SUBJECTIVE ASSESSMENT OF HEALTH STATUS, ACCESSIBILITY OF MEDICAL CARE, AND LIFE SUPPORT CONDITIONS OF PERSONS LIVING IN THE TERRITORIES OF DIRECT AND INDIRECT IMPACT OF WAR: RESULTS OF A MEDICO-SOCIOLOGICAL STUDY

Abstract

The full-scale war in Ukraine has been accompanied by disruptions to living conditions, access to health care, and psychosocial well-being. A comprehensive assessment of problems reported by people who lived in areas directly or indirectly affected by the war can inform public health priorities and the organization of health services. Objective. To characterize respondent-reported changes in physical and psycho-emotional health, living conditions, and access to health care; to determine the frequency of the main reported barriers to obtaining medical services; and to identify priority areas for organizational response. Materials and methods. A descriptive cross-sectional medical-sociological study with a retrospective component was conducted. In November–December 2025, a convenience sample of 105 adults who had been forcibly displaced from areas directly or indirectly affected by the war was surveyed in three temporary accommodation dormitories in Zhytomyr, Ukraine. Of 108 individuals invited, three declined to participate. Data were collected using an author-developed questionnaire comprising three blocks covering general characteristics, physical health and access to health care, and psycho-emotional health and support. Retrospective questions referred to the period before displacement, whereas items with other time frames were interpreted according to their wording. Categorical data were presented as counts (n), valid denominators (N), and percentages. Ninety-five percent confidence intervals (CIs) were calculated using the Wilson method. No comparative analysis between territorial groups was performed. Results. Physical injuries resulting from military actions were reported by 27.6% of respondents. Limited or partial access to health care was reported by 70.5% (95% CI 61.2–78.4), while 59.0% rated the quality of medical services as low or reported that services were unavailable. The most frequently reported barriers were shortages of health professionals (48.6%) and necessary medicines (42.9%). Unmet needs for medicines used to treat chronic diseases and for psychological assistance were reported by 42.9% and 40.0%, respectively. Frequent headaches were reported by 53.3% of respondents and elevated blood pressure by 51.4%. Substantial or partial deterioration in food quality was reported by 74.3% (95% CI 65.2–81.7), food shortages by 65.7%, and irregular or no access to clean drinking water by 53.3%. Persistent fear for one’s own life or the lives of loved ones was reported by 65.7%, frequent or almost constant anxiety by 60.0%, and emotional exhaustion occurring daily or several times a week by 57.1%. During the preceding year, 13.3% received regular psychological or psychotherapeutic assistance and a further 21.9% sought such assistance once or several times. Overall, 34.3% did not know where psychological support could be obtained. These findings describe respondents’ reported experiences and symptoms rather than clinically established diagnoses or objectively audited service capacity. Conclusions. The study identified a substantial frequency of reported medical, psycho-emotional, and social problems in the surveyed group. The findings support further assessment of health and social needs and barriers to care, with particular attention to continuity of health services, access to essential medicines, psychosocial support, and coordination between health and social services. The descriptive design and non-probability sampling define the limits of interpretation and do not permit causal conclusions or extrapolation of the observed percentages to the population of Ukraine as a whole