23. Тамхины хэрэглээ, эрэгтэй,30–59 нас,
Финланд
60
50
40
30
20
10
х
у
у
л
ь
ь
х
у
у
л
ь
ь
х
у
у
л
ь
ь
1972 1977 1982 1987 1992 1997 2002 2007
North Karelia
Kuopio province
Southwest Finland
Helsinki area
Oulu province
Lapland province
23
%
North Karelia project evaluation and FINMONICA and the National FINRISK Studies 1972 - 2007
24. extension of the Project nationally
- 82 %
24
Age-adjusted mortality rates of coronary heart
disease in North Karelia
and the whole of
700
Finland among
males aged
600
35-64 years
500
from 1969
to 2002
400
300
Mortality per
200
100 000
population 100
start of the North Karelia Project
North Karelia
All Finland
- 75%
Year 69 72 75 78 81 84 87 90 93 96 99 2002
25. 25
0
-10
-20
-30
-40
-50
-60
-70
-80
-90
1972 1977 1982 1987 1992 1997 2002 2007
Year
%
Observed
All risk factors
Cholesterol
Diastolic BP
Smoking
Observed and Predicted Decline
in CHD mortality
35-64 year old men
26. Age adjusted mortality rate of lung cancer in North Karelia and in all
Finland in male population aged 35-64 years in 1969-1995
26
27. MORTALITY CHANGES IN NORTH KARELIA
from 1969–71 to 2006 (Men 35–64 Years, Age
27
Adjusted)
Rate (per 100.000) Change
from 1969–71 2006 1969–71 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 06/12/2014 Pekka Puska, Director General - 80% 27
28. Changes in perceived health
(self-reported very good/good)
70
60
50
40
30
1972 1977 1982 1987 1992 1997 2002
Year
%
North Karelia
Kuopio province
Southwest Finland
Helsinki area
28
29. Life expectancy at birth in Finland in 1941–2004
29
Source: Statistics Finland. Koskinen
S, Aromaa A, Huttunen J, Teperi J.
Health in Finland. Helsinki 2006.
www.ktl.fi/hif
30. 30
FOR SUCCESSFUL
PREVENTION
Strong leadership combined with
Good partnership
Do the right things
Do enough
06/12/2014 30
31. 31
STRONGER SUPPORT FOR
IMPLEMENTATION
Stronger public health
infrastructures
Stronger health
surveillance/monitoring
Innovative financial support
mechanisms
06/12/2014 31
32. 32
CIVIL SOCIETY
The role of civil society is
increasing in most countries
NGO’s: mobilize people, serve
people, watchdogs, etc.
Push for childhood obesity to
public / political agenda
06/12/2014 32
33. 33
PRIVATE SECTOR
Food, eating, physical activity
Commercial issues are of increasing impact to
public health
Health is increasingly important business
argument
Product development, marketing
Social responsibility? Regulation? Market push?
06/12/2014 33
34. 34
HEALTH MONITORING
Power of monitoring
Feed back to people and decision
makers
Need to emphasize risk factors,
lifestyles, determinants
06/12/2014 34
35. Use of butter for cooking
35
80
70
60
50
40
30
20
10
0
1972 1977 1982 1987 1992 1997 2002
Year
North Karelia
Kuopio province
Southwest Finland
Helsinki area
Oulu province
Lapland province
%
36. 36
THE MAIN CHALLENGE IS NOT
WHAT TO DO, BUT HOW
TO DO!
06/12/2014 36
37. 37
FOR SUCCESSFUL
PREVENTION
Strong leadership combined with
Good partnership
Do the right things
Do enough
06/12/2014 37
38. 38
STRONGER SUPPORT FOR
IMPLEMENTATION
Stronger public health
infrastructures
Stronger health
surveillance/monitoring
Innovative financial support
mechanisms
06/12/2014 38
39. 39
CIVIL SOCIETY
The role of civil society is
increasing in most countries
NGO’s: mobilize people, serve
people, watchdogs, etc.
Push for childhood obesity to
public / political agenda
06/12/2014 39
40. 40
PRIVATE SECTOR
Food, eating, physical activity
Commercial issues are of increasing impact to
public health
Health is increasingly important business
argument
Product development, marketing
Social responsibility? Regulation? Market push?
06/12/2014 40
41. 41
HEALTH MONITORING
Power of monitoring
Feed back to people and decision
makers
Need to emphasize risk factors,
lifestyles, determinants
06/12/2014 41
42. 42
Partnerships are
important, but
Governments have a
basic responsibility for
public health!
06/12/2014 42