ETHNOCULTURAL DIVERSITY AS A DETERMINANT OF REGIONAL HEALTH POLICY: EVIDENCE FROM THE ZHETYSU REGION OF KAZAKHSTAN

Abstract

This article examines the institutional implications of the ethnocultural diversity of the Zhetysu region of Kazakhstan for the design of regional public health policy. Drawing on the verified data of the regional budget for 2024 (KZT 506.6 billion in total, of which KZT 18.3 billion was allocated to health care), demographic indicators of the Bureau of National Statistics of the Republic of Kazakhstan (population of 686.8 thousand as of 1 April 2026, rural share of 54.05 per cent) and the materials of the latest national population census (approximately 130 ethnic groups; ethnic Kazakhs constitute 71.3 per cent, ethnic Russians 14.6 per cent, ethnic Uzbeks 3.3 per cent), the article demonstrates that the synergetic effect of the rural majority, the second-highest poverty rate among Kazakhstani regions, and ethnolinguistic diversity creates a structural inequality in the access of ethnocultural groups to preventive health programmes. Per capita regional health expenditure in Zhetysu (KZT 26.6 thousand) is found to be 4.6 times lower than the national consolidated indicator (KZT 122 thousand) and approximately one ninth of the OECD average. International meta-analyses suggest that the gap in screening coverage between mainstream populations and ethnic minorities ranges between 13 and 50 percentage points; applied to the ethnocultural population of Zhetysu (estimated at 120-150 thousand), this translates into a conservative under-coverage of 10-20 thousand people. The article argues that this inequality cannot be eliminated through the medical contour alone and that institutional engagement of the regional Centre for Public Accord (CPA) of the House of Friendship under the Assembly of the People of Kazakhstan represents the structurally adequate institutional response to the identified gap. The argument is positioned within the framework of Sustainable Development Goals 3, 10 and 16