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PubMed1984

Oral health in Finland and the Soviet Union. A joint study.

To develop the functions of a health care system it is essential to compare and evaluate the systems of different countries. The World Health Organization (WHO) has emphasized the importance of collaborative studies in the field of epidemiology. In countries with similar social systems the basis for health care is usually the same. Comparison of health care in such countries is relatively easy because in most cases the criteria for functions, diagnosis, etc. are similar. Comparison of countries having different bases for health care and different philosophies of research is much more complicated and time-consuming. Soviet health care, including oral health care, is based on community responsibility and has complex prophylaxis as its main emphasis. In the USSR there are no private dentists. All dental services are available at polyclinics located either near the place of residence or at the work place. In Finland there are two separate systems for oral health care. Children up to the age of 18 and some special groups of the adult population (pregnant women, military recruits, and students) are treated in municipal polyclinics (called health centres in Finland). Otherwise, the adult population is treated mainly by private dentists. The study will be carried out in three towns in Finland and six towns in the USSR. The aim of this study is to describe the causal epidemiology of dental caries among children 6 to 7, 9 and 12 years old in Finland and the Soviet Union. In addition, certain measures and compounds for caries prevention will be tested during 3 years of follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

Health-related social mobility: a comparison of currently employed men and women in Britain and Finland.

Selective health-related social mobility has been suggested as one possible explanation for health inequalities. The aim of this paper is to examine the size and significance of the contribution which health-related social mobility makes to social class differences in health. We do this by examining the association between intergenerational social mobility and health among currently employed men and women in Britain and Finland. We used comparable nationally representative interview surveys from Britain and Finland. The British data is derived from the General Household Survey for 1988 and 1989, and the Finnish data from the 1986 Survey on Living Conditions. Health measures included limiting long-standing illness and self-assessed health as below good. Social mobility was measured comparing the respondent's class of origin (father's occupation) with his/her class of destination (own current occupation). Social structural changes and related social mobility have been more dramatic in Finland than in Britain during the last few decades. Downward mobility has been relatively rare, and mobility has taken place predominantly upwards. In Finland downward mobility from upper non-manual to manual worker was associated with a somewhat higher risk of limiting long-standing illness than expected among men as well as women. However, there was no statistically significant interaction effect on health between the respondent's father's occupational class and his/her own current class. In Britain, neither self-assessed health nor limiting long-standing illness were related to social mobility. Some weak evidence for health-related downward social mobility was found for currently employed Finnish men and women, but not for their British counterparts. Moreover, the evidence is weaker for self-assessed health than for limiting long-standing illness. Where social mobility may have been health-related, it concerns very rare and small groups; therefore health inequalities among the currently employed cannot be explained by intergenerational health-related social mobility.

Adult↗
PubMed1994

Haemostatic factors and lipoprotein (a) in three geographical areas in Finland: the Finrisk Haemostasis Study.

BACKGROUND: An increasing volume of evidence suggests that haemostatic factors play a role in the risk of coronary heart disease. It is not known, however, whether between-population differences in haemostatic factors correspond with the differences in mortality related to coronary heart disease. We examined this question in Finland, where, in North Karelia (in the eastern part of the country), the mortality from coronary heart disease is 1.5-1.7 times higher than that in southwestern areas. METHODS: A random sample of 3000 people aged 45-64 years was drawn from the population registers of North Karelia, of the area surrounding Turku and Loimaa in southwestern Finland and of the Helsinki area in southern Finland. Of the 3000 people approached, 79.6% took part in the study. differences in coronary heart disease mortality and morbidity. RESULTS: Factor-VII coagulant activity was significantly higher in North Karelia than in the other areas (P = 0.0008). The fibrinogen level was also higher in North Karelia, although the difference was significant only among non-smokers (P = 0.02). Levels of factor-VII antigen, plasminogen and lipoprotein (a) did not differ between the areas. Within North Karelia, the levels of both factor-VII coagulant activity, and factor-VII antigen were higher in rural areas than in urban areas. Levels of factor-VII coagulant activity, factor-VII antigen and plasminogen were higher in women than in men and increased with age in women but not in men. The fibrinogen level increased with age in both sexes. CONCLUSION: These baseline findings of the Finrisk Haemostasis Study demonstrate that the geographical differences in levels of factor-VII coagulant activity and fibrinogen in Finland are consistent with the population

