L.N. Gumilyov Eurasian National University, a dissertation defense for the degree of Doctor of Philosophy (PhD) by Battakova Kamila on the topic «Geography of the territorial distribution of morbidity of the population of Central Kazakhstan» in the educational program «8D05213 – Geography».
The dissertation was carried out at the Department of «Physical and economical geography» of L.N. Gumilyov Eurasian National University.
The language of defense is russian
Official reviewers:
Temirbaeva Roza Kabdikarimovna – Doctor of Philosophy (PhD), Senior Researcher at the «Geotourism and Geomorphology» Laboratory of JSC «Institute of Geography and Water Security», specialty: «6D060900-Geography» (Almaty city, Republic of Kazakhstan);
Kelinbayeva Roza Zharmukhametovna – Doctor of Philosophy (PhD), Senior Lecturer at the Department of Geography, Land Management, and Cadastre, Faculty of Geography and Environmental Management, Al-Farabi Kazakh National University, specialty: «6D060900-Geography» (Almaty, Republic of Kazakhstan).
Temporary members of the Dissertation Council:
Pashkov Sergey Vladimirovich – Candidate of Geographical Sciences, Associate Professor of the Department of Geography and Ecology, Dean of the Faculty of Mathematics and Natural Sciences, Manash Kozybayev North Kazakhstan University, specialty: 25.00.36 – «Geoecology» (Petropavlovsk, Republic of Kazakhstan);
Mukayev Zhandos Toleubekovich – Doctor of Philosophy (PhD), Associate Professor, Dean of the Faculty of Graduate School of Natural Sciences, Shakarim University, specialty: «6D060900 – Geography» (Semey, Republic of Kazakhstan);
Kurepina Nadezhda – Candidate of Geographical Sciences, Senior Researcher, Institute of Water and Environmental Problems of the Siberian Branch of the Russian Academy of Sciences, specialty: 25.00.33 – «Cartography» (Barnaul, Russian Federation).
Scientific consultants:
Saipov Abdimazhit Amanzholovich – Doctor of Pedagogical Sciences, Professor of the Department of Physical and Economic Geography of the L.N. Gumilyov Eurasian National University, specialty: 13.00.08 – «Theory and Methodology of Professional Education» (Astana, Republic of Kazakhstan);
Ostanin Oleg – Candidate of Geographical Sciences, Associate Professor of the Department of Physical Geography and Geoinformation Systems of Altai State University, specialty: 25.00.23 – «Physical Geography and Biogeography, Soil Geography and Landscape Geochemistry» (Barnaul, Russian Federation).
The defense will take place on April 23, 2025, at 11:00 AM in the Dissertation Council for the training direction «8D052 – Environment» in the educational program «8D05213 – Geography» of L.N. Gumilyov Eurasian National University. Conducting a meeting of the dissertation council in a mixed (offline and online) format.
Address: Astana, st. Kazhymukan, 13, educational building No. 3, meeting room (room No. 333).
Abstract (English): Relevance of the Research Topic. Environmental pollution is a major factor contributing to the deterioration of public health worldwide due to industrialization, urbanization, human impact on nature, excessive resource consumption, emissions of hazardous chemicals, and the consequences of industrial production, climate change, and biodiversity loss. The environment begins to change under the influence of continuous human economic activity. Around large industrial enterprises, new artificial biogeochemical provinces emerge. In each specific case, the pollution level in these areas is determined by the development of various industrial sectors, the type of raw materials and products, natural and climatic conditions, and societal attitudes toward production. The mining industry poses health risks due to the adverse effects of toxic metals, dust, explosives, and gases, as well as the contamination of water, soil, and air with heavy metals and the loss of arable land. Therefore, this sector must take corporate responsibility seriously, adhere to sustainable development goals, assess health and safety risks, and ensure the protection of the rights of local communities. In this context, Central Kazakhstan was selected as the study area, with environmental objects in the Karaganda region analyzed. The research investigates the cause-and-effect relationship between the territorial distribution of diseases and their geographic patterns in industrial cities and settlements during urbanization. Additionally, the study includes the zoning of territories based on cartographic analysis and an integrated assessment. The aim of the dissertation research is to examine the impact of geographical factors on the formation of the spatial structure of morbidity in the population of Central Kazakhstan over a ten-year period. Research objectives: - justification of the modern system of geographical factors influencing the health of the population of Central Kazakhstan as a result of anthropogenic impact. - development and justification of a theoretical model of the system of geographical prerequisites preceding the formation and progression of morbidity in the population of Central Kazakhstan. - study of statistical data on the spatial and territorial differentiation of morbidity, disease prevalence, and occupational health indicators of the population of Central Kazakhstan for the period from 2011 to 2021. - medical-geographical zoning of territories based on an integrated assessment and correlation analysis of the relationship and interdependence between population morbidity and the current state of intensive anthropogenic changes in natural environment objects. The methodological framework of the dissertation is based on traditional and innovative geographical research methods, including cartographic, comparative-descriptive, spatial analysis, GIS technologies, statistical methods, as well as the scoring and expert assessment method. Provisions for the thesis defense: 1. The territory of Central Kazakhstan is characterized by a pronounced heterogeneity of the natural environment due to various geographical factors influencing public health. This determines the varying degrees of integral predisposition of the region to the emergence of specific forms of morbidity among the population. 