Community wide health intervention effective

communityFranklin County in Maine, over a 40 year period, has led a community wide intervention leading to a reduction of death rates and attributed to and stroke.

In the 1960s community members including a community group, a nonprofit medical group and local hospital began a proactive health intervention campaign targeting areas such as smoking cessation, hypertension, , diet and cholesterol. As a result the Franklin Cardiovascular Health Program was established in 1974.

A study published in the JAMA journal documented the impact of the community led health intervention. The researchers determined that compared to Maine as a whole, Franklin County had higher smoking cessation rates and higher rates of cholesterol control as well as lower rates and death rates related to and stroke during the decades since the program began. The County has tackled the problem of and stroke in numerous ways, from improving health access and quality to establishing community campaigns about hypertension and heart-healthy .

Prior to inception of the program Franklin County’s related to and stroke was above the state average. After the program was implemented, the declined and remained below the state average for almost the entirety of the time between 1970 and 2010. Franklin County was the only county in Maine to consistently have lower-than-expected mortality rates related to and stroke.

“Wonderful changes can start with one person, or in this case, one small group,” said Pearson, executive vice president of and education at the University of Florida Health and a leading authority on prevention. Pearson has been working with the team in Maine as a consultant for 20 years.

“I proposed this communitywide program should be a model,” Pearson said. “This is something everyone could do. Many of these programs and interventions are well-described. If and stroke has its roots in our society, this community-based approach may be the best way to combat it. There are a variety of ways to do this. Community organizations could take it on.”


Community-Wide Prevention Programs and Health Outcomes in a Rural County, 1970-2010, N. Burgess Record, MD; Daniel K. Onion, MD, MPH; Roderick E. Prior, MD; David C. Dixon, MD; Sandra S. Record, RN; Fenwick L. Fowler, BA; Gerald R. Cayer, BS, MPH; Christopher I. Amos, PhD; Thomas A. Pearson, MD, PhD, MPH, JAMA, doi:10.1001/jama.2014.16969, published 13 January 2015.

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