Health assessment among cadets throughout their studies at the institutions of military medical education

Relevance. Academic publications report ample evidence showing that throughout their studies in the institutions of military education cadets and their health is exposed to a combination of military service-specific factors. Military professional activity, strictly organized teamwork, intensified training in senior years of studies, and others factors can have a negative impact on the health of the military, leading to an increased number of working days lost to sickness absence among students and therefore impaired quality of higher military education in the Russian Armed Forces.

The objective is to elaborate specific morbidity-related factors among cadets studying at an institution of military education; the present study analyzes the case of the Kirov Military Medical Academy (St. Petersburg).

Methods. The morbidity rates among male (n = 1768) and female (n = 209) cadets who had completely recovered from the disease were studied based on their medical records and the results of annual medical examinations (n = 5151 and n = 621 respectively). The obtained morbidity rates were correlated with disease chapters of the International Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). The incidence rate was calculated in ppm (%). The results were verified for normal distribution; the mean values and standard errors (M ± m) were calculated. The dynamics of changes was evaluated using the dynamic analysis with 2nd order polynomial trends and the coefficient of determination (R2).

Results and discussion. The average long-term general morbidity among cadets throughout the 6 academic years’ study at a military university stood at 1149 %, including among men – 995.5 % and women – 2092.5 %. We noted an upward trend in the dynamics of the overall morbidity in the general group of the examined male and female cadets. Compared to male cadets, women had a significantly elevated total morbidity rate for all disease chapters, as well as higher statistics for the endocrine, nutritional and metabolic diseases (Chapter IV, ICD-10), diseases of the nervous system (Chapter VI), the circulatory system (Chapter IX), the respiratory system (Chapter X), the skin and subcutaneous tissue (Chapter XII), the musculoskeletal system and connective tissue (Chapter XIII) and the genitourinary system (Chapter XIV). When compared to year 1 at baseline, by year 6 of studies, the number of cadets in the healthiest health group I decreased by 1.3 times among men and 2.2 times among women; the less healthy health group II showed a decrease by 2.5 and 1.0 times for men and women respectively; while the least healthy health group III became more populated by 8.4 and 20.1 times for men and women respectively. The average long-term demand for screening among health group III cadets amounted to 228.3 %, including 200.6 % among men and672.5 % among women. Evidence showing upward dynamics in the cadets’ demand for screening is provided. Compared to male cadets, diseases of the eye and adnexa (Chapter VII), the circulatory system (Chapter IX), the musculoskeletal system and connective tissue (Chapter XIII), the genitourinary system (Chapter XIV), as well as the total morbidity rate for all disease chapters were statistically significantly higher in women requiring follow-up screening.

Conclusion. The increased general morbidity and demand for follow-up screening by the end of studies suggests that the current measures to preserve and strengthen the cadets’ health are insufficient and have low efficiency. At admission to institutions of military education, greater focus on health issues among applicants is required during medical examination.

1. Belova E.A., Grigoriev S.G., Shuba A.V. Mediko-biologicheskie i sotsial’no-psikhologicheskie problem bezopasnosti chrezvychaynykh situatsiyakh [Morbidity rates dynamics among the military women of the Russian Ministry of Defense (2012 to 2021)]. Mediko-biologicheskie i sotsial’no-psikhologicheskie problemy bezopasnosti v chrezvychaynykh situatsiyakh [Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations]. 2024; (3):15–36. (In Russ.)

2. Berdiev R.M., Kiryushin V.A., Motalova T.V. [et al.]. Sostoyanie zdorov’ya studentov-medikov i faktory ego opredely ayushchie [Health state of medical students and its determinants]. Rossijskij mediko-biologicheskij vestnik imeni akademika I.P. Pavlova [I.P. Pavlov Russian medical biological herald]. 2017; 25(2):303–315. DOI: 10.23888/PAVLOVJ20172303-315. (In Russ.).

3. Gorbatkova E.Yu., Zul’karnaev T.R., Ahmadullin U.Z. [et al.]. Fizicheskoe razvitie studentov vysshih uchebnyh zavedenij g. Ufy [Physical development of students in higher educational institutions of the Ufa city]. Gigiena i sanitariya [Hygiene and Sanitation, Russian journal]. 2020; 99(1):69–75. DOI: 10.33029/0016-9900-2019-99-1-69-75. (In Russ)

4. Evdokimov V.I., Sivashhenko P.P., Grigor’ev S.G. Pokazateli zabolevaemosti voennosluzhashhih kontraktnoj sluzhby Vooruzhennyh sil Rossijskoj Federacii (2003–2016 gg.) [Indicators of morbidity among contract soldiers of the Armed Forces of the Russian Federation (2003–2016): monograph]. St. Petersburg. 2018. 80 p. (In Russ.).

5. Evdokimov V.I., Sivashhenko P.P. Pokazateli zdorov’ja voennosluzhashhih-zhenshhin Vooruzhennyh sil Rossijskoj Fed eracii (2003–2016 gg.) : [Health indicators of female servicemen of the Armed Forces of the Russian Federation (2003–2016) : monograph]. St. Petersburg. 2018. 82 p. (Serija «Zabolevaemost’ voennosluzhashhih» ; vypusk 3 [Series “Morbidity of military personnel”; Iss. 3]). (In Russ.).

