Settlement Inequality and Social Exclusion of People with Epilepsy
Introduction. Patients with epilepsy, due to the presence of the chronic disorder, belong to deprived social groups. The results of many studies confirm the discrimination of patients with epilepsy on various social parameters, such as the availability of high-quality medical care, education and jobs. The settlement factor aggravates the deprived situation of patients with epilepsy and significantly affects their socio-psychological well-being. Based on the materials of the study conducted, the article identifies the interconnection between the characteristics of the place of residence of a patient with epilepsy, indicators of social exclusion, and the level of emotional-volitional and cognitive disorders. Materials and Methods. The data from a survey of 157 patients with epilepsy registered in neuropsychiatric dispensaries in Penza, Saransk, and Alatyr were used as materials for the study. The survey was conducted using the authors' tools in May - December 2020 as formalized interviews. The results were processed using mathematical statistics methods in the SPSS software package. Results. The survey data have confirmed the stigmatization and deprivation of patients with epilepsy: they are less likely to marry, have limited opportunities for vocational education, and are more often unemployed. The settlement factor manifests itself in the unequal availability of modern medical services and provision of drugs, inclusive educational programs and opportunities for occupational socialization. The performed cluster analysis of the data has made it possible to single out three groups of respondents that differ significantly in terms of indicators and the degree of social exclusion: “educational deprivation”, “exclusion in the labor market” and “coping with stigma”. Analysis of these categories regarding the settlement factor shows that the share of the most deprived groups is inversely related to the population of the cities under study. Discussion and Conclusion. The authors have drawn the conclusions that the availability of social integration mechanisms reduces the likelihood of developing negative consequences of epilepsy, and the corresponding opportunities are largely due to the size of the city. The data obtained can be used to identify categories of patients with similar social problems, which will facilitate more targeted emotional and instrumental support for patients with epilepsy, with regard to the settlement factor.