Can a sustainable community intervention reduce the health gap? 10-Year evaluation of a Swedish community intervention program for the prevention of cardiovascular disease

Objectives: This paper evaluates the 10-year outcomes of a Northern Sweden community intervention program for the prevention of cardiovascular disease (CVD), with special reference to the social patterning of risk development . Methods: Using a quasi-experimental design, trends in risk factors and pred icted mortality in an intervention area (Norsjo municipality) are compared with those in a reference area (Northern Sweden region) by repeated indepen dent cross-sectional surveys. Results: There were significant differences in changes in total cholesterol level and systolic blood pressure between the intervention and reference p opulations. The predicted coronary heart disease mortality (based on the No rth Karelia risk equation), after adjustment for age and education, was red uced by 36% in the intervention area and by 1% in the reference area. Conclusions: We conclude that a long-term community-based CVD prevention pr ogram which combines population and individual strategies can substantially promote a health shift in CVD risk in a high risk rural population. When e valuated for different social strata, we found no signs of an increasing he alth gap between socially privileged and less privileged groups. Socially l ess-privileged groups benefited the most from the present prevention progra m.