Community Education for Cardiovascular Disease Prevention: Morbidity and Mortality Results from the Minnesota Heart Health Program
Abstract
The Minnesota Heart Health Program was a community trial of cardiovascular disease prevention methods that was conducted from 1980 to 1990 in three Upper Midwestern communities with three matched comparison communities. A 5- to 6-year intervention program used community-wide and individual health education in an attempt to decrease population risk. A major hypothesis was that the incidence of validated fatal and nonfatal coronary heart disease and stroke in 30- to 74-year-old men and women would decline differentially in the education communities after the health promotion program was introduced. This hypothesis was investigated using mixed-model regression. The intervention effect was modeled as a series of annual departures from a linear secular trend after a 2-year lag from the start of the intervention program. In the education communities, 2,394 cases of coronary heart disease and 818 cases of stroke occurred, with 2,526 and 739 cases, respectively, being seen in the comparison communities. The overall decline in coronary heart disease incidence was 1.8 percent per year in men (p = 0.03) and 3.6 percent per year in women (p = 0.007). For stroke, there were no significant secular trends. The authors recently published findings showing minimal effects of sustained intervention on risk factor levels. In the current report, there was no evidence of a significant intervention effect on morbidity or mortality, either for coronary heart disease or for stroke.
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Similar media and education strategies in the Minnesota Heart Health Program and the Pawtucket Heart Health Program did not lead to significant improvements in cardiovascular risk factors or events when compared with control communities.
“In contrast, similar media and education strategies in the Minnesota Heart Health Program and the Pawtucket Heart Health Program did not lead to significant improvements in cardiovascular risk factors or events when compared with control communities.61–63”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [61]
In the Minnesota and Pawtucket studies, secular improvements in risk factors were also seen in the control communities, perhaps in response to similar national campaigns targeting these risk factors; these trends may have limited detection of any added effects of the community-level interventions.
“In the latter studies, secular improvements in risk factors were also seen in the control communities, perhaps in response to similar national campaigns targeting these risk factors; these trends may have limited detection of any added effects of the community-level interventions.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [61]
Intensive community-level media and education interventions that targeted physical activity as part of a comprehensive set of health factors and behaviors produced mixed results, with benefits on risk factors in 1 study but no clear benefits in the other 2 studies compared with secular trends.
“These interventions produced mixed results, with benefits on risk factors seen in 1 study49 but without clear benefits in the other 2 studies, as compared with secular trends.61,62”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [61]
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“They have been used in several previous GRTs, including the Minnesota Heart Health Program [22], the Rapid Early Action for Coronary Treatment trial [23,24], and the Communities Mobilizing for Change in Alcohol study [25].”
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“Studies from the USA (Stanford Five Project and Minnesota Heart Health Program) failed to show any differences in trends for CVD morbidity and mortality between the intervention and control group [29, 30].”
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“Third, another limitation was information disclosure in the communitybased intervention (Luepker et al. 1996; Korhonen et al. 1998; Tudor-Smith et al. 1998; Lingfors et al. 2003).”
BackgroundEvaluation of “Live for Life”, a health promotion programme in the County of Skaraborg, Sweden
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“Heart and Stroke Foundation of Canada: The Growing Burden of Heart Disease and Stroke in Canada. http://www.cvdinfobase.ca/cvdbook/ CVD_En03.pdf; last date of access: 2013 Mar 26.”
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“In the Stanford Five City Project [7] [8] and the Minnesota Heart Health Program [9] , this intervention approach has been moderately successful in changing the prevalence and level of risk factors and of cardiovascular disease-related mortality in communities.”
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APPLIED STUDY OF AFFINITIES FOR PERSONAL ATTRIBUTES USING AN EPIDEMIOLOGICAL MODEL
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“30 years, the Minnesota Heart Health Program has provided such leadership.(24,25) In 2015, in collaboration with the State”
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Community Stroke Prevention Programs
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“In particular, one can mention the works performed by Fortmann et al (116) who studied the impact of a multidomain education programme on cardiovascular disease morbidity and mortality in the Stanford Five-City project, and those undergone by Luepker RV et al (117) within the Minnesota Heart Health Program.”
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ResultThe Relationship between Monetary Incentives, Social Status, and Physical Activity
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- Authors
- Luepker, R. V., Rastam, L., Hannan, P. J., Murray, D. M., Gray, C., Baker, W. L., Crow, R., Jacobs, D. R., Pirie, P. L., Mascioli, S. R., Mittelmark, M. B., & Blackburn, H.
- Affiliations
- University of Minnesota (US)
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 1996-08-15
- Volume
- 144
- Issue
- 4
- Pages
- 351-362
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2071078087
- Cited by
- 105
- References
- 41
- Citations by year
- 2025: 3 · 2024: 1 · 2022: 3 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 2 · 2015: 3 · 2013: 5 · 2012: 3
- FWCI
- 5.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Vetenskapsrådet
- National Institutes of Health (5r01hl025523-13)
- National Heart, Lung, and Blood Institute (R01-HL 25523)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- cardiovascular disease prevention, community health education, coronary heart disease incidence, stroke incidence, health promotion interventions, secular trends, intervention effects, risk factor reduction, community-based trial
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Community Health Services, Female, Health Education, Humans, Male, Middle Aged, Minnesota, Population Surveillance, Risk Factors, Rural Health, Urban Health, Incidence, Linear Models
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