Cohort Profile: the Cooperative Health Research in South Tyrol study

Why was the cohort set up?Italy's autonomous South Tyrol province is uniquely adapted to longitudinal population studies of health and healthy aging with its alpine setting, self-governance, and control of most tax revenue, factors associated with improved health outcomes [1, 2], particularly in Europe.Italy is ranked 8th worldwide for life expectancy and 10th for healthy life expectancy at birth [3].Among its regions, South Tyrol has the highest life expectancy at birth (83.7 years, 81.5 for males, 86.0 for females), and the autonomous province of Bolzano-South Tyrol has the highest healthy life expectancy at birth (69.3 years for males, 69.4 for females) [3].South Tyrol has the second lowest probability of death from cancer, diabetes, and cardiovascular and respiratory diseases between the ages of 30 and 69 (7.2%) [4].The South Tyrolean Val Venosta/Vinschgau administrative district (Vinschgau) has 13 municipalities with collaborative administration and a single reference hospital serving 36 000 inhabitants [5], a stable population with relatively homogeneous environment and lifestyles.This facilitates assessment of genetic health determinants [6], which, together with molecular and behavioral predictors, serve as ideal targets for studies of precision prevention, early detection, and treatment.Direct engagement with the local community strengthens participation in recall studies and fosters a proactive attitude to monitoring and promoting health. Key Features The Cooperative Health Research in South Tyrol (CHRIS) cohort was established to study genetic and lifestyle determinants of health and healthy aging in a single administrative district of the alpine Bolzano-South Tyrol province of Italy with a stable population, cooperative administration, shared single reference hospital, relatively homogenous customs and environment, and high healthy life expectancy. A baseline visit at the district reference hospital was completed by 13 393 adults aged 18 years (median 46, range 18-94, 54% female) in 2011-2018, providing socio-demographic, health, lifestyle, and exposure data from self-report questionnaires, interviews, and instrumental examinations, plus urine and blood samples for biobanking, DNA extraction, and molecular characterization (chip genotyping, exome sequencing, metabolomics, proteomics). To date, 4500 baseline participants have completed a visit as part of ongoing follow-up, providing most of the same data and samples as at baseline; additional data collection from wearable activity trackers and on prominent themes like COVID-19 have been introduced. Longitudinal data and biological samples have been collected in the CHRIS study district for over two decades, from 2003, encompassing sociodemographic information, medical history, clinical data, and molecular phenotypes.