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Local health planning and intervention: the case of a Swedish municipality
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
SPRI, Stockholm, Sweden.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.ORCID-id: 0000-0003-3025-2690
1988 (engelsk)Inngår i: Scandinavian journal of primary health care. Supplement, ISSN 0284-6020, Vol. 1, s. 57-64Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

This article attempts to illustrate the process from community diagnosis to community involvement by a case study from the north of Sweden. The case of Norsjö is one of few documented Swedish examples of a preventive program with a broad participation from the community. The results up to now are promising and further illustrate the importance of decentralized health planning and local data.

sted, utgiver, år, opplag, sider
1988. Vol. 1, s. 57-64
HSV kategori
Identifikatorer
URN: urn:nbn:se:umu:diva-64715PubMedID: 3227203OAI: oai:DiVA.org:umu-64715DiVA, id: diva2:602446
Tilgjengelig fra: 2013-02-01 Laget: 2013-02-01 Sist oppdatert: 2018-06-08bibliografisk kontrollert
Inngår i avhandling
1. Community participation and social patterning in cardiovascular disease intervention
Åpne denne publikasjonen i ny fane eller vindu >>Community participation and social patterning in cardiovascular disease intervention
1993 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

This study addresses health policy and public health in the field of cardiovascular disease (CVD) on the local level in Sweden. The overall aim is to contribute to the assessment of structural and social conditions within public health by analysing participation processes and outcome patterns in a local health programme. The northern Swedish MONICA study served as a reference area. The research strategy has been to integrate quantitative and  qualitative methodologies and, thereby, focus on different aspects of the health programme under study.

The mortality rate was excessive in the study area of Norsjö relative to both provincial and national figures over a period of more than 10 years. This finding formed the basis for a tenyear comprehensive and community-based health programme towards the prevention of CVD and diabetes.

Even in this seemingly homogeneous area it was found that socio-economic circumstances were associated with the public health. Almost half of the study population had hypercholesterolaemia (;>6.5 mmol/1), 19% of men and 25% of women were smokers and 30% and 29%, respectively, had high blood pressure. Age had a strong impact on all outcome measures. After adjustments for age and social factors it was found that the relative risk of having hypercholesterolaemia dropped significantly in both sexes during the six years of intervention. The probability of being a smoker was significantly reduced only in highly educated groups. No statistically significant change over time could be found for the risk of suffering high blood pressure. In the reference area of northern Sweden there were no changes over time for any of the selected risk factors. The likelihood of self-assessed good health decreased with increasing risk factor load, with the exception of hypercholesterolaemia , in all social strata.

The authorities, including the health and medical staff, were the main actors on the mediastage. Men in manual occupations were least affected by the media coverage. The actors and the public as well as the media viewed the health programme as orientated towards individual lifestyles. Community participation was mainly defined by the actors based on the medical and health planning approach. Differences in interpretations, social interests, personal conflicts and ideological constraints among the actors at local level were observed. Some critical attitudes towards the organization and management of the health programme were also noted among the citizens. However, a majority of the public wanted the health programme to continue. The present study underlines the importance of considering age, gender and social differences in the planning and evaluation of CVD preventive programmes.

sted, utgiver, år, opplag, sider
Umeå: Umeå Universitet, 1993. s. 49
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 383
Emneord
cardiovascular disease, diabetes, prevention, social factors, evaluation, social epidemiology, folkhälsovetenskap
HSV kategori
Forskningsprogram
epidemiologi; folkhälsa
Identifikatorer
urn:nbn:se:umu:diva-7544 (URN)91-7174-816-4 (ISBN)
Disputas
1993-11-19, Tandläkarhögskolan, Rosa salen, 9tr., Umeå universitet, Umeå, 09:00 (svensk)
Opponent
Veileder
Prosjekter
digitalisering@umu
Tilgjengelig fra: 2008-01-10 Laget: 2008-01-10 Sist oppdatert: 2018-03-15bibliografisk kontrollert

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