6. Zelenina N.V., Nazarov S.S., Gabueva F.A. [et al.]. Narusheniya adaptacii u zhenshchin-voennosluzhashchih raznyh voenno-uchetnyh special’nostej v processe voenno-professional’nogo obrazovaniya [Adaptation disorders in female militar personnel of different military-occupational specialities in course of military education]. Vestnik Rossijskoj voenno-medicinskoj akademii [Bulletin of the Russian Military Medical Academy]. 2016. 2(54):151–156. (In Russ.)

7. Zobov A.E., Panov A.A., Kuzin A.A. [et al.]. Osobennosti formirovaniya zabolevaemosti voennosluzhashchih ostrymi respiratornymi infekciyami verhnih dyhatel’nyh putej [Features of formation of the military personnel’s morbidity of acute respiratory infections of the upper respiratory tract]. Zhurnal infektologii [Journal Infectology]. 2020. 12(4):87–92. DOI 10.22625/2072-6732-2020-12-4-87-92. (In Russ)

8. Ivanov N.M., Ichitovkina E.G., Evdokimov V.I. [et al.]. Analiz pokazatelej zabolevaemosti lichnogo sostava MVD Ros sii [Analysis of morbidity indicators in the personnel of the Ministry of Internal Affairs of Russia]. Mediko-biologicheskie i sotsial’no-psikhologicheskie problemy bezopasnosti v chrezvychaynykh situatsiyakh [Medicо-Biological and Socio-Psych logical Problems of Safety in Emergency Situations]. 2024; (2):14–38. DOI: 10.25016/2541-7487-2024-0-2-14-38 (In Russ)

9. Klimov V.V., Kulishenko V.V., Stepanov A.P. [et al.]. Mediko-statisticheskaya harakteristika zabolevaemosti hroniches kimi boleznyami u kursantov voennogo vuza [Medical and statistical characteristics of the incidence of chronic diseases in children cadets of a military university]. Izvestiya Rossijskoj voenno-medicinskoj akademii [Russian Military Medical academy Reports]. 2020; 39(4-1):212–215. (In Russ.)

10. Klimov V.V., Novikova I.I., Savchenko O.А. Model’ dopolnitel’nyh profilakticheskih meropriyatij, napravlennyh na predotvrashchenie negativnyh izmenenij zdorov’ya kursantov [A model of additional preventive measures aimed at prevent ing negative changes in the health of cadets]. Medicina truda i promyshlennaya ekologiya [Russian Journal of Occupational Health and Industrial Ecology]. 2023; 63(3):155–162. DOI: 10.31089/1026-9428-2023-63-3-155-162. (In Russ)

11. Kovalev A.V., Polyakov A.S. Kachestvo zhizni pri zhelezodeficitnyh sostoyaniyah u zhenshchin molodogo vozrasta [Health-related quality of life in iron deficient young women]. Izvestiya Rossijskoj voenno-medicinskoj akademii [Russian Mili tary Medical academy Reports]. 2022; 41(2):169–174. DOI: DOI: 10.17816/rmmar104651. (In Russ.).

12. Novikova I.I., Klimov V.V., Sorokina A.V. [et al.]. Gigienicheskaya ocenka faktorov obucheniya i zhiznedeyatel’nosti kur santov v period obucheniya v voennoj obrazovatel’noj organizacii [Hygienic assessment of training factors and life activities of trainers during training in a military educational organization]. Medicina truda i ekologiya cheloveka [Occupational Health and Human Ecology]. 2021; 2:48–59. DOI: 10.24412/2411-3794-2021-10204. (In Russ

13. Sartakov P.G., Novoselov V.P., Samchukov G.G. [et al.]. Ocenka sostoyaniya zdorov’ya kursantov voennogo instituta vnutrennih vojsk MVD Rossii za period obucheniya [Health evaluation in the students from the Military Institute of Internal Troops Russian Ministry of Internal Affairs]. Sibirskij medicinskij zhurnal [Siberian Medical Journal]. 2013; 28(4):111–114. (In Russ.).

14. Tret’yakov A.A., Nikulina T.V., Sokorev V.V. [et al.]. Dinamika pokazatelej zdorov’ya kursantov za period obucheniya v vysshem uchebnom zavedenii [Law institute cadets’ physical and health progress analysis]. Teoriya i praktika fizicheskoj kul’tury [Theory and Practice of Physical Culture]. 2021; 3:76–79. (In Russ.).

15. Kholmatova K.K., Grjibovski A.M. Panel’nye issledovanija i issledovanija trenda v medicine i obshhestvennom zdra voohranenii [Panel- and Trend Studies in Medicine and Public Health]. Jekologija cheloveka [Human Ecology]. 2016; (10):57 63. DOI: 10.33396/1728-0869-2016-9-57-64. (In Russ)