Swiss study reveals mortality ‘röstigraben’

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Swiss study reveals mortality ‘röstigraben’
Photo: Leonid Mamchenkov

People in French and Italian-speaking Switzerland are more likely to die from alcohol-related liver diseases than their countrymen in German-speaking cantons, according to a new study.


The Swiss Mortality Atlas, led by Frédérique Chammartin for the Swiss Tropical and Public Health Institute (Swiss TPH) in Basel, examined data from around 60,000 death certificates between 2008 and 2012.

Researchers analyzed the geographical distribution of the major causes of death in Switzerland, including cancers, cardiovascular diseases and Alzheimer’s, showing some stark divides.

The majority of deaths from liver disease, lung cancer, flu and Alzheimer’s occurred in French and Italian-speaking Switzerland, while more people in German-speaking cantons died from cardiovascular diseases – Switzerland’s leading cause of death – and diabetes.

This ‘Röstigraben’ divide when it comes to liver disease is no surprise to experts, reported Sunday paper Sonntags Zeitung.

“The difference is clearly due to higher alcohol consumption in Western Switzerland,” Gerhard Gmel, a researcher at Lausanne hospital CHUV, told the paper.

“We know that alcohol is responsible for nearly all liver damage,” he added.

Figures from Addiction Monitoring in Switzerland for 2014 – the latest available – show that people in the Italian-speaking canton of Ticino are the heaviest drinkers in the country, with 20.8 percent of the population there drinking every day.

In French-speaking Switzerland 14.7 percent admit to drinking daily, while in German-speaking cantons only 8.2 percent quaff alcohol on a daily basis.

The Swiss Mortality Atlas also pointed to the link between lung cancer and smoking, both of which were more prevalent in French-speaking areas.

“The most important risk factor for lung cancer is tobacco consumption,” said the report, quoting another study that shows “a significantly higher prevalence in smoking in the French-speaking part of Switzerland than in the German-speaking part, especially among women.”

The research has annoyed some.

Jean-Felix Savary, general secretary of addiction study group GREA, based in Lausanne, told daily Le Matin that this type of study only serves to stigmatize.

“What does it seek to show? That we have risky behaviour that increases the cost of healthcare?” he said.

“The non-problematic consumption of alcohol is actually larger in French-speaking Switzerland, particularly for cultural reasons,” he added.

“By contrast, regional differences are less obvious when it comes to heavy drinkers.”

According to the report authors, a mortality atlas is important “because it provides insight for underlying risk factors that can be environmental, sociocultural or health systems related.”

“From a public health perspective, it enables areas (e.g. municipalities) to be identified where interventions, preventive measures and modifying behaviour might be warranted, and hence will assist in health resource allocation.”

Life expectancy in Switzerland remains among the highest in the world at 80.4 years for men and 85.4 years for women, according to the World Health Organization.


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