A clinico-epidemiological study of the patients who developed stroke or myocardial infarction from April 1989 to March 1991 was done in Saku District, Nagano Prefacture. Four hundred fifty cases of stroke were registered during the two years. Annual incidence rate of stroke stood at 205.2 per 100, 000 population . The distribution of stroke types was 66.2% in cerebral infarction, 24.0% in cerebral hemorrhage and 9 .8% in subarachnoid hemorrhage and male/female ratio was 1.2. Two hundred fifty seven cases of stroke in the first year were followed up during one year after the onset. Case-fatality rate within 28 days after onset of stroke was 15.5%. After one year 132 cases (51.4%) did not need help for activities of daily living and 53 cases (20.6%) need it. Seventy cases (27.2%) were fatal. Two cases (0.8%) were unknown. Eighty cases of myocardial infarction were registered during the two years. Annual incidence rate of myocardial infarction stood at 36 . 5 per 10 0.000 population and male/female ratio was 2.5. Thirty eight cases of myocardial infarction in the first year were followed up during one year after onset. The case-fatality rate within 28 days after onset of myocardial infarction was 10.5%. Seven cases (18.4%) were fatal within one year. The incidence rate of stroke was 5.6 times higher than that of myocardial infarction.
To evaluate the actual conditions of accidents occurred among the babies and infants after their birth, questionnaire survey was performed on the seven kinds of accidents, namely, drowning, traffic accident, choking, burn, fall, swallowing a foreign substance and sewing up the wound. During the special health examination for infants in their 1.5 years of age, ?66 questionnaires were filled out by the their mothers living in Gif a city. The results obtained were as follows: 1. There were only half of the infants without experience of any of the seven kinds of accidents. 2. Among seven kinds of accidents, falls were most frequently experienced, and burn accidents were next frequently occurred in the infants. There were no significant differences between boys and girls in the experience rate of each accident. 3. Sex differences were observed in the domestic factors relating to the occurrence of accidents. Namely, in boys, the number of occurred traffic accidents were negatively correlated with the activity of play, and this value for crash from staires were related to the residence in the detached house. On the other hand, in girls, the numbers of occurred choking were correlated with the matter that her mother was a person who mainly took care of infant during the day time. The burn accidents were related to the activity of play and the matter that her mother was not a houswife and a person who mainly took care of her infant during the day time. In addition, the cases of swallowing foreign substances were negatively related to the numbers of the members of her family, and were related to the residence in the detached house. As all of the occurrence of the accidents were not explained by the factors used in this study, it was considered that it is necessary to add other factors in the future study.
The effects of community health education were evaluated, based on the results of health examination aiming at lifestyle change for primary prevention. The subjects were 62 men and 148 women aged 35-68 years living in two communities of a town surrounded by mountains located at the northern part of Gifu Prefecture, Japan. Intensive health education was carried out for the subjects from the two communities for 3 years, and the changes in health status of the subjects were compared with those in the control community. The education program conducted here toward prevention of hypertension, obesity and hepatic dysfunction was adoption of some of the recommended behaviors, e.g., reducing the intake of salt, energy, fat and alcohol, and increasing exercise. Subjects of the intervened community showed some improvements in lifestyle and in the results of health examination compared with the control community. The rate of subjects with vigorous physical activity and vegetable oil intake increased in the intervened community, though the rate of green vegetable intake decreased. The results showed that objective and quantifiable indices were needed to evaluate the behavior change. Mean body weight of subjects in the intervened community showed a 1.0 kg greater reduction than in the control community. Systolic and diastolic blood pressure and γ-GTP rose in the subjects from control community significantly, but the increase was little in the intervened community. The rate of the subjects who needed to consult a physician decreased in the intervened community. The improvements in health status were significantly less in the subjects within normal limits in health examination. It was concluded that motivation is more important to achieve the educational goals than merely increasing the chance of health education to increase their knowledge.