Nutrition and Health Sciences, Department of


Date of this Version



Published in Consumer Behavior in the Health Marketplace: A Symposium Proceedings, Ian M. Newman, Editor, Nebraska Center for Health Education & University of Nebraska-Lincoln, 1976.


This afternoon I want to tell you about the results of a major study we have been doing as a part of the Stanford Heart Disease Prevention Program. The Stanford Heart Disease Prevention Program is an interdisciplinary project directed by Dr. John W. Farquhar, Professor of Medicine at Stanford University and I am co-director. This paper was really co-authored by fifteen people as part of an interdisciplinary team. With a group of different people like this, we had to spend a significant amount of time trying to teach each other our respective professional languages. Initially, communication within our group was a terrible problem. We have worked through this stage and now we have, among other things, a post doctoral training program in which both young M.D.'s or young Ph.D.'s can become involved in cardiovascular work in its various aspects. This project has a psychlogical component, a pathological component, a biochemical component, a behavioral component and a communications component. This afternoon I want to talk about our major community study.

The gradual rise in age-adjusted cardiovascular disease mortality in industrialized countries has considerably diminished what would otherwise be seen as striking gains in health in the last 75 years. These gains, due primarily to increased and improved practices in modern medicine, have occurred mainly in the prevention of infant and early childhood mortality and in the improvement in crisis intervention techniques after the onset of disease symptoms. Unfortunately, much cardiovascular disease is apparently unresponsive to anything but pre-crisis preventive intervention. The U.S. male who has survived to age 45 now has only a slightly greater life expectancy than did his forebear in 1900. Table I shows comparative rates of coronary heart disease, treating the U.S. rate as base 100. That is not the actual figure but shows, by comparison, for example, that Japan and Greece and Yugoslavia have considerably lower rates and that only Finland is worse off than we are.