PERSPECTIVES ON THE RISE AND FALL OF SWEDISH CARDIAC EPIDEMICS: The cases of Linköping and Norrköping

Morbidity and mortality in cardio-vascular diseases can be described as an ongoing epidemic, although a very protracted one, lasting more than 100 years. Cardiovascular diseases still top mortality rates in the world today, accounting for about 30% of all deaths around the globe. But it is in the industrialized world that cardio-vascular diseases dominate, although differences are great among various regions. Myocardial infarctions are significantly more common in Sweden than in southern Europe, but less common than in Eastern Europe. The overall question concerns the consequences for health in areas on the road to a postindustrial society. Over the years a clearer link has become visible between lifestyle and health. In Sweden infectious diseases diminished as result of rising living standards. At the same time cardiovascular diseases were beginning their upward phase, reaching a peak in the 1960s. Deaths due to cardio-vascular disease bring to light significant discrepancies related to socioeconomic and cultural factors. A comparison of the Swedish twin cities Linköping and Norrköping show considerable differences in death rates in favor of Linköping, amounting to about 30 % fewer in the1920s with a tendency toward rising differences thereafter. A preliminary investigation of diagnoses has shown that links commonly made between health and socio-economic patterns need revision. The differences in cardio-vascular morbidity show another pattern than was expected. It is obvious that the neighborhood environments themselves have significance, and that the inequalities need additional research based on complementary explanatory models.