Age Distribution↗
PubMed2006

Gender differences in health care use among the elderly population in areas of Norway and Finland. A cross-sectional analysis based on the HUNT study and the FINRISK Senior Survey.

BACKGROUND: The aim of the study was to examine gender differences in the self-reported use of health care services by the elderly in rural and metropolitan areas of two Nordic countries with slightly different health care systems: Finland and Norway. METHODS: Population based, cross-sectional surveys conducted in Nord-Tröndelag Norway (1995-97) and in rural and metropolitan areas of Finland (1997) were employed. In the Norwegian data, a total of 7,919 individuals, aged 65-74 years old were included, and the Finnish data included 1,500 individuals. The outcome variables comprised whether participants had visited a general practitioner or a specialist, or had received hospital care or physiotherapy during the past 12 months. Gender differences in the use of health care services were analysed by multiple logistic regression, controlling for health status and socio-demographic characteristics. RESULTS: In Norway, elderly women visited a specialist or were hospitalised less often than men. In Finland, elderly women used all health care services except hospital care more often than men. In Norway, less frequent use of specialist care by women was not associated with self-reported health or chronic diseases. CONCLUSION: The findings revealed differences in self-reported use of secondary care among different genders in areas of Norway and Finland.

Aged↗
PubMed1996

Structure and costs of health care of diabetic patients in Finland.

OBJECTIVE: The aim of the present study was to examine both the structure, including modes of drug treatment, ambulatory care, and hospital inpatient care, and the costs of health care for drug-treated diabetic patients in Finland. RESEARCH DESIGN AND METHODS: The modes of drug treatment and ambulatory care were studied with the help of a questionnaire given to all diabetic patients obtaining their medication through pharmacies in Finland during a 7-week period in 1989. The questionnaire sought information on drug treatment, site of health care, and frequency of visits to physicians. Hospital inpatient care was evaluated by linking the patient data from the Hospital Discharge Register and the Central Drug Register. The direct costs of health care were calculated by using relevant average costs. RESULTS: A total of 30,266 questionnaires were returned, representing > 70% of all drug-treated diabetic patients receiving medication in the period studied. Of the diabetic patients, 63% were treated by oral medication only, 31% by insulin only, and 6% by a combination of insulin and oral agents. Of the patients in whom diabetes was diagnosed at > or = 30 years of age, 75% were treated at health centers, whereas > 60% of those in whom diabetes was diagnosed at < 30 years of age were treated at outpatient clinics. The mean annual frequency of visits was 4.0 for patients receiving insulin treatment and 3.3 for patients receiving treatment with oral medications. The diabetic patients used 1.5 million hospital inpatient days per year, which was 13% of the total inpatient days in Finland. Of the inpatient days, 20% were for diabetes as the principal cause, 52% for diabetes-related diseases, and 28% for causes unrelated to diabetes. The direct costs of the health care of drug-treated diabetic patients in 1989 were 5.8% of the total costs of health care in Finland and were three times higher than the average costs of care for nondiabetic individuals. The direct costs were divided into inpatient care (81%), medication (9%), ambulatory care (8%), and self-care equipment (2%). CONCLUSIONS: Hospital inpatient care is the major contributor to the excess of health care expenditures for diabetic patients.

Ambulatory Care↗
PubMedDate not supplied

The epidemiology of insulin-dependent diabetes mellitus (IDDM) in Finland and in northern Europe.

