sustainable Development Studies,
Ukraine. ORCID ID: https://orcid.org/0000-0002-6634-723X
** Doctor of Medical Sciences, Head of Surgery Department №3 of O.
Bohomolets National Medical University, Ukraine. ORCID ID: https://orcid.org/0000-0001-6201-
4203
*** Doctor of Economics, PhD in Law, Professor of the Department of Marketing, Economics, Management
and Administration, Vice-Rector for Strategic Development of the Higher Educational Institution
"National Academy of Management". Ukraine. ORCID ID: https://orcid.org/0000-0001-6835-5930
**** PhD in Law, Senior Research Fellow of the Scientic Institute of Public Law, Ukraine. ORCID ID:
https://orcid.org/0000-0002-5052-2697
***** Doctor of Law, Leading Researcher of the Scientic Institute of Public Law, Ukraine. ORCID ID:
https://orcid.org/0000-0001-6080-7752
943
CUESTIONES POLÍTICAS
Vol. 39 Nº 71 (2021): 942-956
Prevención de enfermedades para el bienestar
social y económico
Resumen
El objetivo del artículo fue analizar la ecacia socioeconómica de las
medidas preventivas de las principales enfermedades de personas de
diferentes grupos de edad en la realidad de Ucrania. El tema del estudio
son las características de la prevención de enfermedades para varios grupos
de edad. En el artículo se utilizan los siguientes métodos de investigación:
análisis y síntesis; sistematización de resultados de investigaciones teóricas
y empíricas; analogía y resumen. Como resultado se aclara el papel de la
prevención de las principales enfermedades humanas para garantizar el
potencial socioeconómico de los países, aumentar el capital laboral y la
productividad y, además, contribuir a la expansión del producto interno
bruto. Se caracterizan las posibilidades de prevención para reducir la carga
de morbilidad. A nivel práctico, se proponen medios integrales de prevención
de enfermedades para diferentes grupos de edad de la población. A modo
de conclusión se determinan las condiciones y posibilidades de reducción
de los desenlaces mortales de las principales enfermedades inherentes a la
población de Ucrania, como el cáncer y las enfermedades cardiovasculares,
entre otras.
Palabras clave: política de salud pública; prevención de enfermedades;
esperanza de vida; productividad laboral; bienestar
socioeconómico.
Introduction
Health is a crucial factor of well-being and a fundamental human
right; its protection, in addition to its social signicance, has an important
economic eect. Over the last century, improving health has been a critical
driver of global growth, by stimulating the growth of the labour force and
productivity.
The improvements in hygiene, nutrition, and the invention of antibiotics
and vaccines over the past century have led to tremendous progress
in global health; scientic and technological progress and continuous
innovation have signicantly contributed to a signicant improvement in
the survival rate of people with non-infectious diseases, especially cancer
and cardiovascular diseases. This allowed life to be extended almost 2.5
times between 1800 and 2017 – from just over 30 years to 73 (McKinsey
Global Institute 2020), thus increasing labor potential.
944
Vasyl Shevchuk, Pavlo Ivanchov, Igor Paryzkyi, Vitalii Maltsev y Vitaliy Oksin
Disease prevention for the social and economic well-being
As life expectancy increases, the working age of the population, its
participation in social production also increases, which leads to higher
economic eciency of the countries. However, these conditions place
new demands on the health care system to ensure high health status, as
there is now a growing risk of premature death and the development of
health problems that not only disrupt the normal functioning of people,
but also prevent their full production potential. Given this, it is important
to understand the importance of disease prevention in achieving the socio-
economic well-being of the country.
1. Methodology
The realization of the purpose of the article involves the use of the
following research methods:
Theoretical method is used to review the relevant literature in order to
study scientic sources and develop conceptual foundations of the research.
• The method of systematization of theoretical and empirical results
of the study allows to determine the features of disease prevention
to support the socio-economic well-being of the population.
• The method of analogy is applied to determine the eectiveness of
preventive measures to preserve the health of people of dierent
ages.
• The method of summarization makes it possible to formulate the
conclusions deriving from this study.
• To consider the eectiveness of prevention of key diseases and the
possibility of reducing the consequences of diseases, logical method
is used.
The data of ocial reports of the State Statistics Service of Ukraine is
analyzed with the help of statistical method.
