title: Attempt to eliminate health inequalities in Poland arising at the time of political and economic transformation: Polish 400 Cities Project.
abstract: OBJECTIVE
  Epidemiological data show that citizens of small towns and villages have presented worse trends in cardiovascular mortality during the political, social and economic transformation in Poland during past 15 years than citizens of large towns. To try to eliminate these inequalities the Polish 400 Cities Project (P400CP), a large educational and interventional project, was prepared. The project consists of two arms: medical and social interventions.
  
  
  METHODS
  The main aim of the medical screening intervention in P400CP is to increase detection and control of cardiovascular risk factors in inhabitants of 418 small cities (<8000 inhabitants) and surrounding villages, particularly in men and people of lower education. In 2003 and 2004 the P400CP covered 123 cities. All together, 36 696 subjects aged between 18 and 98 years were examined. In all participants, blood pressure (BP), anthropometric measurements, laboratory tests and questionnaire interviews were performed. The social arm of P400CP is one of multi-level educational intervention. Modern techniques of social psychology and marketing were involved to increase participation in interventions.
  
  
  RESULTS
  Only 12.5% of all subjects had normal BP, cholesterol (<190 mg/dl) and glucose (<100 mg/dl in whole capillary blood) levels. During the first screening visit 65.5% of all examined subjects had BP>/=140 mmHg or >/=90 mmHg. The fasting glucose level was increased in 19% of women and 26% of men. Almost two-third of all subjects had a total cholesterol level above the norm.
  
  
  CONCLUSIONS
  The prevalence of cardiovascular risk factors in participants of the screening programme P400CP in small towns in Poland was very high. High prevalence and low control of risk factors in participants of the P400CP confirm the decision to target this programme at citizens of small towns and villages.
authors.affiliation: Medical University of Gdansk, Jagellonian University, Cracow, Poland. tzdroj@amg.gda.pl
authors.forename: Tomasz
authors.initials: T
authors.lastname: Zdrojewski
authors.forename: Bogdan
authors.initials: B
authors.lastname: Wyrzykowski
authors.forename: Lukasz
authors.initials: L
authors.lastname: Wierucki
authors.forename: Tomasz
authors.initials: T
authors.lastname: Grodzicki
authors.forename: Andrzej
authors.initials: A
authors.lastname: Januszewicz
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Narkiewicz
authors.forename: Marzena
authors.initials: M
authors.lastname: Zarzeczna-Baran
authors.forename: Jerzy
authors.initials: J
authors.lastname: Gluszek
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
authors.forename: Witold
authors.initials: W
authors.lastname: Zatonski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Tykarski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Drygas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D002947:Cities; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D011044:Poland / Q000453:epidemiology; D011057:Politics; D015995:Prevalence; D012307:Risk Factors; D014504:Urban Health / Q000706:statistics & numerical data*