Mortality from stroke among women in a Swedish community, Strömstad. Evaluation of data obtained from official death certificate registers broken down to the community level.

The present paper is an example of an active way of delivering primary health care. Data obtained from the Bureau of Central Statistics on mortality, based on death certificates during the years 1969-1978, were broken down to community level within the County of Göteborg and Bohus. A significantly increased total mortality was observed among women in the community of Strömstad in the northern part of the county, as well as an increased mortality from cardiovascular diseases, especially cerebrovascular diseases. Similar observations were made for the neighbouring communities. In order to evaluate the diagnoses stated in the death certificates, records from patients who died of cerebrovascular disease during the years 1970-1979 were studied. Out of 146 women in whom cerebrovascular disease was stated as main cause of death, it was possible to draw conclusions about diagnosis of death in 140. The vast majority of the subjects had correctly been given the diagnosis of cerebrovascular disease. Based on this "community diagnosis", a special preventive program has been started in the community of Strömstad.