Premature Death in the New Independent States (1997) / Chapter Skim
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Chronic Disease Prevention in the New Independent States: Finnish Experiences
Chronic Disease Prevention in the New Independent States: Finnish Experiences
Pages 335-354
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From page 335... ...
In 20 years, this work has been associated with a marked reduction in target risk factors and with a more than 50 percent reduction in cardiovascular disease mortality rates among the middleaged population. As documented in several of the early chapters of this volume, the republics of the former Soviet Union are now facing a similar serious problem of chronic disease, which represents a major challenge to the public health in these states.
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From page 336... ...
The major objective of the North Karelia Project has been to decrease mortality and morbidity rates from cardiovascular and other chronic diseases, as well as to promote general health among the population of the area. Special emphasis has been on the middle-aged male population, which had esneciallv high mortality rates prior to the start of the project.
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From page 337... ...
Evaluation and National Applications In the spring of 1972, prior to the start of the project, a large baseline survey was carried out in North Karelia and in the chosen matched reference area, Kuopio province. Target risk factors, related behaviors, and background variables among the population were carefully measured.
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From page 338... ...
During the last few years, new and remarkable changes have taken place, particularly cholesterol-lowering dietary changes that have been associated with major further reductions in serum cholesterol levels. Table 13-2 shows that over the 20-year period, the annual mortality rate from coronary heart disease among the middle-aged (below age 65)
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From page 339... ...
339 Cq a' o VO a' o _' a' o so o ·~4 _' ·_4 a' ·_4 Cq so o L It)
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From page 340... ...
All causes 1,556 -37 Cardiovascular disease 912 -46 Coronary heart disease 695 -46 All cancers 293 -45 Lung cancer 167 -63 cause mortality rate declined by about 40 percent, leading also to greater life expectancy (Table 13-2~. Associated with the favorable risk factor and lifestyle changes, the general health status of the population greatly improved.
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From page 341... ...
The project has also shown that a major national demonstration project can be a strong tool for favorable national development. The decline in heart disease mortality during the last few years in Finland has been among the most rapid in the world.
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From page 342... ...
Contacts between Finland and the Republic of Karelia have also increased greatly. At the same time that experiences with chronic disease prevention have been very encouraging in Finland, the neighboring countries of Estonia and the Republic of Karelia, as well as other NIS countries, have been facing major health problems, especially those involving noncommunicable diseases.
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From page 343... ...
Health Databases Databases developed and used as part of the collaboration include mortality statistics; cardiovascular disease incidence rates; population risk factor levels; and health behavior, health-related behavior, and subjective health (an individual's perception of his or her health status)
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From page 344... ...
age-adjusted mortality rates in Finland, Estonia, and the Republic of Karelia. They also show the rates in the province of North Karelia for the period 1990-1992 and 20 years earlier, before the project.
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From page 345... ...
In Finland, the MONICA-based acute myocardial infarction registers have corroborated the mortality statistics shown in Figures 13-3a and b, concerning both international comparisons and declining trends (Mustaniemi, 1993~. Preliminary experience from the acute myocardial infarction register in Tallinn has corroborated the high cardiovascular disease rates there (Laks et al., 1991~.
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From page 347... ...
The obesity pattern in Tallinn seems to resemble that of Pitkaranta more than that of Finland. TABLE 13-4 Mean Levels of Risk Factors in North Karelia (Finland)
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From page 348... ...
and Republic of Karelia, Pitkaranta (risk factor survey) , males.
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From page 349... ...
Also, the collaboration has focused on the WHO-initiated CINDI program as a comprehensive and effective tool for chronic disease prevention in Estonia. In addition, a broad range of other collaborative activities has taken place between Finland and Estonia in formulating and implementing strategies for disease prevention and health promotion.
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From page 350... ...
. HEALTH CHALLENGES AND THE POTENTIAL FOR CHRONIC DISEASE PREVENTION The Importance of Lifestyle Changes It is obvious that major improvements in public health in Estonia and the Republic of Karelia, as well as in many other parts of Russia and other NIS countries, are overwhelmingly dependent on changes in the rates of the major noncommunicable diseases.
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From page 351... ...
Thus, preventive health work should focus not only on government action, but also on health communication and mobilization of the people. The experience of the North Karelia Project, as well as that of many other countries, shows that a major national demonstration program can be a strong tool for national chronic disease prevention and health promotion.
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From page 352... ...
As for the content of such interventions, initial health information campaigns are needed. There still is, and probably will be for the next few years, a lack of accurate information on risk factors and on the best advice for disease prevention and health promotion.
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From page 353... ...
In II KTL Symposium: Two Decades of Chronic Disease Prevention-Lessons for International Action. Publications of the National Public Health Institute KTL B4/93.
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From page 354... ...
[Ischemic and atherosclerotic heart disease risk factors among Tallinn population]
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