2. Literature Review
The relationship between health and socio-economic issues has been
in the attention of scholars and ocials since the second half of the 20th
century, but in recent decades they have taken on special importance. The
World Health Organization (WHO) stressed in 2009 on the need to assess
health not only in terms of viability, but also in terms of social and economic
opportunities. The WHO recommendations for identifying the economic
consequences of diseases and injuries at both micro and macro levels,
945
CUESTIONES POLÍTICAS
Vol. 39 Nº 71 (2021): 942-956
as well as the losses incurred by individuals, households, rms, and the
state as a whole, formed the basis for the further in-depth theoretical and
empirical research. At the same time, the scientists have analyzed various
aspects of health and their impact on economic potential.
The economic impact of infectious diseases has been determined by
international organizations (World Bank (2017) and WHO (2009)), as
well as by some scientists (Saker et al. 2004; Parpia et al. 2016; Alfaro-
Murillo et al. 2016). Besides, many researchers (Egger 2009; Merkur,
Sassi, and Mcdaid, 2015; Machalaba et al. 2017; Palamar & Gruzeva 2018)
have studied certain aspects of health and socio-economic consequences of
certain infectious and non-infectious diseases. The threat of psychological
disorders and diseases for human life and the economy as a whole was raised
in the works by (McDaid, Park, and Wahlbeck 2019). The researchers of
the Аmerican Heart Association and American Stroke Association (2017),
as well as foreign scientists (Barolia et al. 2019; Archer, and Blair, 2011;
Volpe, Battistoni et al. 2020; Chatterjee & Cheng 2020) analyzed the cost of
cardiovascular disease treatment and the possibilities of their prevention.
The empirical study by the Institute for Health Metrics and Evaluation
(IHME) is important for the systematic analysis of the economic role of
disease prevention. The IHME found that the global burden of disease
(disability-adjusted life year) could be reduced by about 40% if standardized
disease prevention measures and the most eective of the available tools
were applied (Table 1). Thus, for middle-aged people, disease prevention
can increase the number of healthy years by a decade (McKinsey Global
Institute 2020).
Table 1. Opportunities to improve health status by preventing
major diseases for dierent age groups
Period Risk for health Preventive measures Potential
for disease
reduction, %
Pregnancy
Maternal and neonatal
diseases
Safe delivery in hospital
with obstetric support
and appropriate care 74
HIV/AIDS and sexually
transmitted infections Antiretroviral therapy 74
Genetic and birth
defects Pre-conceptional
prevention 41
946
Vasyl Shevchuk, Pavlo Ivanchov, Igor Paryzkyi, Vitalii Maltsev y Vitaliy Oksin
Disease prevention for the social and economic well-being
0-14 years
Respiratory infections
and tuberculosis
Integrated child
immunization
programme; Regular
clinical examinations
81
Meningitis and gepatitis Vaccination, access to
qualied treatment 24
Intestinal infections Healthy development
and sanitation 24
14-21
years
Bad habits Comprehensive
Programme to Reduce
Substance Abuse 29
Mental ilness Access to psychological
assistance 18
Injuries and
interpersonal violence
Review, education,
referral and treatment
for adolescents and
adults
28
21-60
years
Cancer
Hepatitis B and C
vaccine, habit-free,
annual screening, early
detection and treatment
of breast cancer
27-36
Cardiovascular diseases
Comprehensive
cardiovascular
prophylaxis, including
drug use, lifestyle and
behavioural change,
specialized cardio
31-39
Musculoskeletal
abnormalities
Weight control,
physiotherapy,
occupational health and
safety, sport
34
Mental illness Psychotherapy 15
After 60
years
Cardiovascular diseases
Comprehensive
cardiovascular
prophylaxis
and specialized
cardiovascular care
40
Cancer Adoption of a healthy
lifestyle 29
Diabetes and kidney
disease
Diabetes prevention
programme, including
awareness-raising,
weight control,
maintenance treatment
33
Developed by the Authors.
