ASSESSMENT OF THE GENERAL HEALTH PROFILE TRENDS IN THE MALE-POPULATION OF TALLINN, ESTONIA

Objective: To construct a complex indicator, the Health Index, for the determination of the general health profile of the population and to assess the time trends of the latter in the male population of Tallinn , the capital of Estonia. Design: Three epidemiological studies of car diovascular diseases (CVD) risk factors involving independent random s amples of the male population of Tallinn aged 30-59 y were carried out in 1981/82 (survey I), in 1984/85 (survey II) and in 1992/94 (survey III), the total number of participants was 5019. The screening procedu re included standard epidemiological methods. The cohorts of the surve ys I and II were followed up for 11 y on average; 457 deaths of cases were registered during that period. For the assessment of the general health profile of the population the Health Index was constructed on t he basis of mortality follow-up data of the above mentioned two cohort s by means of the survival analysis methods using SAS (Statistical Ana lysis System). 20 variables were tested, 11 of them were selected as s tatistically significant for the prediction of total mortality: systol ic blood pressure, heart rate, coronary heart disease (CHD) status (P < 0.0001), total cholesterol (TC), TC2, body mass index (BMI), BMI2, e ducation, smoking, alcohol consumption (P < 0.01), marital status (P < 0.05). The predictive ability of the Health Index for CHD, CVD and to tal mortality was confirmed by analysing the age-adjusted relative ris ks according to the deciles of the Health Index. Results: The Health I ndex was used to determine the general health profile of the male popu lation of Tallinn aged 30-59 y at surveys I, II and III and for the as sessment of its time trends between the three surveys (1981/82-1992/94 ). We have established an improvement of the health profile in the stu died population from survey I to survey II and a further improvement f or those aged over 40 y from the surveys II and III. Conclusion: The H ealth Index should be regarded as a valuable tool for the assessment o f health trends in the population. The mortality decline expected in t his study was confirmed by observed mortality trends in the Estonian m ale population.