2. The theoretical model of the system of geographical prerequisites preceding the formation and development of morbidity in the population of Central Kazakhstan, proposed by the author, can be successfully adapted for studying regional public health issues in Kazakhstan. 3. The determinants of the geographical prerequisites for human diseases are the objectively established infrastructure of the territorial organization of the economy, which includes numerous influencing factors such as natural, anthropogenic, social, and, as a consequence, ecological factors. 4. The geographical aspects of the correlation between morbidity and the state of environmental objects reveal modern patterns of territorial evolutionary development. This dynamic process is reflected in medical-geographical zoning, where stable zones emerge, formed by the concentration of areas affected by harmful factor transformations and specific types of diseases. 5. The geographical prerequisites for population morbidity are proposed to be considered as an integral indicator of environmental quality, providing an in-depth analysis of the conditions leading to medical-ecological stress and the overall risk of morbidity for territorial differentiation. Based on the obtained results, the following conclusions can be drawn: 1. The system of geographical prerequisites for the territorial distribution of morbidity, substantiated as a result of the study, serves as an integral indicator of environmental quality. The assessment of geographical factors, based on the theoretical model we developed for the system of geographical prerequisites preceding the development of population morbidity, establishes a cause-and-effect relationship between adverse anthropogenic impacts in the cities of Karaganda, Zhezkazgan, Abay, Temirtau, Shakhtinsk, and the Abay district, directly resulting from the activities of industrial enterprises in the mining and metallurgical industries, including Kazakhmys Corporation LLP, ArcelorMittal JSC, the Balkhash Mining and Metallurgical Combine, and the Abay Coal Mine. 2. The correlation assessment between the content of heavy metals in the soil and population morbidity established a relationship between copper (Cu) levels and mental and behavioral disorders, with r=0.598 (p=0.012). Statistically significant moderate positive correlations were found between environmental water indicators and various health conditions, including: pH levels and nervous system diseases (r=0.467, p=0.06); Dissolved oxygen levels and neoplasms (r=0.733, p=0.003); Manganese levels and the incidence of injuries and poisonings (r=0.494, p=0.048); Manganese levels and diseases of the ear and mastoid process (r=0.584, p=0.020); Manganese levels and mental and behavioral disorders (r=0.539, p=0.031); Mental and behavioral disorders also correlated with copper levels (r=0.689, p=0.006) and magnesium levels (r=0.511, p=0.040). Additionally, we identified correlations between: SO₂ levels in atmospheric air and eye diseases (r=0.633, p=0.028), skin and subcutaneous tissue diseases (r=0.567, p=0.049), ear and mastoid process diseases (r=0.633, p=0.028); NO₂ levels in atmospheric air and circulatory system diseases (r=0.567, p=0.049), endocrine diseases (r=0.700, p=0.015); Dust and suspended particulate matter levels and skin and subcutaneous tissue diseases (r=0.618, p=0.033), infectious and parasitic diseases (r=0.618, p=0.033). The above findings indicate statistically significant positive correlations of technogenesis as geographical prerequisites, which have absolute advantages in determining the medical-geographical conditions of public health in Central Kazakhstan. 3. The geography of technogenic impact has established characteristics of high-level water pollution in Lake Balkhash and moderate-level water pollution in the Nura River. Mercury contamination in the Nura River revealed an average mercury concentration of 18.377 mg/dm³, exceeding the maximum permissible concentration (MPC) by 36,755 times. The multi-year average mercury concentration in surface water bodies in Temirtau was 3.5246 mg/dm³, exceeding the MPC by 7,049 times. In the Nura district, the mercury concentration in soil was 15.137 mg/dm³, surpassing the MPC by 30,200 times. 4. A systematic analysis of the comparative advantages of geographical prerequisites for diseases characterizes the status of territorial structures in rural areas as more favorable, which is confirmed by the determination of total risk and medical-geographical zoning. The following cartographic materials have been developed: Map of the multi-year average level of morbidity and disease prevalence in Central Kazakhstan (2012–2021); Map of the multi-year average level of disease prevalence in Central Kazakhstan (2012–2021); Map of the distribution of patients with occupational pathologies in the Karaganda Region (2010–2020); Map of heavy metal content in the soil of Central Kazakhstan (2011–2021); Map of the multi-year average level of morbidity in Central Kazakhstan (2012–2021); Map of air pollutant emissions in the Karaganda Region (2010–2020); Map of major industrial enterprises of the Republic of Kazakhstan (2022); Map of medical-geographical zoning of Central Kazakhstan based on the integrated public health indicator; Map of medical-geographical zoning of Central Kazakhstan based on the integrated indicator of environmental factors; Map of medical-geographical zoning of Central Kazakhstan based on the total risk assessment results. 