947
CUESTIONES POLÍTICAS
Vol. 39 Nº 71 (2021): 942-956
Thanks to preventive measures, a global improvement of $12 trillion, or
just about 8% of world GDP can be achieved by 2040. This is a consequence
of changes in the labour market due to increased employment (Low rate of
early death from cardiovascular diseases, cancer, malaria and other causes),
reduction of periods of temporary disability due to health condition and
higher involvement of healthy people in work process, improving physical
and cognitive health of employees. Besides, higher economic eciency is
achieved due to the fact that older people can work longer, which reduces
the need to care for the elderly and sick, and ensuring the health of children
and adolescents has a positive impact on human development (McKinsey
Global Institute 2020, pp. 87 – 90). Investment in maintaining and
improving health has a signicant rate of return of 2-4 times depending on
the level of economic development.
Therefore, given the signicant socio-economic impact of health on the
quality of life and welfare of countries in general, the aim of the article is to
analyze socio-economic eectiveness of measures to prevent major diseases
of people of dierent ages in Ukraine.
3. Results and Discussion
The success of disease prevention depends on the eectiveness of
preventive measures at all ages, starting with pregnancy planning. At
this stage it is extremely important to go through the set of measures
for preconception prevention - diagnosis and correction of the health of
future parents. It should be started at least 3 months before the planned
conception – that’s how long it takes to undergo medical examinations
and adjust your lifestyle and diet. If doctors nd any diseases (such as
TORCH infections) during the examinations, it will take some time to treat
them. This approach to reproductive medicine will most likely count on a
favorable pregnancy and the birth of a healthy baby.
Maintaining and improving children’s health (0-14 years) is an important
function of the State is a scientically sound system of measures aimed
at socio-legal (primary) and medical (secondary and tertiary) prevention
of diseases in children age, which is implemented by public policy. The
purpose of preventive pediatrics, including adolescence, is to organize
and conduct an eective set of measures to preserve, improve and restore
children’s health, ensure normal growth and development of the child from
the moment of family planning to the age of majority, providing medical
care, social and mental well-being, social adaptation of the child, as well as
the possibility of realizing personal potential according to age.
Prevention of diseases of people of working age is perhaps the most
important task of the State, as the health of workers determines the quantity
948 Vasyl Shevchuk, Pavlo Ivanchov, Igor Paryzkyi, Vitalii Maltsev y Vitaliy Oksin
Disease prevention for the social and economic well-being
and quality of labor potential of the country, which ensures the welfare,
economic growth, defense, and independence of the State (Shevchuk et al.
2016, p. 5). The mortality of people of working age signicantly reduces
the average life expectancy because in Ukraine; in particular, the total
mortality of the population is mainly (38%) 30 – 70 of age. One third of
the population does not live to the end of their working life (60-65 years)
(Saker et al. 2004). Thus, with the premature death of the population alone,
the country loses about 4 million years of potential life and UAH 47.9 - 89.1
billion of the national product respectively, despite the fact that most losses
are due to premature death of men. The diseases of the circulatory system,
tumors, injuries, poisonings, and some other consequences of external
causes are among the main causes of mortality among the working age
population (Table 2).
Table 2. The causes of death in Ukraine, 2010-2019
Indicator
Рік From
2019
to
2010,
+/-
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Total death,
including
from:
698235 664588 663139 662368 632296 594796 583631 574123 587665 581114 -117121
- certain
infectious
and
parasitic
diseases
14642 14050 13922 12921 10974 9900 9326 8714 8964 8120 -6522
- neoplasm 88767 88957 92896 92337 83894 79530 78959 78324 78597 78223 -10544
- circulatory
system
diseases
465093 440346 436445 440369 425607 404551 392298 384810 392060 389348 -75745
- respiratory
illnesses 19480 17871 17109 16540 14810 13951 13840 12166 13006 12504 -6976
- diseases
of digestive
system
26817 25230 27719 27953 25225 22818 22013 21999 24489 24144 -2673
- external
causes 43955 42380 41713 40298 40135 34569 31746 31185 30905 30009 -13946
Developed by the Authors.
Therefore, we consider it important to prevent diseases at all stages of
people’s lives, which will contribute to the prevention, early detection, and
timely treatment of diseases at the primary level of care, which will not only
reduce the burden on the medical system but also the burden of disease.
949
CUESTIONES POLÍTICAS
Vol. 39 Nº 71 (2021): 942-956
To preserve health, standardized protocols of medical supervision are
created, active prevention of diseases of all age groups is carried out (the
main measures are given in Table 3), the diagnostic base is developed;
there is also a constant clinical introduction of fundamentally new, eective
methods of treatment, which, on the one hand, generally reduces the
incidence of disease and full recovery from severe illness without disability
on the other one.
