Village competition as an innovative method for lowering population cholesterol

In the early 1970s, Finland had the highest cardiovascular-related mortalit y in the world. Since 1972, active prevention programmes carried out in the framework of the North Karelia Project have reduced these high rates. A ce ntral target of these programmes was promotion of dietary changes to reduce population cholesterol levels. In spite of the great success in the 1970s and 1980s, cholesterol levels at the end of the 1980s remained, by internat ional standards, relatively high in North Karelia, especially in rural area s. The village cholesterol competition was introduced as an innovative meth od to promote further cholesterol reduction in the population. This paper d escribes two competitions (1991 and 1997) in which serum cholesterol values of people aged 20-70 years in participating villages were measured twice d uring a 2-month period. The village with the greatest mean reduction in ser um cholesterol was awarded a monetary prize. In the 1991 competition, the m ean serum cholesterol value in seven villages was reduced by 5.8%, and in t he winning village, by 10.8%. In 1997, the mean reduction in 16 villages wa s 9.0% and in the winning village, 16.0%. These reductions were clearly rel ated both to self-reported dietary changes and to the reported use of a pla nt stanol ester-containing dietary spread. Village competition was a positi ve and cost-effective way of promoting simple and healthy dietary changes. The competitions used positive incentives, local participation and ownershi p to strengthen cooperation between the villages and the healthcare sector.