REDUCING THE BURDEN OF CORONARY HEART-DISEASE - HEALTH PROMOTION, ITSEFFECTIVENESS AND COST

Coronary heart disease (CHD) is one of five key areas identified in th e Health of the Nation white paper produced by the Department of Healt h in 1992. The main CHD targets are to reduce death rates from CHD by at least 40% in people below 65 and 30% in those between 65 and 74 by the year 2000, respectively. Improvements in treatment and rehabilitat ion are expected to contribute to reducing the burden of CHD; however, in the long term, prevention is believed to hold the greatest potenti al. CHD health promotion therefore has a big role to play in securing the Health of the Nation targets. In contrast to treatment interventio ns, however, little is known about the effectiveness or cost-effective ness of health promotion. The purpose of this article is two-fold. Its main aim is to illustrate the potential of health promotion in reduci ng the health burden of CHD to the turn of the century and beyond for a representative health purchaser. This is achieved with the use of an epidemiological model, Prevent, developed in the Netherlands to simul ate the health outcomes associated with health promotion and preventio n. A subsidiary aim is to present tentative information about the rela tive costs associated with different health promotion options.