In response to new Swedish health legislation, which gives local county councils formal 'epidemiological' responsibility for the health of the whole population, the regional mortality pattern is presented here for the period 1969-78. The findings show that total mortality has decreased somewhat during the ten-year period, while at the same time the difference in life expectancy between men and women has increased to six years. The concept 'lost years before 65' is used as a measure of premature death. Suicide is the cause of death that has resulted in the greatest number of lost years among men as well as women. During the 1970's positive changes have come about for leukaemias, cervical cancers and motor vehicle accidents, changes that can be interpreted as being due to better treatment, increased screening and efficient prevention. On the other hand, failures are obvious when considering, for example, a twofold increase in premature alcohol-related mortality over the decade. The report also discusses the quality of mortality statistics as a basis for health planning.