Analysis of the readiness of Russian regions for the COVID-19 pandemic based on demographic sustainability and development of the healthcare system

Assessment of the readiness of regions for the occurrence of critical situations is atopical area of research in modern conditions. The problem of high mortality in Russia determines the importance of studying the factors that shape the current state of the socio-demographic system of the population and the prerequisites for its change in the future or in the present under the influence of negative processes. To form an objective picture of the current situation, two areas are identified: potential (the state of the region's healthcare system) and demographic stability (risks of population decline), on the basis of which complex integral indices are calculated and regions are ranked. The specificity of the author's approach to the analysis consists in the complex use of demographic indicators, morbidity indicators and the functioning of the healthcare system. As a result of the analysis, it was found out that an ambiguous situation has developed in the regions. According to the assessment of demographic sustainability, the republics of the North Caucasus have become the best, but there is also the lowest level of development of the healthcare system. The opposite situation is observed in remote and sparsely populated regions of the Far East - Sakhalin Oblast, the Jewish Autonomous Oblast and Chukotka Autonomous Okrug - with high indicators of the potential of the healthcare system there are high demographic risks. The depth of the consequences of the pandemic was reflected in the form of excess mortality. In the first year, the regions of the North Caucasus became leaders in terms of mortality growth - Chechnya (by 44%), Dagestan (by 32%) and Ingushetia (by 27%).The most stable were Adygea, Sevastopol and Buryatia - excess mortality did not exceed 6%. In the second year, actively increasing mortality has already affected all regions, with the exception of the Republic of Tyva and Chukotka Autonomous Okrug having the lowest proportion of the population over working age. The proposed concept of a two-way study of regions will make it possible to trace the main problem areas in dynamics and give an opportunity to prevent the consequences of other possible force majeure.