North Karelia Project
The North Karelia Project was launched in 1972 in response to a local petition to get urgent and effective help to reduce exceptionally high coronary heart disease mortality rates in the area. In cooperation with local and national authorities and experts as well as with WHO, the North Karelia Project was formulated and implemented to carry out a thorough intervention through the community organizations and the action of the people themselves. The Project included a comprehensive evaluation, and has acted as major demonstration programme for national and international applications.
Over the years the scope of the Project has been enlargened to include broader objectives of integrated prevention of major non-communicable diseases and health promotion, as well as prevention of risk related lifestyles in childhood and youth. After its initial five years the Project actively contributed to national prevention of cardiovascular and other chronic diseases, as well as national health promotion. The results and experiences of the North Karelia Project show that a determined and well-conceived intervention can have a major impact on health-related lifestyles and on population risk factor levels and that such a development, indeed, leads to reduced disease rates and improved health of the population. By 2006 the annual mortality rate of coronary heart disease in North Karelia in the working age population had fallen approximately 85 %, compared with the rate before the Project.
The co-ordinating centre of the North Karelia Project was situated in Helsinki at the National Institute for Health and Welfare which was centrally involved in national NCD prevention work in Finland for decades. Chronic disease prevention work is continued in the new National Institute for Health and Welfare established in January 2009. The North Karelia Project and Finland have strongly contributed to many of WHO’s NCD Prevention and Control activities.
The experience from the North Karelia Project and the need for sustained continuation led planning and launching of the new provincial prevention and health promotion center: the North Karelian Center for Public Health in year 2000.
Table 1. Main risk factors in North Karelia between 1972 and 2007 among men and women aged 30-59 years
|
Year |
Men |
Women |
||||
| Smoking
(%) |
Serum
cholesterol (mmol/l) |
Blood
pressure (mmHg) |
Smoking (%)
|
Serum
cholesterol (mmol/l) |
Blood pressure
(mmHg) |
|
| 1972 | 52 | 6.9
|
149/92
|
10
|
6.8
|
153/92
|
| 1977
|
44
|
6.5
|
143/89
|
10
|
6.4
|
141/86
|
| 1982
|
36
|
6.3
|
145/87
|
15
|
6.1
|
141/85
|
| 1987
|
36
|
6.3
|
144/88
|
16
|
6.0
|
139/83
|
| 1992
|
32
|
5.9
|
142/85
|
17
|
5.6
|
135/80
|
| 1997
|
31
|
5.7
|
140/84
|
16
|
5.6
|
133/80
|
| 2002
|
33
|
5.7
|
137/83
|
22
|
5.5
|
132/78
|
| 2007
|
31
|
5.4
|
138/83
|
18
|
5.2
|
134/78
|
Table 2. Mortality changes in North Karelia among 35-64 years aged men in 1970-2006 (per 100 000, age adjusted)
| Rate in
1969-1971 |
Rate in 2006
|
Change from
1969-1971 to 2006 |
|
| All causes
|
1509 | 572
|
-62%
|
| All cardiovascular
|
855 | 182
|
-79%
|
| Coronary heart disease
|
672 | 103
|
-85%
|
| All cancers
|
271 | 96
|
-65%
|
| Lung cancers
|
147 | 30
|
-80%
|
Annex:
Age-adjusted mortality rates of coronary heart disease in North Karelia and the whole of Finland among males aged 35–64 years from 1969 to 2006