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Surveying mortality in northern Finland: two towns with contrasting trends.

Mortality was compared in two major towns in northern Finland (Kemi and Oulu), which according to previous studies have high and low mortalities, respectively. In 1991-1995 life expectancy at birth in Oulu exceeded the national average by 0.7 years in males and 0.4 years in females but in Kemi it fell short of the national average in both sexes by 2.5 years. The shorter life-time in Kemi resulted from a slower-than-average decline in male mortality since the 1960's and an increase in female mortality by a factor of 1/5 in 1981-1995. In the 1990's, Kemi as marked by ischaemic heart disease (excess over national mortality 10% in males, 18% in females), pneumonia among the elderly (excess 2-fold), cancer in females (excess 30%), accidents (excess 24% in males, 82% in females) and male suicides (excess 76%), most of which in Oulu were below the national figures. Surveys are underway to clarify reasons for this mortality difference between the two towns.