Geographical variations in cardiovascular mortality in Finland, 1961-1985

Mortality from diseases of the circulatory organs in Finland during the period 1961-1985 is examined by communes, separate analyses being made for ischaemic heart disease (IHD) and cerebral vascular accidents (CVA). Data on deaths are abstracted from the 0.58 million death certificates referring to these conditions, and information on demographic variables is taken from the 1950 and 1970 population censuses. There was a sharp frontier separating the area of high mortality in Eastern and Northern Finland from the area of low mortality in Western Finland, the difference between the extreme quintiles being 2-3-fold. Mortality from IHD and CVA increased with the proportion of the lowest social class and with crowdedness in the commune, being lower in communes with high proportions of the higher social classes. In-migration was associated with a lowering in mortality whereas the opposite was true for out-migration. The regional variations in IHD and CVA are explicable in terms of major social factors to a certain extent, but not exhaustively. The detailed geographical pattern of deaths shows a similarity to the history of settlement of Finland, but it is not possible to separate social and genetic influences within the scope of the present study.