| Summary: | Mortality from ischaemic heart disease (IHD) is compared between the Sámi (Lapp) and Finnish areas of northern Finland. During the period 1961-1990 male mortality from IHD was 41% lower in the predominantly Sámi area (Utsjoki) and 37% and 24% lower in two partially Sámi areas (Enontekiö and Inari, respectively) than in the purely Finnish reference area (Kittilä). The corresponding differences for females were 47%, 36% and 19%. Mortality figures diverged over time, the excess mortality increasing in the areas having the greatest percentages of Finns in their population and the deficit increasing in the area where the percentage of Sámi was greatest. The trends observed were paradoxical, since the risk factor pattern in the Sámi district is highly unfavourable, and the Finnicization of the Sámi in recent years should imply a convergence of mortalities rather than a divergence. It is concluded that the epidemic wave of IHD in Finland, which culminated in the early 1970s, showed a time lag in the north, especially in the Finnish and predominantly Finnish areas, while there is no indication that this epidemic ever reached Utsjoki, the core Sámi area. The reasons for the anomalous trends in IHD in the far north of Finland remain unknown, but the local diet may play a role in them. ischaemic heart disease ethnic group regional variation temporal trends Finland
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