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.