The incidence and prevalence of IDDM are high by international standards in all Nordic countries, and Finland has the highest incidence and prevalence figures of the disease in the world. During the period 1970-1980, the mean annual incidence (per 100,000) in 0-14-yr-old children was 28.6 in Finland, 22.7 in Sweden, 17.6 in Norway, and 14.0 in Denmark. The corresponding prevalence figures were: Finland 191, Sweden 148, Iceland 141, Norway 120, and Denmark 83. Thus, on a countrywide basis the incidence increased from south to north (and from west to east). However, within some of the Nordic countries (Finland, Norway, and Sweden) there were regional variations not compatible with the above "latitude rule." As in many studies from other countries, the following characteristics were observed in the IDDM epidemiology in children and adolescents: a steady rise of incidence throughout childhood until puberty, the peak occurring earlier in girls than in boys, a male excess in young children and adolescents, a seasonal variation, and a secular trend. The possible causes of the high incidence and prevalence are briefly discussed.

Adolescent↗
PubMed1997

Primary gastrointestinal non-Hodgkin's lymphoma. A population based study in central Finland in 1975-1993.

Gastrointestinal lymphomas have been uncommon, but the frequency of their predisposing conditions is increasing. The objective of the present study is to determine the frequency of gastrointestinal lymphomas in the area of central Finland as well as the influence of clinical features and therapeutical approaches on the survival of these patients. All samples of gastrointestinal non-Hodgkin's lymphomas diagnosed of patients living in the province of central Finland in 1975-1993 were re-examined. In central Finland the mean annual frequency of new gastrointestinal lymphomas was 10/1000000 in 1975-1984 and 16.0/1000000 in 1985-1993. The total incidence of gastrointestinal lymphomas in Finland adjusted for age to the world standard population was 12.5/1000000 in 1992. Two patients with peripheric T-cell lymphoma had a coeliac disease. Other predisposing conditions were not found. The stage of distribution of the lymphoma (p < 0.01) and radicality of the surgery (p < 0.01) were the most influencing factors on the survival of these patients. In conclusion the early distinction of gastrointestinal lymphomas is vital because of an increasing frequency of predisposing factors and a better prognosis due to new combination therapies.

Adolescent↗
PubMed2004

Spirometry values in adults in northern Finland.

OBJECTIVES: If reference values do not accurately reflect the distribution of lung function in the population, the interpretation of spirometry results may be incorrect. Differences in lung function exist between populations, which supports the use of local reference values. In Finland, the national reference values for spirometry are currently in use. The aim of this study was to assess the correlation between measured spirometric values from healthy adults and the reference values used in Finland. METHODS: In the present population-based study, spirometry results were assessed in healthy adults aged 21 to 70 years in northern Finland. After exclusions for any chronic pulmonary disease or symptom, 206 men and 215 women remained in the group. We calculated regression equations for spirometric reference values in adults and compared these with European recommendations, and with the reference values currently used in Finland. RESULTS: These comparisons revealed large differences. The linear models do not take into account the physiological changes in both young and old adults and, thus, the reference values calculated according to the European recommendations differed from the real measured results at both ends of the 20- to 70-year age scale. Moreover, values from the logarithmic Finnish reference equations also diverged from our measurements; the differences were largest in subjects younger than 30, and in elderly men. CONCLUSION: Differences between populations and reference equations make international comparisons difficult, and divergence between reference values and real results may lead to incorrect clinical interpretation.

Adult↗
PubMed2001

Epidemiologic estimate of the proportion of fatalities related to occupational factors in Finland.

