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Slika Zdravlja Požeško-Slavonske Županije Republika Hrvatska Požeško-slavonska županija VELIKA # KAPTOL PAKRAC # # KUTJEVO # # LIPIK JAKŠIĆ # POŽEGA # # # ČAGLIN BRESTOVAC PLETERNICA # 2011. Sadržaj: Uvod . 1 1. Opći podaci o županiji . 2 1.1. Zemljopisni položaj . 2 1.2. Reljef i klima . 3 1.3. Tla, šume, vode i mineralne sirovine . 3 1.4. Administrativna podjela i ustroj . 4 1.5. Prometna infrastruktura . 5 1.6. Komunalna infrastruktura . 6 2. Stanovništvo i demografski procesi . 9 2.1. Vitalna statistika - Prirodno kretanje stanovništva . 10 2.2. Migracije . 11 2.3. Prosječna gustoća naseljenosti . 12 2.4. Prosječna starost stanovništva . 13 2.5. Spolna struktura stanovništva . 14 2.6. Pismenost . 14 2.7. Obrazovna struktura stanovništva . 15 2.8. Nacionalna struktura . 16 2.9. Osobe s invaliditetom . 17 3. Organizacija zajednice . 18 3.1. Zdravstvena zaštita . 18 3.1.1. Zdravstvene ustanove . 18 3.1.2. Neki organizacijski pokazatelji i usporedbe županije s Republikom Hrvatskom 22 3.2. Socijalna skrb . 27 3.2.1. Ustanove socijalne skrbi. 27 3.2.1.1.Ustanove socijalne skrbi kojima je osnivač RH . 27 3.2.1.2. Ustanove socijalne skrbi kojima je osnivač Požeško-slavonska županija . 28 3.2.1.3. Druge ustanove socijalne skrbi . 29 3.2.2. Dnevni boravak starijih osoba . 30 3.3. Obrazovanje . 30 3.4. Kultura i umjetnost . 33 3.5. Civilno društvo (Nevladine organizacije, NVO) . 34 4. Socijalno-ekonomske prilike u Požeško-slavonskoj županiji . 37 4.1. Gospodarstvo . 37 4.2. Zaposlene osobe . 39 4.3. Plaće i bruto domaći proizvod . 40 4.4. Nezaposlene osobe . 40 4.5. Umirovljenici . 43 4.6. Socijalne prilike . 44 5. Zdravstveni pokazatelji . 52 5.1. Vodeći uzroci smrti u Požeško-slavonskoj županiji . 52 5.2. Bolesti cirkulacijskog sustava (skupina IX, MKB-X) . 56 5.2.1. Vodeći pojedinačni uzroci smrti u skupini cirkulacijskih bolesti . 56 5.2.2. Usporedba pokazatelja smrtnosti od cirkulacijskih bolesti . 60 5.3. Novotvorine (skupina II, MKB-X) . 66 5.3.1. Vodeći pojedinačni uzroci smrti u skupini novotvorina . 66 5.3.2. Incidencija (pojavnost) raka i mortalitet (smrtnost) od raka . 68 5.3.3. Usporedba pokazatelja smrtnosti od novotvorina . 69 Rak dojke . 71 Rak bronha i pluća . 73 Rak debelog crijeva . 75 5.4 Smrtnost od bolesti povezanih s pušenjem . 76 5.5. Ozljede, otrovanja i neke druge posljedice vanjskih uzroka . 78 5.5.1. Vodeći pojedinačni uzroci smrti u skupini vanjskih uzroka smrti . 78 5.5.2. Nezgode pri prijevozu . 79 5.5.3. Usporedba pokazatelja smrtnosti od od vanjskih uzroka smrti . 80 5.6. Potencijalno izgubljene godine života (YPLL) . 82 5.7. Vodeći uzroci pobola u Požeško-slavonskoj županiji . 84 5.7.1. Pobol u primarnoj zdravstvenoj zaštiti . 84 5.7.2. Pobol u specijalističko-konzilijarnoj zdravstvenoj zaštiti . 86 5.7.3. Pobol u bolničkoj zdravstvenoj zaštiti . 88 5.7.4. Tuberkuloza . 90 5.7.5. Ovisnost o drogama . 90 5.8. Indikatori zdravstvene zaštite u Požeško-slavonskoj županiji . 92 5.8.1. Stopa smrtnosti dojenčadi . 92 5.8.2. Stopa perinatalne smrtnosti . 92 5.8.3. Procijepljenost . 93 5.8.4. Utilizacija zdravstvene zaštite u primarnoj zdravstvenoj skrbi . 93 5.8.5. Posjete, pregledi i upućivanja na specijalistički pregled u PZZ . 