Becoming the North Karelia Project: The Shaping of an Iconic Community Health Intervention in Finland (1970–1977)

Abstract

Summary The article describes the shaping of an iconic public health intervention, the North Karelia Project (NKP) in Finland in the 1970s. NKP is widely hailed as a landmark project, contributing significantly to the development of the community approach to chronic disease prevention. This approach targets comprehensively a specified health problem in a circumscribed area among the whole population, not only high-risk individuals. Based on published and archival material as well as interviews with a few key actors, the article shows how two interlinked tensions shaped the project: the first between rigorous scientific inquiry and politically motivated practical healthcare development in a disadvantaged area and the second between a broad community approach and a focus on individualised health behaviour. These tensions played out in the planning, funding and administrative structure of NKP, were the key source of criticism of it and have affected the possibilities to evaluate its results.