OBJECTIVES: This study attempts to estimate the proportion of annual deaths related to occupational factors in Finland and considers related methodological issues and associated uncertainties. METHODS: Statistics on causes of death, numbers of subjects exposed, and risk ratios obtained from the epidemiologic literature were used to estimate the population attributable fraction and disease burden for causes of death from work-related diseases. Gender-, age- and disease-specific numbers of deaths were provided by Statistics Finland for 1996. Information on the size of the population, broken down by gender, age, occupation, and industry, was acquired from population censuses. A Finnish job-exposure matrix supplied data on the prevalence of exposure for specific agents and the level of exposure among exposed workers. RESULTS: The attributable fraction of work-related mortality in the relevant disease and age categories was estimated to be 7% (10% for men and 2% for women), and for all diseases and ages the fraction was 4%. For the main cause-of-death categories, the attributable fraction became 12% for circulatory system diseases, 8% for malignant neoplasms, 4% for respiratory system diseases, 4% for mental disorders, 3% for nervous system diseases, and 3% for accidents and violence. The following estimates were obtained for specific important diseases: 24% for lung cancer, 17% for ischemic heart disease, 12% for chronic obstructive pulmonary disease, and 11% for stroke. Based on these fractions, the total number of work-related deaths that occurred in Finland in 1996 was calculated to be on the order of 1800 (employed work force of 2.1 million); 86% involved men. CONCLUSIONS: High-quality epidemiologic studies and national survey data are essential for obtaining reliable estimates of the proportion of deaths attributable to occupational factors. The magnitude of work-related mortality is an insufficiently recognized contributor to total mortality in Finland, especially from circulatory diseases and other diseases caused by exposure to agents other than asbestos.

Adult↗
PubMed2005

European brown hare syndrome in free-living mountain hares (Lepus timidus) and European brown hares (Lepus europaeus) in Finland 1990-2002.

We investigated the epidemiology of the European brown hare syndrome (EBHS) in Finland among free-living mountain hares (Lepus timidus) and European brown hares (Lepus europaeus). Carcasses of 297 European brown hares and 843 mountain hares submitted for postmortem examination were analyzed between 1990 and 2002. One hundred thirty-six cases of EBHS were detected during the examination, 20 cases in European brown hares and 116 in mountain hares. Liver samples from 56 histopathologically positive and 135 negative cases were analyzed by reverse transcription polymerase chain reaction (RT-PCR). The results of RT-PCR correlated well with histopathology. Cases of EBHS appeared only sporadically in a restricted area in eastern Finland during 1990-97. In 1998, the number of cases increased, and the disease spread to the north. In 1998-99, EBHS was the most common disease of mountain hares in necropsy material from northern and eastern Finland. Special features were the occurrence of the disease in areas in which European brown hares are rare and the seasonal distribution of cases, most of which appeared in spring or summer. This is the first report of an outbreak of EBHS occurring mainly among free-living mountain hares from Finland.

Animals↗
PubMed2001

Male suicide mortality in eastern Finland--urban-rural changes during a 10-year period between 1988 and 1997.

AIMS: To investigate urban-rural differences in male suicide mortality between 1988 and 1997 in the province of Kuopio in eastern Finland. METHODS: Male suicide mortality between 1988 and 1997 was studied in eastern Finland. The data were collected from official autopsy reports. Age, marital status, household type, place of death, method of suicide and the region within the county were analysed. RESULTS: The age-adjusted male suicide mortality remained quite constant at 67 and 65/100,000 (> 15 years of age) in 1988 and 1997, respectively. In urban areas, a decline in suicide rates was noted in all age groups of men, whereas in rural areas, after an initial decline, a marked increase took place during the last years of the study period, especially among middle-aged and elderly men. This coincided with the time of recovery from an economic recession in Finland that particularly affected rural areas. CONCLUSION: Male suicide mortality may be regionally diverging in Finland.

Adolescent↗
PubMed1975

Mosquito-borne viruses in Finland.

