A Swiss neighbourhood index of socioeconomic position: development and association with mortality
- Radoslaw Panczak1,
- Bruna Galobardes2,
- Marieke Voorpostel3,
- Adrian Spoerri1,
- Marcel Zwahlen1,
- Matthias Egger1,2,
- for the Swiss National Cohort and the Swiss Household Panel
- 1Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- 2School of Social and Community Medicine, University of Bristol, Bristol, UK
- 3Swiss Centre of Expertise in the Social Sciences (FORS), Lausanne, Switzerland
- Correspondence to Professor Matthias Egger, Institute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 12, CH-3012 Bern, Switzerland;
Contributors ME developed the original idea for the study. RP designed and implemented the data processing and analysis. MZ supervised the statistical analysis. All the authors contributed to the methodology used in the study. RP and ME wrote the first draft of the paper. All the authors have read and approved the final manuscript and contributed to the writing.
- Accepted 11 April 2012
- Published Online First 20 June 2012
Background Area-based measures of socioeconomic position (SEP) suitable for epidemiological research are lacking in Switzerland. The authors developed the Swiss neighbourhood index of SEP (Swiss-SEP).
Methods Neighbourhoods of 50 households with overlapping boundaries were defined using Census 2000 and road network data. Median rent per square metre, proportion households headed by a person with primary education or less, proportion headed by a person in manual or unskilled occupation and the mean number of persons per room were analysed in principle component analysis. The authors compared the index with independent income data and examined associations with mortality from 2001 to 2008.
Results 1.27 million overlapping neighbourhoods were defined. Education, occupation and housing variables had loadings of 0.578, 0.570 and 0.362, respectively, and median rent had a loading of −0.459. Mean yearly equivalised income of households increased from SFr42 000 to SFr72 000 between deciles of neighbourhoods with lowest and highest SEP. Comparing deciles of neighbourhoods with lowest to highest SEP, the age- and sex-adjusted HR was 1.38 (95% CI 1.36 to 1.41) for all-cause mortality, 1.83 (95% CI 1.71 to 1.95) for lung cancer, 1.48 (95% CI 1.44 to 1.51) for cardiovascular diseases, 2.42 (95% CI 1.94 to 3.01) for traffic accidents, 0.93 (95% CI 0.85 to 1.02) for breast cancer and 0.86 (95% CI 0.78 to 0.95) for suicide.
Conclusions Developed using a novel approach to define neighbourhoods, the Swiss-SEP index was strongly associated with household income and some causes of death. It will be useful for clinical- and population-based studies, where individual-level socioeconomic data are often missing, and to investigate the effects on health of the socioeconomic characteristics of a place.
- Socioeconomic position
- cohort study
- spatial analysis
- social inequalities
- CHD/coronary heart
- social epidemiology
- record linkage
Funding This work was supported by the Swiss National Science Foundation (SNSF), grant number 3347C0-108806 and ProDoc research module 123158. The Swiss Household Panel is also supported by the SNSF.
Competing interests None.
Ethics approval Ethics approval was provided by Cantonal Ethics Committee Bern.
Provenance and peer review Not commissioned; externally peer reviewed.