caa a22 4500 397577443 CHVBK 20180308164859.0 cr unu---uuuuu 161202e199612 xx s 000 0 eng 10.1093/oxfordjournals.pubmed.a024547 doi (NATIONALLICENCE)oxford-10.1093/oxfordjournals.pubmed.a024547 Building health promotion into health care reform in Russia [Elektronische Daten] [Stanley J. Tillinghast, Valery E. Tchernjavskii] Summary The health care system of the former Soviet Union, despite serious flaws, did provide the basis for community health activities, and for mandatory immunization and periodic health examinations for which primary care physicians were responsible. Since 1991, a new system of mandatory health insurance has been put into place. Health care funding has decreased substantially, owing to economic conditions. However, there is not yet wide spread acceptance either ofthe strong association between personal behaviour and health consequences, nor of the importance of individual responsibility for one's health. To summarize, efforts at health promotion and disease prevention in Russia face numerous barriers: severe financial constraints owing to the general economic situation; social upheaval with loss of previous constraints on behaviour; cultural characteristics that include fatalism and encouragement of heavy alcohol and tobacco consumption; lack of acceptance of individual responsibility for health; lack of role modelling by the medical community; lack of critical appraisal of benefit and cost-effectiveness for preventive interventions; low priority for health care, and for prevention specifically. Disease prevention and health education must be built into the reformed healthcare system, to promote health for the Russian population. © Oxford University Press Articles nationallicence health promotion nationallicence health status in Russia nationallicence unhealthy behaviour nationallicence health care reform nationallicence Tillinghast Stanley J. Zdravreform Project Novosibirsk, Russia aut Tchernjavskii Valery E. Public Health Institute Medsoceconominifrom, Moscow, Russia aut Journal of Public Health Oxford University Press 18/4(1996-12), 473-477 1741-3842 18:4<473 1996 18 pubmed https://doi.org/10.1093/oxfordjournals.pubmed.a024547 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/oxfordjournals.pubmed.a024547 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tillinghast Stanley J. Zdravreform Project Novosibirsk, Russia aut NATIONALLICENCE 700 1- Tchernjavskii Valery E. Public Health Institute Medsoceconominifrom, Moscow, Russia aut NATIONALLICENCE 773 0- Journal of Public Health Oxford University Press 18/4(1996-12), 473-477 1741-3842 18:4<473 1996 18 pubmed Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford