On "a decline in earning losses associated with a community-based cardiovascular disease prevention project".

Abstract

highest rates of mortality from cardiovascular disease in the world, and Karelia has the highest rate in Finland. For example, age-standardized mortality rates of heart disease in males aged 35-64 years were 466.8 per 100,000, compared with 73.3 in Japan in 1971.2 The mortality rate from this disease increased from 1955 to 1970 in Finland, while falling in many other countries.3 This increase led community representatives in Karelia to petition the central government in Helsinki in 1971 for action against the disease.4'5 The result was the establishment of the North Karelia Project in 1972, sponsored by the province of Karelia, the government of Finland, and the World Health Organization. The project is completely described in a recent report published by WHO.6 The petitioners specified that the area of Karelia had been studied enough. Indeed, a World Health Organization survey completed in 1971 had documented the high rate of cardiovascular disease incidence and mortality in Karelia.7 The request was for action, a service program. Thus, from the beginning the project was constrained from using a prospective research design. It was decided to organize a program based on risk factors that had been identified in other research, including that done in Framingham, Massachusetts,8 and on proven efficacy, such as