Inkoo virus, the Finnish representative of the California group, was isolated from a pool of Aedes communis/punctor. It is distinguishable from Tahyna, California encephalitis, Trivittatus and Melao viruses, but seems to be antigenically related to the Jamestown Canyon virus. The prevalence of Inkoo antibodies increases towards the north in both human beings (16% to 69%) and cows (37% to 88%). Inkoo antibodies are common also in other mammals of large size (reindeer, moose, foxes), less frequent in snow hares, rare in hazel grouse and not detected in other birds and small mammals. Some show hare serum samples react with Inkoo virus only in the hemmaglutination inhibition test suggesting the existence of another California group virus in Finland. In addition, antibodies against some other mosquito-borne viruses have been found in Finland. A Batai virus epizootic among cows may have occured in the early 1960's in southern coastal Finland, and some serological data point to the existence of alphaviruses in Finland. The overwintering mechanism of the Finnish mosquito-borne viruses is still unsolved.

Aedes↗
PubMed1955

TUBERCULOSIS mortality in Finland.

The present report, analysing the official statistics on tuberculosis mortality in Finland during the past 75 years, was undertaken to provide a background for studying the course of tuberculosis after the nation-wide BCG vaccination campaign of 1948-49.TUBERCULOSIS MORTALITY IN FINLAND HAS BEEN HIGH COMPARED WITH OTHER EUROPEAN COUNTRIES: before the end of the first World War the death-rate from respiratory tuberculosis fluctuated between 250 and 300 per 100,000; by 1953 it had dropped to 56 for males and 27 for females.Age-specific death-rates for respiratory tuberculosis usually showed peaks for infancy, young adulthood, and old age. For many years the highest mortality-rates for females were in young adulthood, and a high proportion of all deaths from respiratory tuberculosis, in both males and females, was in the age-group 15-40 years. Tuberculosis proportionate mortality was also high in this age-group: 30%-50% for males and 40%-60% for females. In recent years the pattern has changed, the "weight" in the age distribution of the number of deaths has shifted towards higher ages.The death-rates for non-respiratory tuberculosis, with tuberculous meningitis the most important, are several times higher in infancy than the rates for respiratory tuberculosis. Non-respiratory tuberculosis is of little importance in adults.The cohort curves for respiratory tuberculosis differ in two important ways from the classic curves for Massachusetts. The peaks of the Finnish curves in adult ages shift to lower ages with each succeeding cohort, and the curves often cross each other.Tuberculosis mortality in Finland, as in almost every other country, has decreased very rapidly since the second World War, particularly in the younger age-groups. However, as a similar pattern is found in countries where BCG has not been used, there seems to be little compelling evidence to support a belief that the nation-wide BCG programme caused much, if any, of the recent precipitous drop in mortality-rates. Other factors having a strong influence on tuberculosis mortality have undoubtedly been operating in Finland as almost everywhere.

Adult↗
PubMed2003

Evaluation of the current status of operating and closed landfills in Russia, Finland and Ireland with regard to water pollution and methane emission.

The annual production of municipal solid wastes (MSW) in Russia, Finland and Ireland in the late 1990s accounts for 37.5, 2.5 and 2.05 min. tonnes or 252, 488 and 566 kg per capita, respectively. 96.5, 64 and 91% of these wastes (for Russia, Finland and Ireland, correspondingly) are currently disposed of via landfilling. However, nowadays, MSW management in these countries is undergoing drastic changes (source separation, closure of old landfills, reduction of the number of landfills etc.) forced by recent legislation set by the European Union and Russian authorities. This paper evaluates the current status of MSW landfills, as well as information on current leachate and methane emissions in the three above mentioned countries. Landfill leachates are highly variable in each country and between different countries due to different rainfall and climatic conditions and also due to poor landfill top insulation/cover. Leachates in poorly structured landfills are very dilute, whereas leachates with total COD and nitrogen contents as high as 33,700 mg COD/l and 4,030 mg N/l, respectively, have been detected from state-of-the-art sites. Currently, on-site treatment of leachates exists at only a few landfills in Russia, Finland and Ireland but this situation will be considerably improved during the next years. The annual methane emissions from landfills are estimated as 500-900 and 77 ktonnes for Russia and Finland, respectively. Recent estimates from Ireland suggest an annual landfill methane emission of c. 2.1 Mt CO2 equivalent. Several systems of methane recovery have been developed in all three countries and these are currently in different stages of implementation.

