The insights gained from community wide health surveys can be very relevant to supporting prevention campaigns for improving major public health issues such as cardiovascular diseases, overweight or diabetes. However, in many cases such improvements require both epidemiological researches to assess the influence of various risk factors and knowledge on the impact of changes in the populations’ life-styles.
Figure: In the North Karelia province, the proportion of residents consuming high-fat milk has dropped from about 70 percent to less than 10 percent (source: Buettner, 2015; picture Michael Trek/Bleu Zones).
The community health surveys in North Karelia became quite famous as this project was the direct inspiration for the organisation, in the decades to follow, of community health programs by the World Health Organisation. A second interesting feature of the case is the way it was able to produced new insights on the relationship of the medical problem and the life-style choices in the community. Indeed, what initially was perceived as a medical problem, related to high prevalence of cardiovascular disease, turned out to be related to specific dietary habits inherited from dairy farming activities in the region leading to the consumption of high fat dairy products. Therefore, the solution to the problem required the intervention from many stakeholders, ranging from the health professionals, who introduced specific treatments against high cholesterol levels, to the media, supermarkets and schools, who were directly involved in awareness raising campaigns and the introduction of new practices for promoting more healthy life-style choices.
In the case of North Karelia, health surveying was conducted both at the community level and in specific sub-groups such as schools or hospitals, where a detailed knowledge was available of the ongoing health related social interventions. The main surveys campaigns were organized every five years in 1972, 1977 and 1982 and included over 2000 individuals in each of the surveys, out of a population of around 180.000 in the province of North Karelia. These individuals were examined at the local health centres. Nurses trained in community health surveying took blood samples for analysing cholesterol levels, blood pressure and body weight. This medical examination was each time combined with a quantitative survey with questions on items related to dietary habits, but also a broad diversity of contextual variables such as participation to preventive practices by health personnel, exposure to project activities, social support and interaction, behaviour change intentions and environmental influences (Puska et al., 2009, p. 53-54).