Koke e-rang village is a small,rural community in Clay province located in North-Eastern region,Thailand. It had decreased in population from 1,082 in 1990 to 980 by 2004.The outmigration was composed primarily of young male adults,which increased the mean age of the community from 28 to 35.Adults from 18 to 60 years of age had completed primary school. The birth rate has been gradually decreasing,but it is greater than the country rate. Major causes of death are comparable to those of the country but the order differs with the cancer,CVD,accident,and infant death rate being higher than that of the country. In addition,deaths were reported from measles and diphtheria in children from 2 to 12 years of age. The population over 60 years of age has increased from 10 to 20%.