94 5.8.6. Preventivni pregledi odraslih osoba . 95 5.8.7. Preventivni pregledi dojenčadi i predškolske djece . 95 5.8.8. Zdravstvena zaštita žena . 96 5.8.9. Školska medicina . 96 5.8.10. Drugi pokazatelji u djelatnosti primarne zdravstvene zaštite . 97 5.8.11. Indikatori zdravstvene zaštite u specijalističko-konzilijarnoj zdravstvenoj skrbi 97 5.8.12. Stopa bolovanja . 98 5.8.13. Izabrani ekološki pokazatelji . 98 Zaključak . 100 Literatura . 102 Uvod Požeško-slavonska županija postala je članica Hrvatske mreže zdravih gradova, početkom 2007. godine. Tada je Županijsko poglavarstvo imenovalo dvanaest članova županijskoga tima za provedbu projekta Požeško-slavonska- zdrava županija. Tim je prošao edukaciju u okviru programa "Rukovođenje i upravljanje za zdravlje" (Zdrave županije) koji je idejno osmišljen u jesen 2001. godine s ciljem da podrži županijska tijela uprave i samouprave u procesu decentralizacije zdravstva. U ožujku 2007. godine izrađena je prva Županijska slika zdravlja analizom službenih statističkih podataka, rezultata već provedenih ispitivanja i podataka prikupljenih na terenu informativnim upitnikom i intervjuiranjem oko 2000 stanovnika županije. Nakon izrade Slike zdravlja i provedenog ciljanog istraživanja, izdvojeni su slijedeći javnozdravstveni problemi i potrebe: depopulacija, kardiovaskularne bolesti, mentalno zdravlje odraslog stanovništva, nezaposlenost, niska obrazovna razina stanovništva, organizacija hitne medicinske pomoći, rak dojke, rizična ponašanja mladih s posebnim naglaskom na opijanje, siromaštvo, skrb za starije i nemoćne osobe, socijalna isključenost invalidnih osoba, vodoopskrba-kapacitet i kvaliteta, zagađenost minama. U idućem koraku izdvojeno je pet prioritetnih javnozdravstvenih problema. Ovdje je Županijski tim u suradnji s ključnim sudionicima iz Županije metodom konsenzus konferencije, kao prioritete izdvojio: rak dojke, socijalnu isključenost osoba s invaliditetom, vodoopskrbu, kardiovaskularne bolesti i zagađenost minama. U listopadu 2007. objavljen je Strateški okvir županijskog plana za zdravlje nastao temeljem Županijske slike zdravlja. Radu na navedenim prioritetima se pristupilo, no nastao je zastoj u djelovanju. Neki od razloga bili su: nedostatak sredstava, političke promjene i dr., što je dovelo do postupnog gašenja djelovanja Tima. Zakonom o zdravstvenoj zaštiti, usvojenom krajem 2008. godine, Savjeti za zdravlje, te jedno- i trogodišnji Planovi za zdravlje postaju zakonska obveza županijske razine upravljanja. Požeško- slavonska županija osnovala je Savjet za zdravlje (Požeško-slavonski službeni glasnik broj 12/2009) od devet članova i prema sastavu (brojno i stručno) zadovoljava zakonski okvir. Važno je napomenuti kako članovi Savjeta za zdravlje nisu iste osobe koje su u sklopu Županijskog tima za zdravlje prošle edukaciju i izradile Sliku zdravlja i Strateški okvir županijskog plana za zdravlje 2007. godine, kako je bio slučaj u nekim drugim županijama. Savjet za zdravlje dogovorio je prve korake u nastavku rada, a prije izrade jedno- i trogodišnjih Planova za zdravlje. Ponovno se aktiviralo članstvo u Hrvatskoj mreži zdravih gradova i pristupilo izradi nove Slike zdravlja (2011.) kako bi se dobili što aktualniji