Table 3. Main preventive measures for dierent age groups
Age group Main preventive measures
Planning and
period of
pregnancy
Pre-conception training includes:
- examination of parents for reproductive ability;
- general medical examination;
- using folic acid;
- HIV / AIDS screening and treatment (if necessary);
- screening for sexually transmitted infections and their
treatment;
- therapy in case of detection of various diseases;
- cessation of smoking and alcohol consumption;
- elimination of obesity, etc.
Prevention during pregnancy:
- ultrasound screening;
- hormonal background, blood, urine analysis, etc .;
- detection and treatment of infectious diseases;
- regular gynecological examination, etc.
0-14 years Stages of preventive pediatrics:
- antenatal and intranatal prophylaxis.
- preventive work with children in the rst year of life
and children of early age.
- preventive work with children in preschool, school,
including adolescence.
These measures include:
- assessment of physical development.
- assessment of psychomotor development.
14-21 years Annual preventive examinations by a dentist,
endocrinologist, pediatric surgeon, as well as a pediatric
/ adolescent gynecologist (according to the indications),
child psychologist (according to the indications) include:
- assessment of physical development.
- assessment of body mass index.
- assessment of neuropsychological development.
- passing uorography.
- blood test (hemoglobin) and others according to the
indications.
- control of bad habits and diet, etc.
950
Vasyl Shevchuk, Pavlo Ivanchov, Igor Paryzkyi, Vitalii Maltsev y Vitaliy Oksin
Disease prevention for the social and economic well-being
21-60 years The main preventive measures include:
1) Oncological screening:
For women:
-breast examination (one clinical examination per year,
one mammography every two years).
- cytological diagnosis (PAP test) and human
papillomavirus test (HPV test) – once every 5 years.
- brocolonoscopy - once every 5 years.
- Fibrogastroduodenoscopy - once a year and when
planning a pregnancy.
For men (after 40 years):
- examination by urologist – once a year (PSA test if
necessary);
- fibrocolonoscopy – once every 5 years.
- fibrogastroduodenoscopy – once a year.
2) Treatment of virus and infectious diseases.
3) Timely detection and treatment of chronic diseases.
4) Dental examination.
After 60
years Preventive measures include:
- oncological screening.
- treatment of chronic diseases.
- treatment of virus and infectious diseases.
- sanatorium-resort and rehabilitation treatment.
Additional medical examinations are prescribed on the
recommendation of a family doctor.
Developed by the Authors
Based on research by McKinsey Global Institute, we are convinced that
these preventive measures of the most common diseases in Ukraine over
the next 15 years will help to reduce cancer fatalities by 30%, cardiovascular
diseases – by 35%, birth defects and certain conditions that occur in the
perinatal period – by 74% (Fig. 1).
951
CUESTIONES POLÍTICAS
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Fig. 1. Potential for reducing mortality from major diseases in
Ukraine by implementing preventive measures up to 2035
Developed by the Authors
The above preventive measures should be taken in the context of
national environmental policy in order to continuously improve the
environmental situation in the country for long-term synergies. One
quarter of the population’s health depends on the state of the environment,
the harmonization of human life in the natural environment. High level of
environmental pollution by harmful factors of physical, biological, chemical
and other origin also causes the deterioration of the demographic situation
and population health situation. Therefore, the improvement of air and
drinking water quality in cities and villages, proper waste management,
greening of the agro-industrial sector of the economy and other components
of State environmental policy will help to reduce diseases and improve the
socio-economic well-being of the population of Ukraine (Shevchuk et al.,
2016).
Moreover, the improvement of health contributes to the growth of the
country’s economic potential due to reduced number of sick people and days
of incapacity, thus, in the long run, GDP growth of the country can reach 8
per cent, that in the conditions of Ukraine could make an additional $12.3
billion until 2035-2040. In view of this, disease prevention under current
conditions plays a key role in achieving the socio-economic well-being of
the country along with other factors of growth of the national economy.
This problem is especially acute in developing countries due to low access
952
Vasyl Shevchuk, Pavlo Ivanchov, Igor Paryzkyi, Vitalii Maltsev y Vitaliy Oksin
Disease prevention for the social and economic well-being
of the population to health services (Giangaspero 2015). Therefore, the
development of preventive medicine and primary care should play an
important role in the process of transformation of the medical system. First
of all, it is necessary to strengthen public administration of the country’s
medical system in order to:
1) create and implement targeted prevention programs with the support
of the government, non-governmental organizations, private sector,
and citizens of the country.
2) re-orient the health care system to identify risk groups, timely detect
chronic diseases and conditions, as well as constant monitor their
development.
3) introduce obligatory preventive examination of the working
population with the involvement of the institution of family doctor,
diagnostic centers, and social services in order to prevent the main
classes of diseases.
4) improve the quality of medical services in hospitals of various forms
of ownership on a market basis.
5) promote innovative and technological development of the medical
sector by improving public administration, development of
partnerships between the State, research organizations and medical
institutions, the formation of appropriate nancial and credit support
and tax incentives (Paryzkyy 2018), etc.
The importance of maintaining high health status is at the forefront
of research around the world (Egger 2009; Mcdaid, Sassi, and Merkur,
2015; Machalaba et al. 2017), but the considered theoretical and empirical
achievements in this area relate to the analysis of the importance and forms
of prevention of various diseases, which represent only a fraction of the
threats to human beings, given their etiology and pathogenesis. Therefore,
in contrast to the above issues, we proposed to consider a comprehensive
approach to determining the importance of disease prevention for the
socio-economic well-being of the population.
The problem of the impact of prevention of infectious and non-infectious
diseases on the economy and general social welfare of people is thoroughly
studied in the scientic literature (Parpia et al. 2016; Alfaro-Murillo et
al. 2016; Palamar & Gruzeva 2018). However, dierent, and sometimes
incomplete methodological approaches are used to determine the cost-
eectiveness of disease prevention. The researchers do not pay attention to
the detailed analysis of the system of preventive measures, through which it
is possible to achieve high socio-economic eects in their scientic papers.
The dierence between our study and the existing ones is the formation
of a detailed set of preventive measures for dierent age groups, in
953
CUESTIONES POLÍTICAS
Vol. 39 Nº 71 (2021): 942-956
particular in the following categories: pregnancy planning and the period
of pregnancy; 0-14 years; 14-21 years; 21-60 years; after 60 years. The
choice of such a gradation of age periods is associated with dierent levels
of population participation in the economic processes of the country. At the
same time, special attention is paid to the prevention of diseases among
the working and elderly population, on whose health the socio-economic
well-being of the country depends to a greater extent; the list of mandatory
examinations and their frequency are clearly dened.
The practical value of the study is the identication of the potential
impact of preventive medicine. Considering the most common diseases in
Ukraine (cardiovascular, cancer and congenital malformations and other
pathologies that occur in the perinatal period), the potential to avoid the
serious consequences of these diseases, which can reduce mortality by
more than 30%, are identied.
The probable level of growth of the economic eect of improving
public health due to better disease prevention is established, although the
methodological support for such assessment is somewhat complicated due
to the lack of international statistics on socio-demographic indicators and
public health in Ukraine.
Conclusion
Preventive measures are an important priority of public administration,
as they guarantee the right to healthy life, but also ensure economic growth
by improving labor participation, increasing productivity, reducing the
cost of therapy and care for the elderly. Global experience indicates that
this achieves higher socio-economic prosperity, as it reduces the burden of
disease and promotes greater domestic gross domestic product.
The main risks to the health, ability to work and life of the population in
Ukraine, including diseases of the circulatory system, neoplasms, injuries,
poisoning and some other external causes are identied. Therefore, it is
especially important to maintain health at all stages of human life, which
allows you to achieve long and prosperous life.
The authors’ recommendations for the prevention of diseases of the
population of dierent age groups, which can have a positive impact on
Ukraine by reducing the eects of cardiovascular disease, cancer and
birth defects and other pathologies that occur in the perinatal period, are
formulated. Therefore, the systematization of the recommended preventive
measures for all age groups proposed in the article has a signicant practical
signicance and determines the empirical value of the work.
954
Vasyl Shevchuk, Pavlo Ivanchov, Igor Paryzkyi, Vitalii Maltsev y Vitaliy Oksin
Disease prevention for the social and economic well-being
We see the prospects for further research in the detailed analysis of
economic eect of maintaining public health, which lies in the development
of the relevant methodological support.
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I; GALVANI, Alison P. 2016. “A cost-eectiveness tool for informing
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