The name is absent

Van Gool & Bridges

I INTRODUCTION

The incidence of coronary heart disease (CHD) mortality is declining. In 1983, the
Australian CHD mortality rate for people aged 25-75 was 221.05 per 100,000
population. In 1994 this figure had come down to 123.6 per 100,000-population aged
25-75. Despite these improvements, CHD is still the biggest cause of death in the
industrialised world (Ort-Gomer, 1996). The decline in CHD is not consistent
throughout the community. For example, in the South Western Sydney Area Health
Service (SWSAHS) the mortality rate for CHD is 137.9 per 100,000-population aged
25-75. This phenomenon can be explained by a significant negative correlation between
ischaemic heart diseases, socio-economic status and level of education (Taylor et al,
1992).

CHD is a preventable disease. The risk factors for CHD can be reduced through
modified behaviour. Risk factors such as high blood pressure, high blood cholesterol, a
sedentary lifestyle and smoking are thought to be the most common causes of CHD.
There is strong evidence that these risk factors can be altered through behavioural
change (Nutbeam, et al. 1993).

It has been estimated that 53,698 life years are lost every year due to heart attack. Of
those, about 21,500 life years (around 40%) could be reclaimed through dietary changes
(Page et al, 1990, Crowley et al, 1992).

Evidence on effectiveness of nutritional interventions is varied. A large number of
studies have shown significant reductions in the incidence of CHD as a result of a
particular intervention, while others have not shown such a result. The implication of
this is that investing in nutritional interventions carries some risks. The main risk for
the SWSAHS community and Health Promotion team would be that the investment
does not maximise the desired outcomes (that is, reduce the prevalence of CHD in the
COmmxmity).

An economic evaluation of nutrition interventions is thus an important source of
information for the allocation of resources. This paper will examine the costs-

Chere Project Report 11- November 1999

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