Box 44.2Success in Finland

Finland provides one of the best-documented examples of a community intervention. In 1972, Finland had the world's highest CVD mortality rate. Planners examined the policy and environmental factors contributing to CVD and sought appropriate changes, such as increased availability of low-fat dairy products, antismoking legislation, and improved school meals. They used the media; schools; worksites; and spokespersons from sports, education, and agriculture to educate residents. After five years, significant improvements were documented in smoking, cholesterol, and blood pressure. By 1992, CVD mortality rates for men age 35 to 64 had dropped by 57 percent. The program was so successful that it was expanded to include other lifestyle-related diseases. Twenty years later, major reductions in CVD risk-factor levels, morbidity, and mortality were attributed to the project. Recent data show a 75 percent decrease in CVD mortality (Puska and others 1998).