One of the world’s largest gaps in health and standard of living is between North Karelia and the Republic of Karelia. Chronic illnesses of the working population in Finland have signifi cantly decreased during the last decades. On the other hand, chronic national illnesses and related mortality in the Republic of Karelia have continued to grow. Th e objective of the project was to develop cooperation with neighbouring areas in health issues and health know-how in the border region. In order for the service systems on both sides of the border to be able to prepare for both acute and longer-term new health risks, which could be caused by increased cross-border commuting, tourism and other interaction, it was considered important to get up-to-date information and to develop health indicators based on knowledge.