podaci i Slika zdravlja proširila novim pokazateljima. Slika zdravlja (2011.) koja je pred Vama, nastala je kao rezultat rada djelatnika Službe za javno zdravstvo Zavoda za javno zdravstvo Požeško-slavonske županije. U dokumentu je prikazana aktualna ocjena zdravlja stanovnika Požeško-slavonske županije. Jasmina Kovačević dr.med. 1 1. Opći podaci o županiji S površinom od 1.815 km2 i nešto više od 78.000 stanovnika (Popisu stanovnika, 2011.), Požeško–slavonska županija ubraja se u red manjih županija u Republici Hrvatskoj. Riječ je o županiji koja razbija uobičajenu predodžbu o ravnoj Slavoniji, budući da se ovdje, na relativno malenom prostoru, uz ravnice s plodnim njivama, nalaze i planine i gore čija podnožja, krase nadaleko poznati vinogradi, dok su viši dijelovi uglavnom pod šumama. Požeško-slavonska županija sastoji se od dvije prostorno odvojene cjeline: Požeške kotline i Pakračko-lipičkog kraja. Razvojni potencijal Požeško-slavonske županije je velik. Nevjerojatno privlačan krajolik, bogatstvo prirodnih izvora i izraziti potencijal poljoprivrednog i malog industrijskog sektora općenite su karakteristike županije. 1.1. Zemljopisni položaj Požeško-slavonska županija nalazi se na sjeveroistočnom dijelu Republike Hrvatske s površinom od 1.815 km2, što čini 3,2 % kopnene površine Hrvatske (Slika 1.1.1.). Slika 1.1.1. Položaj i granice Požeško-slavonske županije Županija graniči s: na zapadu - sa Sisačko-moslavačkom županijom na sjeverozapadu - s Bjelovarsko-bilogorskom županijom na sjeveru - s Virovitičko-podravskom županijom na istoku - s Osječko-baranjskom županijom na jugu - s Brodsko-posavskom županijom 2 1.2. Reljef i klima Današnje osobine prirodne osnove područja Županije plod su složene geološke i fizičko- geografske evolucije prostora. U skladu s tim prisutna je izrazita diferenciranost i izražena reljefna dinamika. Županija pripada megaregiji panonskog bazena i predstavlja složeni dio makroregije slavonskog gromadnog gorja. Zapadno područje Županije (pakračko-lipički kraj) pripada zavali sjeverozapadne Hrvatske. Reljef prostora Požeško-slavonske županije podijeljen je na dva osnovna tipa. Centralni dio su nizine uz rijeke Orljavu, Londžu i Pakru. U središnjem dijelu kotline nadmorska visina je od 150- 200 m. Okolni dio su obronci planina: Papuka, Krndije, Psunja, Požeške gore i Dilja s visinama vrhova od 450 do 980 m nadmorske visine. Klimatske prilike posljedica su smještaja Županije te dominira kontinentalna klima. 1.3. Tla, šume, vode i mineralne sirovine U svojoj osnovi Županija je ruralno područje. Šume i poljoprivredne površine zauzimaju 92,7% površine Županije. Najveći dio su poljoprivredne površine (47,4%), od čega se obradivim poljoprivrednim površinama smatra 43,1%. Šumsko zemljište zauzima 45,2%, a oko 5% zauzima neplodno zemljište. Ukupna površina građevinskog područja je samo 6,6 % površine Županije, dok infrastruktura zauzima 2,4% površine (Tablica 1.3.1.). Tablica 1.3.1. Kategorija korištenja zemljišta u Požeško-slavonskoj županiji Osnovne kategorije korištenja zemljišta (km2) Zgrade i Ceste i Poljoprivredno Šume Vode Željeznice Posebna Ostalo zemljište dvorišta putevi namjena 894,9 821,5 27,5 25,4 36,5 2,1 4,3
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