The actions in North Karelia included reducing smoking, increased activity, more social connection and more fruits and vegetables including learning how to cook new recipes. Despite initial strong resistance from farmer organisations the Dept of Health eventually managed to get local farmers producing more healthy foods.

Professor Pekka Puska was the Director General of the Finnish Institute for Health and Welfare in Finland (THL) 2009–2013. Recently (2017-2019) he served as a Member of the Parliament of Finland, including the Health and Social Affairs Committee and of the Education Committee of the Parliament.

Professor Puska continues his affiliation with THL. THL is a comprehensive national institute for public health and welfare. It covers a broad range of health and welfare issues from disease prevention, nutrition, lifestyles and environment, infectious disease control and national vaccination programmes to health and social services, health and welfare monitoring and statistics. THL was formed after a merger of the National Public Health Institute (KTL) and the National Research and Development Centre for Welfare and Health (Stakes), in 2009. Before THL Professor Puska was the Director General of KTL (2004-2008).

Professor Puska has, for most of his career, worked at KTL/THL. He was, for 25 years, the Director and Principal Investigator of the North Karelia Project: prevention of cardiovascular diseases in North Karelia and later on in all Finland. Within 25 years, over 80% decline in annual heart disease mortality among the working age population and a dramatic general improvement in public health took place. The project is widely seen as a model for successful population based prevention of cardiovascular and other noncommunicable diseases (NCD).

In 2001-2003 Professor Puska served as the Director for Noncommunicable Disease Prevention and Health Promotion at the World Health Organization Headquarters in Geneva. At WHO, Pekka Puska directed the work on integrated prevention of NCD targeting the main risk factors (tobacco, unhealthy diet and physical inactivity) through health promotion, national programmes, policy measures and regional networks. Professor Puska's Department was the focal point for the WHO Global Strategy on Diet, Physical Activity and Health adoped in 2004. Recently (2015-16) he chaired the Independent Expert Group for he Impact Assessment of the WHO/FCTC.

Professor Puska has, internationally and domestically, served in a number of scientific, expert and public health functions, WHO's work, multinational projects, international conferences etc. He has over 500 scientific publications.

Internationally, Professor Puska is the past President of the International Association of National Public Health Institutes (IANPHI), past President of World Heart Federation and past Chair of the Governing Council of the WHO International Agency for Cancer Research (IARC).

Domestically, Professor Puska has served as the Chancellor of the University of Turku, Chair of the Finnish University Council, Member of Board of Academy of Finland, Chair of the National Nutrition Committee and President of National Union of Finnish Students. He has served twice as Member of the National Parliament of Finland.

Professor Puska has M.D and M.Pol.Sc. degrees and PhD in epidemiology and public health. Among several honours are Honorary Doctorate at St. Andrew's University (Scotland) and Lisbon University, as well as Academician of the Russian Academy of Natural Sciences. He has received, among other things, WHO's annual Health Education Award (1990), WHO Tobacco Free World Award (1999), the Nordic Award for Public Health (2005), the Rank Prize (2008) and the Ancel Keys Award by ACLM (2019).