title: What does your neighbourhood say about you? A study of life expectancy in 1.3 million Swiss neighbourhoods.
abstract: BACKGROUND
  Switzerland had the highest life expectancy at 82.8 years among the Organisation for Economic Co-operation and Development (OECD) countries in 2011. Geographical variation of life expectancy and its relation to the socioeconomic position of neighbourhoods are, however, not well understood.
  
  
  METHODS
  We analysed the Swiss National Cohort, which linked the 2000 census with mortality records 2000-2008 to estimate life expectancy across neighbourhoods. A neighbourhood index of socioeconomic position (SEP) based on the median rent, education and occupation of household heads and crowding was calculated for 1.3 million overlapping neighbourhoods of 50 households. We used skew-normal regression models, including the index and additionally marital status, education, nationality, religion and occupation to calculate crude and adjusted estimates of life expectancy at age 30 years.
  
  
  RESULTS
  Based on over 4.5 million individuals and over 400,000 deaths, estimates of life expectancy at age 30 in neighbourhoods ranged from 46.9 to 54.2 years in men and from 53.5 to 57.2 years in women. The correlation between life expectancy and neighbourhood SEP was strong (r=0.95 in men and r=0.94 women, both p values <0.0001). In a comparison of the lowest with the highest percentile of neighbourhood SEP, the crude difference in life expectancy from skew-normal regression was 4.5 years in men and 2.5 years in women. The corresponding adjusted differences were 2.8 and 1.9 years, respectively (all p values <0.0001).
  
  
  CONCLUSIONS
  Although life expectancy is high in Switzerland, there is substantial geographical variation and life expectancy is strongly associated with the social standing of neighbourhoods.
authors.affiliation: Department of Geriatrics, Bern University Hospital and Spital Netz Bern Ziegler and University of Bern, Bern, Switzerland Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
authors.forename: André
authors.initials: A
authors.lastname: Moser
authors.affiliation: Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
authors.forename: Radoslaw
authors.initials: R
authors.lastname: Panczak
authors.affiliation: Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
authors.forename: Marcel
authors.initials: M
authors.lastname: Zwahlen
authors.affiliation: Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
authors.forename: Kerri M
authors.initials: KM
authors.lastname: Clough-Gorr
authors.affiliation: Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
authors.forename: Adrian
authors.initials: A
authors.lastname: Spoerri
authors.affiliation: Department of Geriatrics, Bern University Hospital and Spital Netz Bern Ziegler and University of Bern, Bern, Switzerland.
authors.forename: Andreas E
authors.initials: AE
authors.lastname: Stuck
authors.affiliation: Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Matthias
authors.initials: M
authors.lastname: Egger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019352:Censuses; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D013557:Switzerland
keywords: Cohort studies; EPIDEMIOLOGY; SOCIAL EPIDEMIOLOGY; SOCIO-ECONOMIC