Environmental Monitoring↗
PubMed1992

Lung cancer and smoking in Finland and the Czech Republic. Recent trends and predictions.

Trends of mortality from lung cancer in 1953-1989, age-specific lung cancer death rates of five-year birth cohorts, and the cigarette consumption were compared in Finland and the Czech Republic. While the lung cancer mortality and the smoking habits were fairly similar in Finland and the Czech Republic in the 1950s and early 1960s, contrasting differences gradually developed over the subsequent three decades in favor of Finland. In the year 1989, the Czech lung cancer death rates were much higher than the Finnish rates: in males 75.8 vs. 48.1 per 100,000; in females 9.3 vs. 6.6 per 100,000 (adjusted to the world standard population). Results obtained by descriptive epidemiologic methods support the opinion that a major part of the positive changes in the lung cancer epidemic in Finland can be explained as a consequence of the comprehensive smoking control program introduced in this country, including a significant decline in tar yield of cigarettes. In view of a long latency period between exposure and the development of disease, a continuing upward trend in lung cancer mortality is to be expected in the Czech Republic, particularly in females, resulting in an increase in the gap between Czech and Finnish lung cancer mortality. To achieve in future a falling trend in lung cancer rates even in the Czech Republic, amendments in the smoking control system according to the recommendations of the World Health Organization and International Union against Cancer are of importance.

Adult↗
PubMed1991

Problems associated with restorative materials--dentists' views in Finland and Sweden.

During the past 10-15 years the possible side-effects of dental restorative materials, especially due to amalgam fillings, have caused a lively debate in Sweden. There is an extensive literature on the chemical and biological properties of dental materials but no investigations have dealt with the providers' attitudes. The purpose of this study was to find out the dentists' experiences of and attitudes to patients who state they have problems related to dental restorative materials and compare the dentists' subjective assessments of those side-effects in two neighboring countries, Finland and Sweden. Information was collected by postal questionnaires addressed to dentists chosen at random in Finland (n = 625) and in Sweden (n = 960). The response rate was 73 per cent and 72 per cent respectively. The results showed that 99 per cent of the respondents had patients questioning the safety of dental materials. The number of such patients was estimated to be three times higher in Sweden (124 patients per dentist in 1989) than in Finland (39 patients per dentist). More than 90 per cent of the questions from the patients regarded amalgam fillings. Statistically significant differences were found between the respondents' opinions of amalgam, 81 per cent of the Finnish contrary to 59 per cent of the Swedish respondents considered the risk of side-effects to be low when using this material. About 90 per cent of the respondents considered glass-ionomer, gold and ceramic restorations safe, but only half of them were convinced of the safety of composite. A great majority of the Swedish respondents (79 per cent) claimed that the patients should get their fillings changed without odontologic indications if they insisted on it and paid for the treatment in comparison to 22 per cent of the Finnish respondents (p less than 0.001). In case dental insurance was to pay for this kind of treatment it was accepted by 6 per cent of the Finns and 25 per cent of the Swedes. The attitude to amalgam was in general less favorable among the dentists in Sweden than in Finland.

Adult↗
PubMed1991

[50 years of health care of war invalids in Finland. A good 20 years of work remains].

During the years 1939-1945 Finland was involved in the Second World War, divided for her part into three different wars: The Winter War, The Continuation War and The Lappish War. Finland was not occupied and she was spared wholesale bombing. The country suffered most of her casualties through the battles at the front, the majority being men born in 1886-1926. Some 700,000 men and women took part in her defence and almost half of them were wounded or killed. Finland was compelled to build up her health and medical services from scratch for the rehabilitation and care of those wounded in War. During the 1980's the geriatric problems of the war cripples have increased and many new patients are now complaining about their war wounds for the first time. The medical care of war cripples in Finland will cover 70 years; thus 20 years work remains.

Finland↗
PubMed1989

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.

Adult↗