The study Social Change and the Fragile Heart is an analysis of contemporary history in two neighboring Swedish cities, Linköping and Norrköping. The analysis has been made from a special perspective: the changes in deaths due to heart disease in the age group 50-74 years.

The differences in mortality between the two cities is a measurable way to study how well a society functions and is governed. These cities in the county of Östergötland differ historically and socially. This has led to clear differences in socio-economic conditions and even variations in health and mortality that have been to Norrköping’s disadvantage.

There is an exception, the 1970’s, when the rise in the numbers of deaths due to heart disease was broken in Norrköping, while the figures continued to increase in the neighboring city, especially among men. Uneasiness about the future and opportunities to make a living grew. This may have influenced health negatively, especially among middle-aged men who feared their jobs were threatened. In Norrköping the textile industry had definitely died in the beginning of the 1970’s. The closing of this industry meant at the same time that poor working conditions and low-paid work were phased out. The earlier rising trend in deaths due to heart diseases was broken, and instead a noticeable decline occurred that was especially clear among women.

Deaths due to heart disease in ages 50–74 began to decline generally in the 1980’s and sank significantly in the following decade. The difference between the cities, however, grew from the relatively equal situation of the 1970’s. These are the years during which economic and political power shifted from Norrköping to Linköping. As the regional center and a relatively new university town, Linköping survived the recession of the 1990’s rather well. Simultaneously, Norrköping suffered from what might be called a “social exhaustion depression.” During the last decade of the 20th century long-term unemployment and illness affected far more people than in Linköping. The great transformation from an industrial to a post-industrial society left its mark on Norrköping in the form of increased differences between the cities in the case of premature deaths due to heart disease.