Assessment of Mortality and Smoking Rates Before and After Reduction in Community-wide Prevention Programs in Rural Maine.

Importance: It is unclear whether effective population-wide interventions that reduce risk factors and improve health result in sustained benefits to a community's health. If benefits do persist after a program is ended, interventions could be brief rather than maintained long term.

Objective: To measure mortality and smoking rates in a rural community over decades before, during, and after prevention program reductions.

Community-wide cardiovascular disease prevention programs and health outcomes in a rural county, 1970-2010.

Importance: Few comprehensive cardiovascular risk reduction programs, particularly those in rural, low-income communities, have sustained community-wide interventions for more than 10 years and demonstrated the effect of risk factor improvements on reductions in morbidity and mortality.

Objective: To document health outcomes associated with an integrated, comprehensive cardiovascular risk reduction program in Franklin County, Maine, a low-income rural community.

Design, Setting, And Participants: Forty-year observational study involving residents of Franklin County, Maine, a rural, low-income population of 22,444 in 1970, that used the preceding decade as a baseline and compared Franklin County with other Maine counties and state averages.

How much effort is needed to keep up with the literature relevant for primary care?

Objectives: Medicine must keep current with the research literature, and keeping current requires continuously updating the clinical knowledge base (i.e., references that provide answers to clinical questions).