5. The structure of morbidity and disease prevalence varies, as it reflects accumulated illnesses from previous years and includes all patients under dispensary observation, primarily those with chronic pathologies (circulatory system diseases, endocrine disorders, digestive system diseases). In contrast, environmentally dependent conditions and environmentally induced diseases develop as non-specific and specific pathologies among the population of a particular area due to the impact of harmful environmental factors (respiratory diseases, injuries and poisonings, and urinary system disorders). 6. A systematic analysis of the geographical prerequisites for diseases characterizes the medical-geographical status of territorial structures at both the regional and intra-regional levels. These findings can be utilized in developing strategies and regional policies related to the socio-economic sector, including urban planning and development, landscaping and lighting, the implementation of health-preserving technologies, preventive programs, healthcare and rehabilitation initiatives, as well as enhancing comfort and quality of life for the population. 7. In the process of effectively developing a territorial medical-geographical system, health improvement policies for populations residing in highly urbanized industrial centers must take into account regional differences and focus on implementing measures to reduce the negative impact of the environment and industrial conditions on public health. These policies should also promote the use of economic mechanisms to encourage employers to ensure safe working conditions and a healthy lifestyle for employees, as well as strengthen the capacity of primary healthcare and public health services. The scientific novelty of the study is as follows: - the author has substantiated and proposed a theoretical model of the system of geographical prerequisites preceding the formation and development of morbidity in the population of Central Kazakhstan, which can be adapted for studying regional public health issues in Kazakhstan; - a diversified methodology adapted to the conditions of the Republic of Kazakhstan has been tested to study the spatial distribution of morbidity and conduct a correlation analysis of environmental factors' impact on the formation of the spatial structure of morbidity; - based on the scientific analysis of medical-geographical studies, the author has developed and proposed an invariant methodology for cartographic assessment of environmental quality as an integral indicator determining the predisposition of Central Kazakhstan’s territory to morbidity formation; - a medical-geographical zoning of Central Kazakhstan has been conducted using the proposed methodology for the cartographic assessment of environmental quality as an integral indicator; - for the first time, modern patterns in the spatial distribution of morbidity have been identified, considering the significant impact of environmental factors on Central Kazakhstan; - the study examines the scientific-theoretical significance and applied relevance of the concepts of «medical tourism» and «wellness tourism», as well as the typology of territories based on the conducted medical-geographical assessment of Central Kazakhstan. Theoretical and practical significance of the study. The results of this research can be considered a crucial resource that should be utilized in the development of key directions for regional policy in the Republic of Kazakhstan. The study of the spatial distribution of morbidity allows for urban planning and socio-hygienic measures to be effectively planned and implemented within the region. The obtained results can be utilized by organizations engaged in human ecology research, public health institutions, and the sanitary-epidemiological control system to enhance population monitoring efficiency. Additionally, they can be applied in educational institutions as part of the learning process. The developed cartographic materials have been tested and implemented in the activities of the Republican State Enterprise "National Center for Public Health" of the Ministry of Health of the Republic of Kazakhstan. The practical recommendations have been incorporated into the operations of the Republican Clinical Sanatorium "Alatau" of the Ministry of Health of the Republic of Kazakhstan. Furthermore, the educational-methodological manual "Geo-economics, Geoecology, and Medical Geography of cities in Central Kazakhstan in the context of industrial-innovative development" has been integrated into the academic curriculum of the Karaganda Medical University (Non-Profit Joint-Stock Сompany "Medical University of Karaganda"). Structure of the Dissertation. The dissertation consists of designations and abbreviations, three chapters, a conclusion, a list of references, and one appendix. The main content is presented on 131 pages of typed text and is illustrated with 46 figures and 20 tables. The reference list includes 241 sources. The findings and conclusions obtained during the dissertation research have been published in 15 scientific works, including: 1 educational-methodological manual; 3 articles in journals indexed in the Scopus database, including: 1 article in the Geojournal of Tourism and Geosites (Romania), 2 articles in the News of the National Academy of Sciences of the Republic of Kazakhstan, Series of Geology and Technical Sciences (Kazakhstan); 1 article in a journal recommended by the Committee for Control in the Field of Education and Science; 5 publications in proceedings of international conferences; 1 publication in a Kazakhstani scientific electronic journal; 2 publications in foreign scientific journals; 2 articles published within the framework of international competitions. The personal contribution of the author consists of independently conducting the entire research process and presenting the obtained results.
Conclusion of the Research Ethics Committee
Defense of the dissertation: https://www.youtube.com/watch?v=28481qxWM50&t=6s
