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Preventing heart disease through community action: the North Karelia Project.


 In an effort to deal with their province's abnormally high incidence of heart disease, the people of North Karelia, Finland persuaded the government to establish a special project. Initiated in 1972, the project - led by epidemiologist, Dr. Pekka Puska - appears to have had considerable success in lowering the rate of heart disease. 3 risk factors - or likely causes - were identified, and each cause has been the object of a separate campaign. The 3 factors are hypertension, smoking, and high levels of cholesterol in the blood. The easiest of the 3 "risk factors" to fight effectively has been hypertension, because it simply was a matter of adjusting to the new government health services. The greatest success has come with the anti-smoking campaign. An information blitz, obsessive and non-stop interest among the media, canny use of existing animators worked together to make smoking a public crime in North Karelia and to lower the rates and risk of heart disease. 1 of the key elements is group sessions involving 10 or more people who wish to give up smoking. The most difficult of the 3 separate programs has involved cholesterol. Primarily a question of diet, cholesterol has been checked by community action, such as health food meals. Cholesterol reveals the project's limitation and why it fails to act as an entry point into wider political involvement. The diet of North Karelia is heavily influenced by the area's dependency on dairy farming. This raises the broader issue of changing methods of agricultural production, which may not be to the short-term economic advantage of North Karelia.
